Medication Administration

The nurse is administering an IV push medication through an IV lock. After injecting the medication, which action will be taken next? A. Flushing the lock B. Regulating the IV flow C. Clamping the tubing for 10 minutes D. Holding the patient's arm up to improve blood flow

A. Flushing the lock IV locks are to be flushed before and after each use; either heparin or saline flush is used, depending on the individual institution's policy. The other actions are not appropriate.

The nurse is giving an intradermal (ID) injection and will choose which syringe for this injection? a. b. c. d.

B. The proper size syringe for ID injection is 1-mL tuberculin. The other syringes pictured are incorrect. Insulin syringes (marked in units) are not used for intradermal injections.

You note that a primary care provider prescribed morphine sulfate, an opioid agonist, to relieve a client's postoperative pain. Which of the following actions describes the action of an agonist on a receptor? A) Destroys the receptor B) Competes with the receptor C) Activates the receptor D) Blocks the receptor

C) Activates the receptor

What term is used to describe the time it takes for drug concentration to reach a therapeutic level in the blood? A) Peak action B) Duration of action C) Onset of action D) Half-life

C) Onset of action The onset of action is the time needed for drug concentration to reach a high enough level in the blood for its effects to appear.

The nurse prepares to perform a z-track injection to a client. Place the steps of the procedure in correct order. A) Maintain displacement and insert needle at a 90-degree angle. B) Inject medication slowly, keeping skin taut. C) Pull skin 2.5-3.8 cm (1-1. in.) laterally away from the injection site. D) Withdraw needle. E) Release retracted skin.

C, A, B, D, E The injection technique of a z-track injection include the following steps: Pull skin 2.5-3.8 cm (1-1. in.) laterally away from the injection site; maintain displacement and insert needle at a 90-degree angle; inject medication slowly, keeping skin taut; withdraw the needle; release the retracted skin.

The primary care provider prescribes furosemide 40 mg IV for a patient with heart failure. Which drug name is used in this prescription? A) Chemical B) Brand C) Trade D) Generic

D) Generic Furosemide, the generic name, was used by the physician in the drug order.

A novice nurse instructs a client on the use of sublingual nitroglycerin. Which statement by the novice nurse requires intervention by the nurse preceptor? A) "Be sure to take the medication prior to the start of your pain." B) "Do not chew or swallow the tablet." C) "The tablet may cause burning or tingling as it dissolves." D) "Be sure to sit down when you decide to take the medication."

A) "Be sure to take the medication prior to the start of your pain." Nitroglycerin is taken at the onset of the client's symptoms, not prior to.

A nurse is teaching a client who has a prescription for a drug that has a receptor agonist effect. Which of the following information should the nurse include in the teaching? A) "This will increase the effects of normal cellular functions." B) "This prevents cells in your body from performing certain actions." C) "This prevents hormones in your body from attaching to cell receptor sites." D) "This minimizes the risk that the medications you take will become toxic."

A) "This will increase the effects of normal cellular functions." Agonist drugs bind to cell receptors in the body and are targeted to a specific type of receptor. When they attach to the receptors, they perform the same action as a hormone or chemical would, increasing the effects of that hormone or chemical. For example, pharmacological insulin is administered to clients who have little to no insulin to mimic insulin's effects in the body.

Which term refers to the movement of a drug from the site of administration to the bloodstream? A) Absorption B) Distribution C) Metabolism D) Excretion

A) Absorption Absorption refers to the movement of drug from the site of administration into the bloodstream.

A nurse is caring for a client who has a new prescription for a drug. After receiving the first dose of the drug, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents which of the following results of the drug? A) Adverse effect B) Paradoxical effect C) Therapeutic effect D) Toxicity

A) Adverse effect Adverse effects are the unintended and unexpected effects of a drug, which can range from mildly annoying to life-threatening, such as an anaphylactic reaction.

Laboratory test results indicate that warfarin anticoagulant therapy is suddenly ineffective in a patient who has been taking the drug for an extended time. The nurse suspects an interaction with herbal medications. What type of interaction does the nurse suspect? A) Antagonistic drug interaction B) Synergistic drug interaction C) Idiosyncratic reaction D) Drug incompatibility

A) Antagonistic drug interaction In an antagonistic drug interaction, one drug interferes with the actions of another and decreases the resultant drug effect.

Primary care providers prescribe drug dosages for children using which of the following information? (Select all that apply.) A) Body surface area B) Age C) Weight D) Developmental level E) Drug properties

A) Body surface area B) Age C) Weight E) Drug properties

A nurse is caring for a client who is taking acetaminophen and codeine for pain relief. These analgesic drugs interact with one another to cause an additive effect. The nurse should identify that which of the following are characteristics of additive drug interactions? (Select all that apply.) A) Clients can achieve desired effects with the use of lower dosages. B) Taking the two drugs together can reduce the effects of one or both drugs. C) Taking the two drugs together can potentiate the effects of one or both drugs. D) The two drugs can produce an action neither would have produced alone. E) Both drugs have similar actions.

A) Clients can achieve desired effects with the use of lower dosages. E) Both drugs have similar actions.

A nurse is preparing to teach a client how to take care of a newly created colostomy. The nurse should identify that which of the following factors can decrease the client's ability to learn? (Select all that apply.) A) Impaired cognitive level B) Language barrier C) Discomfort D) Repetition of teaching E) Unreadiness to learn

A) Impaired cognitive level B) Language barrier C) Discomfort E) Unreadiness to learn A lack of understanding due to impaired cognitive and developmental levels can decrease the client's ability to learn. The nurse should adjust instructional methods to accommodate the client's developmental or cognitive level. If the nurse and the client speak different languages, this can affect the client's ability to learn. The nurse should provide written information in the language the client speaks and make arrangements for finding an interpreter if necessary. A client who is uncomfortable is not able to learn optimally. The nurse should ensure that the client is comfortable prior to giving instructions. A client's readiness to learn is an essential part of the client's ability to learn. For example, a client who is experiencing denial or distress is not ready to learn.

A patient is in the bathroom and asks the nurse to leave medications on the bedside table. What should the nurse do? A) Inform the patient that she will return when he is finished in the bathroom. B) Wait outside the bathroom door until the patient is ready for the dose. C) Withhold the dose until the next administration time later in the day. D) Document that the dose was omitted in the medication administration record.

A) Inform the patient that she will return when he is finished in the bathroom.

A client who has a peanut allergy comes to the emergency department with suspected anaphylactic shock. Which of the following actions should you anticipate taking? (Select all that apply.) A) Initiate oxygen therapy to support respiratory function. B) Administer epinephrine to increase blood pressure. C) Give diphenhydramine to stop histamine release. D) Establish and maintain an open airway to ensure oxygenation. E) Administer a drug agonist to neutralize the allergic reaction.

A) Initiate oxygen therapy to support respiratory function. B) Administer epinephrine to increase blood pressure. C) Give diphenhydramine to stop histamine release. D) Establish and maintain an open airway to ensure oxygenation.

When reviewing a list of drugs in a drug handbook, a nurse can identify the generic name for a drug in which of the following ways? A) It begins with a lower-case letter. B) It is listed in parentheses along with the trade name. C) There are both letters and numbers in the name. D) The chemical name is listed in parentheses before the generic name.

A) It begins with a lower-case letter. Generic names are not capitalized. The brand, or trade name, is a drug's commercial name and is capitalized.

A nurse is caring for a client who arrived at an emergency department following a bee sting. Which of the following findings indicates an anaphylactic reaction? (Select all that apply.) A) Low blood pressure B) Wheezing C) Bradycardia D) Peripheral edema E) Difficulty swallowing

A) Low blood pressure B) Wheezing E) Difficulty swallowing Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Immediate treatment with epinephrine and IV fluids is imperative. Wheezing is an indication of bronchospasm and is treated using bronchodilators. Difficulty swallowing is an indication of laryngeal edema and, therefore, anaphylaxis.

A nurse is providing teaching for a client who has a new prescription for a drug with a high potential for toxicity. Which of the following information should the nurse include? (Select all that apply.) A) Periodic laboratory tests are essential to measure serum drug levels. B) Monitoring for indications of toxicity is important. C) Taking the drug with an inducing agent will increase the possibility of toxicity. D) Taking the smallest effective dose is crucial. E) Increasing fluid intake is recommended to avoid toxicity.

A) Periodic laboratory tests are essential to measure serum drug levels. B) Monitoring for indications of toxicity is important. D) Taking the smallest effective dose is crucial.

A nurse is caring for a client who was prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that which of the following terms describes why this drug was prescribed for the client? A) Pharmacologic action B) Chemical stability C) Route D) Adverse effects

A) Pharmacologic action The nurse should identify that the mechanism of action of a drug on the body to achieve the desired effect is referred to as pharmacologic action.

Teratogenic drugs should be avoided in which patient population? A) Pregnant women B) Elderly C) Children D) Adolescents

A) Pregnant women Drugs that are known to cause developmental defects are termed teratogenic. These drugs are contraindicated during pregnancy because of the likelihood of adverse effects on the embryo or fetus.

An older client may be at risk for drug toxicity due to which of the following physiologic changes associated with aging? A) Reduced hepatic blood flow B) Increased glomerular filtration rate C) Reduced body fat D) Increased gastric motility

A) Reduced hepatic blood flow

The nurse understands that, in addition to the five client rights of medication administration, there are now more rights for safe medication administration. Which rights are the new rights for safe medication administration? Select all that apply. A) Right documentation B) Right dose C) Right time D) Right route E) Right reason

A) Right documentation E) Right reason Right documentation is a new right for safe medication administration. Right reason is a new right for safe medication administration.

A surgeon prescribes potassium chloride 20 mEq by mouth for a patient with a nasogastric (NG) tube for gastric drainage. How should the nurse proceed? A) Seek clarification from the surgeon about the medication order. B) Clamp the NG tube while administering the dose by mouth. C) Instill the medication through the NG tube. D) Withhold the oral potassium chloride elixir.

A) Seek clarification from the surgeon about the medication order. The nurse should seek clarification from the surgeon about the medication ordered via the nasogastric route. If the patient has a nasogastric tube in place to release gastric drainage, any medication given by mouth would be lost into the drainage collection unit and, therefore, be unavailable to the patient for therapeutic use.

A client with glaucoma asks you about taking oxybutynin, a muscarinic antagonist, to manage an overactive bladder. You explain that glaucoma is a contraindication for taking oxybutynin. Primary care providers should not prescribe contraindicated drugs because of their potential for which of the following? A) Serious adverse reactions B) Drug tolerance C) Drug dependence D) Interactions with other drugs

A) Serious adverse reactions

A nurse is caring for a client who is postpartum and breastfeeding. The client asks the nurse about the effects that taking over-the-counter drugs will have on her newborn. Which of the following should the nurse consider when recommending a drug for the client? (Select all that apply.) A) The newborn's weight B) How much breast milk the newborn consumes each day C) Whether or not the benefits to the client outweigh the risks to the newborn D) The properties of the drug E) The route of administration of the drug

A) The newborn's weight B) How much breast milk the newborn consumes each day C) Whether or not the benefits to the client outweigh the risks to the newborn D) The properties of the drug The lower the newborn's weight, the greater the effects of the drug absorbed via breastmilk will be to the newborn. The more breast milk the newborn consumes, the more of the drug is likely to be absorbed into the newborn's circulation. The nurse should weigh the benefits against the risks when recommending a drug for a client who is breastfeeding. If the benefits will be minimal, it is generally not worth the risk to the newborn. Certain drugs can transfer more easily into breast milk, depending on properties like fat solubility.

A nurse is caring for a client who is taking diphenhydramine for insomnia and reports drowsiness. The nurse should identify that drowsiness indicates which of the following? A) Therapeutic effect B) Adverse reaction C) Contraindication D) Precaution

A) Therapeutic effect Drowsiness is a therapeutic effect of diphenhydramine for a client who is taking the drug to treat insomnia.

A nurse is obtaining a client's health history and discovers that the client takes loratadine, an over-the-counter drug. The nurse should identify that which of the following is correct regarding over-the-counter drugs? (Select all that apply.) A) They do not require the supervision of a nurse. B) They can interact with other drugs. C) They should be included in the client's drug history assessment. D) They are less effective than prescription drugs. E) They do not cause toxicity.

A) They do not require the supervision of a nurse. B) They can interact with other drugs. C) They should be included in the client's drug history assessment. Over-the-counter drugs do not require a prescription or the supervision of a nurse. Many over-the-counter drugs interact with other drugs. Over-the-counter drugs are often omitted from the drug history assessment, but they should be included. Nurses should ask specific questions about over-the-counter drugs and herbal remedies.

A nurse is reviewing drugs in a drug reference. The nurse should identify that drugs in the same class share which of the following similarities? A) They have similar mechanisms of actions. B) They have the same half-life. C) They are administered by the same route. D) They have similar availability.

A) They have similar mechanisms of actions. Drugs in the same class often share similar mechanisms of action, as well as assessment guidelines, interactions, and precautions.

A nurse is reviewing measurement systems to perform dosage calculations with a newly licensed nurse. Which of the following instructions should the nurse include? A) To convert g to mg, move the decimal point 3 places to the right. B) Liters is a unit of measurement for distance. C) The metric system uses fractions rather than decimals. D) Grains is used as a measurement of weight in the metric system.

A) To convert g to mg, move the decimal point 3 places to the right. Calculation in the metric system moves the decimal either to the left or to the right. When converting from smaller to larger, move the decimal to the correct number of places to the left. When converting from larger to smaller, move the decimal the correct places to the right.

A nurse is performing a medication reconciliation for a client who is being transferred to a long-term care facility. Which of the following actions should the nurse take? (Select all that apply) A) Place the medication reconciliation form with the client's transfer documents. B) Reinforce teaching about the medications to the client upon discharge. C) Add medications the client is no longer taking in the medication reconciliation. D) Include over-the-counter medications in the medication reconciliation. E) Compare the client's home medications with prescribed discharge medications.

A, B, D, E The nurse should include the medication reconciliation with the transfer documents to provide an accurate, up-to-date list of the client's medications and reduce the risk of medication error. The nurse should reinforce teaching about medications with the client upon discharge to promote safe and effective care. The nurse should include all medications the client currently takes, including over-the-counter medications, herbal supplements, and vitamins. The medication reconciliation process involves the comparison of the client's home medications against prescribed discharge medications. The nurse should note any duplications or discrepancies.

A nurse is assisting with teaching a client who has a new prescription for a nitroglycerin patch. Which of the following actions should the nurse take? (Select all that apply) A) Ask the client what they know about the nitroglycerin patch. B) Find out whether the client is able to pay for the medication. C) Determine the client's ability to apply the patch. D) Check the client's reading comprehension level. E) Use medical terminology to instruct the client about the patch.

A, C, D The nurse should check to determine what the client already knows about the medication when beginning to reinforce teaching. The nurse should build on the client's existing knowledge to provide effective teaching. The nurse should determine the client's ability to perform the skill of applying the patch. The nurse should ask the client to provide a return demonstration to determine whether the client is able to perform the procedure. The nurse should check the client's reading comprehension level to make sure they can read and understand any written material.

A nurse is reviewing the pharmacokinetics of medications with a newly licensed nurse. The nurse should include that which of the following factors can affect the rate of absorption? (Select all that apply) A) Age of the client B) First pass effect C) Lipid solubility of a medication D) Route of administration E) Metabolism of the medication

A, C, D The nurse should include that the age of the client affects the rate of absorption of medications. In older adult clients, delayed gastric emptying can slow the absorption rate of oral medications. The lipid solubility of a medication affects the rate of absorption. A medication that is highly lipid soluble has a higher rate of absorption than one that has low lipid solubility. The nurse should include that the route of administration affects the rate of absorption of medications. Oral or enteral medications are absorbed at a slower rate than intravenous medications.

A nurse is participating in a committee to reduce medication errors on a medical unit. Which of the following interventions should the nurse recommend? (Select all that apply) A) Mark the area around the automated medication dispensing system. B) Encourage the use of cell phones while dispensing medications. C) Override the automated medication dispensing system during emergencies. D) Provide the nurse administering medications with a vest. E) Double check dosages of high-alert medications.

A, D, E The nurse should recommend marking the area around the automated medication dispensing system to stop people from interrupting the nurse working in the labeled area. Interruptions while dispensing medications can result in medication administration errors. The nurse should recommend providing the nurse administering medications with a vest to indicate they should not be interrupted. Interruptions while dispensing medications can result in medication administration errors. The nurse should recommend to double check dosages and calculations for high-alert medications with a second nurse to reduce medication errors.

A patient asks the nurse if an enteric-coated tablet can be crushed and put in pudding to make it easier to swallow. How will the nurse respond to the patient? A. "Crushing the medication can lead to a possibly toxic medication dose." B. "Crushing the medication is safe and can prevent gagging on pills." C. "The tablet may be done if a small amount of pudding is used." D. "The tablet may be dissolved in liquid but not crushed and put in food."

A. "Crushing the medication can lead to a possibly toxic medication dose." Enteric-coated tablets must be swallowed whole to maintain a therapeutic drug level since they are designed to be absorbed in the small intestine. If crushed, an initial excessive release of the drug may occur, causing toxicity. Enteric-coated tablets should not be dissolved in liquid.

The nurse is preparing to administer an intramuscular injection to a 14-month-old toddler. To help with site selection for this injection, what will the nurse ask the child's parent? A. "How long has your child been walking?" B. "How much does your child weigh?" C. "Is your child afraid to look at needles?" D. "Is your child right- or left-handed?

A. "How long has your child been walking?" The ventrogluteal muscle is the preferred injection site for toddlers who have gluteal muscle development associated with firmly established walking. The muscle development, and not the child's weight, is more important. Asking if a patient is right- or left-handed is necessary if deltoid muscles are used.

The nurse is teaching an overweight patient to administer subcutaneous heparin. Which statement by the patient indicates understanding of the teaching? A. "I should insert the needle and inject the medication without aspirating for blood." B. "I should put firm pressure on the injection site to decrease the risk for bleeding." C. "I will insert the needle at a 10-degree angle when injecting." D. "The subcutaneous route is used because absorption is faster this way."

A. "I should insert the needle and inject the medication without aspirating for blood." Patients giving subcutaneous medication should be taught not to aspirate after inserting the needle. They should not apply pressure. The needle should be inserted at a 45- to 90- degree angle. Absorption is slower with this route than with the intramuscular and intravenous (IV) routes.

The nurse is demonstrating the Z-track injection technique to a nursing student on a patient who is receiving iron dextran. Which statement by the student indicates understanding of the teaching? A. "This is necessary to prevent staining of the patient's skin." B. "This technique allows slower, more sustained absorption." C. "You may use the deltoid site when using this method." D. "I should use a 27-gauge needle to minimize discomfort with this method."

A. "This is necessary to prevent staining of the patient's skin." The Z-track method is used to prevent staining of the skin. It does not affect absorption. The ventrogluteal site is preferred, and, generally, the needle is a larger bore.

When administering nasal spray, which instruction by the nurse is appropriate? A. "You will need to blow your nose before I give this medication." B. "You will need to blow your nose after I give this medication." C. "When I give this medication, you will need to hold your breath." D. "You need to sit up for 5 minutes after you receive the nasal spray."

A. "You will need to blow your nose before I give this medication." Clear the nasal passages before receiving nasal spray. Blowing one's nose after receiving the medication will remove the medication from the nasal passages. The patient will receive the spray while inhaling through the open nostril and needs to remain in a supine position for 5 minutes afterward.

A patient is ordered to take an extended-release medication twice daily but has difficulty swallowing the tablet because of its size. The nurse will perform which action? A. Contact the provider to discuss an alternate form of the medication. B. Crush the tablet and put it in applesauce to help the patient swallow it. C. Cut the tablet in half so the patient can take it more easily. D. Dissolve the tablet in liquid.

A. Contact the provider to discuss an alternate form of the medication. Enteric-coated and extended-release tablets must be swallowed whole to maintain a therapeutic drug level since they are designed to be absorbed in the small intestine. If crushed, an initial excessive release of the drug may occur, causing toxicity. Enteric-coated or extended-release tablets should not be dissolved in liquid. The nurse should contact the provider to discuss another form of the medication.

While the nurse is assisting a patient in taking his medications, the medication cup falls to the floor, spilling the tablets. What is the nurse's best action at this time? A. Discarding the medications and repeating preparation B. Asking the patient if he will take the medications C. Waiting until the next dose time, and then giving the medications D. Retrieving the medications and administering them to avoid waste

A. Discarding the medications and repeating preparation Medications that fall to the floor must be discarded, and the procedure must be repeated with new medications. The other actions are not appropriate.

The nurse will plan to use the Z-track method of intramuscular (IM) injections for which situation? A. The medication is known to be irritating to tissues. B. The patient is emaciated and has very little muscle mass. C. The medication must be absorbed quickly into the tissues. D. The patient is obese and has a deep fat layer below the muscle mass.

A. The medication is known to be irritating to tissues. The Z-track method is used for medications known to irritate tissues or for medications that are painful or cause stains to the tissues. It also prevents the deposit of medication into more sensitive subcutaneous tissues. The other options are not appropriate situations for the Z-track method.

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the client can receive the drug? A) Adverse effects B) Contraindications C) Implementation D) Black box warning

B) Contraindications The nurse should review the contraindications section in the drug handbook to determine if a client can receive the drug. This section lists pre-existing diseases or clinical situations that could make it unsafe to administer a drug.

A nurse is assisting with teaching a client about self-administration of insulin. Which of the following actions should the nurse take? A) Repeat the least important information to the client. B) Have the client perform a return demonstration of the procedure. C) Provide the client with educational materials written at an 8th-grade reading level. D) Dim the lights in the client's room before beginning the teaching.

B) Have the client perform a return demonstration of the procedure. The nurse should have the client perform a return demonstration of the procedure to determine the client's understanding.

A client asks you about the difference between a generic drug and a trade- or brand- name drug. Which of the following are true regarding generic drugs? (Select all that apply.) A) Have the potential for abuse and dependence B) Have the same chemical composition as the brand-name drug C) May have several brand names D) May have several generic names E) Are usually less expensive than a brand-name drug

B) Have the same chemical composition as the brand-name drug C) May have several brand names E) Are usually less expensive than a brand-name drug

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use? A) Adverse effects B) Indications C) Pharmacokinetics D) Nursing implications

B) Indications The indications section provides information on conditions and diseases for which the drug is used.

A patient who just returned from the postanesthesia care unit (PACU) is complaining of severe incision pain. Which drug contained in the medication administration record will offer the fastest relief? A) Liquid acetaminophen with codeine B) Intravenous morphine sulfate C) Intramuscular meperidine D) Oral oxycodone tablets

B) Intravenous morphine sulfate

Which factor in a patient's medical history is most likely to prolong the half-life of certain drugs? A) Heart disease B) Liver disease C) Rheumatoid arthritis D) Tobacco use

B) Liver disease Metabolism takes place largely in the liver. If there is a decrease in liver function (e.g., because of liver disease), the drug will be eliminated more slowly, prolonging the drug's half-life.

A charge nurse is reviewing routes of medication administration with a newly licensed nurse when providing care to a client. Which of the following routes of administration should the charge nurse include as having the slowest onset of action? A) Intramuscular B) Oral C) Buccal D) Intravenous

B) Oral The oral route, while convenient and most preferred by clients, has a slow onset of action.

The primary care provider prescribes nitroglycerin 1/150 g SL for a patient experiencing chest pain. How should the nurse administer the drug? A) Place the drug in the cheek and allow it to dissolve. B) Place the drug under the tongue and allow it to dissolve. C) Inject the drug superficially into the subcutaneous tissue. D) Give the pill and water to the patient for him to swallow the tablet.

B) Place the drug under the tongue and allow it to dissolve. Drugs administered by the sublingual (SL) route should be placed under the patient's tongue and allowed to dissolve.

A nurse is reviewing a drug handbook prior to administering a drug to a client who has kidney disease. The handbook states that the drug can be administered but identifies certain risks. Which of the following terms describes these risks? A) Contraindications B) Precautions C) Paradoxical effects D) Adverse effects

B) Precautions A precaution includes disease states, such as kidney disease, or clinical situations in which use of a drug involves particular risks or dosage modification might be necessary.

The nurse is acting as preceptor for a novice nurse. Which action by the novice nurse requires the nurse preceptor to intervene? A) Labeling medications placed in a medication cup. B) Removing prepackaged medication and placing in a medication cup. C) Keeping narcotics separated from other medications that need to be administered. D) Breaking scored tablets as needed for correct dosage.

B) Removing prepackaged medication and placing in a medication cup. The nurse should leave prepackaged medications in their original package to ensure proper labeling and to maintain sanitary approaches.

A nurse is collecting data on a client who is receiving vancomycin IV. The nurse observes the client has a rash on their neck, chest, and back. Which of the following actions should the nurse take first? A) Notify the client's provider. B) Stop the infusion of the vancomycin. C) Administer diphenhydramine to the client. D) Document the incident in the client's chart.

B) Stop the infusion of the vancomycin. The greatest risk to the client is injury from an acute allergic reaction. Therefore, the first action the nurse should take is to stop the infusion of the vancomycin to reduce the risk of further injury.

A nurse is preparing to teach a client about a newly prescribed drug. Prior to providing teaching, the nurse should review the precautions section of a drug handbook for which of the following reasons? A) To determine drug-food interactions B) To determine if dosage modification is indicated C) To determine how the drug is absorbed D) To determine availability

B) To determine if dosage modification is indicated The precautions section includes diseases or clinical situations in which drug use involves particular risks or dosage modification might be necessary, such as the presence of a client condition or restrictions due to the client's age.

The nurse must administer hepatitis B immunoglobulin 0.5 mL intramuscularly to a 3-day-old infant. Which injection site should the nurse choose to administer this injection? A) Ventrogluteal B) Vastus lateralis C) Deltoid D) Dorsogluteal

B) Vastus lateralis The preferred site for IM injections for infants who are not yet walking is the vastus lateralis muscle because there are no major blood vessels or nerves in the area and the gluteal muscles have not been developed by walking.

A patient asks the nurse why the provider has ordered a transdermal form of a medication. How will the nurse respond? A. "The patch can always be cut when dosage adjustments are needed." B. "Drug levels fluctuate less with the patch." C. "There are fewer systemic side effects with transdermal patches." D. "There is less risk of toxicity when using a patch."

B. "Drug levels fluctuate less with the patch." Transdermal patches provide more consistent blood levels. Cutting the patch is not recommended. Drugs given transdermally can still produce side effects and toxicity.

The nurse is teaching a nursing student about giving liquid medications. Which statement by the student indicates understanding of the teaching? A. "A suspension is a mixture in which drug particles are dissolved in solution." B. "I will line up the bottom of the medication curve with the line in the syringe." C. "I will need to shake an elixir before measuring the dose." D. "I will not need to refrigerate liquids once they are reconstituted."

B. "I will line up the bottom of the medication curve with the line in the syringe." To measure liquid medications accurately, line up the bottom of the curve of the medication with the desired line on the syringe. Suspensions are liquids in which particles are mixed but not dissolved. As a general rule, elixirs do not require shaking; shaking may suspend air into the liquid and affect accurate dosing by volume. Many liquids require refrigeration.

A patient with asthma is to begin medication therapy using a metered-dose inhaler. What is an important reminder to include during teaching sessions with the patient? A. Repeat subsequent puffs, if ordered, after 5 minutes. B. Inhale slowly while pressing down to release the medication. C. Inhale quickly while pressing down to release the medication. D. Administer the inhaler while holding it 3 to 4 inches away from the mouth.

B. Inhale slowly while pressing down to release the medication. Position the inhaler to an open mouth, with the inhaler 1 to 2 inches away from the mouth, or attach a spacer to the mouthpiece of the inhaler, or place the mouthpiece in the mouth. To administer, press down on the inhaler to release the medication while inhaling slowly. Wait 1 to 2 minutes between puffs if a second puff of the same medication has been ordered.

When administering medication by IV bolus (push), the nurse will occlude the IV line by which method? A. Not pinching the IV tubing at all B. Pinching the tubing just above the injection port C. Pinching the tubing just below the injection port D. Pinching the tubing just above the drip chamber of the infusion set

B. Pinching the tubing just above the injection port Before a medication is injected by IV push, the IV line is occluded by pinching the tubing just above the injection port. The other locations are incorrect

When adding medications to a bag of intravenous (IV) fluid, the nurse will use which method to mix the solution? A. Shaking the bag or bottle vigorously B. Turning the bag or bottle gently from side to side C. Inverting the bag or bottle one time after injecting the medication D. Allowing the IV solution to stand for 10 minutes to enhance even distribution of medication

B. Turning the bag or bottle gently from side to side When medications are added to IV fluid containers, the medication and the IV solution are mixed by holding the bag or bottle and turning it end-to-end, mixing it gently. Shaking vigorously is not appropriate; inverting the bag just once or simply allowing the bag to stand for 10 minutes may not be sufficient to mix the medication into the fluid.

A patient who has asthma will begin taking an inhaled corticosteroid medication to be used with a spacer. The patient asks why the spacer is necessary. The nurse will explain that the spacer A. allows a larger dose to be given safely. B. distributes medication to target tissues. C. minimizes adverse effects of the steroid. D. prevents contamination of the metered-dose inhaler.

B. distributes medication to target tissues. Spacers are used to enhance the delivery of medication to the lower, smaller airways. They do not allow higher dosing or minimize drug side effects

A nurse is obtaining a client's health history. The client reports no allergies but has experienced mild itching while taking amoxicillin in the past. Which of the following responses should the nurse make? A) "Itching is an expected adverse effect of amoxicillin." B) "Itching can indicate amoxicillin toxicity." C) "Itching can indicate a hypersensitivity to amoxicillin." D) "Itching can result from dry skin, which is often caused by amoxicillin."

C) "Itching can indicate a hypersensitivity to amoxicillin." Itching can be an indication of drug hypersensitivity, and a more severe allergic reaction can develop with future exposures. The client might be allergic to amoxicillin and other penicillins.

A nurse is caring for a group of clients. Which of the following clients should the nurse identify is at the greatest risk of developing medication toxicity? A) A client who has a respiratory infection B) A client who has rheumatoid arthritis C) A client who has impaired kidney function D) A client who has hyperthyroidism

C) A client who has impaired kidney function The nurse should identify that the client who has impaired kidney function is at the greatest risk for medication toxicity because many medications are excreted by the kidneys, A decrease in function of the kidneys can result in a buildup of medication metabolites.

A nurse is preparing to administer a medication to a client who has an enteral feeding tube. Which of the following actions should the nurse take? A) Mix the medication with the client's feeding infusion. B) Flush the feeding tube with 10 mL of water prior to administration of the medication. C) Administer the medication to the client in a liquid form. D) Place the client in a supine position prior to administering the medication.

C) Administer the medication to the client in a liquid form. The nurse should administer the medication in a liquid form to reduce the risk of clogging the feeding tube. The nurse should consult with the pharmacist to determine which medications are available as a liquid and which can be crushed and mixed with water prior to administration.

A patient is prescribed fluoxetine 20 mg by mouth daily for treatment of depression. The nurse caring for the patient is unfamiliar with this drug. Which action should the nurse take before administering the medication? A) Inform the prescriber that she is not comfortable administering the drug. B) Ask a nursing colleague for relevant information about the drug. C) Consult the drug formulary accessible to staff at the patient care unit. D) Trust the prescriber who writes the dose and administer the drug as intended.

C) Consult the drug formulary accessible to staff at the patient care unit. The nurse is responsible for every medication she administers. Therefore, the nurse must be familiar with the indications, routes of administration, dosages, contraindications, adverse reactions, drug interactions, and any special administration guidelines associated with each drug before administration.

A nurse is caring for client who has a history of renal insufficiency and is taking lithium. The nurse should monitor the client for which of the following? A) Tolerance to the drug B) Drug interaction C) Drug toxicity D) Dependence on the drug

C) Drug toxicity Drug toxicity develops when the amount of a drug that is taken is greater than its rate of excretion, and it results in the drug accumulating in the body. A client who has renal insufficiency might have delayed or impaired excretion of the drug. The drug dosage should be reduced if toxicity occurs.

A nurse is caring for a client who is having difficulty remembering to take their prescribed drug three times each day. The nurse should identify that which of the following alternate forms of the drug can help to promote adherence to the prescribed dosage? A) Liquid suspension B) Immediate-release capsule C) Extended-release tablet D) Powder form

C) Extended-release tablet Extended-release tablets release the drug over an extended period of time. Clients can take them less frequently.

A nurse mixes two insulins in one syringe for a client with diabetes. Which action by the nurse is incorrect? A) Injecting a volume of air equal to the volume of medication to be withdrawn into the first vial. B) Drawing up air in the syringe equal to the dose of both insulins. C) Gently shaking the vials in order to ensure medication has dissolved. D) Withdrawing the needle from the first vial and injecting the remaining air into the second vial.

C) Gently shaking the vials in order to ensure medication has dissolved. Shaking the insulins is not recommended because it will cause the medication to become frothy and difficult to measure. Instead, the nurse should gently roll the insulins in order to mix them.

A nurse is preparing to administer insulin to a client. Which of the following actions should the nurse take first? A) Document the insulin administration. B) Assist with teaching the client about the insulin. C) Have a second nurse confirm the insulin dose. D) Monitor the client for adverse effects of the insulin.

C) Have a second nurse confirm the insulin dose. The first action the nurse should take is to have a second nurse confirm the insulin dose to reduce the risk for a medication error. All forms of insulin are considered high alert medications that require a second nurse to confirm the dosage prior to medication administration.

You are helping a client learn how to give himself an insulin injection. Which of the following is the best method for evaluating effective learning? A) Verbally quiz a family member B) Instruct the client to complete a written test C) Have the client demonstrate an insulin injection D) Ask the client several key questions about the procedure

C) Have the client demonstrate an insulin injection

A nurse is caring for a client who is receiving nitroglycerin IV and is switching to the oral form of the drug. The nurse should identify that the oral dose will be higher than the IV dose for which of the following reasons? A) The IV form crosses the blood-brain barrier. B) The oral form has a decreased half-life. C) The oral form has decreased bioavailability because of the first-pass effect. D) The oral form has an increased rate of excretion.

C) The oral form has decreased bioavailability because of the first-pass effect. Oral doses are often larger than IV doses of the same drug because of the first-pass effect by the liver, which reduces the bioavailability of the drug. Enzymes in the liver metabolize drugs, making less of the drug available for use by the body.

You are talking with a client about taking tetracycline along with an antacid. You tell the client not to take these two drugs at the same time because an antacid can reduce the absorption of tetracycline. When one drug reduces the effect of another drug, it is: A) an allergic reaction. B) a synergistic effect. C) an antagonist effect. D) an adverse reaction.

C) an antagonist effect.

The nurse prepares to mix two medications (vial A and B) in one syringe. Place the steps in correct order for how the nurse will perform the procedure. A) Inject a volume of air equal to the volume of medication to be withdrawn into vial A. B) Withdraw the required amount of medication from vial B. C) Draw up a volume of air equal to the volume of medications to be withdrawn from both vials A and B. D) Withdraw the needle from vial A and inject the remaining air into vial B. E) Withdraw the required amount of medication from vial A.

C, A, D, B, E Mixing two medications from two vials in one syringe has the following steps: After performing appropriate hand hygiene, draw up a volume of air equal to the volume of medications to be withdrawn from both vials A and B. Inject a volume of air equal to the volume of medication to be withdrawn into vial A. Next withdraw the needle from vial A and inject the remaining air into vial B. Finally, withdraw the required amount of medication from vial A.

A nurse is preparing to administer medications to a client. The nurse should identify that which of the following factors contributes to medication errors? (Select all that apply) A) The use of automated dispensing systems B) Administering a generic medication C) Administering medication outside of prescribed time intervals D) Failing to administer a medication E) Incorrect dose of the prescribed medication administered to the client

C, D, E Medication administration outside of prescribed time intervals contributes to medication errors, also known as wrong-time errors. Wrong-time errors are one of the most common causes of medication errors. The nurse failing to administer a medication to a client is one of the most common causes of medication errors. Administering the incorrect dose to a client is one of the most common causes of medication errors.

The nurse is assisting the parent of a 6-month-old infant to administer an oral liquid medication. The parent asks why the medication can't be given in a bottle of formula to make it taste better. How will the nurse respond? A. "Adding a medication to the formula will cause the formula to curdle." B. "Formula and medications can form toxic compounds if mixed together." C. "The infant may not always take the entire bottle of formula." D. "This may cause the infant to refuse formula in the future."

C. "The infant may not always take the entire bottle of formula." Medications should not be mixed with a large amount of food or beverage because patients may miss the full dose if they do not consume the entire amount. If the entire bottle is not consumed, the nurse will have difficulty determining how much dose was received. If medications interact with formula in vivo, package information will indicate this

A patient says he prefers to chew rather than swallow his pills. One of the pills has the abbreviation SR behind the name of the medication. The nurse needs to remember which correct instruction regarding how to give this medication? A. Break the tablet into halves or quarters. B. Dissolve the tablet in a small amount of water before giving it. C. Do not crush or break the tablet before administration. D. Crush the tablet as needed to ease administration.

C. Do not crush or break the tablet before administration. Sustained-release (SR) and enteric-coated tablets or capsules are forms of medications that must not be crushed before administration so as to protect the gastrointestinal lining or the medication itself. Do not break, dissolve, or crush these tablets before administering.

The nurse is preparing to start an IV line in a preschool-age child. After applying a eutectic mixture of local anesthetics, what will the nurse do to prepare the child? A. Describe what the IV line will feel like and how long it will be in place. B. Explain the purpose of the procedure. C. Give the child equipment to handle and practice on a doll. D. Reassure the child that the pain will only last a few minutes.

C. Give the child equipment to handle and practice on a doll. Preschool children should be allowed to play with and handle equipment and give "play" injections using a doll or stuffed animal. Describing the procedure or discussing pain will only heighten anxiety.

The nurse is preparing to administer a rectal suppository antipyretic medication. Which action by the nurse is correct? A. Allowing the suppository to soften at room temperature before inserting B. Asking the patient to lie on the right side during insertion of the medication C. Having the patient remain in a side-lying position for at least 5 minutes after insertion D. Using a lubricant such as petrolatum gel (Vaseline) to lubricate the medication

C. Having the patient remain in a side-lying position for at least 5 minutes after insertion Patients should remain on their side for at least 5 minutes after insertion of suppositories. Softening the suppository is not indicated. Patients should lie on their left side, not the right. A water-soluble lubricant should be used.

The nurse needs to administer insulin subcutaneously to an obese patient. Which is the proper technique for this injection? A. Using the Z-track method B. Inserting the needle at a 5- to 15-degree angle until resistance is felt C. Pinching the skin at the injection site, and then inserting the needle to below the tissue fold at a 90-degree angle D. Spreading the skin tightly over the injection site, inserting the needle, and then releasing the skin

C. Pinching the skin at the injection site, and then inserting the needle to below the tissue fold at a 90-degree angle The proper technique for a subcutaneous injection for an obese patient is to pinch the skin at the site and inject the needle to below the skin fold at a 90-degree angle.

When giving a buccal medication to a patient, which action by the nurse is appropriate? A. Encouraging the patient to swallow, if necessary B. Administering water after the medication has been given C. Placing the medication between the upper or lower molar teeth and the cheek D. Placing the tablet under the patient's tongue and allowing it to dissolve completely

C. Placing the medication between the upper or lower molar teeth and the cheek Buccal medications are properly administered between the upper or lower molar teeth and the cheek. Caution the patient against swallowing, and do not administer with water. Medications given under the tongue are sublingually administered.

A 2-year-old child is to receive eardrops. The nurse is teaching the parent about giving the eardrops. Which statement reflects the proper technique for administering eardrops to this child? A. Administer the drops without pulling on the ear lobe. B. Straighten the ear canal by pulling the lobe upward and back. C. Straighten the ear canal by pulling the pinna down and back. D. Straighten the ear canal by pulling the pinna upward and outward.

C. Straighten the ear canal by pulling the pinna down and back. In an infant or a child younger than 3 years of age, the ear canal is straightened by pulling the pinna down and back. In adults, the pinna is pulled up and outward. Pulling the lobe and administering eardrops without pulling on the ear lobe are not appropriate actions

The nurse is teaching a parent to administer medications using a child's gastrostomy tube. The parent asks why it is necessary to give water after each medication. The nurse explains that the water is given for which purpose? A. To decrease gastrointestinal upset B. To dilute the medication and enhance absorption C. To ensure that all medication is infused into the stomach D. To improve overall hydration

C. To ensure that all medication is infused into the stomach Flushing the tube after the medication is instilled ensures that the medication reaches the stomach, to maintain patency of the tubing. It is not always given to decrease gastrointestinal upset, to dilute the medication, or to improve hydration.

After administering an intradermal (ID) injection for a skin test, the nurse notices a small bleb at the injection site. The best action for the nurse to take at this time is to: A. apply heat. B. massage the area. C. do nothing. D. report the bleb to the physician.

C. do nothing. The formation of a small bleb is expected after an ID injection for skin testing. The other actions are not appropriate.

A nurse is teaching a client about the adverse effects of digoxin. Which of the following statements should the nurse include in the teaching? A) "Adverse effects are the intended effects of the medication." B) "Adverse effects indicate a severe allergy to the medication." C) "Decrease your medication dose if adverse effects occur." D) "Contact your provider if adverse effects occur."

D) "Contact your provider if adverse effects occur." Adverse effects can be severe and life-threatening. The client should contact their provider if adverse effects occur.

A nurse is teaching a client about naproxen enteric-coated tablets. Which of the following statements should the nurse include in the teaching? A) "Drug absorption occurs in the stomach." B) "You should expect immediate absorption of the drug." C) "You should allow the tablet to dissolve in your mouth." D) "Do not crush or chew the tablet."

D) "Do not crush or chew the tablet." Drugs that irritate the stomach are often covered with an enteric coating that does not dissolve until the drug enters the alkaline environment of the small intestine. Clients should not crush or chew enteric-coated drugs because this will damage the enteric coating.

A nurse is reinforcing teaching with a client who has a new prescription for an antibiotic to treat a urinary tract infection. Which of the following statements should the nurse make? A) "You can expect to experience a rash while taking this medication." B) "Natural supplements do not interact with antibiotics." C) "This medication is used to treat a viral infection." D) "Finish the entire course of the prescription."

D) "Finish the entire course of the prescription." The nurse should instruct the client to complete the entire course of the antibiotic prescription, even if they are feeling better, to eradicate the infection.

A nurse is preparing to administer an intradermal injection to a client. At which of the following degree angles should the nurse insert the needle? A) 60° angle B) 90° angle C) 45° angle D) 10° angle

D) 10° angle The nurse should insert the needle at a 5° to 15° angle about 1/8 inch under the skin and observe for the tip of the needle, which would indicate that the needle is in the intradermal layer of the client's skin.

A nurse has received a prescription to administer a medication STAT to a client. Which of the following actions should the nurse take? A) Administer the medication whenever the client reports specific manifestations, such as pain. B) Administer the medication at specific times until directed by health care provider. C) Administer the medication at regular intervals of 4 hr. D) Administer the medication within 30 min of the health care provider prescribing the medication.

D) Administer the medication within 30 min of the health care provider prescribing the medication. STAT medication prescriptions should be given immediately and usually one time. STAT prescriptions should be administered within 30 min of the health care provider prescribing the medication.

A nurse is caring for a client who is newly admitted to the facility for chest pain. At which of the following times should the nurse begin teaching about drugs and discharge planning? A) After the client has a definitive diagnosis B) On the day of discharge C) When the client's family members are present D) As soon as possible

D) As soon as possible Instruction should start at the beginning of care and when the client is receptive to learning.

A nurse is planning to use the teach-back method to educate a client about a new antihypertensive medication. Which of the following should the nurse include to demonstrate this method? A) Provide the client with an internet link to research the medications. B) Refer the client to the American Heart Association. C) Give the client written educational material about the medication. D) Ask the client to explain the information using their own words.

D) Ask the client to explain the information using their own words. The teach-back method is a teaching approach in which the client repeats the instructions or information back to the nurse using their own words. This method allows the nurse to determine the client's understanding of the information and whether further education is required.

A nurse is speaking to a client who is taking sertraline and reports drinking grapefruit juice. The nurse explains that grapefruit juice inhibits an enzyme in the liver that is used to metabolize sertraline. The nurse should recognize the client's risk for which of the following? A) Reduced drug absorption B) Drug dependence C) Altered drug distribution D) Drug toxicity

D) Drug toxicity Grapefruit juice can cause increased levels of certain drugs, such as sertraline, which can lead to drug toxicity. Clients should avoid drinking grapefruit juice while taking these drugs.

A nurse is providing a discharge teaching to a client. Which of the following strategies should the nurse include? A) Use closed-ended questions. B) Provide written material at a 9th-grade reading level. C) Use passive listening skills. D) Encourage the client to ask questions.

D) Encourage the client to ask questions. The nurse should encourage the client to ask questions to facilitate an active role in their own care and promote an understanding of the education.

A nurse is providing teaching to a pregnant client who is taking captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. The nurse should explain that teratogenic drugs can cause which of the following? A) Maternal bleeding B) Maternal blood clots C) Gestational diabetes mellitus D) Fetal malformation

D) Fetal malformation Teratogenic drugs can cause birth defects. Clients who are pregnant should not take these drugs.

A nurse is preparing to administer medications to a client who is not wearing an identification bracelet. Which of the following actions should the nurse take before administering the medications? A) Verify the client's identity using their diagnosis. B) Use one identifier to confirm the client's identity. C) Use the client's room number to identify the client. D) Have the client confirm their name and date of birth.

D) Have the client confirm their name and date of birth. The client's identity must be verified using two unique identifiers prior to medication administration to ensure the correct medication is being given to the right client. The nurse should confirm the client's identity and replace the client's identification band.

A nurse is preparing to administer medication to a preschooler. Which of the following information should the nurse keep in mind when administering medications to this client? A) The dosage is calculated by height. B) The preschooler is unable to take capsules. C) Preschoolers receive the same amount of medication as adults. D) The deltoid muscle can be used to administer intramuscular injections.

D) The deltoid muscle can be used to administer intramuscular injections in preschoolers as well as in adults.

A nurse is assisting with teaching a newly licensed nurse about administering a transdermal nitroglycerin patch to a client. Which of the following instructions should the nurse include? A) Place a new transdermal patch over the same site as an old patch. B) Apply no more than two transdermal patches at a time. C) Expect the transdermal medication to absorb rapidly. D) Wear clean gloves to apply the transdermal medication.

D) Wear clean gloves to apply the transdermal medication. The nurse should wear clean gloves to apply the transdermal patch to protect the nurse from accidentally absorbing the medication.

The nurse is teaching a patient about using sublingual nitroglycerin at home. Which statement by the patient indicates understanding of the teaching? A. "I may put the tablet in food if I don't like the taste." B. "I may take a sip of water after placing the tablet in my mouth." C. "I will place the tablet between my cheek and gum." D. "I will place the tablet under my tongue and let it absorb."

D. "I will place the tablet under my tongue and let it absorb." Drugs given sublingually should be placed under the tongue. No foods or fluids should be given, since the tablet must remain under the tongue until it is fully absorbed. Medications ordered to be given "buccally" should be placed between the cheek and gum.

A patient is to receive a penicillin intramuscular (IM) injection in the ventrogluteal site. The nurse will use which angle for the needle insertion? A. 15 degrees B. 45 degrees C. 60 degrees D. 90 degrees

D. 90 degrees The proper angle for IM injections is 90 degrees. The other angles are incorrect

A patient is receiving eyedrops that contain a beta-blocker medication. The nurse will use what method to reduce systemic effects after administering the eyedrops? A. Wiping off excess liquid immediately after instilling the drops B. Having the patient close the eye tightly after the drops are instilled C. Having the patient try to keep the eye open for 30 seconds after the drops are instilled D. Applying gentle pressure to the patient's nasolacrimal duct for 30 to 60 seconds after instilling the drops

D. Applying gentle pressure to the patient's nasolacrimal duct for 30 to 60 seconds after instilling the drops When administering ophthalmic drugs that may cause systemic effects, one's finger should be protected by a clean tissue or glove and gentle pressure applied to the patient's nasolacrimal duct for 30 to 60 seconds. The other actions are not appropriate.

Before administering any medication, what is the nurse's priority action regarding patient safety? A. Verifying orders with another nurse B. Documenting the medications given C. Counting medications in the medication cart drawers D. Checking the patient's identification using two identifiers

D. Checking the patient's identification using two identifiers Verifying the patient's identity, using two identifiers, before administering any medication is essential for the patient's safety and reflects checking one of the "Nine Rights" of medication administration. Documentation is done after the medications are given.

When giving medications, the nurse will use Standard Precautions, which include what action? A. Bending the needle to prevent reuse B. Recapping needles to prevent needle sticks C. Discarding all syringes and needles in the trash can D. Discarding all syringes and needles in a puncture-resistant container

D. Discarding all syringes and needles in a puncture-resistant container Standard Precautions include wearing clean gloves when there is potential exposure to a patient's blood or other body fluids; never recapping needles; never bending needles or syringes; and discarding all disposable syringes and needles in the appropriate puncture- resistant container.

The nurse is about to give a rectal suppository to a patient. Which technique would facilitate the administration and absorption of the rectal suppository? A. Having the patient lie on his or her right side, unless contraindicated B. Having the patient hold his or her breath during insertion of the medication C. Lubricating the suppository with a small amount of petroleum-based lubricant before insertion D. Encouraging the patient to lie on his or her left side for 15 to 20 minutes after insertion

D. Encouraging the patient to lie on his or her left side for 15 to 20 minutes after insertion Position the patient on his or her left side for rectal suppository insertion. The suppository is then lubricated with a small amount of water-soluble lubricant, not petroleum-based substances. The patient is told to take a deep breath and exhale through the mouth during insertion. Then the patient needs to remain lying on the left side for 15 to 20 minutes to allow absorption of the drug.

The nurse is performing tuberculin testing on a patient. Which action by the nurse is correct? A. Insert the needle, bevel up, at a 30-degree angle. B. Massage the area gently after the injection. C. Measure the diameter of the area of erythema when reading the result. D. Use a 25-gauge, 3/8" needle.

D. Use a 25-gauge, 3/8" needle. Intradermal injections should be given with a 25- to 27-gauge, 3/8"- to 5/8"-long needle. The needle should be inserted at a 10- to 15-degree angle. The area should not be massaged. The nurse measures the area of induration, not erythema.

The nurse has an order to administer an intramuscular (IM) immunization to a 2-month- old child. Which site is considered the best choice for this injection? A. Deltoid B. Dorsogluteal C. Ventrogluteal D. Vastus lateralis

D. Vastus lateralis The vastus lateralis is the preferred site of injection of drugs such as immunizations for infants. The other sites are not appropriate for infants. The ventrogluteal site is the preferred site for adults and children. The deltoid site is used only for the administration of immunizations to toddlers, older children, and adults (not infants) and only for small volumes of medication. The dorsogluteal site is no longer recommended because of the possibility of nerve injury.

7. When administering topical medications, which is an important nursing action? A. Applying the medication liberally B. Cleaning skin with alcohol before applying C. Using sterile technique D. Wearing gloves

D. Wearing gloves To avoid contact with the medication, nurses should wear gloves when applying topical medications. Some topical medications are applied sparingly. Skin should be clean and dry, but it is not necessary to use alcohol. It is not always necessary to use sterile technique

The nurse is measuring 4 mL of a liquid cough elixir for a child. Which method is most appropriate? A. Using a teaspoon to measure and administer B. Holding the medication cup at eye level and filling it to the desired level C. Withdrawing the elixir from the container using a syringe without a needle attached D. Withdrawing the elixir from the container using a calibrated oral syringe

D. Withdrawing the elixir from the container using a calibrated oral syringe Small doses of liquid medications must be withdrawn using a calibrated oral syringe. A hypodermic syringe or a syringe with a needle or syringe cap must not be used. If hypodermic syringes are used, the drug may be inadvertently given parenterally, or the syringe cap or needle, if not removed from the syringe, may become dislodged and accidentally aspirated by the patient when the syringe plunger is pressed. The other methods are not accurate for small volumes.

The nurse prepares to administer an intermittent intravenous solution using a secondary administration set. Place the steps of assembling the secondary infusion in correct order. A) Insert the secondary tubing needleless cannula into the distal primary tubing port located above the infusion pump. B) Hang the secondary container above the level of the primary bag. C) Attach the appropriate label to the secondary tubing. D) Lower medication bag to clear tubing and back-prime tubing. E) Close the clamp on the secondary infusion tubing and spike the medication infusion bag.

E, A, B, D, C The correct steps of assembling the secondary infusion is as follows: Close the clamp on the secondary infusion tubing and spike the medication infusion bag; insert the secondary tubing needleless cannula into the distal primary tubing port located above the infusion pump; hang the secondary container above the level of the primary bag; lower medication bag to clear tubing and back-prime tubing; Attach the appropriate label to the secondary tubing.