Chapter 28 - NUR 240 Review Questions

A client is to take Demerol 35 mg IM. You have Demerol 50 mg per ml. How many ml will you administer? a) 0.7 ml b) 0.5 ml c) 0.9 ml d) 1.3 ml

0.7 ml The nurse will administer Demerol 35 mg or 0.7 ml.

What is the common maximum volume of an Intramuscular injection?

An intramuscular injection is the administration of up to 3 mL of medication into one muscle or muscle group.

A nurse is administering medications through an enteral tube to a client with swallowing difficulties due to a cerebrovascular accident (CVA). Which action should the nurse perform to prevent gastric reflux? a) Check for drug allergies in the client's history. b) Help the client into a Fowler's position. c) Administer the medication over several minutes. d) Add diluted medication to the syringe.

Help the client into a Fowler's position. Assuming Fowler's position can help prevent gastric reflux when medications are administered through an enteral tube. Adding diluted medication to the syringe as it becomes nearly empty prevents instilling air into the syringe. Administering the medication over several minutes has no effect on reflux.

A nurse instills eardrops into a client's ear to soften a wax buildup. What is a guideline the nurse should follow? a) The dropper should be held with its tip resting on the ear. b) Pull the pinna down and back for a child over 3 years of age, and straight back for an infant or a child younger than 3 years. c) If both ears are to be treated, wait 5 minutes before instilling drops in the second ear. d) Eardrops should not be considered if the ear canal has swollen to the point that medication cannot pass.

If both ears are to be treated, wait 5 minutes before instilling drops in the second ear. If both ears are to be treated, wait 5 minutes before instilling drops in the second ear. The pinna should be pulled straight back for a child over 3 years of age, and down and back for an infant or a child younger than 3 years. If the ear canal has swollen, a wick can be inserted into the ear canal to deliver the medicine. The dropper should be held in the ear with its tip above the auditory canal without touching the ear.

What is the common maximum volume of an Intradermal injection?

Intradermal injections are commonly used for diagnostic purposes in small volumes, usually 0.01 to 0.05 mL

To convert 0.8 grams to milligrams, the nurse should do which of the following? a) Move the decimal point 2 places to the right. b) Move the decimal point 3 places to the right. c) Move the decimal point 3 places to the left. d) Move the decimal point 2 places to the left.

Move the decimal point 3 places to the right.

When administering heparin subcutaneously, the nurse should: a) vigorously massage the site. b) never aspirate. c) aspirate after the injection. d) aspirate before the injection.

Never aspirate. When administering heparin subcutaneously, never aspirate before administration.

A client has an intermittent infusion device inserted for the administration of antibiotic therapy every 6 hours. The nurse would expect to flush the device at which frequency?

Peripheral intermittent lines are usually flushed with preservative-free 0.9% NaCl before and after each medication administration and every 8 hours when medications are not being given. Most agencies recommend changing intermittent devices every 72 hours to ensure patency and prevent common complications of IV therapy.

A client with an infection is receiving intravenous antibiotic therapy. The client has an intermittent infusion device in place. The nurse flushes the device with normal saline solution before administering the antibiotic based on which rationale?

Prevent Blood Clot Formation The intermittent infusion devices are irrigated or flushed with a small quantity of sterile saline to prevent blood clot formation, thus maintaining patency.

A client has been prescribed nasal medication. What care should the nurse take to avoid potential complications due to the administration of this medication? a) Review the client's medication, allergy, and medical history. b) Read and compare labels on the medication with the medical record. c) Allow sufficient time to prepare the medication with minimal distraction. d) Administer medication within 30 to 60 minutes of the scheduled time.

Review the client's medication, allergy, and medical history. Explanation: To avoid any potential complications, the nurse should review the client's medication, allergy, and medical history. The nurse should read and compare the label on the medication with the medical record at least 3 times

A nurse educator is teaching a student nurse how to choose the correct needle for an injection. Which guidelines for needle selection might they discuss?

The larger the gauge, the smaller the needle. The first number on a needle package is the gauge or diameter of the needle; the second number is the length in inches. When giving an injection, the viscosity of the medication directs the choice of gauge. The size of the syringe is directed by the amount of the medication to be given.

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

The volume of a subcutaneous injection is usually up to 1 mL.

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? a) Provide oxygen therapy 30 minutes prior to administration. b) Provide multiple puffs of the medication in rapid sequence. c) Use a spacer or extender with the metered-dose inhaler. d) Place the inhaler as deeply into the client's mouth as is comfortable.

Use a spacer or extender with the metered-dose inhaler. The use of an extender or spacer ensures that the client receives as much of the inhaled medication as possible. MDIs are placed 1 or 2 inches in front of the mouth, not deeply into the mouth. Oxygen therapy prior to administration does not aid in delivery. Multiple puffs, if ordered, are given after 1 to 5 minutes

An acute care facility follows the unit dose supply method to supply medication to the clients. What is meant by the unit dose supply method? a) systems that contain frequently used medication for that unit b) a container with enough prescribed medications for several days for a client c) self-contained packets that hold one tablet or capsule for individual clients d) a supply that remains on the nursing unit for use in emergency

self-contained packets that hold one tablet or capsule for individual clients

When instructing a client regarding sublingual application, the nurse should inform the client that which action is contraindicated when administering the drug? a) taking the medication on an empty stomach b) swallowing the medication c) talking when taking the medication d) performing physical activities

swallowing the medication When administering medication by sublingual application, the client should avoid swallowing or chewing the medication. Eating or smoking during administration is also contraindicated. Taking the medication on an empty stomach, talking, or performing physical activities may not be contraindicated when administering drugs sublingually

What would be considered a "right" of drug administration

• Right drug • Right documentation • Right dose • Right client

Which medication dosage is properly written? a) 00.125 mg b) .125 mcg c) .8 mg d) 0.25 mg

0.25 mg

A client with a central venous catheter develops a catheter-related bloodstream infection (CRBSI). The nurse understands that which route is the most common for causing this type of infection? a) irregularities in the catheter's material b) an infection in another part of the body traveling to the catheter tip c) catheter tip contamination due to skin organisms encountered during insertion d) contamination of the infusion solution being used

Catheter tip contamination due to skin organisms encountered during insertion There are four recognized routes for catheter contamination. The most common route of infection is colonization of the catheter tip due to migration of skin organisms from insertion site. Direct contamination of the catheter or catheter hub is also a contributing factor

What action should the nurse take when giving an intramuscular injection using the Z-track method? a) Inject the medication quickly, and steadily withdraw the needle. b) Do not massage the site because it may cause irritation. c) Apply pressure to the injection site. d) Use a needle at least 1 inch long.

Do not massage the site because it may cause irritation. The nurse should use the Z-track technique for intramuscular injections that are irritating to the subcutaneous tissues in order to prevent leakage of medication into the needle track, thus minimizing discomfort.

A client at a health care facility has been prescribed scopolamine, to be administered transdermally. Which statement describes transdermal application? a) drugs placed under the tongue and allowed to dissolve slowly b) drugs bonded to an adhesive and applied to the skin c) drugs within a thick base applied, not rubbed, into the skin d) drugs placed against the mucous membrane of the inner cheek

Drugs bonded to an adhesive and applied to the skin Transdermal applications are drugs that are bonded to an adhesive and applied to the skin. After application, the drug migrates through the skin and eventually is absorbed into the bloodstream. Pastes are drugs within a thick base that are applied, but not rubbed, into the skin. Sublingual applications are drugs that are placed under the tongue and left to dissolve slowly. Buccal applications are drugs that are placed against the mucous membrane of the inner cheek.

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? a) It is a battery-operated device that spins. b) It suspends finely powdered medication. c) It has propellers that get activated during inhalation. d) It is a canister that contains pressurized medication.

It is a canister that contains pressurized medication. A meter-dose inhaler has a canister that contains medication under pressure. It is much more commonly used than the turbo-inhaler, which is a propeller-driven device that spins and suspends a finely powdered medication.

A nurse preparing medication for a client is called away to an emergency. What should the nurse do?

Lock the medications in a cart and finish them upon return. Once medications have been prepared the nurse must either stay with the medications or lock them in an area such as the medication cart. The medications should never be left unattended or placed back in their containers. Another nurse cannot administer medications that have been prepared by the first nurse.

The nurse is providing care to a client who has a Groshong catheter inserted. When irrigating the catheter, the nurse would use which solution? a) Diluted heparin b) Sterile water c) 5% dextrose d) Normal saline

Normal saline Catheter patency is usually maintained by periodically flushing the catheter with diluted heparin. However, because of its unique design, the Groshong catheter requires irrigation with normal saline rather than heparin.

A nurse brings a client the prescribed dose of medication and finds that the client is not in the unit. What should the nurse do in this case? a) Inform the head nurse about the client's absence. b) Inform the physician about the client's absence. c) Leave the medication on the client's bedside table. d) Return the medication to the medication cart or medication room.

Return the medication to the medication cart or medication room.

The nurse is caring for a client who has problems coordinating his breathing with the inhaler use. Therefore, the client is unable to receive the full dose. Which would help maximize drug absorption in this client? a) Spacer b) Nasal drops c) Metered-dose inhaler d) Turbo-inhaler

Spacer A spacer would help maximize the absorption of the drug in a client who is having problems coordinating his breathing with the inhaler use. A spacer provides a reservoir for the aerosol medication. As the client takes additional breaths, he continues to inhale the medication held in the reservoir. This tends to maximize the drug's absorption because it prevents drug loss.

The primary reason for the Controlled Substances Act is: a) to prevent overuse of antibiotics. b) to regulate the purchase of antibiotics. c) to regulate the purchase of narcotics. d) to prevent drug abuse.

To prevent drug abuse. The primary reason for the Controlled Substances Act is to prevent drug abuse and dependence, provide treatment and rehabilitation for people who are dependent on drugs, and strengthen drug abuse laws

A nurse is using the Z-track technique to administer an injection to a client. Which injection route utilizes the Z-track technique?

When administering intramuscular injections, nurses may administer drugs that may be irritating to the upper levels of tissue by the Z-track technique.

At what angle would you give a(an): Intradermal Injection Subcutaneous Injection Intramuscular Injection Intravenous Injection

When giving an intradermal injection, the nurse instills the medication shallowly at a 10- to 15-degree angle of entry. When the nurse administers a subcutaneous injection, the angle of entry is either 45 degrees or 90 degrees, whereas for intramuscular injections, the angle is 90 degrees. Intravenous injections are instilled into the veins of the client at an angle of around 15 degrees, but only if no venous access port is in place.

A nurse needs to administer a subcutaneous injection to a client. Which techniques should the nurse use to reduce discomfort?

• Support the client's tissue when withdrawing the needle. • Numb the skin with an ice pack before the injection. • Insert and withdraw the needle without hesitation. • Instill the medication slowly but steadily.