prepU 30
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 The nurse converts mg to mcg. 0.125 mg is equal to 125 mcg. The nurse will administer 1 tablet. Desired dose is 125 mcg. Dose on hand or supplied dose is 125 mcg. Quantity is 1 tablet. 125mcg/125mcg * 1 tablet = 1 tablet
The nurse is administering morphine oral solution 5 mg to a client requesting medication for pain. The preparation is delivered as morphine solution 10 mg/5 ml. Calculate the amount, in milliliters, the will nurse administer. Record your answer to one decimal place.
2.5 The desired dose is 5 mg. The dose on hand or supplied dose is 10 mg. Quantitiy is 5 ml. The nurse would administer 2.5 ml. 5 mg/10 mg × 5 ml = 2.5 ml
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? a. Check the expiration date. b. Determine if there is an odor from the medication. c. Prepare the medication with good lighting. d. Return the medication if the label is unclear.
a. Check the expiration date. Checking the expiration date on liquid medication can ensure the medication is at the desired potency, because liquid medications may become stronger or weaker with the passing of time. Administering an expired medication could have a deleterious effect on the client. Determining an odor does not ensure the potency of the medication, because many liquid medications have an odor that is not pleasant. Returning the medication if the label is unclear is a step to take to ensure safe administration, but this action does not determine the potency of the medication.
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? a. Check the tube placement before administration. b. Bring the liquids to room temperature before administration. c. Have the client swallow the pills around the tube. d. Flush the tube with 30 to 40 mL saline before medication administration.
a. Check the tube placement before administration. The nurse must first verify that the tube is in place and not in the lungs prior to administering the medication. Next, the nurse can bring the liquids to room temperature. Typically the tube is flushed with 15 to 30 mL of water for adults (5 to 10 mL for children). The nurse should never have the client swallow the pills if the client has an nasogastric tube.
A nurse is administering a hepatitis B shot intramuscularly. What would be the appropriate site for administration? a. Deltoid b. Ventrogluteal c. Vastus lateralis d. Scapula
a. Deltoid The deltoid is the best site for this medication. Biologicals for infants and young children are administered at the vastus lateralis. The ventrogluteal site is used for depot formulations and irritating medications. The scapula is a site for an intradermal injection.
A client with a new diagnosis of glaucoma (increased pressure within the eye) has been prescribed a medication that is to be administered by an eye drop. Which action should the nurse perform? a. Ensure that drops of the medication fall onto the client's conjunctival sac. b. Ask the client to close his eyes for 15 to 30 seconds prior to administration. c. Apply a few drops of normal saline to the eye to irrigate the eye. d. Cleanse the tip of the container with an alcohol swab.
a. Ensure that drops of the medication fall onto the client's conjunctival sac. Eye drops should be applied to the conjunctival sac. Irrigation is not necessary prior to administration, nor does the client need to close his or her eyes. The tip of the container must be sterile, but it is not routinely swabbed with alcohol.
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? a. Offer a sip of water prior to the administration of the medication. b. Crush the pills and mix the pills in applesauce. c. Have the client gargle with an alcohol-based mouthwash. d. Instruct the client to chew the pills before swallowing.
a. Offer a sip of water prior to the administration of the medication. The nurse will have the client sip water prior to the administration of medications. Sipping water moisturizes the mouth and is particularly helpful to the client who reports dry mouth. This action also will help the pills glide better through the mouth and through the throat. Alcohol-based mouthwashes can make the mouth feel more dry and not aid in the swallowing of pills. The nurse will avoid crushing pills and having the client chew pills. These actions may alter the effect of some medications.
A postoperative client's medication administration record (MAR) provides for PRN administration of a number of analgesics by various routes. Which action should the nurse take to assess the client's pain to determine the appropriate analgesic to administer? a. The nurse will have the client rate pain on the pain scale of 1 to 10 and proceed accordingly. b. The nurse will call the health care provider to ask which medication should be used. c. The nurse will explain the options to the client and let the client decide. d. The nurse will consult with the charge nurse to make the decision.
a. The nurse will have the client rate pain on the pain scale of 1 to 10 and proceed accordingly. By assessing the client's pain using the pain scale the nurse can determine how severe the pain is and act accordingly. Intravenous drugs, because they are introduced directly into the circulatory system, have an onset that is faster than that of intramuscular (IM), subcutaneous (SC), or by mouth (PO) routes. IM and SC injections have to penetrate the muscles and tissues to be circulated in the body, which takes about 30 to 45 minutes. PO takes about 45 to 60 minutes for onset of action, as the drug needs to be digested in the stomach and then get into the circulation via the portal or hepatic vein.
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? a. intradermal b. subcutaneous c. intramuscular d. intravenous
a. intradermal 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.
The nurse is reviewing the plan of care for several clients who have prescriptions for intravenous medications. The nurse understands that which client is at the highest risk for greater effect of the IV medication? a.73-year-old client diagnosed with liver disease b. 35-year-old client diagnosed with migraines c. 45-year-old client diagnosed with lung cancer d. 16-year-old client diagnosed with left radial fracture
a.73-year-old client diagnosed with liver disease Older adults have a decrease in plasma protein, which is needed to bind and inactivate the medication in the bloodstream. The decrease in plasma proteins can increase the amount of medication circulating, which increases the effects. Decreased liver and kidney function also increases the amount of medication in the blood. The other options can have a risk, but they are not the highest.
A client who has been prescribed an inhaler points to the spacer and asks, "What is this for?" What is the appropriate nursing response? a. "It makes the inhaler easier to hold in case you have arthritis." b. "Medication stays in the chamber so you can continue to inhale it." c. "This is to decrease the amount of drug that you receive." d. "You will receive the medication faster as it goes through this device."
b. "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.
A nurse is preparing to administer a rectal suppository to an adult client. How many inches (centimeters) should the nurse plan to insert the suppository? a. 5 in (12.5 cm) b. 3 in (7.5 cm) c. 1 in (2.5 cm) d. 2 in (5 cm)
b. 3 in (7.5 cm) A rectal suppository must make contact with the rectal mucosa for absorption to occur, so it should be inserted about 3 to 4 in (7.5 to 10 cm). Inserting the suppository 1 or 2 in (2.5 to 5 cm) will not make contact with the rectal mucosa and inserting it 5 in (12.5 cm) could affect the client's comfort level.
When administering a subcutaneous injection to a client, the needle pulls out of the skin when the skin fold is released. What would be the appropriate next action of the nurse in this situation? a. Discard the equipment and start the procedure from the beginning. b. Engage safety shield on needle guard and discard needle appropriately. c. Pull out and discard the needle. d. Document the incident and inform the primary care provider.
b. Engage safety shield on needle guard and discard needle appropriately. The needle needs to be disposed of properly after engaging the safety guard because the needle cannot be reinserted due to contamination. A new needle can be attached to the syringe and the remainder of the medication administered after cleansing the site again. The incident does warrant notifying the primary care provider.
The nurse is teaching a client how to use nasal spray. What will the nurse include in the teaching plan? Select all that apply. a. Tilt the head slightly forward. b. Hold the breath for a few seconds after administering the spray. c. Insert the tip of the nose piece into one nostril. d. Blow the nose 1 minute after administering the spray. e. Sit up comfortably in the bed.
b. Hold the breath for a few seconds after administering the spray. c. Insert the tip of the nose piece into one nostril. e. Sit up comfortably in the bed. The nurse will teach the client to sit up and tilt the head slightly back, not forward. The client will blow the nose before administering the spray to help clear the nasal passage ways. Then insert the tip of the nose piece into one nostril while closing off the other nostril. Next, the client will administer the spray and then hold the breath for a few seconds to allow the medication to remain in contact with the mucosa. The client should not blow the nose for 5 to 10 minutes after administration of a nose spray.
The nurse is preparing to administer an allergy test via an intradermal injection. Which injection site would be most appropriate in this situation? a. Abdomen b. Inner surface of the forearm c. Shoulder d. Anterior aspect of the thigh
b. Inner surface of the forearm Sites commonly used for intradermal injections are the inner surface of the forearm and the upper back, under the scapula. The deltoid muscle of the shoulder is a common injection site for intramuscular injections. The abdomen and anterior aspect of the thigh are common injection sites for subcutaneous injections.
Which technique should the nurse employ when instilling otic medication in an adult ear? a. Tilt the client's head toward the ear in which the medication is being instilled. b. Pull the client's ear up and back. c. Tilt the client's head back with face upward. d. Pull the client's ear down and back.
b. Pull the client's ear up and back Pulling the client's ear up and back is correct, as this will straighten the auditory canal of the adult client. Tilting the client's head towards the ear in which the medication is being instilled and tilting the client's head back with face upward are incorrect, as these techniques will allow the medication to drain outside the ear. Pulling the ear down and back is incorrect, as this technique is used to straighten the auditory canal of a child, not an adult.
Which parts of the syringe and needle must be kept sterile when preparing and administering an injection? Select all that apply. a. The outside of the barrel b. The needle hub c. The needle d. The outside of the cap e. Inside the barrel
b. The needle hub c. The needle e. Inside the barrel Techniques of surgical asepsis must be strictly followed to avoid risk of infection. The parts of the syringe and needle that must be kept sterile are the inside of the barrel, the part of the plunger that enters the barrel, the tip of the barrel, and the needle (including the hub). The outside of the cap and barrel do not need to be kept sterile.
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? a. aspirin chewable tablet b. oxycodone extended release tablet c. furosemide liquid d. acetaminophen tablet
b. oxycodone extended release tablet The nurse would withhold the oxycodone extended release tablet. The extended release tablet is meant for delivery of the drug over an extended period of time, such as 12 hours. If crushed, the client would get an immediate release of the medication and could experience an adverse reaction. The other medications can be administered through an enteral tube: liquid, tablet that is crushed, chewable tablet that is crushed.
The primary reason for the Controlled Substances Act is: a. to regulate the purchase of opioids. b. to prevent drug use and dependence. c. to regulate the purchase of antibiotics. d. to prevent overuse of antibiotics.
b. to prevent drug use and dependence. The primary reason for the Controlled Substances Act is to prevent drug use and dependence, provide treatment and rehabilitation for people who are dependent on drugs, and strengthen drug use laws.
The nurse is preparing to administer an enteric-coated aspirin to a client. The client states, "I cannot swallow that so you will have to crush it and put it in applesauce for me as the other nurse does." Which is an appropriate reply from the nurse? a. "I will ask the health care provider to cancel the prescription for aspirin since you are unable to take it." b. "The nurse should not have crushed this medication. It could have caused an allergic reaction." c. "Crushing the medication may cause the medication to irritate the stomach, so it must be swallowed whole." d. "I can crush the medication but will not be able to mix it in the applesauce, because it will limit the effectiveness."
c. "Crushing the medication may cause the medication to irritate the stomach, so it must be swallowed whole." An enteric-coated medication should never be crushed since it disrupts the integrity of the pill and may cause irritation. The drug will dissolve prematurely in the gastric secretions and irritate the lining of the stomach. Crushing the medication does not cause an allergic reaction unless the client is already allergic to the medication. It is not appropriate for the nurse to make disparaging comments about other nurses to the client. The prescription should not be canceled. If needed, the nurse may contact the prescriber for a different form of the medication.
The nurse just completed a refresher course on parenteral drug administration. Which statement by the nurse indicates that teaching was effective? a. "Reconstitution is a glass or plastic container of parental medication with a self-sealing rubber stopper." b. "Reconstitution is a sealed glass cylinder of parenteral medication with an attached needle." c. "Reconstitution is the process of adding liquid, known as diluent, to a powdered substance." d. "Reconstitution is a sealed glass drug container that must be broken to withdraw the medication."
c. "Reconstitution is the process of adding liquid, known as diluent, to a powdered substance." Reconstitution is the process of adding liquid, known as diluent, to a powdered substance. A sealed glass cylinder of parenteral medication with an attached needle is a refilled cartridge, not reconstitution. A glass or plastic container of parental medication with a self-sealing rubber stopper is a vial, not reconstitution. A sealed glass drug container that must be broken to withdraw the medication is an ampoule, not reconstitution.
The nurse is teaching a client about metformin SA. When the client asks, "What does the SA mean?" what is the appropriate nursing response? a. "sustained release" b. "extended release" c. "sustained action" d. "continuous release"
c. "sustained action" The nurse will clarify that SA means "sustained action." XR means "extended release;" CR means "continuous release;" SR means "sustained release."
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? a. A larger syringe is required when giving an intramuscular injection on an obese person. b. When giving an injection, the amount of the medication directs the choice of gauge. c. As the gauge number becomes larger, the diameter of the needle and the lumen become smaller. d. The size of the syringe is directed by the viscosity of the medication to be given.
c. As the gauge number becomes larger, the diameter of the needle and the lumen become smaller. The larger the gauge, the smaller the needle. An obese person requires a longer needle to reach muscle tissue than does a thin person. When giving an injection, the viscosity of the medication directs the choice of needle gauge. The size of the syringe is directed by the amount of the medication to be given.
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? a. Assume that the provider meant to order buspirone. b. Administer the drug as ordered. c. Contact the health care provider for order clarification. d. Ask another nurse to verify the order.
c. 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.
The nurse is caring for a client with a secondary urinary tract infection for which amoxicillin 250 mg PO has been prescribed. The nurse recognizes this as a drug that is routinely administered every 8 hours; however, the prescription does not state the frequency of administration. The health care provider is no longer present. What is the appropriate nursing action? a. Ask another nurse to validate the frequency as every 8 hours, update the electronic medical record (EMR), flagging the prescription for the health care provider to review and cosign the prescription within 24 hours. b. Ask the nursing supervisor to validate the frequency as every 8 hours and update the electronic medical record (EMR). c. Contact the health care provider to clarify the prescription by reading back to the provider, update the electronic medical record (EMR) while on the phone, then document it was a phone prescription. d. Input the prescription into the electronic medical record (EMR) to reflect that the drug is given every 8 hours, after verifying with the pharmacy.
c. Contact the health care provider to clarify the prescription by reading back to the provider, update the electronic medical record (EMR) while on the phone, then document it was a phone prescription. The nurse should always have the health care provider clarify the prescription. The nurse cannot assume that a medication is to be given at certain times, nor should another nurse verify the frequency or clarify the prescription. The nurse should remain on the phone with the provider and read back the entire prescription for verification. Documentation should reflect that it is a phone prescription. Usually the phone prescription has to be reviewed and cosigned by the provider within 24 hours.
The nurse has given a client an injection. How will the nurse prevent an accidental needle stick? a. 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. b. Immediately activate the safety needle and have a colleague hold the Sharps container within reach for disposing of the syringe and needle. c. Immediately activate the safety needle and place the syringe and needle into a Sharps container. d. Immediately activate the safety needle and hold it close to the body until disposing it into the Sharps container.
c. 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 educating a client on how to self-administer subcutaneous insulin injections. The client asks why the needle must be removed at the same angle as that of insertion. How will the nurse respond? a. This verifies correct injection of the drug. b. It prevents needlestick injuries. c. It minimizes tissue trauma. d. This helps to control placement of the needle.
c. It minimizes tissue trauma. Removing the needle at the same angle at which it was inserted to administer medication minimizes tissue trauma and discomfort to the client. To verify correct injection of the drug, the client will push the plunger and watch for a small wheal. To prevent needlestick injuries, the client will cover the needle with a protective cap. Holding the arm still and stretching the skin taut helps to control placement of the needle.
The nurse is preparing to administer a transdermal medication. How should this be accomplished? a. The nurse should inject the medication just below the dermis of the skin. b. The nurse should inject the medication into a body cavity. c. The nurse should apply the medication directly to the skin. d. The nurse should ask the client to swallow the medication.
c. The nurse should apply the medication directly to the skin. Transdermal medications are adsorbed through the skin. Injectable medications are either delivered intramuscularly (in the muscle) or subcutaneously (or below the dermis). By mouth medications are taken by swallowing. Medications can also be given in the vagina, rectum, eyes, and ears.
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. Administer the medication and monitor the client for 30 minutes after administration b. Administer the medication, the reaction may not occur again c. Withhold the medication and notify the health care provider that ordered the medication d. Substitute another medication with the same action
c. 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.
A nurse needs to administer a prescribed injection to an older adult client with impaired mobility. Which intramuscular site is preferred for administering an injection to older adult clients? a. upper chest b. rectus femoris c. ventrogluteal d. gluteus maximus
c. ventrogluteal The ventrogluteal or deltoid muscles may be the preferred intramuscular sites for older adult clients experiencing impaired mobility. This site has the potential of retaining greater muscle mass longer than other sites. It is also usually less painful for the client. The dorsogluteal site, which has the gluteus maximus, should be avoided because of the risk of damage to the sciatic nerve with diminished musculature. The rectus femoris site is most suitable for infants. The upper chest muscle is part of intradermal injections, not intramuscular injections.
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? a. "Oral antibiotics are not as effective as IV infusions." b. "The IV infusion will treat your infection slower." c. "The health care provider can control the dose of medication you receive through IV." d. "An IV infusion maintains a therapeutic level of the medication in your blood."
d. "An IV infusion maintains a therapeutic level of the medication in your blood." When treating certain infections, blood levels of the medication are needed to maintain a consistent therapeutic level. IV infusion does not necessarily treat the infection faster, but provides a consistent blood level. Oral antibiotics can be effective in treating infections. The dose can be controlled through IV infusion, but this is not the reason the client is receiving the medication via IV infusion.
The nurse is performing the admissions assessment for a client admitted with right hip pain. When performing the assessment, the client stated all of the prescribed medications they take from the previous admission. Which question is the priority for the nurse to ask the client? a. "Do you have someone to help you at home?" b. "Do you use cold therapy for your hip pain?" c. "What time do you take your medications?" d. "Do you take any over-the-counter medications?"
d. "Do you take any over-the-counter medications?" Assessing whether the client takes any over-the-counter medications is the priority because the nurse will need to identify any medication interactions that can occur while the client is in the hospital. Knowing what time the client takes their medications is important but does it not take priority over knowing drug-drug interactions. Discussions about help at home and about alternative pain management therapies are not a priority in the admission assessment; correct medication reconciliation is the priority here.
A nurse is administering a subcutaneous injection to a client. What is the common maximum volume of a subcutaneous injection? a. 3 mL b. 0.05 mL c. 0.01 mL d. 1 mL
d. 1 mL The volume of a subcutaneous injection is usually up to 1 mL. An intramuscular injection is the administration of up to 3 mL of medication into one muscle or muscle group. Intradermal injections are commonly used for diagnostic purposes in small volumes, usually 0.01 to 0.05 mL.
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? a. 45 degrees b. 10 to15 degrees c. 20 to 30 degrees d. 90 degrees
d. 90 degrees Insulin injections are given subcutaneously to clients with obesity at a 90-degree angle. Other answers are incorrect.
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? a. Assess the vaginal mucosa. b. Assess the client's blood pressure. c. Monitor the IV infusion rate. d. Assess the IV site for redness.
d. Assess the IV site for redness. If tenderness, fever without obvious source, or symptoms of local or bloodstream infection are present, remove the dressing and inspect the site directly.
Which situation accurately describes a recommended guideline when administering oral medications to clients? a. Assume that the client is the authority on whether or not the medication was swallowed. b. If a pill is dropped, it should be briefly immersed in saline to remove any dirt or germs. c. If a client vomits immediately after receiving oral medications, readminister the medication. d. If a child refuses to take medication, crush the medication, if allowable, and add to a small amount of food.
d. If a child refuses to take medication, crush the medication, if allowable, and add to a small amount of food. Medication can be added to small amounts of food, but should not be added to liquids. If unsure whether the medication was swallowed, check the client's mouth and cheeks. If a pill is dropped, it should be discarded. If a client vomits, notify the health care provider to see if the medication should be readministered.
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? a. Refuse to implement the order and notify the nurse manager. b. Input the order into the computerized provider order system. c. Have another nurse witness and record the order into the medication administration record (MAR). d. Tactfully request the provider to input the order into the computerized provider order system.
d. 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.
A nurse needs to instill eye medication in a client with conjunctivitis. Which action is best to distribute the medication over the surface of the eye? a. The nurse should instill medication drops in the upper eyelid. b. The nurse should make a pouch in the lower eyelid. c. The nurse should gently rub the client's eyelids. d. The client should blink the eye.
d. The client should blink the eye. To distribute the eye medication over the surface of the eye, the client should blink the eyes rather than rubbing them. In order to provide a natural reservoir for liquid medication, the nurse makes a pouch in the lower lid by pulling the skin downward over the bony orbit. To prevent injury and blink reflexes, the nurse should not instill medication in the upper eyelid but should steady the medication container and move it from below the client's line of vision or from the side of the eye instead.
Which nursing strategy should the nurse employ to assist a child who has difficulty coordinating inspiration with the use of a handheld inhaler? a. The nurse should instruct the child to prolong his/her inhalation. b. The nurse should provide simple written instructions. c. The nurse should assess the child's mucous membranes. d. The nurse should use a nebulizer to administer the medication.
d. The nurse should use a nebulizer to administer the medication. The nurse's use of a nebulizer to administer the medication is correct, as this is an alternative to administering an inhalant for young children. Instructing the child to prolong his/her inhalation is incorrect, as this is used to reduce side effects of using inhalants. Assessing the child's mucous membranes is incorrect, as this action is used to identify any break in the continuity of the membranes and will not assist with the coordination of inspiration. Providing simple written instructions is incorrect, as this will enhance the teaching/learning process of the child and not the coordination of the child's inspiration.
Regarding medication administration, what must occur at the change of shifts? a. Only the LPNs on the division count medications. b. The client's medications must be drawn up. c. The medications for the division are counted. d. The opioids for the division are counted.
d. The opioids for the division are counted. Health care facility personnel perform a count of controlled medications at specified times (each shift or when removed from an automated dispensing machine).
The nurse has begun caring for a surgical client who has been ordered preoperative antibiotics prior to bowel surgery. While the nurse will adhere to all the principles of safe medication administration, which domain will the nurse pay particular attention toroute in this situation? a. Client b. Route c. Dose d. Time
d. Time The rights of medication administration include right client, right drug, right route, right dose, right time, right reason, and right documentation. While the nurse will adhere to all of these, timing is particularly important for preoperative medications, since these must be times so that peak efficacy aligns with the time of peak risk.
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? a. continuous drip b. electronic infusion device c. gravity infusion d. bolus administration
d. 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.
The nurse is preparing to administer a client's intramuscular injection and intends to use the technique shown. What potential benefit of this technique should the nurse describe? a. less frequent administration of the medication b. decreased risk for infection c. more rapid administration of the medication d. decreased irritation and pain in subcutaneous tissue
d. decreased irritation and pain in subcutaneous tissue This technique is Z-tracking. The Z-track technique allows the medication to be administered into the muscle tissue with no tracking of medication in the subcutaneous tissues as the needle is removed, resulting in less pain and irritation.
A nurse is administering an adult client's ordered antipsychotic drug intramuscularly. What would be the most appropriate site for administration? a. Scapula b. Biceps brachii c. Vastus lateralis d. Deltoid
d. 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.
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. administer medication within 30 to 60 minutes of the scheduled time b. allow sufficient time to prepare the medication with minimal distraction c. read and compare labels on the medication with the medical record d. review the client's medication, allergy, and medical history
d. review the client's medication, allergy, and medical history 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 (before, during, and after preparing the medication) to ensure that the right medication is given at the right time by the right route. Administering the medication within 30 to 60 minutes of the scheduled time demonstrates timely administration and compliance with the medical order. Allowing sufficient time to prepare the medication with minimal distraction promotes the safe preparation of medications.
The nurse is preparing to administer nasal medication via a dropper to a client with severe congestion. Into which position will the nurse place the client? a. oblique b. prone c. lithotomy d. supine
d. supine To best facilitate instillation of nasal medication via a dropper, and to ensure that the drug is administered into the place where its effects are desired, the nurse will place the client in supine position. The other positions are not appropriate.
A nurse needs to administer a prescribed injection to a toddler. Which injection site is most suitable for the client? a. ventrogluteal site b. deltoid site c. dorsogluteal site d. vastus lateralis site
d. vastus lateralis site The vastus lateralis site is most desirable for administering injections to infants and small children, as well as clients who are thin or debilitated with poorly developed gluteal muscles. The dorsogluteal site is avoided in clients younger than 3 years because their gluteus maximus muscle is not sufficiently developed. The ventrogluteal site, however, is safe for children. The deltoid site is the least-used intramuscular injection site because it is a smaller muscle than the others. It is used only for adults because the muscle is not sufficiently developed in infants and children.
