Prep U medication

Which parts of the syringe and needle must be kept sterile when preparing and administering an injection? Select all that apply. The needle hub The needle The outside of the cap Inside the barrel The outside of the barrel

The needle hub The needle Inside the barrel

When administering heparin subcutaneously, the nurse should: never aspirate. aspirate before the injection. gently massage the site. aspirate after the injection.

never aspirate.

The nurse has begun caring for a surgical client who has been prescribed preoperative antibiotics prior to bowel surgery. While the nurse will adhere to all the principles of safe medication administration, which of the rights of administration will the nurse pay special attention to in this situation? route dose client time

time

What is the best explanation from the nurse as to why a client must return to the unit in 48 hours after having a tuberculin skin test intradermal? to determine the extent to which the client responded to the drugs to prevent interfering with test results to administer timely emergency treatment to implement measures to reduce the transmission of microorganisms

to determine the extent to which the client responded to the drugs

The primary reason for the Controlled Substances Act is: to regulate the purchase of opioids. to prevent overuse of antibiotics. to prevent drug use and dependence. to regulate the purchase of antibiotics.

to prevent drug use and dependence.

The nurse is caring for a confused client who requires a transdermal patch application. Which location will the nurse choose to apply the patch? upper arm side of buttock lower abdomen upper back

upper back

During a visit to the clinic, the health care provider prescribes an intramuscular injection of a medication for an 8-month-old. At which site should the nurse administer the medication to the infant? dorsogluteal vastus lateralis deltoid ventrogluteal

vastus lateralis

A nurse needs to administer a prescribed injection to a toddler. Which injection site is most suitable for the client? deltoid site vastus lateralis site dorsogluteal site ventrogluteal site

vastus lateralis site

Which instruction should the nurse give to a client to ensure that a nasal medication is deposited within the nose rather than into the throat? "Place a rolled towel beneath the neck if you are unable to sit." "Breathe through your mouth as the drops are instilled." "Aim the tip of the container toward the nasal passage." "Remain in the sitting position for 5 minutes."

"Aim the tip of the container toward the nasal passage."

The nurse is caring for a client who is receiving a prescribed intravenous (IV) infusion of an antibiotic to treat an infection. The client asks the nurse, "Can I just take a pill?" What is the best response by the nurse? "Oral antibiotics are not as effective as IV infusions." "The IV infusion will treat your infection slower." "An IV infusion maintains a therapeutic level of the medication in your blood." "The health care provider can control the dose of medication you receive through IV."

"An IV infusion maintains a therapeutic level of the medication in your blood."

A client is taking numerous eye drops to prepare for cataract surgery. Which teaching about ophthalmic application will the nurse provide? "Rest the eye dropper on the inner canthus to make it easier to instill the drops." "If you cannot instill these drops from the bottle, you will be unable to have surgery." "Wait 5 minutes between instillation of different types of eye drops." "Dispose of these medications every 7 days due to possible bacterial contamination."

"Wait 5 minutes between instillation of different types of eye drops."

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? 45 degrees 90 degrees 20 to 30 degrees 10 to15 degrees

90 degrees

It is particularly important for the nurse to use this technique when administering intramuscular (IM) medication to which client? A 70-year-old demonstrating muscle wasting prescribed chlorpromazine A 40-year-old client diagnosed with breast cancer prescribed fulvestrant A 30-year-old client diagnosed with Tourette syndrome prescribed haloperidol A 50-year-old client demonstrating delirium tremors prescribed lorazepam

A 70-year-old demonstrating muscle wasting prescribed chlorpromazine

A nurse at the health care facility needs to administer an otic application for a client with an earache. What should the nurse do after instilling the prescribed eardrops in the client's ear? Clean the external ear of drainage with cotton balls moistened with water or normal saline solution. Immediately repeat the application in the second ear if prescribed. Ask the client to remain lying down for at least 5 minutes. Straighten the auditory canal by pulling the cartilaginous portion of the pinna up and back.

Ask the client to remain lying down for at least 5 minutes.

A young woman has an IV infusing for magnesium sulfate to treat preterm labor. The woman develops a fever. What is the first assessment the nurse should make? Assess the IV site for redness. Monitor the IV infusion rate. Assess the vaginal mucosa. Assess the client's blood pressure.

Assess the IV site for redness.

A nurse gives a client 0.25 mg of digoxin instead of the prescribed dose of 0.125 mg. What should the nurse do next? Hold the next dose to make sure the total amount balances. Give another 0.125 mg as soon as possible. Nothing; the dose will not make a significant difference. Assess the client and notify the client's health care provider.

Assess the client and notify the client's health care provider.

A nurse needs to administer a prescribed dosage of oral medication to a client with influenza. Which action should the nurse perform when administering oral medication to the client? Check the label of the medication container three times at the bedside. Bring the prescribed medication in a ceramic cup or glass container. Avoid administering medication prepared by another nurse. Prepare the exact dosage of medication in front of the client.

Avoid administering medication prepared by another nurse.

A nurse is caring for a client who is being tube fed. What care should the nurse take when administering medications through an enteral tube? Mix all the medications together in 15 mL of water. Add medications to the formula. Use cold water when mixing powdered medications. Avoid crushing sustained-release pellets.

Avoid crushing sustained-release pellets.

After inserting an intravenous catheter into a client's vein, the nurse does not obtain blood return. What is the appropriate nursing action? Begin infusion of IV fluids and document the procedure. Obtain a larger bore catheter. Change the catheter insertion site. Gently insert the IV catheter further into the vein.

Change the catheter insertion site.

The nurse is preparing to administer a liquid form of medication to a client. What action will the nurse take to ensure that administration of the drug is at the desired potency? Prepare the medication with good lighting. Determine if there is an odor from the medication. Check the expiration date. Return the medication if the label is unclear.

Check the expiration date.

An oral medication has been ordered for a client who has a nasogastric tube in place. Which nursing activity would increase the safety of medication administration? Flush the tube with 30 to 40 mL saline before medication administration. Check the tube placement before administration. Have the client swallow the pills around the tube. Bring the liquids to room temperature before administration.

Check the tube placement before administration.

The nurse reviews the following prescription in the client's record: "Morphine sulfate 3 mg every 4 hours as needed for postoperative pain." Which action by the nurse is correct? Clarify the prescription with the health care prescriber. Draw the dose up using a 3-ml syringe. Re-enter the prescription using a "trailing 0." Administer morphine sulfate as prescribed for postoperative pain.

Clarify the prescription with the health care prescriber.

The nurse is administering a subcutaneous injection of insulin to a client. Which action would the nurse take after choosing the appropriate administration site? Pinch up the subcutaneous tissue Cleanse the area around the injection site with alcohol. Use a firm, back and forth motion to cleanse the site. Remove the needle cap with the dominant hand, pulling it straight off.

Cleanse the area around the injection site with alcohol.

The nurse is preparing to administer two IV medications. What is the appropriate nursing action? Administer the drugs through the same tubing. Consult a current drug reference book for IV compatibility. Hold one medication for an hour and administer it after the first medication. Prepare to administer through two separate tubes.

Consult a current drug reference book for IV compatibility.

The nurse is caring for a client who has had a cerebrovascular accident. Prior to administering oral medications, what is the nurse's appropriate action? Consult with a speech therapist for dysphagia. Mix medications in applesauce or pudding. Convert orders for oral medications to intravenous or intramuscular. Give the client water to drink.

Consult with a speech therapist for dysphagia.

A nurse who is administering an injection to a client has an accidental needlestick injury after withdrawing the needle from the client's tissue. Which action(s) will the nurse take? Select all that apply. Document the injury per agency protocol in a timely manner. Seek a medical assessment and follow up as needed. Perform hand hygiene per agency protocol. Ask the client if he or she is diagnosed with any bloodborne diseases. Report the injury to a supervisor immediately.

Document the injury per agency protocol in a timely manner. Seek a medical assessment and follow up as needed. Perform hand hygiene per agency protocol. Report the injury to a supervisor immediately.

In which order should the nurse instruct the client to follow when inserting vaginal medication?

Empty your bladder just before inserting the medication .Lubricate the applicator tip with water-soluble lubricant. Lie down, bend your knees, and spread your legs. Separate the labia and insert the applicator into the vagina, and insert the medication. Remain recumbent for at least 30 minutes. Wash and store the reusable applicator properly.

The nurse has given a client an injection. How will the nurse prevent an accidental needle stick? Immediately activate the safety needle and remove the needle from the syringe. Place the needle in the Sharps container and the syringe in the trash. Immediately activate the safety needle and have a colleague hold the Sharps container within reach for disposing of the syringe and needle. Immediately activate the safety needle and hold it close to the body until disposing it into the Sharps container. Immediately activate the safety needle and place the syringe and needle into a Sharps container.

Immediately activate the safety needle and place the syringe and needle into a Sharps container. - The nurse will immediately activate the safety needle and place the syringe and needle into a Sharps container. Removing the needle from the syringe or holding it close to the body puts the nurse at risk for a needle stick. Safety needles are not failproof. Thus, having a colleague hold the Sharps container puts the colleague at risk if the safety needle falls and the nurse misses the opening of the container.

The nurse is preparing to administer prescribed intravenous antibiotics to a client. While assessing the medication lock, the nurse notes that there is resistance when administering the saline flush solution. What would be the best action by the nurse? Flush the lock with heparin solution. Call the health care provider to request oral antibiotics. Insert a new IV medication lock and remove the old one. Administer the prescribed antibiotics as prescribed.

Insert a new IV medication lock and remove the old one.

Which parenteral route of administration has the longest absorption time? Intravenous Intradermal Intramuscular Subcutaneous

Intradermal

A nurse is administering an injection to a client at a 15-degree angle. The client has a venous access port. Which injection can be administered at this angle? subcutaneous intradermal intramuscular intravenous

intradermal

A nurse is using an 18-gauge needle to administer medication to a client. The nurse knows that, when compared with a 27-gauge needle, an 18-gauge needle has which feature? shorter length smaller diameter larger diameter greater length

larger diameter

The nurse is caring for a client who is taking nitroglycerin. Which client statement requires immediate nursing intervention? "I understand that this drug may lower my blood pressure." "I will apply this as frequently as prescribed." "I am taking tadalafil in addition to nitroglycerin." "I will wear gloves when applying this."

"I am taking tadalafil in addition to nitroglycerin." -Clients taking nitroglycerin in any form should not take drugs or herbs for erectile dysfunction. This may cause severe hypotension due to the combined vasodilation effect. Other client statements are appropriate and do not require further nursing teaching.

A client with gastritis who is taking aspirin for cardiovascular prophylaxis asks the nurse whether there is benefit in buying the enteric-coated product. What is the appropriate nursing response? "That is the only way that aspirin is sold." "Enteric coated products are significantly more expensive." "The enteric coating will protect your stomach." "There is no difference between the enteric-coated product and the regular one."

"The enteric coating will protect your stomach."

An older adult client has been prescribed a transdermal patch. Which client statement demonstrates the need for further teaching by the nurse? "I will remove the patch before I have my MRI tomorrow." "This medication is likely to work slower on me than on a younger person." "When changing patches, I will change the location of application." "I will close the adhesive edges of the patch before I dispose of it."

"This medication is likely to work slower on me than on a younger person."

The nurse is preparing to insert a short intravenous catheter in a 1-year-old child for a one-time administration of fluids due to dehydration. Which needle would the nurse likely select? 18-gauge intravenous catheter 23-gauge winged infusion set 22-gauge intravenous catheter 19-gauge winged infusion set

23-gauge winged infusion set

The client is prescribed ear drops to be given in both ears. After administering the ear drops in one ear, how long would the nurse wait before administering the ear drops in the other ear? 15 minutes 20 minutes 10 minutes 5 minutes

5 minutes - When ear drops are to be administered in both ears, the nurse would wait 5 minutes after giving the ear drops in the first ear before administering the ear drops into the second ear. This avoids causing the medication to run out immediately after administration. Other times are longer than are needed between ears.

The nurse is preparing to give medications to a client with anxiety. The order indicates that the client is to have bupropion, 7.5 mg by mouth twice daily. What is the appropriate nursing action? Ask another nurse to verify the order. Assume that the provider meant to order buspirone. Administer the drug as ordered. Contact the health care provider for order clarification.

Contact the health care provider for order clarification. - The nurse should contact the health care provider to verify the order. Bupropion and buspirone are drugs that have look-alike and sound-alike properties but are different in indication. The nurse should not automatically administer the drug, nor ask another nurse to verify an order, nor assume what is meant by an order.

A nurse is administering a hepatitis B shot intramuscularly. What would be the appropriate site for administration? Scapula Ventrogluteal Deltoid Vastus lateralis

Deltoid

A nurse is administering an adult client's ordered antipsychotic drug intramuscularly. What would be the most appropriate site for administration? Biceps brachii Deltoid Scapula Vastus lateralis

Deltoid - The deltoid and ventrogluteal sites are more appropriate for adults than the vastus lateralis. The scapula is a site for an intradermal injection. The biceps brachii muscle is not used for intramuscular injections.

The nurse is preparing to administer two types of insulin by mixing in one syringe. What is the first action by the nurse? Roll the modified insulin vial to mix it well. Inject air into each vial equal to the amount of insulin prescribed. Determine compatibility of the insulins by checking a drug compatibility table. Check the expiration date on each vial.

Determine compatibility of the insulins by checking a drug compatibility table.

An emergency room nurse is ordered to administer nitroglycerin to a client being treated for acute pulmonary hypertension. Which means of drug administration would the nurse use to achieve rapid results in this emergency situation? Inhalation IV Infusion Subcutaneous injection Oral powder

IV Infusion - Intravenous infusion is the fastest route of administration because the medication goes into the bloodstream immediately and is dispensed over a period of time which is needed in pulmonary hypertension. The second fastest route is an injection because they are quickly absorbed into vessels. Oral medication is a slow route and should not be used in an emergency situation. Medication via patches would not administer the medication quickly enough in an emergency situation. Inhalation medications are specifically given for respiratory issues.

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. It has propellers that get activated during inhalation. It is a battery-operated device that spins. It suspends finely powdered medication.

It is a canister that contains pressurized medication.

The adult child of a client with insulin-dependent diabetes will be responsible for administering the parent's medications when the client is discharged tomorrow. Which information does the nurse teach the client's child about administering the insulin? Select all that apply. Keep insulin refrigerated until the vial is opened Draw up the number of insulin units prescribed Roll insulin bottle between hands before inserting syringe Inject insulin into muscle of upper arm Inject the same number of units of air as the insulin dose into insulin bottle

Keep insulin refrigerated until the vial is opened Roll insulin bottle between hands before inserting syringe Draw up the number of insulin units prescribed Inject the same number of units of air as the insulin dose into insulin bottle

A client who has been prescribed an inhaler points to the spacer and asks, "What is this for?" What is the appropriate nursing response?

Medication stays in the chamber so you can continue to inhale it. - A spacer provides a reservoir for aerosol medication. The client can take additional breaths (after the initial breath) to continue inhaling the medication held in the reservoir. The spacer does not decrease the amount of medication received, make the medication move faster, or serve as a holding device.

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

Move the decimal point 3 places to the right.

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? Proceed with the administration of the second dose. Notify the health care provider. Give the first and second doses of antibiotics. Call the pharmacy before notifying anyone else.

Notify the health care provider.

The client reports dry mouth following chemotherapy treatments. The nurse is administering oral medications to the client. What action will the nurse perform to aid the client in taking medications? Offer a sip of water prior to the administration of the medication. Crush the pills and mix the pills in applesauce. Instruct the client to chew the pills before swallowing. Have the client gargle with an alcohol-based mouthwash.

Offer a sip of water prior to the administration of the medication.

A nurse is taking care of a client who requests acetaminophen to help with a headache. The nurse checks to see if there is an order for acetaminophen and notices that the client is able to have 650 mg every 4 hours as needed for pain. What type of order is this considered? standing order PRN order one-time order stat order

PRN order - A PRN order is one that is given to a client on an "as needed" basis.

Which nursing action(s) promotes safety in the preparation of medication? Select all that apply. Prepare medications in well-lit conditions. Note the expiration dates on liquid medications. Return medications with obscured labels to the pharmacy. Take verbal prescriptions for medications whenever possible. Ensure a second nurse cosigns all medications.

Prepare medications in well-lit conditions. Note the expiration dates on liquid medications. Return medications with obscured labels to the pharmacy.

The nurse plans discharge teaching for a client leaving the medical center with new medication prescriptions. Which action(s) does the nurse include in the discharge teaching? Select all that apply. Provide client with a list of medications and directions for taking them Explain the benefit in placing medications in a place that links to normal events in the client's life such as brushing teeth or going to bed Confirm that the client understands the reason for the medications Tell client to always choose brand name over-the-counter medications to ensure consistency in color, shape, and size of pills Teach client and caregivers how to fill a pill box using the medicine list as a guide

Provide client with a list of medications and directions for taking them Explain the benefit in placing medications in a place that links to normal events in the client's life such as brushing teeth or going to bed Confirm that the client understands the reason for the medications Teach client and caregivers how to fill a pill box using the medicine list as a guide

The nurse is preparing to administer an intramuscular (IM) injection into a client. Which procedure should the nurse use to administer the injection? Pull the skin taut between two fingers while injecting. Pull skin and subcutaneous tissue 1 to 1.5 in (2.5 to 3.75 cm) to one side of the injection site while injecting. Insert the needle until the entire bevel lies immediately under the skin while injecting. Pinch the skin up between two fingers while injecting.

Pull skin and subcutaneous tissue 1 to 1.5 in (2.5 to 3.75 cm) to one side of the injection site while injecting.

The nurse administers the client's scheduled morning medications. The previous dose of antihypertensive was held due to a blood pressure that was too low according the health care provider's parameters. What does the nurse do with this upcoming dose of scheduled unit-dose packaged antihypertensive medication? Ask the client to report any dizziness and lightheadedness. Teach the client to use the call bell whenever getting out of bed. Set the antihypertensive dose aside pending assessment. Place the dose in the medication cup with other medications.

Set the antihypertensive dose aside pending assessment.

A health care provider who just arrived on the unit gives a verbal order to the nurse regarding a nonemergent client situation. What is the nurse's appropriate response? Refuse to implement the order and notify the nurse manager. Have another nurse witness and record the order into the medication administration record (MAR). Input the order into the computerized provider order system. Tactfully request the provider to input the order into the computerized provider order system.

Tactfully request the provider to input the order into the computerized provider order system. - Providers are to enter their own orders when they are physically present. It is appropriate for the nurse to tactfully request that the provider do so. The nurse should not input the order, nor refuse to implement it.

The nurse correlates the metric system as the most accurate method utilized to administer medications for which reason? It uses a system based on household measurements which are easily understood and measured It prevents errors by never using leading zeros for doses less than one measurement unit It ensures accuracy by expressing quantities in fractions and Arabic numbers The dosage prescriptions of medications most often use this system as it is measured in 10s and can be easily converted between measurements

The dosage prescriptions of medications most often use this system as it is measured in 10s and can be easily converted between measurements

The nurse is preparing to administer a transdermal medication. How should this be accomplished? The nurse should inject the medication just below the dermis of the skin. The nurse should inject the medication into a body cavity. The nurse should ask the client to swallow the medication. The nurse should apply the medication directly to the skin.

The nurse should apply the medication directly to the skin.

A health care provider at a health care facility suggests the use of a metered-dose inhaler for an asthmatic client. Which describes the mechanism of a metered-dose inhaler? a device that forces liquid drug through a narrow channel using pressurized air a canister containing medication that is released when the container is compressed a propeller-driven device that spins and suspends a finely powdered medication a device that forces medication through a narrow channel with the help of inert gas

a canister containing medication that is released when the container is compressed

To which client would the nurse be most likely to administer a PRN medication? a client who requires daily medication to control hypertension a client who is experiencing severe and unprecedented chest pain a client who is reporting pain near the surgical site a client whose asthma is treated with inhaled corticosteroids

a client who is reporting pain near the surgical site - A report of "breakthrough" pain, especially postsurgery, would likely require the nurse to administer a PRN analgesic. A new onset of chest pain would likely require a stat order, while longstanding treatment of hypertension and asthma would likely include standing orders for relevant medications.

A nurse needs to administer a prescribed medication to a client using IV push. In which way is the medication being administered to the client? gravity infusion electronic infusion device bolus administration continuous drip

bolus administration - A bolus is a relatively large amount of medication given all at once; bolus administration sometimes is described as a drug given by IV push, or rapid intravenous administration. A continuous infusion, also called continuous drip, is instillation of a parenteral drug over several hours. It involves adding medication to a large volume of IV solution. After the medication is added, the solution is administered by gravity infusion or, more commonly, with an electronic infusion device such as a controller or pump.

A client with chronic obstructive pulmonary disease has been prescribed a bronchodilator to be administered by small-volume nebulizer. The nurse should ensure that the client: coughs intermittently while the medication is being administered. takes rapid, shallow breaths until the medication is complete. rinses his or her mouth with water before the medication is administered. breathes through his or her mouth until all the medication has been inhaled.

breathes through his or her mouth until all the medication has been inhaled.

Which client does the nurse recognize will require an intramuscular administration of the medication instead of an intravenous administration? client who is low risk for hemorrhage and prescribed the Hepatitis B vaccination client who is diagnosed as having sepsis and is prescribed antibiotic therapy client who is beginning treatment with chemotherapy following a diagnosis of ovarian cancer client who is in the emergent phase of a 50% partial-thickness (second-degree) burn and requiring medication for pain

client who is low risk for hemorrhage and prescribed the Hepatitis B vaccination

The nurse is preparing to administer a medication to a client when the client states, "Last time I took that medication, I broke out in hives." What is the priority action by the nurse? a. Substitute another medication with the same action b. Administer the medication and monitor the client for 30 minutes after administration c. Administer the medication, the reaction may not occur again d. Withhold the medication and notify the health care provider that ordered the medication

d. Withhold the medication and notify the health care provider that ordered the medication - Whenever a client reports being allergic to a medication, the nurse should withhold the medication and notify the provider so that something else may be ordered. The medication should never be administered due to the risk of a potential anaphylactic reaction. The nurse may not substitute any medication without a providers order.

The nurse is providing teaching to an older adult with arthritis and an implanted catheter. What living arrangement does the nurse anticipate in the discharge plan of care? continued inpatient admission assisted living arrangement long-term care facility admission home nursing visits

home nursing visits

A nurse is preparing to administer several prescribed medications to a client. The medications ordered are to be given by the following routes: oral, subcutaneous, intramuscular and intravenous. Place the routes in the proper order from slowest to fastest absorption.

oral, sub q, intramuscular, iv

The client cannot swallow and just had an enteral tube placed for feeding and medications. Medications will have to be in liquid form or crushed for administration. The client has the following medications prescribed. Which medication will the nurse withhold and consult with the health care provider? furosemide liquid oxycodone extended release tablet aspirin chewable tablet acetaminophen tablet

oxycodone extended release tablet

The nurse is caring for a client who has normal saline infusing through a peripheral intravenous catheter with a prescription for a secondary infusion of antibiotic. Which technique would be most appropriate for the nurse to administer the secondary infusion by gravity? stopping the primary solution until the secondary infusion is completed placing the secondary infusion higher than the primary solution placing the primary solution higher than the secondary solution placing the secondary and primary infusion at equal height

placing the secondary infusion higher than the primary solution

A client has been prescribed nasal medication. What care should the nurse take to avoid potential complications due to the administration of this medication? review the client's medication, allergy, and medical history read and compare labels on the medication with the medical record allow sufficient time to prepare the medication with minimal distraction administer medication within 30 to 60 minutes of the scheduled time

review the client's medication, allergy, and medical history

What would be considered a "right" of drug administration? Select all that apply. right client right drug right documentation right dose right class

right client right drug right documentation right dose