EAQ Review Fundamentals of Nursing

A registered nurse (RN) is teaching a patient about preventive measures for electrical shocks. Which statement by the patient indicates the need for further teaching?

"Use extension cords at all times." Rationale: Extension cords are meant to be used as temporary power sources. They should be used only when necessary, not always. Unfamiliar equipment should not be operated to prevent electrical shocks. Electrical items should be kept away from water to prevent shocks. While unplugging, the plug should be grasped and not the cord.

Arrange the steps involved in administering a vaginal suppository in the correct sequence

1. Lubricate index finger of dominant hand. 2. Expose vaginal orifice with nondominant hand. 3. Insert suppository along posterior wall of vagina 4.Wipe away remaining lubricant around orifice. Rationale: When performing vaginal administration of a suppository, the index finger of the dominant hand is lubricated with a water-soluble lubricant jelly. Then the vaginal orifice is exposed with the nondominant hand by retracting the labial folds. The rounded end of the suppository is then inserted along the posterior wall of the vagina to ensure uniform distribution of medication along the walls of the vaginal cavity. Last, wipe off the remaining lubricant around the orifice and labia. Test-Taking Tip: If you are having trouble with a sequencing question, use your first reading of the choices to pick the last or the first step, or both. Then work toward the middle steps. It's usually easier to spot the last or first steps than to determine the entire sequence on first reading.

Arrange the activities in the correct order for examination of the patient's abdomen.

1.Consent from the patient 2.Inspection of abdomen 3.Auscultation of abdomen 4.Palpation of abdomen Rationale: The correct sequence is as follows: (1) consent from the patient, (2) inspection of abdomen, (3) auscultation of abdomen, and (4) palpation of abdomen. The nurse must receive consent before performing any procedure on a patient. Inspection is then completed. During the abdominal assessment, auscultation of the abdomen would be done before palpation because manipulation of the abdomen alters the frequency and intensity of bowel sounds.Test-Taking Tip: Remember that the order of examination techniques moves from least invasive to most invasive as the examination progresses.

The nurse is caring for a patient in the home and is checking for hazards. Which assessment made by the nurse is priority?

Adequacy of light When the nurse is caring for the patient at home, the priority action is to assess the adequacy of light. Sufficient lighting in the room ensures that everything is visible and reduces the risk of injuries. The presence of safety devices, the presence of locks, and the safety of the kitchen and bathroom should be assessed after the adequacy of light is assessed.Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.

Which intervention is no longer recommended for routine home treatment of poisoning cases?

Administration of ipecac syrup Rationale: The administration of ipecac syrup to induce vomiting is no longer recommended for routine home treatment of poisoning. The victim should be positioned with the head turned to the side to prevent choking. The signs or symptoms of ingestion of a harmful substance, such as nausea, vomiting, and foaming at the mouth, should be assessed. The type and amount of the substance ingested should be identified. 88%of students nationwide answered

A couple intends to place their 5-year-old child in the car. Which advice would the nurse provide to this couple?

Advise the couple of the need for an appropriate car seat for this child. Rationale: Children less than 8 years of age or those who weigh less than 80 pounds should use an appropriate car seat as specified by the manufacturer. If there is a car accident, the child is likely to have fewer injuries when seated in the back seat than the front seat, regardless of the length of the drive. It is inappropriate to advise the parents to avoid taking children for long rides. Children should be taken for family rides with appropriate safety measures. In cases of a sudden stop or a car crash, the child is susceptible to severe head injuries if left unrestrained; therefore a child should never sit on an adult's lap rather than being properly buckled into a car seat.

Which action would the nurse take first after discovering a medication error has occurred?

Assessing and examining the patient's condition Rationale: When a medication error occurs, the nurse should first assess and examine the patient's condition and report it to the health care provider. Preparing and filing an incident report is appropriate, but not the first action. Reporting the incident to the manager and supervisor are also appropriate, but not the first interventions in this situation.

Which informatics technology helps scan the medication before administration?

Bar-coding technology Rationale: Bar-coding technology is used to scan medications before administration. AMDS and eMAR are used for medication reconciliation, administration, and documentation. CPOE is used to enter medication prescriptions directly into a networked computer system.

Which color of the lips indicates carbon monoxide poisoning?

Bright Red Rationale: Bright red (cherry-colored) lips indicate carbon monoxide poisoning. Respiratory or cardiovascular conditions (not carbon monoxide poisoning) may cause cyanosis, indicated by blue-colored lips. Very pale pink to white lips can indicate pallor from anemia, not from carbon monoxide poisoning. Pink- to plum-colored lips are normal and are not caused by carbon monoxide poisoning.

The nurse is having difficulty reading a physician's prescription for a medication. Which step should the nurse take next?

Call the physician to have the prescription clarified Rationale: The nurse must have the right documentation and clarify all orders with the prescriber before administering medications. It is most appropriate to call the physician rather than asking other medical personnel to interpret the order.Test-Taking Tip: Notice that most of the choices suggest having someone else interpret the physician's handwriting. Noticing similarities of choices can help you realize the correct response is the only choice where the nurse contacts the physician directly.

Which complication would the nurse be aware of when using physical restraints?

Constipation Incontinence Pressure injury Rationale: Constipation can result from immobility. Incontinence can be caused by the inability to get out of bed in time to use the toilet. Pressure injuries can result from pressure on bony prominences caused by immobility. Increased appetite is generally not a complication and may not be related to the use of restraints. Improved alertness is a good sign and is not a complication of the use of restraints.Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient.

Which site would the nurse choose when administering an intramuscular (IM) injection?

Deltoid Vastus lateralis Ventroglutea Rationale: The three common sites for administering IM injections are the deltoid, vastus lateralis, and ventrogluteal muscles. The deltoid site is easily accessible and is used for injecting small volumes. The vastus lateralis is a thick and well-developed muscle, located on the anterior lateral aspect of the thigh. The ventrogluteal muscle is the safest site for injection. It is deep and away from major nerves and blood vessels. The brachioradialis is a muscle of the arm and is not used for injecting medications. The sternocleidomastoid is a muscle of the neck and is not a favorable site for administering IM injections.Test-Taking Tip: Make up a memory device, also called a mnemonic, to remember groups of information. For IM injection sites, you could use the first letters of the method and sites and incorporate them into one sentence: I'm delighted to view the vase. So IM = I'm, del = deltoid, view = ventrogluteal, and vase = vastus lateralis. Making your mnemonics silly or memorable in some other way helps you remember them. You can certainly use the one in this study tip, but memory devices that YOU create will be most helpful. The process of creating the memory device helps anchor the information in your mind. Then when it comes time for the test question, your recall of the memory device gives you the answer.

Which instruction regarding sublingual nitroglycerin would the nurse provide to the patient?

Do not swallow the medication. Place the medication under the tongue. Rationale: When administering medications through the sublingual route, the medication must be placed under the tongue until it fully dissolves. The medication should not be swallowed. Swallowing can make the medication ineffective. The medication should not be spit out to prevent irritation; however, it may be spit out if the desired therapeutic effect is attained. The medication should not be taken with water because this can alter its effectiveness. Sublingual medication should be administered under the tongue, not between the tongue and cheeks.

Which positioning of the patient would be appropriate while administering vaginal suppositories?

Dorsal recumbent position Rationale: In the dorsal recumbent position, the patient lies on the back, with lower limbs flexed and rotated outward. This position is used in the vaginal examination, application of obstetrical forceps, and other procedures. Therefore this position will be helpful while administering vaginal suppositories in the patient. This is also called the lateral position. Sims' positioning is helpful while administering rectal suppositories in a patient. The sitting position will be required while administering intravenous injections. The supine position will be helpful while instilling nasal drops.

Which principle would a nurse follow when mixing insulin?

Draw up regular insulin first, and then draw up the intermediate-acting (NPH) insulin. Agitate NPH insulin by rolling it between the palms of the hands. Verify the insulin dosage with a second nurse while preparing the injection. Rationale: When mixing insulin, the nurse should ensure that the insulin dosages are verified with a second nurse while preparing the injection. The nurse should draw up regular insulin first and then draw up the NPH insulin. The nurse should agitate NPH insulin by rolling it between the palms of the hands. Administer the rapid-acting insulin mixed with NPH insulin within 15 minutes before a meal. Insulin glargine or insulin detemir should not be mixed with other types of insulin.Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation.

The nurse is caring for a patient who is at risk of falls because of an improper gait. Which measure would the nurse take to ensure patient safety?

Ensure that the patient wears rubber-soled slippers. Move the patient on crutches or walkers after ensuring the patient's integrity. Remove excess furniture from the path. Use of rubber-soled slippers helps prevent slips and decreases the risk of falls. The patient should be encouraged to use assistive aids such as crutches and walkers to provide support. Excess furniture can be in the way during ambulation and should be removed. Restraints should not be used because they can make the patient restless and also increase the risk of immobility-related complications. Family members should be instructed regarding the patient's issues, but it is the nurse's responsibility to take care of the patient.

While instilling nasal drops in a patient, the nurse places a small pillow under the patient's shoulder and tilts the patient's head backward in order to access which body cavity?

Ethmoid sinus Rationale: For access to the ethmoid or sphenoid sinus, the nurse should tilt the patient's head back over the edge of the bed or place a small pillow under the patient's shoulder and tilt the head backward. For access to the frontal or maxillary sinus, the head is tilted backward over the edge of the bed or laid on a pillow with the head turned toward the side that requires treatment. For access to the posterior pharynx, the patient's head is tilted backward.

Which reason would justify the use of restraints on a disoriented patient?

Helps reduce the risk of patient injury from falls Prevents the patient from removing intravenous (IV) infusions Helps reduce the risk of injury to others by the patient Raionale: Restraints are a means to maintain patient safety. Nurses use restraints to protect patients who are confused, disoriented, repeatedly fall, or try to remove medical devices such as IV infusions or oxygen equipment. A disoriented patient can harm others and should be restrained. A restraint is not used to control the patient or to discontinue care.STUDY TIP: Before using restraints, be clear about the requirements and the purposes of restraints.

The family of a patient who is confused and ambulatory insists that all four side rails be up when the patient is alone and in bed. Which action by the nurse would be best in this situation?

Inform the family of the risks associated with side-rail use. Discuss alternatives with the family that are appropriate for this patient. Ask the family to stay with the patient if possible Rationale: The family is concerned about ensuring a safe environment for their loved one. The nurse should discuss their concerns, inform them of the risk of using four side rails, and offer safer alternatives such as the presence of a family member. If the family still insists on using four side rails, then the nurse could contact the nursing supervisor to further discuss the situation with them. This is not a reason to restrict visitation; the nurse should appreciate their concern but should avoid the use of four side rails.

Which injection is given to a patient receiving a tuberculin screening test?

Intradermal Rationale: Tuberculin may be potent, and a patient may have a severe anaphylactic reaction when tuberculin enters the circulation too rapidly. Therefore tuberculin is administered through the intradermal route. An intrathecal injection is given to the spinal canal and is very painful. An intravenous injection may cause the patient to experience anaphylactic reactions. A subcutaneous injection may lead to unwanted reactions.

Which route of administration is illustrated in the image?

Intramuscular route Rationale: The image illustrates an intramuscular injection at the deltoid site at an angle of 90 degrees. An intradermal injection is given to the epidermal layer of the skin at a 15-degree angle. An intravenous injection is given to a large vein present in the limbs. A subcutaneous injection is given to the dermis at a 45- or 90-degree angle.

Which of the nursing student's actions indicates the need for further teaching regarding administration of oral medications in the pediatric patient?

Mixing the medication in the child's favorite drink Rationale: Mixing the medication in the pediatric patient's favorite drink should be avoided because the child may later refuse the same drink. A pediatric patient may accidentally aspirate a pill, which could be fatal. Therefore liquids or elixirs are safer in children. Offering the child juice after he or she has swallowed the medication will help get rid of any bad taste in the child's mouth and incentivize the child to take the next dose if he or she is promised juice afterward. Droppers are indicated for the administration of tablet solutions to infants.

The nurse instructs the patient to color code the hot water faucets and dials. To which age-group would this patient belong?

Older adult Rationale: Older adults are instructed to color code the hot water faucets and dials to prevent burns and scalds. The color coding makes it easier for an older adult to know which is hot and which is cold. Young adults and adolescents usually do not confuse hot and cold water, so this suggestion may not be helpful for them. Preschoolers usually need a parent's help taking baths and would not use hot-water faucets and dials.

Which statement regarding hearing acuity in older adults is accurate?

Ototoxicity is a high risk of hearing loss Rationale: The accurate statement is ototoxicity is a high risk of hearing loss. Older adults are at risk of hearing loss caused by auditory nerve injury, a condition called ototoxicity, which results from high doses of certain antibiotics, like aminoglycosides. High-frequency sounds are not heard best; in fact, older adults have trouble hearing high-frequency sounds. Consonant, not vowel, sounds are harder to hear. Thickening (not thinning) of the tympanic membrane causes older adults to gradually lose hearing acuity.

Which portion of the hand is used to assess the thickness of skin?

Palmar surface Rationale: The palmar surface of the hand is used to assess the thickness of skin. Finger pads are used to assess the tenderness of skin, not the thickness. The dorsum of the hand is used to assess temperature, not the thickness. Grasping with fingertips is used to measure the turgor and elasticity of skin, not the thickness.

Which assessment technique will the nurse use when examining a patient's head and neck?

Palpation Inspection Rationale: Both inspection and palpation are used when assessing the head and neck. The nurse would not use olfaction when examining the head and neck, which is a method for recognizing the nature and source of body odors. The nurse would use percussion to locate organs or masses, not while examining the head and neck. Visual acuity is a measurement obtained by assessing the head and neck, not an assessment technique.

Which patient is at increased risk of cervical cancer?

Patient who has a history of human papillomavirus (HPV) infection Rationale: Patients who have a history of HPV infection are at an increased risk of cervical cancer. Painful perianal tissues may indicate a sexually transmitted infection or other pathological condition. Patients who are taking tamoxifen for the treatment of breast cancer are at an increased risk of endometrial cancer caused by the estrogen-like effects of the drug on the uterus. Patients who have received postmenopausal estrogen therapy are at increased risk of endometrial cancer.

Which pupil finding would the nurse observe in a patient intoxicated with opioids?

Pinpoint Rationale: Pinpoint pupils are a common sign of opioid intoxication. Cloudy pupils indicate cataracts, not opioid intoxication. Dilated pupils may result from glaucoma, trauma, certain eye medications, and opioid withdrawal, but not from opioid intoxication. Inflammation of the iris or certain drugs (pilocarpine, morphine, or cocaine) causes constricted pupils but not pinpoint pupils.

An 80-year-old patient demonstrates some confusion but no anxiety. The nursing assessment reveals that the patient is a fall risk because the patient continues to get out of bed without help despite frequent reminders. Which nursing intervention would be initiated to prevent falls for this patient?

Place a bed alarm device on the bed Rationale: The nurse should consider and implement alternatives as appropriate before using a restraint. A bed alarm is an alternative that the nurse implements independently. Restraints and one-on-one observation are not indicated for this patient at this time.STUDY TIP: Be clear on the requirements to be met before using restraints. For the situation in this question, alternatives had not yet been implemented.

Which intervention would the nurse follow while preparing to administer liquid medication from a multidose bottle?

Place the cup at eye level on a firm surface and pour the medication Rationale: While administering liquid medications, the nurse should place the medicine cup on a firm surface at eye level and pour the medication for dosing accuracy. The nurse should hold the bottle so that the label is against the palm to protect the integrity of the label. The nurse should shake the bottle before administration to mitigate any settling of contents. The nurse should draw a volume of less than 10 mL into an oral syringe, not a parenteral syringe.

Which pulse is difficult to palpate in a normal patient?

Popliteal pulse Rationale: The popliteal pulse is difficult to palpate in a normal patient. The femoral pulse is measured by directing the patient to lie down and placing the fingertips of both the hands on the opposite sides of the pulse site. The brachial pulse is measured by placing the fingertips of the first three fingers in the muscle groove. The dorsalis pedis pulse is measured by placing the fingertips between the first and second toes.

Which route of administration is suitable for administering a suppository?

Rectal Rationale: Suppositories are meant to be inserted into the body cavities, such as the rectum or the vagina. The oral route is used for administering tablets, capsules, and liquid medications. Transdermal patches are applied on the skin. The parenteral route generally refers to intravenous injections.

Which nursing intervention would be beneficial and safe for a patient who has an existing transdermal patch?

Removing the existing patch before applying the new patch Rationale: The nurse should remove the old patch before administering a new transdermal patch to avoid an overdose; this is because the medicine remains in the patch even after its prescribed duration of use. Placing the new patch over the old patch could cause an overdose, which may result in potential adverse effects. A noticeable label is not applied to the old patch. If the new patch is difficult to see, then a noticeable label should be applied to the new patch. Applying the new patch next to the old patch could cause an overdose.Test-Taking Tip: Read the question carefully before looking at the answers: (1) determine what the question is really asking by looking for key words; (2) read each answer thoroughly and see if it completely covers the material asked by the question; and (3) narrow the choices by immediately eliminating answers you know are incorrect.

Which patient assessment finding would alert the nurse to substance abuse in an adult?

Reports sleep disturbance and insomnia Visits the emergency department frequently Has a habit of forgetting appointments and schedules Rationale: Patient assessment findings include reports sleep disturbance and insomnia, visits the emergency department frequently, and has a habit of forgetting appointments and schedules. Individuals who have substance-related problems tend to be socially isolated or withdrawn; therefore regularly attending friends' social gatherings does not necessarily indicate substance-related issues. Taking three medications from the same health care provider is not a sign of substance abuse; taking medication from several different health care providers or changing health care providers are suspicious for substance abuse.

When there is a fire in the hospital, which action by the nurse is priority?

Rescuing patients in immediate danger Rationale: The nurse should use the mnemonic RACE to set priorities in case of a fire. When there is a fire in a hospital, the nurse's first and most important intervention is to Rescue and remove all patients in immediate danger. After those patients are removed, the nurse should Activate the fire alarm so that other patients and staff will know of the fire danger. After this, the nurse should Confine the fire by closing all doors and windows and turning off oxygen and electrical equipment. Finally, the nurse may attempt to Extinguish the fire with an appropriate fire extinguisher.Test-Taking Tip: Did you notice the mnemonic RACE in the choices? When the textbook has explained (or your instructor has taught) an acronym, look for it in the choices. It may have been shuffled out of order, but recognizing that it is there will provide a huge clue for the correct response.

Which action by the nurse would be effective when administering eardrops to a 2-year-old patient?

Straightening the ear canal by pulling the auricle down and back Rationale: For patients younger than 3 years of age, the nurse should straighten the ear canal by pulling the auricle down and back. For patients 3 years of age and older, the nurse should straighten the ear canal by pulling the auricle upward and outward. The nurse should help patients of every age remain in the side-lying position for 2 to 3 minutes so that the medication completely enters the ear canal. For patients of every age, the nurse should apply gentle massage or pressure to the tragus of the ear with a finger after the administration of medication unless contraindicated because of pain. The nurse should instill prescribed drops by holding the dropper at 1 cm (1/2 inch) above the ear canal for patients of every age-group.Test-Taking Tip: Be alert for details. Details provided in the stem of the item, such as "behavioral changes" or "clinical changes" (or both) "within a certain time period", can provide a clue to the most appropriate response or, in some cases, responses.

The nurse advises the mother of a 4-month-old infant to remove plastic bags from the home to reduce the risk of which hazard?

Suffocation Rationale: Plastic bags from the cleaners or grocery store may cause an infant to suffocate. Choking can be prevented by avoiding the use of toys with small parts like buttons. Poisoning may be caused by toxic or poisonous substances, including plants. Head injury may be caused by falls. 93%

Which statement is true regarding the use of the deltoid muscle site in parenteral administration?

The deltoid muscle site is used to administer the hepatitis B vaccine Rationale: The deltoid muscle site is easily accessible and is used to administer small volumes of a medication. It is mainly used for giving immunizations such as hepatitis B and flu shots. Heparin is most likely to be administered via the subcutaneous route of administration. Medications that are more than 2 mL would be administered through the ventrogluteal muscle site. The ventrogluteal site is also preferred for medications that are viscous and irritating.

The emergency department nurse gives a patient a total score of 10, based on the Glasgow Coma Scale. Which statement correctly describes the responses given by the patient during the neurological assessment performed by the nurse?

The patient opens the eyes in response to speech, utters inappropriate words, and exhibits flexion withdrawal. Rationale: According to the Glasgow Coma Scale, a score of 3 is given if the eyes are opened in response to speech. A score of 3 is given if the best verbal response is uttering inappropriate words, and a score of 4 is given if the best motor response is flexion withdrawal. So this patient will have a total score of 3 + 3 + 4 = 10. Exhibiting abnormal flexion is given a score of 3; so the patient who opens the eyes in response to speech, utters inappropriate words, and exhibits abnormal flexion is given a total score of 3 + 3 + 3 = 9. Opening the eyes in response to pain is given a score of 2, and exhibiting abnormal extension is also given a score of 2; so the patient who opens the eyes in response to pain, utters inappropriate words, and exhibits abnormal extension has a total score of 2 + 3 + 2 = 7. A score of 2 is given if the patient's best verbal response is making incomprehensible sounds. So the patient who opens the eyes in response to pain, makes incomprehensible sounds, and exhibits abnormal extension has a total score of 2 + 2 + 2 = 6.

Which right do patients have regarding medication administration?

The right to know the name and purpose of medications The right to refuse a medication regardless of the consequences Rationale: In accordance with the Client Care Partnership and because of the potential risks related to medication administration, a patient has the right to know the name, purpose, action, and potential undesired effects of a medication, and the right to refuse a medication. The patient has the right not to receive unnecessary and unlabeled medications. Patients do not have the right to administer the medication him- or herself unless prescribed to do so.

Which statement is true regarding insulin syringes?

They are designed for use with U-100 strength insulin Rationale: Insulin syringes are designed to be used with U-100 strength insulin. Insulin syringes are available in 0.3 to 1 mL sizes. They are marked in units. The needles have three parts: the hub, shaft, and the bevel (slanted tip).

For which reason would the nurse wear disposable gloves while removing and applying a transdermal patch for a patient?

To prevent medication from being absorbed into the nurse's skin Rationale: Many locally applied medications create systemic and local effects; therefore these medications are applied with gloves and applicators. The nurse should wear disposable gloves while removing and applying transdermal patches for a patient to prevent the absorption of medications by the skin. Infections may not occur because of the application of a patch without the use of gloves. Using sterile techniques will help prevent contamination of the patch. To prevent contact with the body fluids of the patient, wearing gloves may be appropriate.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items with four options. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses

Which action would the nurse perform during a fire?

Use a fire extinguisher. Turn off sources of oxygen. Close all doors and windows Rationale: A fire can be extinguished if the oxygen supply to the fire is cut off. Therefore important measures to extinguish a fire include using a fire extinguisher, turning off sources of oxygen, and closing all doors and windows. Opening all doors and windows would increase the oxygen supply and fuel the fire. Water should not be poured as it leads to unnecessary waste and only helps with fires that involve paper, wood, or cloth.

Which action of the nursing student needs correction regarding administration of eyedrops to a patient?

Using the eye medication for both the affected and unaffected eye of the patient Rationale: The nurse should instill the eye medication only for the patient's affected eye and not for both eyes. The cornea of the eye has many pain fibers and thus is very sensitive to anything applied to it. Therefore the nurse should avoid the instillation of medications directly onto the cornea. The nurse should avoid touching the eyelids or other eye structures with eyedroppers or ointment tubes to prevent the risk of transmitting infection from one eye to the other.

Which nursing measure is helpful in minimizing medication errors? Select all that apply. One, some, or all responses may be correct.

Using two patient identifiers Ensuring adequate rest for the nurse Preparing medications for one patient at a time Rationale: Using at least two patient identifiers before administering drugs ensures that the medication is given to the right patient. The nurse should get adequate rest because fatigue increases medication errors. Medication errors are greatly reduced if medications are prepared for one patient at a time. Medication errors should be evaluated for their health impact and should be dealt with accordingly; concealing them is ethically unacceptable. Illegible prescriptions should be confirmed rather than interpreted.Test-Taking Tip: If you are anxious about a multiple-response question, read through the choices and then consider which are not correct. It is often easiest to determine the incorrect responses, and then the remainder of the responses may be the answer. For this question, concealing medication errors and attempting to interpret illegible prescriptions are clearly incorrect.

Which injection site for vaccines is preferred for infants and toddlers who are not yet walking?

Vastus lateralis Rationale: The vastus lateralis site is the preferred injection site for infants and toddlers who are not yet walking to receive vaccines. The deltoid site is used to inject small medication volumes; this site is not used for infants and toddlers. The dorsogluteal is not used for infants and toddlers receiving vaccines. The ventrogluteal site is used for adults, children, and infants.

Which site is depicted in the image?

Vastus lateralis site Rationale: The image depicts the vastus lateralis muscle, located on the anterior lateral aspect of the thigh, which is suitable for intramuscular injections. The deltoid site is an easily accessible site that lies within the upper arm under the triceps and along the humerus. The ventrogluteal muscle involves the gluteus medius site. The dorsal gluteal site is an alternative subcutaneous injection site.

Under which prescription would the nurse perform an assessment to determine whether the patient needs medication?

prn order Rationale: When there is a prn order, the nurse may use his or her own discretion for administering or withholding medication based on a subjective or objective assessment. STAT orders refer to single doses of medication to be given immediately or only once. Standing orders and routine medication orders are the same; in either case, the nurse continues the medication as directed by the prescriber until the prescriber asks the nurse to stop the medication.