NURS (FUNDAMENTAL): Ch 28 NCLEX Medications

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. 1 Intramuscular 2 Subcutaneous 3 Intravenous 4 Oral

4, 2, 1, 3 Absorption is the process by which a medication enters the bloodstream. The route of administration affects how quickly and completely a medication is absorbed. Intravenous (IV) administration offers the quickest rate of absorption, followed in descending order by intramuscular (IM), subcutaneous, and oral (PO) routes.

A nurse is administering a subcutaneous injection to a client. What is the common maximum volume of a subcutaneous injection? a) 1 mL b) 3 mL c) 0.05 mL d) 0.01 mL

a) 1 mL

A nurse is placing an IV in a newly admitted 30-year-old man. Which size catheter (lumen size and length, respectively) is most appropriate? a) 20 gauge, 1 inch b) 24 gauge, 2 inches c) 18 gauge, 2 inches d) 14 gauge, 1 inch

a) 20 gauge, 1 inch Typical lumen size in an adult is between 18 and 22 gauge. The catheter should be the shortest possible length. Usually 1 to 1.25 inches is sufficient for IV therapy.

A nurse is caring for a client, age 4 years, who is being treated for osteomyelitis in his left femur. He is on a 28-day course of IV vancomycin to be administered daily at 1 p.m. Today is day 3 of treatment, and the pharmacist asks the nurse to draw a peak vancomycin level. What would be the most appropriate time to draw this blood? a) 3 p.m. b) 12 noon c) Wait until day 5 of treatment. d) 8 p.m.

a) 3 p.m. Peak levels are drawn shortly after the drug is administered. The best choice is 3 p.m. because it closely follows the time of infusion, which is when the drug concentration would be highest.

A nurse is administering a piggyback infusion to a client with second-degree burns. Which of the following describes the most important feature of a piggyback infusion? a) A parenteral drug is given in tandem with IV solution. b) Medication is given all at one time as quickly as possible. c) Medication locks are changed every 72 hours. d) Primary IV solution is infused by gravity.

a) A parenteral drug is given in tandem with IV solution.

A nurse is administering a pain medication to a patient. In addition to checking his identification bracelet, the nurse correctly verifies his identity by: a) Asking the patient his name b) Reading the patient's name on the sign over the bed c) Asking the patient's roommate to verify his name d) Asking, "Are you Mr. Brown?"

a) Asking the patient his name

A nurse is administering an oral medication to a patient via a gastric tube. The nurse observes the medication enter the tube, and then the tube becomes clogged. What would be the appropriate initial action of the nurse in this situation? a) Attempt to dislodge the medication with a 10-mL syringe. b) Notify the primary care provider. c) Remove the tube and replace it with another tube. d) Flush the tube with 60 mL of water.

a) Attempt to dislodge the medication with a 10-mL syringe.

A nurse receives orders from the physician to mix a client's insulin in a syringe with two other medications. What is the recommended guideline in this situation? a) Call the pharmacist to determine compatibility of the drugs. b) Call the physician to determine the necessity of mixing the three drugs or to see if they are compatible. c) Check with the nursing team before mixing and administering the drugs. d) It cannot be done because it is not possible to mix more than two medications in one syringe.

a) Call the pharmacist to determine compatibility of the drugs.

The nurse is reviewing a client's newly written medication order and is unable to read the prescriber's handwriting. Which action by the nurse is most appropriate? a) Contact the prescriber to clarify the order. b) Send the order to the pharmacy for accurate interpretation. c) Confer with another nurse who is more familiar with the prescriber's handwriting. d) Disregard the order until the prescriber returns to the unit.

a) Contact the prescriber to clarify the order.

A nurse who is administering medications to patients in an acute care setting studies the pharmacokinetics of the drugs being administered. Which statements accurately describe these mechanisms of action? Select all that apply. a) Distribution occurs after a drug has been absorbed into the bloodstream and is made available to body fluids and tissues. b) Metabolism is the process by which a drug is transferred from its site of entry into the body to the bloodstream. c) Absorption is the change of a drug from its original form to a new form, usually occurring in the liver. d) During first-pass effect, drugs move from the intestinal lumen to the liver by way of the portal vein instead of going into the system's circulation. e) The gastrointestinal tract, as well as sweat, salivary, and mammary glands, are routes of drug absorption. f) Excretion is the process of removing a drug, or its metabolites (products of metabolism), from the body.

a) Distribution occurs after a drug has been absorbed into the bloodstream and is made available to body fluids and tissues. d) During first-pass effect, drugs move from the intestinal lumen to the liver by way of the portal vein instead of going into the system's circulation. f) Excretion is the process of removing a drug, or its metabolites (products of metabolism), from the body.

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

a) Help the client into a Fowler's position.

Which actions would the nurse perform when administering a subcutaneous injection correctly? Select all that apply. a) Inject the needle quickly at an angle of 45 to 90 degrees. b) After removing the needle, do not massage the area to prevent hematoma formation. c) If blood appears when aspirating, withdraw the needle and reinject it at another site. d) Grasp and bunch the area surrounding the injection site or spread the skin taut at the site. e) Remove the needle cap with the dominant hand, pulling it straight off. f) If using the outer aspect of the upper arm, place the client's arm over the chest with the outer area exposed.

a) Inject the needle quickly at an angle of 45 to 90 degrees. b) After removing the needle, do not massage the area to prevent hematoma formation. d) Grasp and bunch the area surrounding the injection site or spread the skin taut at the site.

A nurse is explaining to a client the correct method of using a metered-dose inhaler when self-administering a prescribed dose of medication. What is a feature of a metered-dose inhaler? a) It is a canister that contains pressurized medication. b) It has propellers that get activated during inhalation. c) It is a battery-operated device that spins. d) It suspends finely powdered medication.

a) It is a canister that contains pressurized medication.

A nurse is preparing medications for patients in the ICU. The nurse is aware that there are patient variables that may affect the absorption of these medications. Which statements accurately describe these variables? Select all that apply. a) Patients in certain ethnic groups obtain therapeutic responses at lower doses or higher doses than those usually prescribed. b) Some people experience the same response with a placebo as with the active drug used in studies. c) People with liver disease metabolize drugs more quickly than people with normal liver functioning. d) A patient who receives a pain medication in a noisy environment may not receive full benefit from the medication's effects. e) Oral medications should not be given with food as the food may delay the absorption of the medications. f) Circadian rhythms and cycles may influence drug action.

a) Patients in certain ethnic groups obtain therapeutic responses at lower doses or higher doses than those usually prescribed. b) Some people experience the same response with a placebo as with the active drug used in studies. d) A patient who receives a pain medication in a noisy environment may not receive full benefit from the medication's effects. f) Circadian rhythms and cycles may influence drug action.

A 17-year-old girl is admitted to pediatrics with a diagnosis of diabetic ketoacidosis. She requires intravenous therapy to a) Provide access for the administration of insulin b) Provide access for blood and blood products c) Provide dextrose 10% and sodium bicarbonate d) Provide replacement of daily body fluids

a) Provide access for the administration of insulin A client with acute diabetic ketoacidosis requires intravenous access for the administration of insulin.

A nurse is teaching an adolescent patient how to use a meter-dosed inhaler to control his asthma. What are appropriate guidelines for this procedure? Select all that apply. a) Remove the mouthpiece cover and shake the inhaler well. b) Take shallow breaths when breathing through the spacer. c) Depress the canister releasing one puff into the spacer and inhale slowly and deeply. d) After inhaling, exhale quickly through pursed lips. e) Wait 1 to 5 minutes as prescribed before administering the next puff. e) Gargle and rinse with salt water after using the MDI.

a) Remove the mouthpiece cover and shake the inhaler well. c) Depress the canister releasing one puff into the spacer and inhale slowly and deeply. e) Wait 1 to 5 minutes as prescribed before administering the next puff.

A home care nurse is educating a client with diabetes on how to self-administer insulin. Which teaching point would the nurse include in the education plan? a) Rotate the injection site. b) Reuse syringes and needles up to three times. c) Store needles and syringes in a glass container. d) Use the same site on the body for each injection.

a) Rotate the injection site.

A nurse is caring for a 6-year-old client on the hematology-oncology floor. During a packed red blood cell transfusion, the client complains of pain at her peripheral IV site. The nurse assesses the site and notices that the site is purple. What is the nurse's best course of action? a) Stop the transfusion and discontinue the peripheral IV. b) Stop the transfusion and aline lock the peripheral IV. c) Continue the transfusion and note any findings in the chart. d) Call the physician and notify them of a transfusion reaction.

a) Stop the transfusion and discontinue the peripheral IV. This is a sign of infiltration. Infiltration with PRBCs will give the appearance of a bruise.

The nurse is preparing a packed red blood cell transfusion for a client. The nurse checks the client's blood type in the electronic medical record (EMR) and notes that it is blood type B. What does this mean? a) The client has anti-A antibodies. b) The client is a universal donor. c) The client has anti-B antibodies. d) The client has both anti-A and anti-B antibodies.

a) The client has anti-A antibodies. Clients with type B blood have anti-A antibodies. This means they would attack any type A blood they receive, prompting a transfusion reaction. Clients with type O blood are universal donors.

A nurse needs to administer a prescribed injection to a toddler. Which injection site is most suitable for the client? a) Vastus lateralis site b) Ventrogluteal site c) Dorsogluteal site d) Deltoid site

a) Vastus lateralis site

Elaine is a 28-year-old woman pregnant with multiples. She is diagnosed with hyperemesis gravidarum (excessive vomiting during pregnancy). She is unable to keep enteral fluids down. A licensed practitioner orders home IV therapy for 2 weeks. What type of IV access is most appropriate for Elaine? a) a PICC line b) a tunneled catheter c) a peripheral IV d) an implanted access port

a) a PICC line PICC lines are appropriate for long-term therapy and can easily be used in the home environment. A peripheral IV is rarely used for home therapy, especially when the client will need infusions for more than 1 day. The tunneled catheter and implanted ports require an operation to place; this is too invasive for this client.

The nurse is preparing to administer meperidine as an intramuscular injection in an adult client's deltoid site. Which needle should the nurse select for this injection? a) 2"; 18 gauge b) 1"; 22 gauge c) 5/8"; 24 gauge d) 1½"; 18 gauge

b) 1"; 22 gauge IM injections using the deltoid site require a 20- to 25-gauge needle that is between 1" and 1½" in length.

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? a) Add medications to the formula. b) Avoid crushing sustained-release pellets. c) Use cold water when mixing powdered medications. d) Mix all the medications together in 15 mL of water.

b) Avoid crushing sustained-release pellets.

Ms. Hall has an order for hydromorphone (Dilaudid), 2 mg, intravenously, q 4 hours PRN pain. The nurse notes that according to Ms. Hall's chart, she is allergic to Dilaudid. The order for medication was signed by Dr. Long. What would be the correct procedure for the nurse to follow in this situation? a) Administer the medication; the doctor is responsible for medication administration. b) Call Dr. Long and ask that she change the medication. d) Ask the supervisor to administer the medication. e) Ask the pharmacist to provide a medication to take the place of Dilaudid.

b) Call Dr. Long and ask that she change the medication.

A nurse is applying a vaginal cream to a client with a vaginal infection. What is a recommended guideline for this application? a) Position the client in the prone position. b) Cleanse area at vaginal orifice with washcloth and warm water. c) Spread the labia with dominant hand and introduce the applicator with the nondominant hand gently, using a pushing motion. d) Wipe from the sacrum to the vaginal orifice upward (back to front).

b) Cleanse area at vaginal orifice with washcloth and warm water.

A physician orders a pain medication for a postoperative patient that is a PRN order. When would the nurse administer this medication? a) A single dose during the postoperative period b) Doses administered as needed for pain relief c) One dose administered immediately d) Doses routinely administered as a standing order

b) Doses administered as needed for pain relief

A nurse is caring for a client who has a PICC line. Which nursing action is recommended? a) Use clean technique when changing dressing. b) Flush using normal saline and/or heparin solution according to facility policy. c) Keep external portion of catheter coiled on top of dressing. d) Change catheter caps every 10 days or as per facility policy.

b) Flush using normal saline and/or heparin solution according to facility policy.

Which situation accurately describes a recommended guideline when administering oral medications to clients? a) If a pill is dropped, it should be briefly immersed in saline to remove any dirt or germs. b) If a child refuses to take medication, the medication can be crushed and added to a small amount of food. c) Assume that the client is the authority on whether or not the medication was swallowed. d) If a client vomits immediately after receiving oral medications, re-administer the medication.

b) If a child refuses to take medication, the medication can be crushed and added to a small amount of food.

A patient requires 40 units of NPH insulin and 10 units of regular insulin daily subcutaneously. What is the correct sequence when mixing insulins? a) Inject air into the regular insulin vial and withdraw 10 units; then, using the same syringe, inject air into the NPH vial and withdraw 40 units of NPH insulin. b) Inject air into the NPH insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the regular insulin vial and withdraw 10 units; then, withdraw 40 units of NPH insulin. c) Inject air into the regular insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the NPH insulin vial and withdraw 40 units; then, withdraw 10 units of regular insulin. d) Inject air into the NPH insulin vial and withdraw 40 units; then, using the same syringe, inject air into the regular insulin vial and withdraw 10 units of regular insulin.

b) Inject air into the NPH insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the regular insulin vial and withdraw 10 units; then, withdraw 40 units of NPH insulin.

Which "rights" are included in the "six rights for medication administration"? Select all that apply. a) Right room b) Right route c) Right time d) Right diagnosis e) Right dose f) Right medication

b) Right route c) Right time e) Right dose f) Right medication

A nurse is caring for a client undergoing IV therapy. The nurse knows that intravenous administration of medication is appropriate in which of the following situations? a) When the drug needs to be administered only once b) When the client has disorders that affect the absorption of medications c) When the client wants to avoid the discomfort of an intradermal injection d) When the drug needs to act on the client very slowly

b) When the client has disorders that affect the absorption of medications

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

b) larger diameter

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

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

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 which have 30 g in 45 mL. How many milliliters is the nurse going to administer every 6 hours to the client? a) 22.5 mL b) 15 mL c) 30 mL d) 67.5 mL

c) 30 mL The formula to calculate the correct medication amount is: (Dose on hand/Quantity on hand = Dose desired/X). If you use this for this scenario you would have 30 g/45 mL = 20 g/X, where X = 30 mL

A nurse needs to administer a continuous medication drip to a client. The nurse knows that, for a continuous infusion, she will likely need to add medication to which volume of IV solution? a) 150 to 250 mL b) 50 to 100 mL c) 500 to 1,000 mL d) 15 to 50 mL

c) 500 to 1,000 mL a continuous infusion is the instillation of a parenteral drug over several hours. It is also called a continuous drip, which involves adding medication to a large volume of IV solution—approximately 500 to 1,000 mL, not less.

A nurse has administered an injection to a client. Which intervention should the nurse perform to reduce discomfort and provide quick relief? a) Apply a eutectic mixture of local anesthetic to the site. b) Numb the skin with an ice pack after the injection. c) Apply pressure to the site during needle withdrawal. d) Massage the site following injection.

c) Apply pressure to the site during needle withdrawal.

When educating an older adult client about the administration of medication during discharge, the nurse notes that the client is having difficulty comprehending the instruction. What intervention should the nurse follow in this case to ensure the client's safety? a) Ask the client's physician to provide instruction. b) Write discharge instructions on the medication containers. c) Ask a second nurse to repeat the instruction. d) Involve a second responsible person in the instruction.

c) Ask a second nurse to repeat the instruction.

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? a) Instill the medication in the opposite ear if prescribed. b) Place a cotton ball in the ear to absorb excess medication. c) Ask the client to maintain the position for some time. d) Briefly postpone the application in the second ear.

c) Ask the client to maintain the position for some time.

A nurse administers a dose of an oral medication for hypertension to a patient who immediately vomits after swallowing the pill. What would be the appropriate initial action of the nurse in this situation? a) Readminister the medication and notify the primary care provider. b) Readminister the pill in a liquid form if possible. c) Assess the vomit, looking for the pill. d) Notify the primary care provider.

c) Assess the vomit, looking for the pill.

Which of the following is a recommended guideline for the nurse who is administering a piggyback intermittent intravenous infusion of medication? a) Place the additive solution lower than the primary solution container. b) Using clean technique, remove the cap on the tubing spike and the cap on the port of the medication container. c) Attach infusion tubing to the medication container by inserting the tubing spike into the port with a firm push and twisting motion. d) Ask the physician to calculate and regulate the infusion with an infusion pump.

c) Attach infusion tubing to the medication container by inserting the tubing spike into the port with a firm push and twisting motion.

A nurse is using an IV port when administering medication to a client. Which IV administration has the greatest potential to cause life-threatening changes? a) Electronic infusion device b) Secondary administration c) Bolus administration d) Continuous administration

c) Bolus administration

The nurse is administering a medication to a patient via a nasogastric tube. Which are accurate guidelines related to this procedure? Select all that apply. a) Crush the enteric-coated pill for mixing in a liquid. b) Flush open the tube with 60 mL of very warm water. c) Check for proper placement of the nasogastric tube. d) Give each medication separately and flush with water between each drug. e) Lower the head of the bed to prevent reflux. f) Adjust the amount of water used if patient's fluid intake is restricted.

c) Check for proper placement of the nasogastric tube. d) Give each medication separately and flush with water between each drug. f) Adjust the amount of water used if patient's fluid intake is restricted.

A nurse discovers that she made a medication error. What should be the nurse's first response? a) Record the error on the medication sheet. b) Notify the physician regarding course of action. c) Check the patient's condition to note any possible effect of the error. d) Complete an incident report, explaining how the mistake was made.

c) Check the patient's condition to note any possible effect of the error.

A nurse is administering heparin subcutaneously to a patient. What is the correct technique for this procedure? a) Aspirate before giving and gently massage after the injection. b) Do not aspirate; massage the site for 1 minute. c) Do not aspirate before or massage after the injection. d) Massage the site of the injection; aspiration is not necessary but will do no harm.

c) Do not aspirate before or massage after the injection.

A nurse is administering an intradermal injection to a client for a skin allergy test. When the nurse is finished, there is no sign of a wheal or blister at the site of injection. What is the nurse's best action in this situation? a) Prepare another syringe and administer it to the client at the same site. b) Document the administration as correctly administered. c) Document the administration and inform the primary care provider. d) Choose another site and reinject the medication.

c) Document the administration and inform the primary care provider.

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

c) If both ears are to be treated, wait 5 minutes before instilling drops in the second ear.

A nurse is caring for a client on IV therapy. The IV tubing has a volume-control set. Which of the following is a function of the volume-control set? a) It is used when IV medications are irritating to peripheral veins. b) It is used to administer medication in a large volume of blood. c) It is used to administer small volumes of IV medication. d) It is used to administer medication continuously.

c) It is used to administer small volumes of IV medication.

A nurse preparing medication for a client is called away to an emergency. What should the nurse do? a) Have another nurse guard the preparations. b) Put the medications back in the containers. c) Lock the medications in a cart and finish them upon return. d) Have another nurse finish preparing and administering the medications.

c) Lock the medications in a cart and finish them upon return.

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

c) Return the medication to the medication cart or medication room.

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) Allow sufficient time to prepare the medication with minimal distraction. b) Administer medication within 30 to 60 minutes of the scheduled time. c) Review the client's medication, allergy, and medical history. d) Read and compare labels on the medication with the medical record.

c) Review the client's medication, allergy, and medical history.

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? a) Subcutaneous injections are administered at a 30- to 45-degree angle based on the amount of subcutaneous tissue present. b) Pinching is advised for obese clients to lift the adipose tissue away from underlying muscle and tissue. c) Subcutaneous injections are administered into the adipose tissue layer just below the epidermis and dermis. d) Sites commonly used for a subcutaneous injection are the inner surface of the forearm and the upper back, under the scapula.

c) Subcutaneous injections are administered into the adipose tissue layer just below the epidermis and dermis.

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 narcotics for the division are counted. d) The medications for the division are counted.

c) The narcotics for the division are counted.

A nurse is reconstituting powdered medication in a vial. Which action is a recommended step in this process? a) The nurse draws up the proper amount of powered medication into the syringe. b) The nurse inserts the needle through the rubber stopper of the diluent vial. c) The nurse gently agitates the powdered medication vial to mix the powder and diluent completely. d) The nurse draws up the prescribed amount of medication while holding the syringe horizontally at eye level.

c) The nurse gently agitates the powdered medication vial to mix the powder and diluent completely.

A medication order reads: "K-Dur, 20 mEq po b.i.d." When and how does the nurse correctly give this drug? a) Daily at bedtime by subcutaneous route b) Every other day by mouth c) Twice a day by the oral route d) Once a week by transdermal patch

c) Twice a day by the oral route

A nurse is administering an intramuscular injection to a client using the Z-track method. Which action should the nurse perform to prevent leaking and ensure sealing of medication in the subcutaneous and dermal layers of tissue? a) Apply pressure and massage the site immediately. b) Insert the needle at a 90-degree angle into the tissue. c) Withdraw the needle and release taut skin immediately after injection. d) Manipulate the plunger with the help of the thumb.

c) Withdraw the needle and release taut skin immediately after injection. Withdrawing the needle and immediately releasing the taut skin creates a diagonal path that prevents the medication from leaking into the subcutaneous and dermal layers of tissue. Manipulating the plunger with the help of the thumb avoids releasing the tissue held taut by the nondominant hand. Applying pressure, but not massaging the site, ensures that the medication remains sealed. Inserting the needle at a 90-degree angle directs the tip of the needle within the muscle.

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

c) to prevent drug abuse.

The nurse is working the night shift in the ER when an ambulance arrives carrying a man s/p motor vehicle accident (MVA). His initial BP is 100/56 and the nurse notes that he is bleeding heavily from a laceration on the forehead. Fifteen minutes later, the nurse reassesses the client and finds that his BP is 95/58. What IV fluid would the nurse expect to be ordered? a) 3% NS b) 0.45% NS c) D5 ¼ NS d) 0.9% NS

d) 0.9% NS

A nurse needs to administer a subcutaneous heparin injection to a client. Which injection site is most suitable for heparin? a) Back b) Upper chest c) Forearm d) Abdomen

d) Abdomen

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) When looking at a needle package, the first number is the length in inches and the second number is the gauge or diameter of the needle. b) When giving an injection, the amount of the medication directs the choice of gauge. c) The size of the syringe is directed by the viscosity of the medication to be given. d) As the gauge number becomes larger, the size of the needle becomes smaller.

d) As the gauge number becomes larger, the size of the needle becomes smaller.

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) Electronic infusion device b) Gravity infusion c) Continuous drip 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.

A nurse is providing care for a client who has a history of dementia. Which method should the nurse use in order to determine the client's identity prior to medication administration? a) Cross-reference the MAR with the client's medical record. b) Enlist the help of a colleague who is familiar with the client. c) Ask the client his name prior to giving the drug. d) Check the client's identification band.

d) Check the client's identification band.

A medication order reads: "Hydromorphone, 2 mg IV every 3 to 4 hours PRN pain." The prefilled cartridge is available with a label reading "Hydromorphone 2 mg/1 mL." The cartridge contains 1.2 mL of hydromorphone. Which nursing action is correct? a) Give all the medication in the cartridge because it expanded when it was mixed. b) Call the pharmacy and request the proper dose. c) Refuse to give the medication. d) Dispose of 0.2 mL correctly before administering the drug.

d) Dispose of 0.2 mL correctly before administering the drug.

Which is a drug class that strengthens cardiac contraction? a) Diuretics b) Anticoagulants c) Antiarrhythmics d) Inotropes

d) Inotropes

Which parenteral route of administration has the longest absorption time? a) Intramuscular b) Subcutaneous c) Intravenous d) Intradermal

d) Intradermal

Which factor is associated with rapid absorption of a drug? a) Decreased blood flow b) Oral route of administration c) Basic environment in the stomach d) Intravenous route of administration

d) Intravenous route of administration

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

d) Spacer

While injecting a needle into a client for an intramuscular injection, the nurse hits the client's bone. What would be the appropriate initial response of the nurse to this situation? a) Document the incident according to facility policy, then remove the needle and syringe and discard it. b) Remove the needle and have another nurse stay with the client while informing the primary care provider. c) Remove the needle and discard the needle and syringe; call the primary care provider. d) Withdraw the needle, apply a new needle to syringe, and administer the injection in an alternate site.

d) Withdraw the needle, apply a new needle to syringe, and administer the injection in an alternate site. When the bone is hit during an intramuscular injection the nurse should withdraw and discard the needle. A new needle is then applied to the syringe and administered in an alternate site. Documentation of the incident in client's medical record is necessary and the primary care provider should be notified. Appropriate paperwork related to special events according to facility policy should be completed.

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) a propeller-driven device that spins and suspends a finely powdered medication b) a device that forces medication through a narrow channel with the help of inert gas c) a device that forces liquid drug through a narrow channel using pressurized air d) a canister containing medication that is released when the container is compressed

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

To which of the following clients would the nurse be most likely to administer a p.r.n. medication? a) a client who requires daily medication to control hypertension b) a client who is experiencing severe and unprecedented chest pain c) a client whose asthma is treated with inhaled corticosteroids d) a client who is reporting pain near her surgical site

d) a client who is reporting pain near her surgical site

Which action describes buccal medication administration? a) placing a medication through a nasogastric tube b) placing a medication, which is designed to be absorbed through the skin for systemic effects, on the skin c) placing a medication under the tongue and allowing it to dissolve d) placing a medication underneath the upper lip or in the side of the mouth

d) placing a medication underneath the upper lip or in the side of the mouth

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

d) swallowing the medication

A nurse flushes an intravenous lock before and after administering a medication. What is the rationale for this step? a) to dilute the infusion and maintain homeostasis b) to keep the inside of the needle or catheter sterile c) to facilitate client comfort and decrease anxiety d) to clear medication and prevent clot formation

d) to clear medication and prevent clot formation