Fundamentals success Medication administration questions

A nurse plans to administer a 3-mL intramuscular injection. Which muscle is the least desirable to use for the administration of this medication? 1. Deltoid 2. Dorsogluteal 3. Ventrogluteal 4. Vastus lateralis

1. Deltoid : 1. The deltoid muscle, on the lateral aspect of the upper arm, is a small muscle that is incapable of absorbing a large medication volume. This site is more appropriate for 1 mL of solution.

A primary health-care provider prescribes a topical medication to be administered to a patient with an area of excoriated skin. Place the following steps in the order in which they should be implemented. 1. Don clean gloves. 2. Evaluate the results of the lotion on the skin. 3. Warm the tube of medication before application. 4. Cleanse the skin gently with soap and water and pat dry. 5. Don sterile gloves and apply a thin layer of lotion to the desired area.

1. Don clean gloves. 4. Cleanse the skin gently with soap and water and pat dry. 3. Warm the tube of medication before application. 5. Don sterile gloves and apply a thin layer of lotion to the desired area. 2. Evaluate the results of the lotion on the skin

A nurse is preparing to draw up medication from a vial. Which action should the nurse implement first? 1. Ensure that the needle is firmly attached to the syringe. 2. Rub vigorously back and forth over the rubber cap with an alcohol swab. 3. Inject air into the vial with the needle bevel below the surface of the medication. 4. Draw up slightly more air than the volume of medication to be withdrawn from the vial.

1. Ensure that the needle is firmly attached to the syringe. This will ensure a tight seal and a closed system. If not firmly connected, the hub of the needle may disengage from the barrel of the syringe during preparation or administration of the medication when internal and external pressures are exerted on the needle and syringe.

A nurse is preparing to reconstitute a medication in a multiple-dose vial. Which is the most essential step in the preparation of this medication? 1. Instilling an accurate amount of diluent into the vial 2. Using a filtered needle when drawing up the medication from the vial 3. Instilling air into the vial before withdrawing the reconstituted solution 4. Wiping the rubber seal of the vial with alcohol before and after each needle insertion

1. Instilling an accurate amount of diluent into the vial

Which route is inappropriate for a topical medication? 1. Intradermal 2. Bladder 3. Rectum 4. Vagina

1. Intradermal . An intradermal injection is inserted below, not on top of, the epidermis.

A nurse holds a bottle with the label next to the palm of the hand when pouring a liquid medication. Which is the rationale for this action? 1. Prevent soiling of the label by spilled liquid. 2. Conceal the label from the curiosity of others. 3. Ensure accuracy of the measurement of the dose. 4. Guarantee the label is read before pouring the liquid.

1. Prevent soiling of the label by spilled liquid. Liquid medication may drip down the side of the bottle and soil the label, which may interfere with the ability to read the label accurately.

A nurse must administer a medication into the ear of an adult. Which should the nurse do to limit patient discomfort when administering ear drops? 1. Warm the solution to body temperature. 2. Place the patient in a comfortable position. 3. Pull the pinna of the ear upward and backward. 4. Instill the fluid in the center of the auditory canal.

1. Warm the solution to body temperature. Instilling cold medication into the ear canal is uncomfortable and can cause vertigo and nausea. Holding the bottle of medication in the hand for several minutes warms the solution to body temperature.

A primary health-care provider orders a unit of packed red blood cells for a patient with a low hemoglobin level. Which actions should be implemented by the nurse when administering this transfusion? Select all that apply. 1. _____Adjust the flow rate to 20 drops per minute for the first 15 minutes. 2. _____After 15 minutes with no reaction, assess the vital signs every 45 minutes. 3. _____Administer 100 mL of 0.9% sodium chloride before administering the transfusion. 4. _____Discontinue the blood transfusion if it extends beyond 4 hours after its initiation. 5. _____Stay with the patient for 15 minutes after initiating the blood transfusion while taking vital signs every 5 minutes.

1. _____Adjust the flow rate to 20 drops per minute for the first 15 minutes. 4. _____Discontinue the blood transfusion if it extends beyond 4 hours after its initiation. 5. _____Stay with the patient for 15 minutes after initiating the blood transfusion while taking vital signs every 5 minutes.

Which routes are unrelated to the parenteral administration of medications? Select all that apply. 1. _____Buccal 2. _____Z-track 3. _____Sublingual 4. _____Intravenous 5. _____Intradermal

1. _____Buccal 3. _____Sublingual

A primary health-care provider prescribes an oral medication for a patient. The nurse identifies that the patient is having some difficulty swallowing. What should the nurse plan to do? Select all that apply. 1. _____Crush tablets that are crushable and mix with a small amount of applesauce. 2. _____Have the patient hyperextend the neck slightly when swallowing. 3. _____Give water before, during, and after medication administration. 4. _____Stroke under the chin over the larynx. 5. _____Have the patient use a straw.

1. _____Crush tablets that are crushable and mix with a small amount of applesauce. 3. _____Give water before, during, and after medication administration. 4. _____Stroke under the chin over the larynx.

A nurse is to administer an eye irrigation to a patient's right eye. Which should the nurse do? Select all that apply. 1. _____Direct the flow of solution from the inner to the outer canthus. 2. _____Irrigate with a bulb syringe held several inches above the eye. 3. _____Expose the conjunctival sac and hold open the upper lid. 4. _____Don sterile gloves before beginning the procedure. 5. _____Position the patient in a right lateral position.

1. _____Direct the flow of solution from the inner to the outer canthus. 3. _____Expose the conjunctival sac and hold open the upper lid.

A primary health-care provider prescribes an oral medication for a patient with a nasogastric tube on low continuous suction. Which actions should the nurse implement when administering this medication? Select all that apply. 1. _____Give each medication separately. 2. _____Follow medication administration with 100 mL of free water. 3. _____Crush crushable tablets into a fine powder and mix with 30 mL of warm water. 4. _____Shut off nasogastric tube suctioning for 30 minutes after medication administration. 5. _____Ensure nasogastric tube placement by instilling 30 mL of air while auscultating over the epigastric area for a "whooshing" sound.

1. _____Give each medication separately. 3. _____Crush crushable tablets into a fine powder and mix with 30 mL of warm water. 4. _____Shut off nasogastric tube suctioning for 30 minutes after medication administration.

A primary health-care provider prescribes a rectal suppository for an adult patient. Which actions should the nurse implement when administering the rectal suppository? Select all that apply. 1. _____Lubricate the medication before insertion. 2. _____Warm the medication equal to body temperature. 3. _____Instruct the patient to take deep breaths through the mouth. 4. _____Insert the medication just inside the rectum's external sphincter. 5. _____Place the patient in the prone position to administer the medication.

1. _____Lubricate the medication before insertion. 3. _____Instruct the patient to take deep breaths through the mouth.

A primary health-care provider prescribes nose drops to be administered twice a day. Which should the nurse do when instilling the nose drops? Select all that apply. 1. _____Tell the patient not to sniff the medication once administered. 2. _____Place the patient in the supine position with the head tilted backward. 3. _____Pinch the nares of the nose together briefly after the drops are instilled. 4. _____Instruct the patient to blow the nose 5 minutes after the drops are instilled. 5. _____Insert the drop applicator ½ inch into the nose toward the base of the nasal cavity.

1. _____Tell the patient not to sniff the medication once administered. 1. Avoiding sniffing the nose drops after administration allows the medication to reach desired areas (ethmoid and sphenoid sinuses) via gravity.

A nurse is interviewing a newly admitted patient in the process of completing a nursing admission history and physical. Which information should be included in a medication reconciliation form? Select all that apply. 1. _____Vitamins 2. _____Drug allergies 3. _____Food supplements 4. _____Over-the-counter herbs 5. _____Prescribed medications

1. _____Vitamins 3. _____Food supplements 4. _____Over-the-counter herbs 5. _____Prescribed medications

Which should the nurse use when administering a subcutaneous injection? 1. 5-mL syringe 2. 25-gauge needle 3. Tuberculin syringe 4. 1½-inch-long needle

2. 25-gauge needle 2. A subcutaneous injection should use a 25- to 29-gauge needle, which minimizes tissue trauma. The diameter of a needle is referred to as its gauge, which ranges from 28 (small) to 14 (large).

A nurse is preparing to administer a tablet to a patient. When should the nurse remove the medication from its unit dose package? 1. Outside the door to the patient's room 2. At the patient's bedside 3. In the medication room 4. At the medication cart

2. At the patient's bedside 2. The medication should be opened and administered immediately to the patient, thereby limiting the potential for contamination. Reading the label immediately before opening the package is an additional safety check. Immediate administration prevents accidental disarrangement of medications that may result in a medication error.

A nurse plans to administer a bolus dose of a medication via a currently running intravenous infusion. Which should the nurse do first? 1. Use a volume-control infusion set with microdrip tubing. 2. Ensure that it is compatible with the IV solution being infused. 3. Pinch the tubing above the infusion port while instilling the bolus. 4. Instill it into a 50-mL bag of normal saline and infuse it via a secondary line.

2. Ensure that it is compatible with the IV solution being infused :An incompatible solution can increase, decrease, or neutralize the effects of the medication. In addition, an incompatibility may result in a compound or cause a precipitate that is harmful to the patient.

A nurse must reconstitute a powdered medication. Which action should the nurse implement? 1. Keep the needle below the initial fluid level as the rest of the fluid is injected. 2. Instill the solvent that is consistent with the manufacturer's directions. 3. Score the neck of the ampule before breaking it. 4. Shake the vial to dissolve the powder.

2. Instill the solvent that is consistent with the manufacturer's directions. Compatibility is necessary so that a compound or precipitate that is harmful to a patient does not result.

Which information about a parenteral medication indicates that the nurse should use a filtered needle when preparing the medication? 1. Has to be reconstituted 2. Is supplied in an ampule 3. Appears cloudy in the vial 4. Is to be mixed with another medication

2. Is supplied in an ampule: The top of an ampule must be snapped off at its neck to access the fluid. A filtered needle prevents glass particles from being drawn into the syringe

A primary health-care provider prescribes a vaginal suppository for a patient. The nurse obtains the suppository, pulls the curtain around the patient's bed, encourages the patient to void, provides perineal care, and then dons a new pair of clean gloves. Place the following steps in the order in which they should now progress to complete the administration of the vaginal suppository. 1. Drape the patient exposing only the vaginal area. 2. Position the patient in the dorsal recumbent position. 3. Encourage the patient to remain in the supine position for 10 to 20 minutes. 4. Lubricate the suppository and the nurse's index finger with a water-soluble jelly. 5. Insert the suppository downward and backward using the full length of the index finger. Answer: _________________

2. Position the patient in the dorsal recumbent position. 1. Drape the patient exposing only the vaginal area. 4. Lubricate the suppository and the nurse's index finger with a water-soluble jelly. 5. Insert the suppository downward and backward using the full length of the index finger. 3. Encourage the patient to remain in the supine position for 10 to 20 minutes.

Which action should be implemented by the nurse when a medication is delivered by the Z-track method? 1. Use a special syringe designed for Z-track injections. 2. Pull the skin laterally away from the injection site before inserting the needle. 3. Administer the injection in the muscle on the anterolateral aspect of the thigh. 4. Insert the needle in a separate spot for each dose on a Z-shaped grid on the abdomen.

2. Pull the skin laterally away from the injection site before inserting the needle.

A nurse must administer a medication that is supplied in an ampule. Which should the nurse do first to access the ampule? 1. Inject the same amount of air as the fluid to be removed. 2. Wipe the constricted neck with an alcohol swab. 3. Break the constricted neck using a barrier. 4. Insert the needle into the rubber seal.

3. Break the constricted neck using a barrier. A barrier, such as a commercially manufactured ampule opener, gauze, or an alcohol swab, should be used to protect the hands from broken glass.

A nurse instructs a patient to close the eyes after the administration of eye drops. Which rationale for this instruction should the nurse explain to the patient? 1. Limits corneal irritation 2. Squeezes excess medication from the eyes 3. Disperses the medication over the eyeballs 4. Prevents medication from entering the lacrimal duct

3. Disperses the medication over the eyeballs

An older adult is transported via ambulance to the emergency department of the hospital after being found unconscious on the living room floor by a family member. The patient regains consciousness and tells the nurse that everything went blank after standing up abruptly from a lounge chair. The patient is diagnosed with dehydration and is admitted for observation and rehydration therapy. The nurse performs a routine patient assessment 18 hours after initiation of the IV therapy. What should the nurse do first after reviewing the patient's clinical record and assessing the patient? 1. Administer oxygen via a nasal cannula. 2. Slow the rate of the intravenous fluid infusion. 3. Elevate the head of the bed to the semi-Fowler position. 4. Notify the primary health-care provider of the patient's status.

2. Slow the rate of the intravenous fluid infusion. 2. The patient is exhibiting signs of fluid volume overload and pulmonary edema. The intravenous fluid infusion rate should be slowed to 15 to 30 mL per hour to decrease the amount of fluid entering the patient's intravenous compartment while maintaining the integrity of the intravenous access site until the rapid response team is notified and arrives.

How often should "docusate sodium 100 mg PO bid" be given? 1. Three times a day 2. Two times a day 3. Every other day 4. At bedtime

2. Two times a day

When the nurse brings pills to a patient, the patient is unable to hold the paper cup with the medications. Which should the nurse do? 1. Crush the pills and mix them with applesauce. 2. Use the paper cup to introduce the pills into the patient's mouth. 3. Have the primary health-care provider prescribe the liquid form of the drug. 4. Put the pills into the patient's hand and have the patient self-administer the pills.

2. Use the paper cup to introduce the pills into the patient's mouth. The patient needs assistance. Keeping medication in the cup, rather than touching it with the hands, maintains medical asepsis.

Which interventions are uniquely related to the administration of an intradermal injection? Select all that apply. 1. _____Using the air-bubble technique 2. _____Circling the injection site with a pen 3. _____Pinching the skin during needle insertion 4. _____Inserting the needle with the bevel upward 5. _____Massaging the area after the fluid is instilled

2. _____Circling the injection site with a pen 4. _____Inserting the needle with the bevel upward

A primary health-care provider prescribes a liquid oral medication for a patient. Which actions should the nurse implement when administering this medication? Select all that apply. 1. _____Vigorously shake the liquid before pouring a dose. 2. _____Measure oral liquids in a calibrated medication cup at eye level. 3. _____Pour liquids with the label facing away from the palm of the hand. 4. _____Place an opened top of a container on a surface with the inside lid facing up. 5. _____Use a needless syringe to measure an oral liquid less than 5 mL and transfer it to a medication cup.

2. _____Measure oral liquids in a calibrated medication cup at eye level. 4. _____Place an opened top of a container on a surface with the inside lid facing up. 5. _____Use a needless syringe to measure an oral liquid less than 5 mL and transfer it to a medication cup.

A nurse is assessing a patient to determine if it is appropriate to administer a prescribed medication via the oral route. Which information indicates that the nurse should ask the primary health-care provider for a change in route? Select all that apply. 1. _____Nausea 2. _____Unconsciousness 3. _____Gastric suctioning 4. _____Emergency situation 5. _____Difficulty swallowing

2. _____Unconsciousness 4. _____Emergency situation

A health-care provider prescribes benztropine 1.5 mg PO STAT. Benztropine is available in 0.5 mg scored tablets. How many tablets should the nurse administer? Record your answer using a whole number. Answer: _________________tablets.

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A nurse instructs a patient to inhale deeply and hold each breath for a second when using a hand-held nebulizer. The patient asks, "Why do I have to hold my breath?" Which information should the nurse include in the response to the patient's question? 1. "It prolongs treatment." 2. "It limits hyperventilation." 3. "It disperses the medication." 4. "It prevents bronchial spasms."

3. "It disperses the medication." 3. A pause at the height of inspiration will promote distribution and absorption of the medication before exhalation begins.

A nurse teaches a patient about taking a sublingual nitroglycerin tablet. Which part of the body identified by the patient indicates that the patient understands the teaching? 1. "On my skin." 2. "Inside my cheek." 3. "Under my tongue." 4. "In my eye on the lower lid."

3. "Under my tongue."

A primary health-care provider prescribes a medication that must be administered transdermally. Which information about the route of administration does the nurse understand is related to a drug prescribed to be administered transdermally? 1. Inhaled into the respiratory tract 2. Dissolved under the tongue 3. Absorbed through the skin 4. Inserted into the rectum

3. Absorbed through the skin :3. A medicated patch or disk can be applied directly to the skin, where the medication is released and absorbed over time. This method ensures a continuous therapeutic drug level and reduces fluctuations in circulating drug levels.

Which should a nurse use when placing a cream into a patient's vaginal canal? 1. A finger 2. A gauze pad 3. An applicator 4. An irrigation kit

3. An applicator: The consistency of a cream requires that an applicator be used to ensure that the medication is deposited along the full length of the vaginal canal.

A home-care nurse observes the spouse of a patient inserting a rectal suppository. Which behavior indicates that the nurse must provide further teaching about suppository administration? 1. Lubricates the tip of the suppository 2. Inserts the suppository while wearing a glove 3. Inserts the suppository while the patient bears down 4. Places the suppository a finger length into the rectum

3. Inserts the suppository while the patient bears down: Bearing down increases intra-abdominal pressure, which impedes the insertion of the suppository. The patient should be instructed to relax and breathe deeply and slowly while the suppository is inserted.

The primary health-care provider prescribes a troche. In which part of the body should the nurse administer the troche? 1. Ear 2. Eye 3. Mouth 4. Rectum

3. Mouth

Which nursing action is appropriate when administering an analgesic? 1. Reassess drug effectiveness every eight hours. 2. Follow the prescription exactly for the first twenty-four hours. 3. Seek a new prescription after two doses that do not achieve a tolerable level of relief. 4. Ask the primary health-care provider to prescribe another medication for breakthrough pain.

3. Seek a new prescription after two doses that do not achieve a tolerable level of relief. 3. Two doses provide enough time to evaluate the effectiveness of a medication for pain. Patients should not have to endure intolerable levels of pain.

A primary health-care provider prescribes a medication via a transdermal patch. Place the following steps in the order in which they should be implemented when administering this medication. 1. Remove the previous patch. 2. Contain and dispose of the used patch. 3. Wear clean gloves throughout the procedure. 4. Write the date, time, and your initials on the patch. 5. Apply a new patch to a different section of the skin. 6. Wash and dry the skin after removal of the used patch. Answer: _________________

3. Wear clean gloves throughout the procedure. 1. Remove the previous patch. 2. Contain and dispose of the used patch. 6. Wash and dry the skin after removal of the used patch. 5. Apply a new patch to a different section of the skin. 4. Write the date, time, and your initials on the patch.

The instructions with a medication states to use the Z-track method. Which actions should the nurse implement that are specific to this procedure? Select all that apply. 1. _____Pinch the site throughout the procedure. 2. _____Massage the site after the needle is removed. 3. _____Add 0.3 to 0.5 mL of air after drawing up the correct dosage. 4. _____Remove the needle immediately after the medication is injected. 5. _____Change the needle after the medication is drawn into the syringe.

3. _____Add 0.3 to 0.5 mL of air after drawing up the correct dosage. 5. _____Change the needle after the medication is drawn into the syringe.

A primary health-care provider prescribes a liquid medication that has an unpleasant taste for a school-aged child. What should the nurse do to facilitate administration of this medication? Select all that apply. 1. _____Mix it with the child's favorite food. 2. _____Teach that the taste only lasts a short time. 3. _____Give an ice pop just before giving the medication. 4. _____Have a parent administer the medication if present. 5. _____Offer the child the choice of a spoon, needleless syringe, or dropper.

3. _____Give an ice pop just before giving the medication. 5. _____Offer the child the choice of a spoon, needleless syringe, or dropper.

A nurse is administering an intradermal injection. At which angle should the nurse insert the needle? 1. 90-degree angle 2. 45-degree angle 3. 30-degree angle 4. 15-degree angle

4. 15-degree angle :An intradermal injection is administered by inserting a needle at a 10- to 15-degree angle through the skin with the bevel of the needle facing upward toward the skin. The small volume of medication instilled just below the epidermis causes the formation of a wheal (localized area of swelling that appears like a small bubble).

Which characteristic is associated with a subcutaneous injection of 5,000 units of heparin? 1. 3-mL syringe 2. 22-gauge needle 3. 1½-inch needle length 4. 90-degree angle of insertion

4. 90-degree angle of insertion : A ½-inch-length needle inserted at a 90-degree angle will ensure that the heparin is inserted into subcutaneous tissue.

A nurse is preparing to administer a subcutaneous injection of insulin. Which site should the nurse use to best promote its absorption? 1. Upper lateral arms 2. Anterior thighs 3. Upper chest 4. Abdomen

4. Abdomen: The abdomen is the preferred site for administration of insulin because it is a large area that promotes a systematic rotation of injections, and it has the fastest rate of absorption.

A primary health-care provider prescribes a medication that must be administered via the intramuscular route. Which site should the nurse eliminate from consideration because it has the highest potential for injury when administering an intramuscular injection? 1. Vastus lateralis 2. Rectus femoris 3. Ventrogluteal 4. Dorsogluteal

4. Dorsogluteal : 4. The dorsogluteal site has the highest risk for injury because of the close proximity of the sciatic nerve, blood vessels, and bone.

A primary health-care provider prescribes a medicated powder to be applied to a patient's lower leg. Which is most essential for the nurse to do when applying the medicated powder? 1. Apply a thin layer in the direction of hair growth. 2. Protect the patient's face with a towel. 3. Dress the area with dry sterile gauze. 4. Ensure that the skin surface is dry.

4. Ensure that the skin surface is dry. 4. Moisture harbors microorganisms and when mixed with a powder will result in a paste-like substance. The site should be clean and dry before medication administration to ensure effective action of the drug.

Which should the nurse do to limit discomfort when administering an injection to an adult? 1. Pull back on the plunger before injecting the medication. 2. Apply ice to the area before the injection. 3. Pinch the area while inserting the needle. 4. Inject the medication slowly.

4. Inject the medication slowly. Injecting slowly allows the fluid to be dispersed gradually, which limits tissue trauma and discomfort.

A home-care nurse is helping a patient with short-term memory loss with how to remember to take multiple drugs throughout the day. Which should the nurse do when teaching this patient? 1. Suggest that the patient wear a watch with an alarm. 2. Ask a family member to call the patient when medications are to be taken. 3. Design a chart of the medications the patient takes each day during the week. 4. Instruct the patient to put medications in a weekly organizational pill container.

4. Instruct the patient to put medications in a weekly organizational pill container.

Which equipment and technique should the nurse use to administer most intramuscular injections? Select all that apply. 1. _____Use a 1-inch needle. 2. _____Use a 25-gauge needle. 3. _____Insert the needle at a 45-degree angle. 4. _____Aspirate before instilling the medication. 5. _____Massage the insertion site after needle removal

4. _____Aspirate before instilling the medication. 5. _____Massage the insertion site after needle removal

Which routes are associated with the administration of a suppository? Select all that apply. 1. _____Ear 2. _____Nose 3. _____Mouth 4. _____Vagina 5. _____Rectum

4. _____Vagina 5. _____Rectum

Which abbreviation indicates that the primary health-care provider wants a medication administered before meals? 1. pc 2. OD 3. PO 4. ac

4. ac The abbreviation for before meals is ac (ante cibum

A primary health-care provider prescribes medicated ear drops for a patient. Place the following steps in the order in which they should be implemented after cleaning the patient's ear. 1. Release the pinna and gently press on the tragus several times. 2. Pull up and back on the cartilaginous part of the pinna gently. 3. Place the drops on the side of the ear canal without touching the canal with the dropper. 4. Position the patient in the side-lying position with the affected ear facing toward the ceiling. 5. Warm the refrigerated ear drops to room temperature by holding the container in the palm of a hand for several minutes. Answer: _________________

5. Warm the refrigerated ear drops to room temperature by holding the container in the palm of a hand for several minutes. 4. Position the patient in the side-lying position with the affected ear facing toward the ceiling. 2. Pull up and back on the cartilaginous part of the pinna gently. 3. Place the drops on the side of the ear canal without touching the canal with the dropper. 1. Release the pinna and gently press on the tragus several times