PrepU Chapter 28: Medications

Which instruction should the nurse give to a client to ensure the nasal medication is deposited within the nose rather than into the throat?

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

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."

During a teaching session on self-administration of insulin, the client asks the nurse why it is necessary to bunch the skin before inserting the needle. What is the nurse's BEST response?

"Bunching your skin facilitates the placement of the needled in the subcutaneous tissue."

The nurse is beginning to administer oral medications to a client. The client state, "I haven't taken that pill before. Are you sure it's correct?" The nurse rechecks the CMAR/MAR and finds that the medication is scheduled to be administered. Which response is most appropriate?

"Don't take that pill yet. I will verify that the medication was ordered by your primary care provider."

The nurse is caring for a client with diabetes. Which client statement reflects that nursing teaching has been effective?

"I will eat a meal within a half hour of taking my morning insulin."

Which statement by a relative indicates the the nurse that the teaching on the application of paste was effective?

"I will not apply the paste on a hairy skin."

What is the BEST response by the nurse when a client asks about the side effects of using nasal spray?

"Long-term use of nasal sprays can cause rebound nasal congestion."

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."

Which statement by a client indicates to the nurse that teaching was effective regarding the different parts of a syringe?

"The plunger is the part of the syringe that moves back and forth to withdraw and instill medication."

A nurse is administering an injection of insulin to a 5-year-old who has type I diabetes. Which statement by the nurse would take into consideration this child's developmental level?

"You will just feel a little pinch."

The 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 a tuberculin test. At which angle is the nurse expected to instill the drug?

15-degree angle

The nurse is preparing to administer insulin to an older client who is frail and has failure to thrive. At what angle will the nurse plan to insert the needle into the client?

45 degrees

A 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

A client is ordered 1000 mL 5% dextrose and normal saline to infuse over 12 hours. When setting up the electronic infusion device, the nurse would set the device to deliver how many milliliters of fluid per hour?

83

The nurse is infusing 0.9% NS to a hypovolemic client s/p an MVA. The nurse is ordered to infuse 1000 mL of fluid over 1 hour. The tube has a drop factor of 5 drops/mL. What is the drip rate of the infusion?

83 drops/minute

The nurse is preparing to insert an intravenous needle in a 1-year-old child for a one-time administration of fluids due to dehydration. Which needle would the nurse likely select?

A 23-gauge winged infusion set.

Which medfication interaction illustrates a synergism?

A client tasked acetaminophen to help her sleep. She also takes an oxycodone for pain related to hip surgery, which makes her even more drowsy.

A nurse is caring for a patient with pancreatic cancer who is receiving continuous morphine for pain. Which of the following would be the most effective method to administer this medication?

Administer a continuous subcutaneous infusion of morphine.

The nurse is preparing to administer a bolus of an intravenous medication. How should the medication be administered?

All at once

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 is preparing medications and is notified that a health care provider is on the phone. What is the nurse's appropriate response?

Ask the unit clerk to take a message from the provider.

Which is a recommended guideline for the nurse who is administering a piggyback intermittent intravenous infusion of medication?

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

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?

Bolus administration

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?

Check the client's identification band.

The nurse has completed administering medications through an enteral tube used for decompression. What is the appropriate nursing action?

Clamp the tube for at least 30 minutes.

A nurse is applying a vaginal cream to a client with a vaginal infection. What is a recommended guideline for this application?

Cleanse area at vaginal orifice with washcloth and warm water.

The nurse has given medications to four clients. Which client will the nurse monitor MOST closely for a possible reaction occur?

Client with infection who received a bonus of Lactated Ringer's solution.

A client asked the nurse what action clients should take in ensuring that medications are distributed within the eye. What answer is the nurse expected to give the client?

Clients should close their eyes temporarily.

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?

Contact health care provider for order clarification.

The nurse is preparing to give medications to a client with high blood pressure. The order indicates that the client is to have Adderal, 40 mg by mouth twice daily. What is the appropriate nursing action?

Contact the health care provider for order clarification.

The nurse is reading a medication order for a drug that is routinely administered every 12 hours. The order does not state the frequency of administration. What is the appropriate nursing action?

Contact the health care provider to clarify the order.

The hospital nurse is using barcode medication administration software when preparing to administer medication to a client. When the scanning system cannot identify the client's identity, what is the appropriate nursing action?

Contact the pharmacy and information technology department for assistance.

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 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?

Document the administration and inform the primary care provider.

A nurse needs to administer an intradermal injection to a client. What is the MOST common site for administering an intradermal injection?

Forearm

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?

Help the client into a Fowler's position

The nurse is providing teaching to an older adults with arthritis and an implanted catheter. What living arrangements does the nurse anticipate in the discharge plan of care?

Home nursing visits

Which medication would MOST likely be administered via a transdermal patch?

Hormonal medications

Which of the following would cause an IV drip rate to increase? Select all that apply.

Increasing the height of the IV pole. Changing the tubing to unclog an air vent. Unkinking the IV tubing.

The nurse is preparing to administer a tuberculin test. Which route will the nurse select to administer this injection?

Intradermal

The Z-track technique is utilized during drug administration by which route?

Intramuscular

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 actions?

Minimizes tissue trauma to the client

To convert 0.8 grams to milligrams, the nurse should do which of the following?

Move the decimal point 3 places to the right.

A nurse is preparing to administer a transfusion of packed red blood cells to a client. Which solution would the nurse expect to use to administer the transfusion?

Normal saline.

The nurse is preparing to administer an oral medication to a client with xerostomia. Which nursing action is appropriate?

Offer a sip of water before administering medication.

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

Oral Subcutaneous Intramuscular Intravenous

What is the name of the process by which a drug moves through the body and is eventually eliminated?

Pharmacokinetics

The nurse is caring for a client with visual impairment who has been prescribed two different types of eye drops. Which nursing intervention will BEST assist the client in differentiating between the bottles of drops?

Place a rubber band snugly around one of the bottles.

Which action describes buccal medication administration?

Placing a medication underneath the upper lip or in the side of the mouth.

A nurse is preparing to convert a client's IV to an intermittent infusion device. The IV is connect to extension tubing. Before disconnecting the IV tubing from the extension tubing, the nurse clamps the extension tubing for which reason?

Prevent air from entering the line

The nurse has received a telephone order for a client from a health care provider. How will the nurse indicate in the documentation that the order was received via telephone?

Record "T.O." at the end of the order.

The nurse is preparing to apply nitroglycerin paste. After checking the order, washing hands, checking the client's identity, and applying gloves, which is the NEXT nursing action?

Removing prior application and any remaining residue from skin.

While administering a medication via a syringe, a client sharply moves and the nurse accidentally encounters a needle stick. What is the PRIORITY nursing action?

Report the needle stick to the nurse manager.

A nurse brings a client the prescribed dose os 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.

What would be considered a "right" of drug administration. (Select all that apply.)

Right drug Right documentation Right dose Right client

A nurse enters a client's room to check on his intravenous infusion. An electronic infusion device is not being used. When checking the solution container and rate, the nurse notes that that fluid is infusing at a rate slower than intended. When assessing the client, which finding would the nurse identify as most likely contributing to the slowed rate of infusion?

The client is resting his arm with the IV on his head.

Regarding medication administration, what must occur at the change of shifts?

The narcotics for the division are counted.

A nurse is preparing to administer a transdermal medication. How should this be accomplished?

The nurse should apply the medication directly to the skin.

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.

Which statement BEST describes the nurse's rationale for selecting the ventrogluteal site when using the Z-track technique for administering an injection?

The ventrogluteal site provides a location with the capacity for depositing and absorbing drug.

The primary reason for the Controlled Substances Act is:

To prevent drug abuse.

In which direction should the nurse demonstrate to clients how to clean their eyes before instilling medications?

Wipe your eyes from the inner canthus toward the outer canthus.

A nurse needs to combine two difference prescribed drugs in a syringe and then administer them to a client with influenza. Which precaution should the nurse take when combining drugs?

Withdraw exact amounts of each drug from each container.