Medication Administration NCLEX Questions

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Examples of medications that are given by enteral routes include which of the following: SELECT ALL THAT APPLY a. total parenteral nutrition (TPN) solutions b. oral tablets c. oral capsules d. rectal suppositories e. liquid medications.

b. oral tablets c. oral capsules d. rectal suppositories e. liquid medications.

A nursing student is administering ampicillin PO. The expiration date on the medication wrapper was yesterday. What is the appropriate action for the nursing student to take next? A. Ask the nursing professor for advice B. Return the medication to pharmacy and get another tablet C. Call the health care provider after discussing this situation with the charge nurse D. Administer the medication since medications are good for 30 days after their expiration date

B. Return the medication to pharmacy and get another tablet

The client receiving an intravenous infusion of morphine sulfate begins to experience respiratory depression and decreased urine output. This effect is described as: A. Therapeutic B. Toxic C. Idiosyncratic D. Allergic

B. Toxic

A 76-year-old client lives alone and takes medications without supervision. Which of the following is the most appropriate question for his home health nurse to ask in regard to his medication regimen? A. "How much do you weigh?" B. "What medications are you currently taking?" C. "We'll have to take away your sedatives if you keep taking them during the day. " D. "Have you been taking other substances than those ordered by the physician?"

D. "Have you been taking other substances than those ordered by the physician?"

When applying a topical nitroglycerin ointment, the nurse will do which of the following? a. massage it thoroughly into the skin. b. squeeze it onto the applicator paper and place it on the skin c. apply it to the medial aspect of the thigh d. shave the skin prior to application

b. squeeze it onto the applicator paper and place it on the skin

A sublingual drug is administered by placing the drug in what part of the body? a. between the cheek and the upper jaw b. under the tongue c. in the nose d. in the eyes

b. under the tongue

If an IV has become infiltrated, the nurse will observe which of the following assessment findings? a. Pallor, pain b. Erythema, warmth c. Erythema, swelling d. Warmth, swelling

c. Erythema, swelling

Before the nurse administers a dose of digoxin (Lanoxin) to a patient, the nurse should assess: a. blood pressure b. respiratory rate c. apical heart rate d. level of consciousness

c. apical heart rate

The licensed nurse who is responsible for doing the narcotic count for the shift should count the drugs. a. alone for accuracy. b. with any licensed person c. with another nurse working on the shift d. with a nurse coming on duty for the next shift.

d. with a nurse coming on duty for the next shift.

The nurse uses a mortar and pedestal to crush a medication before giving it to one of her clients. Which of the five rights is the nurse ensuring? A. The right route B. The right client C. The right time D. The right drug

A. The right route

The nurse checking the MAR finds that an order for an antibiotic is no 8 days old. The nurse should: a. check the medications, performing three medication checks b. give the ordered medication c. contact the physician for a new order. d. give the medication, then notify the physician

c. contact the physician for a new order.

A pediatric nurse takes a medication to a 12-year-old female patient. The patient tells the nurse to take it away because she is not going to take it. What is the nurse's next action? A. Ask the patient's reason for refusal B. Consult with the patient's parents for advice C. Take the medication away and chart the patient's refusal D. Tell the patient that her health care provider knows what is best for her

A. Ask the patient's reason for refusal

After receiving an intramuscular (IM) injection in the deltoid, a patient states, "My arm really hurts. It's burning and tingling where I got my injection. What should the nurse do next? (Select all that apply.) A. Assess the injection site B. Administer an oral medication for pain C. Notify the patient's health care provider of assessment findings D. Document assessment findings and related interventions in the patient's medical record E. This is a normal finding so nothing needs to be done F. Apply ice to the site for relief of burning pain

A. Assess the injection site C. Notify the patient's health care provider of assessment findings D. Document assessment findings and related interventions in the patient's medical record

You are a new graduate nurse completing your orientation on a very busy intensive care unit. You cannot read a health care provider's order for one of your patient's medications. You have heard from more experienced nurses that this health care provider does not like to be called, and you know that another of the health care provider's patients is very unstable. What is the most appropriate next step for you to take? A. Call the health care provider to clarify the order B. Talk with your preceptor to help you interpret the order C. Refer to a medication manual before giving the medication D. Use your best judgment and critical thinking and administer the dose you think the health care provider ordered

A. Call the health care provider to clarify the order

What statement made by a 2-year-old patient's mother indicates that she understands how to administer her son's eardrops? A. "To straighten his ear canal, I need to pull the outside part of his ear down and back." B. "I need to straighten his ear canal before administering the medication by pulling his ear upward and outward." C. "I need to put my son in a chair and make sure that he's sitting up with his head tilted back before I give him the eardrops." D. "After I'm done giving him his eardrops, I need to make sure that my son remains sitting straight up for at least 10 minutes."

B. "I need to straighten his ear canal before administering the medication by pulling his ear upward and outward."

You are working in a health clinic on a college campus. You need to administer medroxyprogesterone acetate intramuscularly (IM) to a female patient for birth control. You look up this medication in a reference manual and determine that it is viscous and injections can be painful. On the basis of this information, you plan which of the following when administering this medication? (Select all that apply.) A. Inject the medication over 3 minutes to reduce pain associated with the injection B. Administer the medication in the ventral gluteal site C. Use the z-track method when administering the medication D. Use the deltoid site for medication administration E. Ask the patient questions about her major and which classes she is taking during the injection to provide distraction

B. Administer the medication in the ventral gluteal site C. Use the z-track method when administering the medication E. Ask the patient questions about her major and which classes she is taking during the injection to provide distraction

After seeing a patient, the health care provider starts to give a nursing student a verbal order for a new medication. The nursing student first needs to: A. Follow ISMP guidelines for safe medication abbreviations. B. Explain to the health care provider that the order needs to be given to a registered nurse. C. Write down the order on the patient's order sheet and read it back to the health care provider. D. Ensure that the six rights of medication administration are followed when giving the medication.

B. Explain to the health care provider that the order needs to be given to a registered nurse.

A clinet is nauseated, has been vomiting for several hours, and needs to receive an antiemetic (anti-nausea) medication. Which of the following is accurate? A. An enteric-coated medication should be given. B. Any medication will not be absorbed as easily because of the nausea problem. C. A parenteral route is the route of choice. D. A rectal suppository must be administered.

C. A parenteral route is the route of choice.

A 73-year-old client who is very obese requires an intramuscular injection of Demerol 100 mg. Which of the following is least appropriate for the administration of this medication? A. A 5/8-inch needle is used at a 45-degree angle to the skin B. Pinching the skin before administration is necessary C. Aspirating the syringe before injecting the medication is a priority D. Using a 25-gauge needle would be best

C. Aspirating the syringe before injecting the medication is a priority

In preparing two different medications from two vials, the nurse must: A. Inject fluid from one vial into the other B. Uncap the syringe and wipe the needle with an alcohol preparation before inserting into either vial C. Discard the medication from vial number two if medication from vial number one is pushed into it D. Insert air into the first vial, but not the second vial

C. Discard the medication from vial number two if medication from vial number one is pushed into it

A nurse admits a 72-year-old patient with a medical history of hypertension, heart failure, renal failure, and depression to a general medical patient care unit. The nurse reviews the patient's medication orders and notes that the patient has three health care providers who have ordered a total of 13 medications. What is the most appropriate action for the nurse to take next? A. Give the medications after identifying the patient using two patient identifiers B. Provide medication education to the patient to help with adherence to the medical plan C. Review the list of medications with the health care providers to ensure that the patient needs all 13 medications D. Set up a medication schedule for the patient that is least disruptive to the expected treatment schedule in the hospital

C. Review the list of medications with the health care providers to ensure that the patient needs all 13 medications

The nurse is administering an intravenous (IV) push medication to a patient who has a compatible IV fluid running through intravenous tubing. Place the following steps in the appropriate order. 1. Release tubing and inject medication within amount of time recommended by agency policy, pharmacist, or medication reference manual. Use watch to time administration. 2. Select injection port of intravenous (IV) tubing closest to patient. Whenever possible, injection port should accept a needleless syringe. Use IV filter if required by medication reference or agency policy. 3. After injecting medication, release tubing, withdraw syringe, and recheck fluid infusion rate. 4. Connect syringe to port of intravenous (IV) line. Insert needleless tip or small-gauge needle of syringe containing prepared drug through center of injection port. 5. Clean injection port with antiseptic swab. Allow to dry. 6. Occlude intravenous (IV) line by pinching tubing just above injection port. Pull back gently on syringe plunger to aspirate blood return. A. 2, 5, 4, 1, 3, 6 B. 2, 5, 6, 4, 1, 3 C. 5, 4, 2, 6, 1, 3 D. 2, 5, 4, 6, 1, 3

D. 2, 5, 4, 6, 1, 3

A toddler is to receive 2.5 mL of an antipyretic by mouth. Which equipment is the most appropriate for medication administration for this child? A. A medication cup B. A teaspoon C. A 5-mL syringe D. An oral-dosing syringe

D. An oral-dosing syringe

A nurse accidently gives a patient the medications that were ordered for the patient's roommate. What is the nurse's first priority? A. Complete an occurrence report. B. Notify the health care provider. C. Inform the charge nurse of the error. D. Assess the patient for adverse effects.

D. Assess the patient for adverse effects.

To determine the proper drug dosages for children, calculations are made on the basis of the child's: A. Weight B. Height C. Age D. Body surface area

D. Body surface area

A nursing student is administering medications to a patient through a gastric tube (G-tube). Which of the following actions taken by the nursing student requires the nursing instructor to intervene? A. The nursing student places all the patient's medications in different medicine cups. B. The nursing student evaluates each medication and holds the tube feeding before administering a medication that needs to be administered on an empty stomach. C. The nursing student flushes the tube with 30 mL of water between each medication. D. The nursing student crushes a nifedipine extended-release tablet and mixes it with water before administering it.

D. The nursing student crushes a nifedipine extended-release tablet and mixes it with water before administering it.

The nurse is preparing 10 units of regular insulin and 5 units of NPH insulin. Which of the following statements is the most accurate? A. The NPH insulin is the shortest acting form of insulin. B. Air is injected first into the regular insulin, then into the NPH. C. The insulin vial should be discarded if there are any bubbles in it. D. This medication order is given via the subcutaneous route.

D. This medication order is given via the subcutaneous route.

The client is to receive a sedative via the buccal route. Which of the following is true? A. The medication is placed under the tongue. B. This route is probably more expensive than the intramuscular route. C. The nurse should offer the client a glass of orange juice after taking the sedative. D. This method of administration would be avoided in the event of facial injuries.

D. This method of administration would be avoided in the event of facial injuries.

An elderly patient is scheduled to take six medications each morning. The nurse administering these medications knows to do which of the following? a. allow extra time to administer all of the medications b. allow the patient to take only the medications she can swallow. c. crush all of the medications before giving them d. leave the medication at the bedside so the patient can take them slowly.

a. allow extra time to administer all of the medications

Before the nurse administers a liquid medication to an 83 yr old male patient, the nurse should: a. assess the swallowing reflex by offering a sip of water b. ask the patient if he would prefer to give the medication to himself. c. mix thoroughly in applesauce or pudding d. assess the ability to understand information relative to the drug

a. assess the swallowing reflex by offering a sip of water

The prescriber orders atenolol (Tenormin) 25 mg to be given orally once a day to control a patients high blood pressure. The nurse takes the patient's vital signs and finds that the blood pressure is 128/80 and the heart rate is 60 b/m. What does the nurse do first before giving this drug? a. check the order for prescriber limitations on when the drug should be given b. notify the prescriber and ask if the drug should be given c. reassess the blood pressure and heart rate in 30 minutes d. give the drug exactly as prescribed.

a. check the order for prescriber limitations on when the drug should be given

What administration technique does the nurse use to give a 2 yr old child ear drops? a. pull the earlobe down and back b. pull the earlobe up and out c. keep the earlobe straight d. hang the patient's head over the side of the bed.

a. pull the earlobe down and back

A patient complains about the taste of the the sublingual nitroglycerin and admits that the swallows it rather then holding it under his tongue. The nurse explains that sublingual medications. a. should not be swallowed because it alters the absorption potential. b. can be inserted rectally without loss of absorption potential c. can be held against the roof of the mouth with the tongue to reduce taste. d. can be taken between the cheek and tongue to diminish taste.

a. should not be swallowed because it alters the absorption potential.

Which of the following represents the proper way for a nurse to administer an oral capsule? a. tell the patient to swallow it whole b. pierce it with a needle and squeeze into the mouth c. crush and dilute it in warm water. d. tell the patient to chew it completely

a. tell the patient to swallow it whole

If Phenergan is available in 100 mg/2 mL ampules, which of the following represents the amount is needed in mL to give a dose of 12.5 mg IM? a. 0.20 b. 0.25 c. 0.50 d. 0.75

b. 0.25

The order reads: Lanoxin 0.125 mg PO now. The medication is available in 0.25 mg tablets. Which of the following represent the number of tablets the nurse will give. a. 2 tab b. 1/2 tab c. 1 1/2 tab d. 1/4 tab

b. 1/2 tab

when administering medications to a patient with a feeding tube, the nurse should dissolve each crushed medication in at least ___ mL of water. a. 30 to 60 b. 20 to 30 c. 15 to 20 d. 5 to 15

b. 20 to 30

When giving a medicine through a nasogastric (NG) tube, the nurse will first do which of the following? a. flush the tube with 30 mL of water b. Check placement of the tube c. take the vital signs d. ask the patient if the tube is painful

b. Check placement of the tube

Which of the following principles of medication administration will be taught to a patient who will be administering his own subcutaneous (SC) injections? a. Use a 22 G, 5/8 in needle b. Rotate sites among the upper arm, abdomen, and anterior thigh c. Avoid injecting within 3 in of a previous injection site d. insert the needle at a 30 degree angle to the skin

b. Rotate sites among the upper arm, abdomen, and anterior thigh

The nurse is preparing to teach a patient about a newly prescribed drug therapy. What time is best for improving teaching effectiveness? a. during lunch so that the patient is not too hungry to learn b. after the patient wakes up from a nap and no visitors are present. c. right after the health care provider has told the patient that the health problem cannot be cured. d. when the patient's spouse and 3 adult children are present so that the family can reinforce the teaching.

b. after the patient wakes up from a nap and no visitors are present.

what is the most important role of the nurse in preventing drug errors? a. always checking the patient's diagnosis before giving a drug b. always following the "six rights" of drug administration c. being the one defense for detecting and preventing drug errors d. being most likely to detect a drug error that has occurred.

b. always following the "six rights" of drug administration

To reduce the systemic absorption of eye drops, the nurse should: a. use finger pressure to close the eyelid tightly b. apply slight finger pressure over the lacrimal duct c. request the patient tilt the head slightly to the side of the unaffected eye d. instruct the patient to widen the eyes in order to increase access to the lacrimal duct.

b. apply slight finger pressure over the lacrimal duct

when is it acceptable for the nurse to take a verbal order from the prescriber before giving a drug to a patient? a. during the night shift when the prescriber is not at the hospital b. in an emergency situation such as a cardiac arrest c. when a patient is experiencing severe pain d. at any time it is necessary

b. in an emergency situation such as a cardiac arrest

Which statement by the nurse is more likely to motivate a patient to adhere to a drug therapy regimen for hypertension? a. your doctor prescribed this drug and your doctor knows what is best for your health. b. if you do not take this drug you are at greater risk to die of stroke or heart attack within the next 10 yrs. c. as an artist, your eyes are important, and taking this drug daily helps prevent eye damage from high blood pressure. d. if you are not taking this drug because you are to poor to afford it, I can call a social worker so you can get financial aid.

c. as an artist, your eyes are important, and taking this drug daily helps prevent eye damage from high blood pressure.

hen giving a drug to a patient who is awake but confused, what is the best way for the nurse to identify the patient? a. check the room and bed number that the patient occupies. b. ask the patient to state his or her name and birth date. c. check the name on the patient's wristband. d. ask the patient if he or she is Mr. or Ms. (name).

c. check the name on the patient's wristband.

The physician orders all of the following drugs for a patient who had surgery 2 days ago. Which drug order does the nurse administer first? a. Alphamine (cyanocobalamin) 100 mcg intramuscularly once b. Benadryl (diphenhydramine) 25 mg orally every 8 hrs. c. compazine (prochlorperazine) 10 mg orally STAT d. Dalmane (flurazepam) 30mg orally at night PRN

c. compazine (prochlorperazine) 10 mg orally STAT

a nurse receives an order to administer 8 units regular insulin and 20 units NPH insulin before breakfast. Using a U-100 syringe, the nurse would prepare this dos in which of the following ways? a. drawing up 8 units NPH, then 20 units regular in the same syringe. b. drawing up 9 units regular in one syringe, and 20 units NPH in a separate syringe. c. drawing up 8units regular, then 20 units NPH in the same syringe d. giving the 20 units NPH insulin 15 min before food, and the 8 units of regular when the food arrives.

c. drawing up 8units regular, then 20 units NPH in the same syringe

In which of the following ways can a nurse prevent injury from a needlestick? a. recap the needle before disposal b. remove the needle from the syringe c. immediately discard the needle and syringe in a puncture-proof container d. stick it into the patient's mattress until it can be disposed of.

c. immediately discard the needle and syringe in a puncture-proof container

A patient is to receive nitroglycerin ointment, 1 inch STAT, for elevated blood pressure. What must the nurse do before giving this drug? a. shave the hair off the patient's chest b. place the patient on a heart monitor c. put on a pair of disposable gloves d. measure the dose directly on the patient's skin.

c. put on a pair of disposable gloves

Metered-dose inhalers are used to deliver specific amounts of medication. The nurse gives the patient which of the following instructions? a. never shake the inhaler medication before use. b. exhale while squeezing the canister to deliver the medication. c. sit upright, exhale, then activate he inhaler as the next inhalation begins. d. hold the head back while inhaling the medication.

c. sit upright, exhale, then activate he inhaler as the next inhalation begins.

A patient on the long-term care unit receives the wrong medication. The charge nurse should instruct which staff member to complete the incident report? a. the nurse who administered the wrong drug b. the nursing supervisor for the day c. the nurse who discovered the error d. no one, because the charge nurse should do it.

c. the nurse who discovered the error

Which of the following is done after giving medication through a nasogastric tube that is connected to suction? a. the tube is reconnected to the suction b. the tube is clamped for 10 min then reconnected to suction c. the tube is clamped for 30min then reconnected to suction d. the suction is left off for 4 hrs then reconnected to suction

c. the tube is clamped for 30min then reconnected to suction

which of the following is the correct needle for an intramuscular (Im) injection? a. 18 G, 1-in b. 20 G, 1/2 in c. 25 G, 2-in d. 21 G, 1 1/2 in

d. 21 G, 1 1/2 in

The nurse is giving morning medications to patient who refuses to take an oral dose of docusate (Colace).What is the nurse's best response? a. your prescriber ordered that you must take this drug twice a day. b. docusate will soften your bowel movements so that you do not strain c. this drug will help prevent constipation while you are on bed rest. d. can you tell me why you do not want to take the docusate?

d. can you tell me why you do not want to take the docusate?

What is the best way for the nurse to make sure that the right patient is receiving a prescribed drug when the patient is alert and oriented? a. ask the patient to state his or her name b. check the patient's wrist band c. look at the patients chart d. have the patient state his or her name and birth date.

d. have the patient state his or her name and birth date.

The nurse receives an order to give vitamin D 10 mcg bid. The nurse recognizes that the abbreviation mcg refers to a measurement in: a. milligrams b. milliequivalents c. milliliters d. micrograms

d. micrograms

What must the nurse be sure to tel the patient after a vaginal drug is administered? a. this drug should be refrigerated b. you may take this drug at home while sitting on the toilet. c. be sure to empty your bladder after receiving this drug. d. remain lying down for 10 to 15 mins after taking this drug.

d. remain lying down for 10 to 15 mins after taking this drug.

The nurse is interviewing a patient. Which action by the nurse indicates active listening? a. asking interview questions while starting an IV b. correcting the patient's use of the word "free bleeder" for hemophilia c. asking the spouse to verify the patient's responses to family history questions d. restating what the patient said to ensure the nurse understands what the patient meant.

d. restating what the patient said to ensure the nurse understands what the patient meant.

The nurse instructs a clinic patient on using an inhaler for his asthma attacks. Which of the following is correct about the use of an inhaler? a. the medication must go into the back of the nose b. the medication must go directly into the throat c. the medication must get to the ears d. the medication must go into the lungs.

d. the medication must go into the lungs.

For an adult patient who has an order to receive an otic medication, the nurse should plan to administer it by pulling the pinna: a. down and forward b. up and forward c. down and back d. up and back.

d. up and back.


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