Module 4: Oral and Topical Medications

The nurse is preparing a liquid medication for a client. The health care provider prescribes cimetidine hydrochloride 600 mg PO for gastrointestinal bleeding. The pharmacy sends cimetidine hydrochloride 300 mg/5 mL. How many teaspoons should the nurse administer?

2 teaspoons

The nurse is administering medications to a client via a gastric tube. After administering the last dose of medication, how much water should the nurse flush through the gastric tube?

30 to 60 mL

The nurse is caring for an adult client by inserting a rectal suppository. Which action would be most appropriate by the nurse?

Lubricate the suppository and gloved finger.

The nurse teaches the client about home use of a transdermal medication patch for pain. The nurse evaluates the teaching as effective when the client makes which statement?

"I can't use my heating pad in the same area as the patch."

The nurse caring for a client has just inserted a rectal suppository. What is the best instruction by the nurse at this time?

"Remain in horizontal position for 10 to 20 minutes."

The client is prescribed digoxin 0.125 mg PO every day. The nurse obtains the medication from unit stock and discovers that digoxin only comes in a 0.25-mg tablet. How many tablets of digoxin should the nurse administer to the client?

0.5 tablet

The nurse is preparing hydrochlorothiazide 50-mg tablet from unit stock. The health care provider orders 75 mg of hydrochlorothiazide PO for the client's hypertension. How many tablets of hydrochlorothiazide will the nurse administer to the client?

1.5 tablets

The client is to receive several medications via a gastric tube. How much water would the nurse flush the tube between the medications?

5 to 10 mL

The client completes use of the dry powder inhaler. What action must the nurse perform after use of this medication?

Assist the client to rinse out the mouth.

The client with a gastric tube is prescribed a delayed-release tablet. Which are appropriate actions for the nurse? Select all that apply.

Call the health care provider for prescription. Check the drug guide. Hold the medication.

The nurse needs half of a tablet of medication and is preparing to split the tablet but there is no score. What should the nurse do? Select all that apply.

Call the health care provider. Refrain from splitting the tablet.

The nurse is to administer a medication to a client in isolation and the medication is in a multi-dose container. How will the nurse complete the third check of medication administration?

Check the multi-dose label before putting the container back in the drawer and label medicine cup with needed information.

The nurse has administered a client's medication. Which action would be most appropriate if the client vomits immediately, or soon after administration?

Check the vomit/emesis for pills or pill fragments and call the client's health care provider.

Prior to the nurse administering eye drops to the client, what should the nurse do?

Clean the eyelids of any loose eyelashes.

The nurse is in the client's room to administer the client's morning oral medications. Which action should the nurse take first?

Confirm the client's identity.

The client tells the nurse that the medication in the cup is not the same as the medication he took the day before. The client is insistent that the medication is not the one prescribed. Which action by the nurse would be least appropriate?

Contact the health care provider to determine if the medication prescribed is correct.

The nurse is administering a medication using a small-volume nebulizer. What would the nurse instruct the client to do?

Have the client inhale slowly and deeply through the mouth.

A nurse is preparing to administer oral medications to a client. While opening the unit dose package, the medication inadvertently falls on the floor. Which action by the nurse would be most appropriate?

Discard the current unit-dose package and obtain a new one.

The nurse will be administering an inhaled medication via a small- volume nebulizer to a client. What would the nurse have the client do first?

Encourage client to blow the nose and cough up secretions.

After the client inhales a dose from a dry power inhaler, which action does the nurse instruct the client to take next?

Hold breath for 5 to 10 seconds.

The nurse is splitting medications. After splitting the tablet and administering half to the client, what should the nurse do with the remaining half? Select all that apply.

If the medication is a narcotic, waste with another nurse present. Dispose of medication per hospital protocol.

After reviewing the skills for administering different medications, a student nurse demonstrates the need for additional review when she does takes which action?

Leaves before verifying that the client has swallowed the medication.

The nurse enters the client's room to administer oral medications. Which action would the nurse take first?

Perform hand hygiene.

When pouring a liquid medication into a graduated liquid medication cup, which nursing action would be most appropriate?

Place the cup on a flat surface at eye level.

The nurse is administering routine medications to a postsurgical client and the client asks, "Could I have something for pain?" The nurse checks the medication administration record (MAR) and notes that the medication is an opioid. What should the nurse do?

Place the opioid into a separate cup.

The nurse is teaching the client how to correctly use a metered-dose inhaler with a spacer. The prescription is for two puffs of the medication. Which client action displays understanding of the education?

Placing the mouthpiece of the inhaler in the mouth

The nurse is preparing to administer a transdermal medication. Which placement is appropriate?

Posteriorly on the shoulder.

The nurse is distributing afternoon medications to the clients. When removing a tablet from a multi-dose bottle, what should the nurse do first?

Pour the tablet into the bottle cap.

A nurse has administered a pain medication to the client. What should the nurse do next?

Reassess the client.

The nurse is preparing to apply a new transdermal patch to a client's chest. What would the nurse do first?

Remove the old patch from the client's skin.

After administering an inhaled medication via a small-volume nebulizer, which action should the nurse have the client do?

Rinse and gargle with tap water.

After administering an inhaled medication via a metered-dose inhaler, the nurse asks the client to take which action?

Rinse and gargle with water.

The nurse is caring for a client with a gastrointestinal bleed who has a nasogastric (NG) tube. After administering the medications via the NG tube, what would the nurse do next?

Shut off nasogastric tube for 30 minutes.

The nurse is inserting a medication via a rectal suppository to a client. What would the nurse instruct the client to do?

Take slow, deep breaths.

A nurse is distributing the 0900 medications to the client. What should the nurse do when removing a tablet from a multi-dose bottle? Select all that apply.

Take the multi-dose bottle into the client's room. Put an extra tablet back into the bottle from cap. Use gloves for extra protection.

The nurse administers a dry powder inhaler to a client. The client takes this medication at home. What action does the nurse take?

Teach the client how to use the inhaler using step-by-step instructions.

The nurse has instructed the client in the use of a metered-dose inhaler. Which instruction should the nurse include in the client education?

Teach the client to push the top of the medication canister while taking a deep breath.

The nurse is preparing to administer medications to a client with a gastric tube. What equipment will the nurse gather to administer medications to the client? Select all that apply.

Waterproof pad Irrigation set Gloves Tap water

The nurse is preparing to administer medications to a client with a gastric tube. What information should the nurse check before administering any medication through the gastric tube? Select all that apply .

Whether tube feedings should be held; Client's allergies; If medication should be given on full or empty stomach

The nurse is administering eye drops to a client. Where should the nurse place the drops?

lower conjunctival sac