Chapter 2 PrepU Administration of Drugs
Several medication errors occur with administration of a drug. Which two drugs have been associated with medication errors?
insulin and heparin
A nurse has received an order to administer a TB skin test to a client. The nurse will inform the client that TB skin tests are most often given intradermally in what part of the body?
medial forearm
Which of the following are examples of changes being made to medication systems to reduce the possibility of errors? Select all that apply.
Computerized provider order entry Bar coding Medication reconcilliation
An infant's current weight indicates that the maximum safe dose of acetaminophen is 30 mg by mouth. The health care provider orders 65 mg to be given, and the nurse administers acetaminophen 65 mg. Who is legally responsible in the event that the infant has a toxic reaction to the medication?
the nurse
The home care nurse is teaching a family member about transdermal medication administration. Which statement by the family member indicates a need for further instruction?
"I will throw the old patch away in the trash container in the kitchen."
A client has been prescribed 1 mg lorazepam (Ativan) sublingual prior to the scheduled insertion of a peripherally inserted central (PIC) line. How should the nurse direct the client when administering this medication?
"Place this under your tongue and let it dissolve there."
A nurse, who is required to administer a drug twice a day to a client, forgets to administer the first dose. What would be most appropriate for the nurse to do?
*Report the drug error immediately. *Complete an unusual occurrence report regarding the error. *Notify the primary care provider immediately.
The nurse is preparing to administer medications and demonstrates knowledge of the 6th right by:
Documenting the medication after administration
Which should be administered intradermally?
PPD Skin test
Nurses are responsible for which part of the drug distribution process?
administration
The nurse is in the hall outside Room 433 preparing medications when a member of the client's family in the adjacent room 432 approaches the nurse and asks a question. What is the nurse's best action in this situation?
Explain to the family member that the nurse is unable to discuss the situation at this time but will return later.
A student nurse is administering medications at a long-term care facility. Which of the following liquid medications is for topical administration?
Eye drops
One route of medication administration requires special precautions to avoid complications. What route is this?
GI tube
The nurse is preparing to discharge a client who has begun to use subcutaneous insulin. What would be the best choice of container for the client to use for disposal of used needles and syringes?
Gallon plastic milk container with a screw-on lid
The health care provider has ordered a troche to be administered to a client. What instructions should be given to the client for correct administration of the medication?
Place the troche between your cheek and lower gums and allow it to dissolve.
The nurse should use which needle when administering a nonviscous solution by the intramuscular (IM) route for an adult?
1.5 inches (3.8 cm), 22 gauge
A nurse is preparing to administer a prescribed medication by subcutaneous injection. When determining the amount to give, the nurse would keep in mind the maximum volume that should be given in a subcutaneous injection as how much?
1mL
The nurse is required to administer 2 mL of a subcutaneous (SC) injection to the client. The injection should be given in _____ sites, with separate needles and syringes.
2
A nurse is preparing to administer an intramuscular injection of an older adult's seasonal influenza vaccination. What size needle should the nurse use to administer the injection?
20 gauge
The nurse is caring for a client who receives intramuscular (IM) injections. What needle gauge is commonly used for an IM injection?
22 gauge
What is the maximum amount of drug a nurse can give a client using the intramuscular method? Fill in the blank with a number.
3
A nurse is to give an intermittent infusion. Approximately how long will it take for the infusion to be given?
30 to 60 minutes
There is a limit to the amount of medication that can safely be administered intramuscularly to an adult. What is that amount?
3mL
When administering a subcutaneous injection to a client weighing 165 lb (74.8 kg) and who is is 5 ft 2 in (1.5 m 5 cm) tall, the nurse should insert the needle at which degree angle?
45
A nurse is preparing to give a client an intermittent infusion. How much fluid would the nurse know that the infusion will be diluted with?
50 to 100 mL
The nurse receives instruction for medication administration on what system that operates using a computer touch screen?
Automated medication management system
A nurse is preparing to administer a medication into a client's cheek. What kind of administration is this?
Buccal
The nurse has received this medication order: Amoxicillin 250 mg every 8 hours. What should the nurse do?
Call the health care provider for clarification
The nurse working the night shift administered 10 mg of an oral medication to a client instead of 5 mg. What is the nurse's next step after discovering the medication error?
Call the health care provider. Complete an unusual occurrence report. Take the client's vital signs.
The nurse is required to administer 4 mL of an intramuscular (IM) injection to the client. Which action would be most appropriate?
Divide the drug and give it as two separate injections.
A client asks the nurse why all medications cannot be given by the oral route. The nurse explains the disadvantages of the route of oral medications are which? Select all that apply.
Dosage is unknown because some drug is not absorbed and some is metabolized in the liver before reaching the bloodstream. Slow drug action Irritation of gastrointestinal mucosa by some drugs
The absorption rate of drugs varies according to the route of administration. Rank the order of absorption from most rapid to least rapid.
IV, IM, SC, PO
An LPN/LVN is preparing to administer medications and knows that which routes of drug administration may only delivered by the health care provider? Select all that apply.
Intra-arterial Intra-articular Intracardial
In response to a client's nausea, the nurse has mixed a dose of an antiemetic with 50 mL of sterile normal saline and will administer the dose by IV piggyback. What is the rationale for the use of IV piggyback?
The client is receiving continuous IV fluids in addition to IV medications.
The nurse is observing a client applying a transdermal patch and knows the client needs further instruction when which of the following occurs?
The client shaves the skin prior to applying the patch.
The nurse is performing ear irrigation on a client with impacted cerumen. This is an example of what type of medication administration?
Topical
The nurse is administering a subcutaneous injection and notices that there is blood in the syringe prior to injecting the medication. What is the nurse's best action?
Withdraw the syringe and prepare a new injection
After teaching a group of nursing students about the Joint Commission and National Patient Safety Goals (NPSG), the instructor determines that the teaching was successful when the group identifies that the NPSG is updated at which frequency?
annually
When is it appropriate to document medication administration on the client's medication administration record (MAR)?
as soon as possible after administration
The nurse is preparing to administer a prescribed drug and scans the client's hospital identification band, the drug unit dose package, and the identification badge. Which type of drug distribution system is the nurse using?
bar-coded point-of-care medication system
Medication reconciliation is a process designed to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions that can occur throughout a client's hospitalization. The list of medications developed from the medication history is:
compared to newly prescribed medications.
A student nurse is administering medications at a long-term care facility. Which of the following liquid medications is for topical administration?
eye drops (wrong but they say its right so )
What is essential for the nurse to obtain before administering a medication to the client?
health care provider's prescription
The nurse is preparing to administer allergy skin testing. Through which parenteral route should the nurse administer drugs to the client to optimize results?
intradermal
The nurse is preparing to administer a prescribed drug parenterally using the Z-track method. The nurse would correctly administer the drug by which route?
intramuscular
