PNU 120 Taylor PrepU Chapter 29: Medications
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 nurse is administering a hepatitis B immunization injection to an adult client. Which site would the nurse choose for this injection?
Deltoid muscle site
When administering heparin subcutaneously, the nurse should:
never aspirate.
When instructing a client regarding sublingual application, the nurse should inform the client that which action is contraindicated when administering the drug?
swallowing the medication
The nurse has received new medication orders for a client that has had a condition change. What components of the medication order's should be present prior to administering the medication? Select all that apply.
the full name of the client the date and time when the order is written or placed in the order entry on the computer the dosage of the drug, stated in either the apothecary or metric system the route by which the drug is to be administered
A nurse needs to administer a prescribed injection to a toddler. Which injection site is mostsuitable for the client?
vastus lateralis site
The nurse is teaching a nursing student regarding safety of chemotherapeutic medication. Which statement by the nurse is correct?
"Antineoplastic drugs can be absorbed through the skin."
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?
"Crushing the medication may cause the medication to irritate the stomach, so it must be swallowed whole."
The charge nurse has just completed an inservice with a group of nursing students. One nurse student asks, "Why do I have to know how to give medications in different ways. I thought the unlicensed assistive personnel (UAP) performs those skills?" What is best response by the charge nurse?
"Entry-level nurses will perform basic skills appropriate to the scope of practice and that includes administering medications through various routes."
The nurse is teaching a client about metformin SA. When the client asks, "What does the SA mean?" what is the appropriate nursing response?
"sustained action"
A client with a complex cardiac history has been prescribed digoxin 0.0625 mg PO. The drug is available as 125 mcg tablets. How many of the tablets will the nurse administer?
0.5
A nurse is administering a subcutaneous injection to a client. What is the common maximum volume of a subcutaneous injection?
1 mL
The nurse is preparing to administer an allergy test intradermally. At what angle will the nurse plan to insert the needle into the client?
10 to 15 degrees
A nurse is in the process of converting a continuous IV infusion to an intermittent infusion device. The nurse has clamped off the primary IV tubing, donned clean gloves, clamped the extension tubing and disconnected the primary IV tubing. The nurse is now cleansing the port on the extension tubing with an antiseptic swab. The nurse cleanses the port for which duration of time?
15 seconds
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
Which medication interaction illustrates a synergism?
A client takes acetaminophen to help her sleep. She also takes an oxycodone for pain related to recent hip surgery, which makes her even more drowsy.
A nurse has administered an injection to a client. Which intervention should the nurse perform to reduce discomfort and provide quick relief?
Apply pressure to the site during needle withdrawal.
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?
Ask the client to maintain the position for some time.
The nurse has inadvertently administered medication ordered for Client A to Client B. What is the appropriate nursing action? Select all that apply.
Assess Client B thoroughly. Complete an incident report. Contact the provider to report the error.
A medication order has ac written after the medication dosage. What does ac stand for?
Before meals
The nurse is administering a subcutaneous injection of insulin to a client. Which action would the nurse take after choosing the appropriate administration site?
Cleanse the area around the injection site with alcohol.
The nurse is preparing to administer two IV medications. What is the appropriate nursing action?
Consult a current drug reference book for IV compatibility.
The nurse is preparing to give medications to a client with high blood pressure. The prescription indicates that the client is to have the combination drug dextroamphetamine saccharate-amphetamine aspartate monohydrate-dextroamphetamine sulfate-amphetamine sulfate 40 mg by mouth twice daily. What is the appropriate nursing action?
Contact the health care provider for clarification of the prescription.
The nurse is preparing to administer eye drops to a client with glaucoma. A discrepancy is noted between dosage recorded on the medication administration record (MAR) and what the client states he or she takes daily at home. Which action should the nurse take?
Contact the health care provider for clarity.
The nurse is assessing a client with diabetes who has poor vision. Which feature of the insulin pen makes it beneficial for this client?
Each unit of insulin is accompanied by a clicking sound in the pen.
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 is preparing to administer a nasal spray. Place the nurse's actions in order, from first to last. Use all options.
Identify the client using two identifiers and verify any allergies. Offer the client a tissue and ask the client to blow the nose. Insert the tip of the nasal spray into one nostril and close the other nostril with a finger. Compress the nasal spray while the client breathes in through the nose. Remove the tip of the spray from the client's nostril and release the compression. Instruct the client to not blow the nose for 5 to 10 minutes.
Which situation accurately describes a recommended guideline when administering oral medications to clients?
If a child refuses to take medication, crush the medication, if allowable, and add to a small amount of food.
A nurse is caring for a client who has been prescribed codeine, a narcotic medication to relieve severe postoperative pain. Which responsibility does the nurse have to complete when handling narcotic 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 narcotic medication at the change of each shift.
A nurse needs to administer a subcutaneous heparin injection to a client. Which injection site is most suitable for heparin?
abdomen
The Z-track technique is utilized during drug administration by which route?
intramuscular
A client has an order for an intermittent infusion of 250 mL of 0.9 normal saline. The nurse understands that this type of infusion is used for which situation?
medications that need to be infused over 20 to 60 minutes
The nurse is caring for a client with a yeast infection. Which medication does the nurse anticipate will be prescribed?
miconazole
The nurse is instructing a client with xerostomia (dry mouth) about taking several pills and capsules that have been prescribed. What statement made by the client indicates to the nurse that the client understood the instructions?
"I will take a sip or two of water prior to taking my pills."
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."
The nurse just completed a refresher course on parenteral drug administration. Which statement by the nurse indicates that teaching was effective?
"Reconstitution is the process of adding liquid, known as diluent, to a powdered substance."
A nurse is taking care of a 56-year-old man with end-stage liver disease. The nurse has a prescription to give 20 g of lactulose every 6 hours to treat the client's hepatic encephalopathy. On hand, the nurse has containers of lactulose that have 30 g in 45 ml. How many milliliters is the nurse going to administer every 6 hours to the client?
30 mL
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?
5 minutes
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?
73-year-old client diagnosed with liver disease
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 administering an adult client's ordered antipsychotic drug intramuscularly. What would be the most appropriate site for administration?
Deltoid
The nurse is preparing to administer two types of insulin by mixing in one syringe. What is the first action by the nurse?
Determine compatibility of the insulins by checking a drug compatibility table.
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 is educating a client on how to use an insulin pen. Which steps reflect recommended procedure? Select all that apply.
Hold the pen upright and tap to force any air bubbles to the top. Dial the dose selector to 2 units to perform an "air shot" to get rid of bubbles. Clean injection site and administer injection by holding pen like a dart.
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?
IV Infusion
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.
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.
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.
After administering medication to a client subcutaneously, the nurse removes the needle at the same angle at which it was inserted. Which explains the nurse's action?
minimizes tissue trauma to the client
If the dosage is inappropriate for a client, who is responsible?
Nurse
In preparing to administer a drug to a client, the nurse has pierced a multi-use vial of medication. What is the appropriate nursing action?
Place the date on the vial and retain for future use.
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?
Return the medication to the medication cart or medication room.
A nurse is administering enoxaparin sodium (anticoagulant) to a client with deep vein thrombosis, via the subcutaneous route. What is a recommended guideline when administering a subcutaneous injection?
Subcutaneous injections are administered into the adipose tissue layer just below the epidermis and dermis.
A nurse needs to administer a subcutaneous injection to a client. Which techniques should the nurse use to reduce discomfort? Select all that apply.
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.
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?
Tactfully request the provider to input the order into the computerized provider order system.
Regarding medication administration, what must occur at the change of shifts?
The narcotics for the division are counted.
Which nursing strategy should the nurse employ to assist a child who has difficulty coordinating inspiration with the use of a handheld inhaler?
The nurse should use a nebulizer to administer the medication.
A physician 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 canister containing medication that is released when the container is compressed
Which actions should the nurse take when applying transdermal patches? Select all that apply.
assessing for skin irritation at the application site marking the patch with date and time of administration documenting in the client's record where the patch is located
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:
breathes through his or her mouth until all the medication has been inhaled.
A nurse is administering medication to a 78-year-old female client who experienced symptoms of stroke. When administering the medication prescribed for her, the nurse should be aware that this client has an increased possibility of drug toxicity due to which age-related factor?
decline in liver function and production of enzymes needed for drug metabolism
A nurse needs to administer an intradermal injection to a client. What is the most common site for administering an intradermal injection?
forearm
The nurse is preparing to administer an IM injection in the vastus lateralis site. Where will the nurse administer the medication?
in the anterolateral aspect of the thigh
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?
intradermal
A nurse has to administer a subcutaneous injection to a client. For which client can the nurse administer a subcutaneous injection at a 90-degree angle?
obese client