Deck 25: Medication Administration and IV Therapy

Question 1

In addition to age,weight,and height,which of these factors can influence drug action?

A)developmental status
B)physical characteristics
C)amount of body fat
D)psychological maturity

Answer 1

amount of body fat

Question 2

When Benadryl tablets are taken by mouth,what type of drug action will result?

A)local
B)local and systemic
C)cellular
D)systemic

Answer 2

local and systemic

Question 3

Knowing a drug's half-life is essential for the health care provider because this factor determines the drug's:

A)onset of action
B)peak plasma level
C)duration of effectiveness
D)schedule for maintaining the drug level over 24 hours

Answer 3

schedule for maintaining the drug level over 24 hours

Question 4

Which of the following types of medications are regulated by Schedule C-III of the Controlled Substance Act of 1970?

A)those containing limited quantities of codeine
B)those containing limited amounts of certain narcotics for use as antitussives and antidiarrheals
C)those having a high abuse potential and no current approved medical use
D)those having a low abuse potential and a current approved medical use

Question 5

The nurse is caring for a client who has difficulty swallowing a large tablet of a prescribed drug.What action should the nurse take FIRST?

A)Crush the tablet before administration.
B)Administer the liquid form of the drug.
C)Administer the parenteral form of the drug.
D)Consult with the client's health care provider.

Question 6

Which of these types of medication orders requires the nurse's judgment about the client's condition before the drug is administered?

A)scheduled
B)single-dose
C)stat
D)PRN

Question 7

The client is to receive 2 tablespoons (tbsp)of medication.The nurse would prepare the equivalent to which of these measurements?

A)4 drams (dr)apothecary
B)30 grams (g)metric
C)15 minims (m)apothecary
D)1 ounce (oz)household

Question 8

Which of these legislative acts empowered the Food and Drug Administration to test all new drugs for toxicity before granting the pharmaceutical company the approval to market a drug?

A)Federal Food,Drug,and Cosmetic Act of 1938
B)Harrison Narcotic Act of 1914
C)Kefauver-Harris Act of 1962
D)Pure Food and Drug Act of 1906

Question 9

Which route of drug administration provides immediate bioavailability?

A)intravenous
B)oral
C)rectal
D)topical

Question 10

A client severely injured in an auto accident has been receiving morphine sulfate intramuscularly (IM)for pain for several weeks.The physician has increased the prescribed dosage of morphine for the client.What type of adverse drug reaction does this situation represent?

A)cumulation
B)potentiation
C)summation
D)tolerance

Question 11

When administering medications,a nurse must know a client's medical history and pharmacokinetics of prescribed medications because MOST drugs are metabolized in the:

A)colon
B)kidneys
C)liver
D)lungs

Question 12

A client has a new prescription for an antihistamine for severe allergies.The client's health assessment indicates that the client has "a couple of drinks" at lunch and after work each day.What action should the nurse take?

A)Suggest the client attend Alcoholics Anonymous meetings.
B)Suggest that the client eat larger portions of food at mealtimes.
C)Tell the client's spouse to monitor the client's response.
D)Tell the client an adverse reaction to the new drug may occur if alcohol is not eliminated.

Question 13

When a drug is administered primarily for a systemic effect,which of these routes provides the quickest onset of action?

A)parenteral
B)rectal
C)sublingual
D)oral

Question 14

After receiving Nembutal PO at bedtime,a client is wide awake all night instead of going to sleep.What kind of adverse reaction to a drug does this situation represent?

A)drug allergy
B)drug tolerance
C)idiosyncrasy
D)toxic effect

Question 15

The generic drug ibuprofen has several trade names,including:

A)Aspirin
B)Advil
C)Clinoril
D)Tylenol

Question 16

A nurse is unable to read a health care provider's order for a new medication.Which of these actions must the nurse take next?

A)Ask another nurse for assistance.
B)Ask the client what new medication is to be started.
C)Call the pharmacist for assistance.
D)Clarify the order with the health care provider.

Question 17

The nurse administering medications to a client is aware that the primary reason that most drugs are administered orally is because the oral route:

A)is best tolerated by clients
B)is most convenient
C)ensures fast drug action
D)is most reliable in terms of onset

Question 18

When a drug cannot be metabolized by the body and accumulates in the blood,the result is known as:

A)a toxic effect
B)an idiosyncratic reaction
C)drug tolerance
D)drug allergy

Question 19

A client complains of "sudden crushing chest pressure" and is having difficulty breathing.A stat dose of nitroglycerin is ordered.What action should the nurse take?

A)Administer this medication at the earliest convenient time.
B)Administer this medication immediately.
C)Administer this medication on a prescribed schedule.
D)Administer this medication as needed.

Question 20

Which of these measurement system units is equivalent to 60 milligrams (mg)metric measurement?

A)6 drops (gtt)household
B)6 grains (gr)apothecary
C)0.06 milliliter (mL)metric
D)0.6 gram (g)metric

Question 21

A client is to receive a medication at 9:00 A.M.To prevent a medication error by administering at the incorrect time,the nurse can administer the medication anytime between:

A)8:00 and 10:00 A.M.
B)8:30 and 9:00 A.M.
C)8:30 and 9:30 A.M.
D)8:45 and 9:15 A.M.

Question 22

Which of these actions should a nurse take just before pouring a dose of a liquid suspension?

A)Pour the dose without shaking the bottle.
B)Rotate the bottle gently,from side to side.
C)Turn the bottle end-over-end,top to bottom.
D)Shake the bottle vigorously.

Question 23

A nurse is to administer a drug ordered in milligrams.The pharmacy has dispensed the drug in grams.Using the ratio method of drug calculation,the drug dosage obtained seems to be unreasonable.After rechecking the calculations,what should the nurse do next?

A)Ask the client the size of the drug usually offered.
B)Call the pharmacist for assistance.
C)Withhold the drug and notify the client's health care provider.
D)Have a colleague check the calculations.

Question 24

A nurse has prepared the 9:00 A.M.client medications for administration but is called off the unit briefly.Who can distribute these medications to clients?

A)any licensed nurse (LP/VN or RN)assigned to the unit
B)a pharmacy technician
C)the nurse who prepared them
D)the head nurse

Question 25

Which of these is the correct way for a nurse to document medication administration?

A)Record the drugs given during the shift before the shift ends.
B)Record the drugs immediately after administration to clients.
C)Record the drugs given by any member of the client-care team.
D)Record the drugs given by the client's pharmacy technician.

Question 26

In which situation can a nurse leave a medication at the client's bedside to be taken later?

A)when an alert,cooperative client is talking on the telephone
B)when the client is away from the unit for an X-ray
C)when the client is busy having a bed bath as the nurse makes rounds
D)never

Question 27

When a nurse is preparing an injection from an ampule,which of these actions should be taken before administering the medication to a client?

A)Discard the ampule.
B)Document the medication on the MAR.
C)Change the needle.
D)Change the syringe.

Question 28

The nurse explains to a client that the drug administration of a medication is to placed between the gum and jaw.By which route is the nurse administering this medication?

A)buccal
B)oral
C)sublingual
D)topical

Question 29

After administering a medication to a client,the nurse realizes that the client was given another client's drug.What must the nurse do next?

A)Administer the original drug,and observe the client frequently for adverse reactions to the first drug.
B)Call the health care provider immediately,and complete an incident report.
C)Check the client's MAR for drug allergies,and if there is no indicated allergy to the drug administered in error,no further action is necessary.
D)Document the error on the client's medical record,and notify the supervisor.

Question 30

To ensure the nurse administers medications to the right client,which method of identification is MOST appropriate?

A)Ask the client to fully state name,and check the client's identification armband with the medication administration record (MAR).
B)Ask the family or visitors the client's name.
C)Call the client's name.
D)Check the client's name on the door or bed.

Question 31

The client refuses a scheduled medication.Documentation on the client's medication administration record (MAR)should be completed:

A)by circling the dosage time and initialing it
B)by circling the dosage time,citing the exact reason for withholding the medication,and initialing the entry
C)by drawing a diagonal line through the time and initialing it
D)by leaving the dosage time blank on the MAR

Question 32

When administering a medication,a nurse should check the label on the drug container against the MAR (medication administration record)when removing the drug container from the client's medication drawer,when removing the drug from the medication container,and:

A)after showing the drug label to the client
B)after checking the drug container with a colleague
C)before calling the pharmacy
D)before returning the drug container to the client's medication drawer

Question 33

The client is to receive 1,000 mL (metric)of an intravenous solution.The nurse is aware that which measurement is equivalent?

A)1 pound (lb)apothecary
B)1 kilogram (kg)metric
C)1 quart (qt)household measurement
D)100 cubic centimeters (cc)metric

Question 34

A client states inability to swallow a large capsule ordered.What should the nurse do first?

A)Consult with the pharmacist regarding other available forms for this drug.
B)Consult with the health care provider regarding client difficulty with the capsule size.
C)Dissolve the capsule's contents in warm water.
D)Obtain and administer the elixir form of the drug.

Question 35

The graduate nurse is aware that the count of the unit's narcotics and controlled substances at the change of shifts should involve:

A)everyone who has given or will be giving narcotics on both shifts
B)one nurse who is going off duty and one nurse coming on duty
C)one pharmacy technician and the unit's head or charge nurse
D)the unit's head nurse and a hospital pharmacist

Question 36

A client requests a throat lozenge that is ordered PRN for pain.The nurse should instruct the client to:

A)Chew it before swallowing.
B)Dissolve it entirely in the mouth.
C)Dissolve it entirely under the tongue.
D)Swallow it whole.

Question 37

The nurse is preparing to give a client a sublingual medication.What amount of water should be given for proper administration?

A)none
B)15 minims
C)1 ounce
D)half a glass

Question 38

A nurse is teaching a client how to use nitroglycerin tablets to be kept at the client's bedside for PRN use.The nurse should instruct the client that to be effective,these tablets are to be:

A)chewed and then swallowed without water
B)dissolved on top of the tongue
C)dissolved under the tongue
D)swallowed with a small amount of water

Question 39

After the nurse hands a client a medication,the client says,"What is this red tablet for? I have always taken a yellow pill." What is the MOST appropriate action for the nurse to take?

A)Administer the medication,but make a mental note to check on it later.
B)Explain that the health care provider probably changed the drug today to something more effective and administer it.
C)Describe the action of the red tablet to the client and administer it.
D)Withhold the drug and recheck the MAR with the health care provider's order sheet.

Question 40

Before delivering a drug through an enteral tube,it is MOST important for the nurse to do which of the following?

A)Assess the client's bowel sounds.
B)Check the tube patency.
C)Check the tube placement.
D)Instill 5 mL of water to rinse the tube.

Question 41

A female client is to use a prescribed vaginal cream to treat a localized infection.It is important for the nurse to instruct the client to do which of the following?

A)Avoid using tampons after the medication is inserted.
B)Keep fluid intake to a minimum.
C)Wear sterile gloves when inserting the medication.
D)Avoid taking a shower for 6 hours after the medication is inserted.

Question 42

Which of these venipuncture sites is preferable to use when initiating IV therapy?

A)proximal end of a normal forearm or hand
B)any portion of an arm or hand
C)arm with functioning arteriovenous fistula
D)most distal end of a normal forearm,hand,or foot

Question 43

How is medication administered to a client using the Z-track technique of injection?

A)The skin is pinched gently,and the needle is inserted at a 45-degree angle.
B)The skin is stretched tautly between thumb and forefinger,and the needle is inserted at a 25-degree angle.
C)The skin is pulled to one side,and the needle is inserted at a 90-degree angle.
D)The skin is cleansed,and the needle is inserted at a 15-degree angle.

Question 44

A nurse is monitoring a client who is receiving a transfusion of whole blood.Which of these signs would indicate to the nurse that the client was having a transfusion reaction?

A)fever and chills
B)restlessness
C)lethargy
D)nausea and vomiting

Question 45

Before administering a bag of intravenous (IV)fluid,a nurse should confirm the type and amount of solution in the medical record and then do which of the following?

A)Mark the time strip on the IV bag with a felt-tip pen.
B)Calculate the tonicity of the solution.
C)Ensure the integrity of the bag.
D)Select a vented solution administration set.

Question 46

The nurse is preparing to administer a rectal suppository and should place the client in which position for insertion?

A)dorsal recumbent
B)prone
C)Sims'
D)supine

Question 47

When IV therapy is initiated for a client,which of these aspects would NOT be documented by the nurse?

A)age of client and company producing the solution
B)date,time,and site of insertion
C)amount and type of the solution
D)type of setups used and how procedure was tolerated

Question 48

In addition to the dorsogluteal and ventrogluteal muscles,which of these sites can safely be used for intramuscular injections?

A)deltoid and vastus lateralis
B)inner forearm and scapular area of the back
C)upper chest and abdomen
D)lower leg

Question 49

A nurse is preparing to administer an intramuscular injection for a client of average weight.At what angle would the nurse insert the needle?

A)25-degree
B)45-degree
C)60-degree
D)90-degree

Question 50

When preparing an intradermal injection,the nurse would use which of these syringes and needles?

A)25-gauge 1/2-inch needle,insulin syringe
B)25-gauge 3/8-inch needle,tuberculin syringe
C)23-gauge 1-inch needle,3 mL syringe
D)21-gauge 1 1/2-inch needle,5 mL syringe

Question 51

The nurse is preparing to administer a subcutaneous injection and is aware that the maximum amount of medication that can be administered via this route is?

A)0.5 mL
B)1 mL
C)1.5 mL
D)2 mL

Question 52

To prevent systemic effects of eyedrops,what should the nurse do as the eyedrops are instilled?

A)Wipe away excess drops immediately.
B)Have the client keep the eye open without blinking for 2 minutes.
C)Put a patch over the eye immediately after instillation.
D)Apply pressure to the inner canthus.

Question 53

The nursing is caring for a client who received a central venous catheter and is monitoring for symptoms of a pneumothorax.Which of the following symptoms would the nurse be concerned about? (Select all that apply. )

A)elevation in temperature
B)sudden dyspnea
C)weak,rapid pulse
D)bounding,rapid pulse
E)hypotension

Question 54

The nurse prepares to administer a subcutaneous injection for a client of average weight.At what angle would the nurse insert the needle?

A)10-degree
B)25-degree
C)45-degree
D)90-degree

Question 55

When preparing to administer an intradermal injection to an adult,the nurse ensures that the dose amount does not exceed 0.1 mL,a 1 mL tuberculin syringe is used with a 25-gauge needle and is administered at which angle?

A)45-degree
B)30-degree
C)15-degree
D)5-degree

Question 56

The client had an acute hemolytic transfusion reaction following the administration of blood products.The nurse is aware that the causes of this type of reaction are which of the following? (Select all that apply. )

A)reaction to donor leukocytes
B)recipient antibodies against donor antigens
C)too rapid flow rate for client's cardiovascular system
D)incompatible blood product transfused

Question 57

A client asks a nurse about the use of an over-the-counter nasal decongestant.It is important for the nurse to emphasize that these medications:

A)have a wide degree of safety and effectiveness
B)can be used whenever the nose feels "stuffy"
C)may have a reverse effect when used in excess
D)should be used in conjunction with oral decongestant products

Question 58

The nurse is preparing to administer a subcutaneous injection and notes that the previous injection was given to the lateral aspect of the upper arm.Which of these sites would be the MOST appropriate choice to administer this dose?

A)anterior forearm
B)anterior thigh
C)upper chest
D)dorsogluteal

Question 59

The Z-track IM technique can be used for administration of medication into which of these sites?

A)vastus lateralis
B)deltoid
C)ventrogluteal and dorsogluteal muscles
D)posterior thigh