PrepU Chapter 21: Medication Administration

The nurse is teaching a client how to take medications upon discharge. The client is alert and oriented but unable to articulate the teaching back to the nurse. What is the appropriate nursing action?

give written instructions to the client and caregivers

The nurse transcribes an order that reads: Colace 100 mg PO daily. This is an example of which type of order?

standing order

A code is called and Nurse A hands several drugs to Nurse B, stating while rushing off, "Give these to my client while I help with the code." What is Nurse B's appropriate response?

state, "I cannot give medications for other nurses."

A nurse needs to administer an intradermal tuberculin skin test injection to a client. What is the most suitable angle when administering an intradermal injection?

10-degree angle

The nurse is preparing to administer insulin to an obese client. At what angle will the nurse plan to insert the needle into the client?

90 degrees

A nurse is caring for a client who has been prescribed codeine, an opioid medication to relieve severe postoperative pain. Which responsibility does the nurse have to complete when handling opioid medications? Select all that apply.

Maintain an accurate account of the use of the medication. Record each medication used from the stock supply. Count each opioid medication at the change of each shift.

What type of prescription would the health care provider most likely write to treat a client whose pain levels vary widely throughout the day?

PRN

A nurse needs to administer a subcutaneous heparin injection to a client. Which injection site is most suitable for heparin?

abdomen

A client who is taking an oral opioid for pain relief tells the nurse he is constipated. What is this common response to opioids called?

adverse effect

The nurse is caring for a client with pneumonia who requires administration of medications. When does the nurse document administration in the medication administration record (MAR)?

after completion of administration of each drug

A nurse should read the instructions stated on a vial container before reconstituting it and administering it to a client. Which instructions are stated on the label of a vial container?

amount of diluent to be added

A nurse is caring for a client in the nursing unit when the physician, during the rounds, prescribes a medication for the client. What appropriate action should the nurse take to ensure the accuracy of the verbal medication order?

ask the physician to write out the order

A nurse is administering a hepatitis B shot intramuscularly. What would be the appropriate site for administration?

deltoid

A nurse is preparing a prescribed dosage of a steroid inhalant medication for a client with asthma. Which action should the nurse take after administering the medication?

instruct the client to rinse mouth following inhalation

A client is ordered to receive an intramuscular injection of medication. When preparing to administer the injection, the nurse selects the ventrogluteal site based on which reason?

the area is free of major blood vessels and fat

A nurse is preparing to draw up two prescribed medications into one syringe. The medications are contained in vial A and vial B. Which would be important for the nurse to do first?

Check to ensure that the two medications are compatible

A nurse is bunching the tissue of a client when administering a subcutaneous injection to that client. What is the reason for bunching when injecting subcutaneously?

to avoid instilling medication within the muscle

The nurse is preparing supplies for a tuberculosis screening. The nurse should choose which syringes and needles?

1 mL syringe; ½-inch (1.25-cm), 26-gauge needle

The nurse is teaching an older adult client with rheumatoid arthritis about taking medications at home. Which client statement does the nurse determine is unsafe and requires further nursing intervention?

"I take my child's anxiety medication occasionally, when I get very anxious about something."

What would a nurse instruct a client to do after administration of a sublingual medication?

"Try not to swallow while the pill dissolves."

An adult with diabetes receives 20 units of insulin each morning and evening. How will the nurse teach the client to administer the insulin?

"Use an insulin syringe and give 20 units."

The nurse is to administer levothyroxine 0.125 mg PO at 0600. The package is labeled levothyroxine 125 mcg. Calculate the number of tablets the nurse will administer. Record your answer as a whole number.

1

A nurse is administering a subcutaneous injection to a client. What is the common maximum volume of a subcutaneous injection?

1 mL

The nurse has a prescription to administer 25 mg of furosemide IV to a client. The drug is supplied in a vial 40 mg/4 ml. How many milliliters will the nurse administer of the medication? Record your answer using one decimal place.

2.5

The health care provider prescribes ciprofloxacin 500 mg PO q12h for a pediatric client with bronchial pneumonia. The nurse has liquid ciprofloxacin 250 mg/10 mL on hand. How many milliliters would the nurse dispense? Record your answer using a whole number.

20

The nurse observes a prescription written for a client for a medication that does not correlate with the client's diagnosis or comorbid factors. What is the best action for the nurse to take?

Call the provider to obtain a rationale for the use of the medication for the client

The nurse manager is reviewing medication order protocols with staff nurses. Which teaching will the nurse include? Select all that apply.

Refrain from using abbreviations. Be mindful of look-alike and sound-alike drugs. Nurses and health care providers are accountable for drug safety.

The nurse is preparing to administer a medication via a nasogastric tube. Which guideline is appropriate for the nurse to follow when administering a drug via this route?

flush the tube with water between each drug administered

The nurse is administering medications for the client with the assigned medication administration record (MAR). It is 0845 on Tuesday. Which medication(s) will the nurse administer? Select all that apply.

furosemide atenolol pantoprazole

A nurse is providing care for a client who has a history of dementia. Which method should the nurse use in order to determine the client's identity prior to medication administration?

check the client's identification band

Which assessment should be conducted by the nurse before the nurse administers tuberculin intradermal injection?

checking for documented allergies to food or drugs

When educating an older adult client about the administration of medication during discharge, the nurse notes that the client is having difficulty comprehending the instructions. What intervention should the nurse follow in this case to ensure the client's safety?

involve a second responsible person in the instructions

A nurse is explaining to a client the correct method of using a metered-dose inhaler when self-administering a prescribed dose of medication. What is a feature of a metered-dose inhaler?

it is a canister that contains pressurized medication

The nurse is preparing to administer the second dose of ordered antibiotics to a client and notes that the first dose of medication is still in the automated medication-dispensing system. The medication administration record (MAR) does not show that the initial dose was given. What is the appropriate nursing action?

notify the health care provider

A nurse needs to withdraw a prescribed medication from an ampule and administer it to a client. Which action should the nurse perform to ensure that all the medication is equally distributed when withdrawing?

tap the top of the ampule before withdrawing the medicine

When the nurse administers the client's amlodipine, the client states that usually only one pill is taken instead of three pills. Which right of medication should now be triple checked before allowing the client to take the medication?

right dose

A client with dry skin has been prescribed inunction. What should the nurse do to promote absorption of the ointment?

rub the ointment into the skin

The nurse is preparing to administer a transdermal medication. How should this be accomplished?

the nurse should apply the medication directly to the skin

A client taking insulin has his levels adjusted to ensure that the concentration of drug in the blood serum produces the desired effect without causing toxicity. What is the term for this desired effect?

therapeutic range

A client with chronic obstructive pulmonary disease (COPD) has been prescribed an inhaled bronchodilator. Which technique should the nurse implement in order to ensure safe and complete delivery of the prescribed medication?

use a spacer or extender with the metered-dose inhaler

The nurse has drawn opioid pain medication into a syringe. When preparing to administer the medication, the client refuses, stating that pain is controlled currently at a level of 2 on a scale of 1 to 10. Which action should the nurse take to waste the medication?

waste the medication with another nurse witness present