Chapter 21: Medication Administration

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. How will the nurse respond? a. "Bunching your skin controls bleeding." b. "Bunching your skin steadies the syringe." c. "Bunching your skin ensures complete delivery of the insulin." d. "Bunching your skin facilitates the placement of the needle in the subcutaneous tissue."

"Bunching your skin facilitates the placement of the needle in the subsutaneous tissue"

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? a. "The nurse should not have crushed this medication. It could have caused an allergic reaction." b. "I can crush the medication but will not be able to mix it in the applesauce, because it will limit the effectiveness." c. "Crushing the medication may cause the medication to irritate the stomach, so it must be swallowed whole." d. "I will ask the health care provider to cancel the prescription for aspirin since you are unable to take it."

"Crushing the medication may cause the medication to irritate the stomach, so it must be swallowed whole"

The "rights" of medication administration help to ensure accuracy when administering medications. What are some of these rights? Select all that apply. a. medication b. client c. prescribing physician d. pharmacy e. dosage f. route

- medication - client - dosage - route

What would be considered a "right" of drug administration? Select all that apply. a. right drug b. right documentation c. right class d. right dose e. right client

- right drug - right documentation - right dose - right client

Which parts of the syringe and needle must be kept sterile when preparing and administering an injection? Select all that apply. a. The outside of the cap b. The outside of the barrel c. The needle hub d. The needle e. Inside the barrel

- the needle hub - the needle - inside the barrel

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? 1000 mcg = 1 mg

0.0625mg / 0.125mg = 0.5mg tablet

The nurse is preparing to administer a sublingual medication. Which instruction to the client is correct? a. "Try not to swallow while the pill dissolves." b. "Take a big drink of water and swallow the pill." c. "Swallow frequently to get the best benefit." d. "Chew the pill so it will dissolve faster."

"Try not to swallow while the pill dissolves"

The nurse is caring for an older adult client who has been prescribed an inhaled bronchodilator. Which priority assessments will the nurse perform before and after administering the medication? (Select all that apply.) a. temperature b. blood pressure c. neurological status d. heart rate e. pain level

- blood pressure - heart rate

The nurse is teaching an older adult client with rheumatoid arthritis about taking medications at home. Which client statement does the nurse determine is unsafe and requires further nursing intervention? a. "I asked the pharmacist to cut my larger pills in half so that I can swallow them easier." b. "I take my child's anxiety medication occasionally, when I get very anxious about something." c. "My child fills up my pill organizer every week and I take whatever my child puts in the organizer." d. "I have trouble holding these little pills while trying to take them so I put it in a small cup and dump the pill from the cup into my mouth."

"I take my child's anxiety medication occasionally, when I get every anxious about something"

The nurse is caring for a client with diabetes. Which client statement reflects that nursing teaching has been effective? a. "I will eat a meal within a half hour of taking my morning insulin." b. "I will drink orange juice if I experience high blood glucose levels." c. "I will test my blood glucose levels immediately after I eat." d. "I will eat meals whenever I feel hungry."

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

A client who is receiving medication via a metered-dose inhaler asks the nurse, "Why don't I put the inhaler mouthpiece in my mouth when I use the medication?" Which response by the nurse would be most appropriate? a. "The medication is more easily trapped in the oropharynx." b. "This helps you to ensure that you swallow the medication." c. "The mist that forms is better inhaled into your airways." d. "Your mouth would contaminate the inhaler and medication."

"The mist that forms is better inhaled into your airway"

A client is taking numerous eye drops to prepare for cataract surgery. Which teaching about ophthalmic application will the nurse provide? a. "Rest the eye dropper on the inner canthus to make it easier to instill the drops." b. "Wait 5 minutes between instillation of different types of eye drops." c. "If you cannot instill these drops from the bottle, you will be unable to have surgery." d. "Dispose of these medications every 7 days due to possible bacterial contamination."

"Wait 5 minutes between instillation of different types of eye drops"

A client is newly prescribed a nitroglycerin transdermal patch daily. Which should the nurse include when educating a client on how to administer this drug? Select all that apply. a. "Place the patch in a hairy location on your body." b. "Rotate the location of the patch daily." c. "Clean the area when removing the old patch." d. "Wrap removed patch in plastic and dispose." e. "Do not remove the current patch until the new one has been placed."

- "Rotate the location of the patch daily" - "Clean the area when removing the old patch" - "Wrap removed patch in plastic and dispose"

The nurse plans discharge teaching for a client leaving the medical center with new medication prescriptions. Which action(s) does the nurse include in the discharge teaching? Select all that apply. a. Explain the benefit in placing medications in a place that links to normal events in the client's life such as brushing teeth or going to bed b. Provide client with a list of medications and directions for taking them c. Confirm that the client understands the reason for the medications d. Teach client and caregivers how to fill a pill box using the medicine list as a guide e. Tell client to always choose brand name over-the-counter medications to ensure consistency in color, shape, and size of pills

- Explain the benefit in placing medications in a place that links to normal events in the client's life such as brushing teeth or going to bed - Provide client with a list of medications and directions for taking them - Confirm that the client understands the reason for the medications - Teach client and caregivers how to fill a pill box using the medicine list as a guide

The adult child of a client with insulin-dependent diabetes will be responsible for administering the parent's medications when the client is discharged tomorrow. Which information does the nurse teach the client's child about administering the insulin? Select all that apply. a. Keep insulin refrigerated until the vial is opened b. Roll insulin bottle between hands before inserting syringe c. Inject the same number of units of air as the insulin dose into insulin bottle d. Draw up the number of insulin units prescribed e. Inject insulin into muscle of upper arm

- Keep insulin refrigerated until the vial is opened - Role insulin bottle between hands before inserting syringe - Inject the same number of units of air as the insulin dose into insulin bottle - Draw up the number of insulin units prescribed

The nurse is providing discharge teaching about multiple medications to a client with mild dementia. Which nursing intervention is appropriate? Select all that apply. a. Obtain referral for skilled nursing visits at home. b. Teach family members about medication administration. c. Recommend the use of a medication dispenser. d. Tell the client that taking medication is a personal responsibility. e. Refrain from teaching the client since information will not be retained.

- Obtain referral for skilled nursing visits at home. - Teach family members about medication administration. - Recommend the use of a medication dispenser.

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. Oral 2. Subcutaneous 3. Intramuscular 4. Intravenous

- Oral - Subcutaneous - Intramuscular - Intravenous

When administering oral medications, which practices should the nurse follow? Select all that apply. a. Dispense multiple liquid medications into a single cup to reduce the number of containers the client must handle. b. Perform hand hygiene before and after medication administration. c. Stay at the bedside until the client has swallowed all the medications. d. Store the client's MAR at the bedside at all times to ensure safe identification. e. Verify the client's response to the medication 30 minutes after administration or as appropriate for the drug.

- Perform hand hygiene before and after medication administration - Stay at the bedside until the client has swallowed all the medications - Verify the client's response to the medication 30 minutes after administration or as appropriate for the drug

The nurse manager is reviewing medication order protocols with staff nurses. Which teaching will the nurse include? Select all that apply. a. Refrain from using abbreviations. b. Be mindful of look-alike and sound-alike drugs. c. IU and U are acceptable abbreviations to use. d. Orders can be carried out without provider signatures. e. Nurses and health care providers are accountable for drug safety.

- Refrain from using abbreviations - Be mindful of look-alike and sound-alike drugs - Nurses and health care providers are accountable for drug safety

Which nursing action(s) promotes safety in the preparation of medication? Select all that apply. a. Ensure a second nurse cosigns all medications. b. Take verbal prescriptions for medications whenever possible. c. Return medications with obscured labels to the pharmacy. d. Note the expiration dates on liquid medications. e. Prepare medications in well-lit conditions.

- Return medication with obscrued labels to the pharmacy - Note the expiration dates on liquid medications - Prepare medication in well-lit condition

When providing discharge teaching to a client who has been diagnosed with early stage Alzheimer disease, which nursing intervention is appropriate? Select all that apply. a. Teach caregivers how to administer medication. b. Provide family with information about skilled home nursing visits. c. Demonstrate proper use of a medication dispenser. d. Recommend discontinuing medication because Alzheimer disease cannot be cured. e. Discontinue client teaching due to the client's memory status.

- Teach caregivers how to administer medication. - Provide family with information about skilled home nursing visits. - Demonstrate proper use of a medication dispenser.

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

1 mL

A nurse needs to administer an intradermal tuberculin skin test injection to a client. What is the most suitable angle when administering an intradermal injection? a. 180-degree angle b. 90-degree angle c. 45-degree angle d. 10-degree angle

10-degree angle

The nurse is preparing to administer a tuberculin test. At which angle is the nurse expected to instill the drug? a. 15-degree angle b. 45-degree angle c. 90-degree angle d. 120-degree angle

15-degree angle

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 1300. 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. 1500 b. 1200 c. 2000 d. Wait until day 5 of treatment.

1500

The nurse has a prescription to administer 25 mg of furosemide IV to a client. The drug is supplied in a vial 40 mg/4 ml. How many milliliters will the nurse administer of the medication? Record your answer using one decimal place.

25mg / 40mg * 4mL = 2.5 mL

A client has been prescribed 300 mg of metronidazole. The supply is metronidazole 200 mg tablets. How many tablets will the nurse administer? Record your answer using one decimal place.

300 mg/200 mg = 1.5 mg Tablet

The nurse is preparing to administer a liquid form of medication to a client. What action will the nurse take to ensure that administration of the drug is at the desired potency? a. Determine if there is an odor from the medication. b. Prepare the medication with good lighting. c. Return the medication if the label is unclear. d. Check the expiration date.

Check the expiration date

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.

500mg / 250mg * 10mL = 20 mL

The nurse is administering morphine oral solution 5 mg to a client requesting medication for pain. The preparation is delivered as morphine solution 10 mg/5 ml. Calculate the amount, in milliliters, the will nurse administer. Record your answer to one decimal place.

5mg / 10 mg * 5mL = 2.5mL

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? a. 10 to 15 degrees b. 20 to 30 degrees c. 45 degrees d. 90 degrees

90 degrees

A medication is prescribed for a pediatric client. The nurse is ensuring the dosage is correct. What factor would the nurse use to calculate the dosage is correct for this client? a. Age b. Developmental level c. Ethnicity d. Body surface area (BSA)

Body surface area (BSA)

It is particularly important for the nurse to use this technique when administering intramuscular (IM) medication to which client? a. A 30-year-old client diagnosed with Tourette syndrome prescribed haloperidol b. A 40-year-old client diagnosed with breast cancer prescribed fulvestrant c. A 50-year-old client demonstrating delirium tremors prescribed lorazepam d. A 70-year-old demonstrating muscle wasting prescribed chlorpromazine

A 70-year-old demonstrating muscle wasting prescribed chlorpromazine

Which medication interaction illustrates a synergism? a. 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. b. A client is taking doxycycline, an antibiotic, for rosacea. She takes this with her morning vitamins, which includes calcium carbonate. She has not noticed a change in her symptoms. c. A client is taking metoprolol for her blood pressure and metformin for her diabetes. Her provider has told her that these are safe to take together. d. A client was told not to take tretinoin topical if she is pregnant because it may be teratogenic.

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

The health care provider has given and signed an order for a specific client for zolpidem, 10 mg by mouth once daily at hour of sleep, and recorded the specific date and time of the order. What is the appropriate nursing action? a. Administer the drug. b. Cosign the order. c. Call the health care provider for order clarification. d. Show the order to the nurse manager.

Administer the drug

The client asks the nurse how to administer medication purchased over the counter for relief of arthritis pain. The nurse reviews the medication and determines that it is to be applied topically. Which instructions should the nurse provide? a. Apply a small amount of the medication to the affected area then repeat after initial dose has dried. b. Apply the medication to clean, dry skin of the affected area using gloves. c. Clean the area with alcohol and apply a quarter size of medication to the affected area. d. Using sterile gauze, apply to the affected area with gloves and cover with a bandage.

Apply the medication to clean, dry skin of the affected area using gloves

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. A larger syringe is required when giving an intramuscular injection on an obese person. b. As the gauge number becomes larger, the diameter of the needle and the lumen become smaller. c. When giving an injection, the amount of the medication directs the choice of gauge. d. The size of the syringe is directed by the viscosity of the medication to be given.

As the gauge number becomes larger, the diameter of the needle and the lumen become smaller

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. Clean the external ear of drainage with cotton balls moistened with water or normal saline solution. b. Straighten the auditory canal by pulling the cartilaginous portion of the pinna up and back. c. Ask the client to remain lying down for at least 5 minutes. d. Immediately repeat the application in the second ear if prescribed.

Ask the client to remain lying down for at least 5 minutes

An oral medication has been ordered for a client who has a nasogastric tube in place. Which nursing activity would increase the safety of medication administration? a. Check the tube placement before administration. b. Have the client swallow the pills around the tube. c. Flush the tube with 30 to 40 mL saline before medication administration. d. Bring the liquids to room temperature before administration.

Check the tube placement before administration

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

Cleanse area at vaginal orifice with washcloth and warm water

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? a. Administer the medication and override the software system. b. Hold the medication until the next day when the system updates. c. Contact the pharmacy and information technology department for assistance. d. Complete an incident report.

Contact the pharmacy and information technology department for assistance

The nurse is caring for a client who has a newly written prescription for "fluoxetine 20 mg by mouth daily for treatment of depression." The nurse is unfamiliar with this medication. What information should the nurse acquire prior to administration of this drug? a. Contraindications of the drug. b. The trade name of the drug. c. If the client has taken the medication previously. d. Previous side effects the client has had.

Contraindications of the drug

After teaching a group of nursing students about pharmacokinetics, the instructor determines that the education was successful when the students identify what process by which the medication is delivered to the target cells and tissues? a. Absorption b. Synergism c. Distribution d. Metabolism

Distribution

The health care provider has prescribed an enteric-coated naproxen for arthritic pain to a client who typically prefers a liquid or chewable medication. Which instruction should the nurse provide the client to ensure the medication is taken appropriately? a. Do not chew the medication as disrupting the enteric coating can cause irritation in the lining of the stomach. b. Particles of the crushed medication can be inhaled causing respiratory irritation. c. The potency of the medication will be increased due to early exposure to gastrointestinal acids if crushed or chewed. d. Crushing or chewing can cause the medication to be ineffective for pain relief

Do not chew the medication as dirupting the enteric coating can cause irritation in the lining of the stomach

The nurse is assessing a client with diabetes who has poor vision. Which feature of the insulin pen makes it beneficial for this client? a. The insulin pen is easily transported on the client. b. It is easier to learn how to use an insulin pen than a syringe and vial. c. Each unit of insulin is accompanied by a clicking sound in the pen. d. With an insulin pen, a large variety of insulin types are available.

Each unit of insulin is accompanied by a clicking sound in the pen

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? a. Provide discharge paperwork to the client. b. Request another nurse to reteach the material. c. Give written instructions to the client and caregivers. d. Arrange for home health to see the client.

Give written instructions to the client and cargivers

When administering a subcutaneous injection to a client, the needle pulls out of the skin when the skin fold is released. What would be the appropriate next action of the nurse in this situation? a. Pull out and discard the needle. b. Discard the equipment and start the procedure from the beginning. c. Engage safety shield on needle guard and discard needle appropriately. d. Document the incident and inform the primary care provider.

Engage safety shield on needle guard and discard needle appropriately

The nurse is preparing to administer a medication via a nasogastric tube. Which guideline is appropriate for the nurse to follow when administering a drug via this route? a. Flush the tube with water between each drug administered. b. Position the client supine prior to administering the drug. c. Administer the medication at a cold temperature. d. If connected to suction, do not reconnect to suction for 5 minutes after drug administration.

Flush the tube with water between each drug administered

A client asks the nurse whether the generic acetaminophen is as effective as the brand name product. Which is the nurse's best response? a. Generic medication performs the same as the corresponding brand-name product. b. Generic medication often has different active ingredients, dosages and route of administration from the brand-name version. c. Dyes, fillers and coatings may be similar, so the generic medication often looks like branded version. d. Generic medication performs a little differently than the corresponding brand-name product.

Generic medication performs the same as the corresponding brand-name product

A nurse is preparing to administer an intradermal injection. What would be most appropriate for the nurse to do? a. Bunch the skin to stabilize the site. b. Hold the syringe at a 10- to 15-degree angle. c. Point the bevel of the needle down facing the skin. d. Pull the skin about 1 inch (2.5 cm) to one side.

Hold the syringe at a 10- to 15- degree angle

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

If a child refuses to take medication, crush the medication, if allowable, and add to a small amount of food

The nurse has given a client an injection. How will the nurse prevent an accidental needle stick? a. Immediately activate the safety needle and place the syringe and needle into a Sharps container. b. Immediately activate the safety needle and remove the needle from the syringe. Place the needle in the Sharps container and the syringe in the trash. c. Immediately activate the safety needle and have a colleague hold the Sharps container within reach for disposing of the syringe and needle. d. Immediately activate the safety needle and hold it close to the body until disposing it into the Sharps container.

Immediately activate the safety needle and place the syringe and needle into a Sharps container

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

Involve a second responsible person in the instructions

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 battery-operated device that spins. b. It suspends finely powdered medication. c. It is a canister that contains pressurized medication. d. It has propellers that get activated during inhalation.

It is a canister that contains pressurized medication

To convert 0.8 grams to milligrams, the nurse should do which of the following? a. Move the decimal point 2 places to the right. b. Move the decimal point 3 places to the right. c. Move the decimal point 2 places to the left. d. Move the decimal point 3 places to the left.

Move the decimal point 3 places to the right

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? a. Give the first and second doses of antibiotics. b. Call the pharmacy before notifying anyone else. c. Notify the health care provider. d. Proceed with the administration of the second dose.

Notify the health care provider

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? a. Discard the remaining drug. b. Place the date on the vial and retain for future use. c. Draw up the remaining medication to give at the next time of administration. d. Send the vial with the remaining drug back to the pharmacy.

Place the date on the vial and retain for future use

The nurse is preparing to administer an oral medication to a client with xerostomia. Which nursing action is appropriate? a. Call the provider to change the order to the intramuscular route. b. Offer a sip of water before administering medication. c. Refuse to give the medication due to safety reasons. d. Administer the medication as usual and document.

Offer a sip of water before administering medication

What type of prescription would the health care provider most likely write to treat a client whose pain levels vary widely throughout the day? a. Stat b. PRN c. standing d. one-time

PRN

A nurse is taking care of a client who requests acetaminophen to help with a headache. The nurse checks to see if there is an order for acetaminophen and notices that the client is able to have 650 mg every 4 hours as needed for pain. What type of order is this considered? a. standing order b. PRN order c. one-time order d. stat order

PRN order

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? a. Write the names of the medications on the bottle. b. Place a rubber band snugly around one of the bottles. c. Color code the bottles with different colors of pens. d. Teach the client to place bottles on different ends of the table.

Place a rubber band snugly around one of the bottles

The nurse is assessing a client who was seen 7 days ago with strep throat. The client states, "I felt better after 2 days of the antibiotic the provider prescribed, so I quit taking it." What would the nurse do to address this situation? a. Instruct the client to return to taking the current prescribed medication until it is all gone b. Offer to speak to the provider for different treatment options c. Provide education on taking all antibiotics for effective treatment d. Instruct the client to take both the current antibiotic along with a new prescribed antibiotic to avoid antibiotic resistance

Provide education on taking all antibiotics for effective treatment

The nurse is preparing to administer an intramuscular (IM) injection into a client. Which procedure should the nurse use to administer the injection? a. Insert the needle until the entire bevel lies immediately under the skin while injecting. b. Pull the skin taut between two fingers while injecting. c. Pinch the skin up between two fingers while injecting. d. Pull skin and subcutaneous tissue 1 to 1.5 in (2.5 to 3.75 cm) to one side of the injection site while injecting.

Pull skin and subcutaneous tissue 1 to 1.5 in (2.5 to 3.75 cm) to one side of the injection site while injecting

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? a. No extra documentation is necessary. b. Have another nurse cosign the order input. c. Tell the provider to sign the order as soon as possible. d. Record "T.O." at the end of the order.

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

The nurse is caring for an adult client who is receiving medication transdermally. What action by the nurse is most important to ensure the safety of the client? a. Donning gloves prior to administration of the patch b. Applying the patch to a clean, dry, hairless, and intact area of skin c. Writing the date, time, and nurse's initials on the new patch d. Removing or ensuring the removal of the previous patch

Removing or ensuring the removal of the previous patch

While administering a medication via a syringe, a client sharply moves and the nurse accidentally encounters a needlestick. What is the priority nursing action? a. Request counseling on the potential for infection. b. Document the injury. c. Report the needlestick to the nurse manager. d. Obtain the client's blood to be tested for HIV and HBV.

Report the needlestick to the nurse manager

The nurse is preparing to administer a transdermal medication. How should this be accomplished? a. The nurse should apply the medication directly to the skin. b. The nurse should inject the medication just below the dermis of the skin. c. The nurse should ask the client to swallow the medication. d. The nurse should inject the medication into a body cavity.

The nurse should apply the medication directly to the skin

When the nurse administers the client's amlodipine, the client states that usually only one pill is taken instead of three pills. Which right of medication should now be triple checked before allowing the client to take the medication? a. Right dose b. Right client c. Right medication d. Right time

Right dose

The client has continuous enteral feedings through a nasointestinal tube. The client has a thyroid medication that is to be taken on an empty stomach. What action does the nurse perform? a. Mix the medication in the tube feeding and administer the tube feeding and medication together. b. Ask the health care provider to prescribe bolus feedings. c. Stop the infusion for 30 minutes before and after administration of the thyroid medication. d. Withhold the thyroid medication.

Stop the infusion for 30 minutes before and after administration of the thyroid medication

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

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

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? a. Input the order into the computerized provider order system. b. Tactfully request the provider to input the order into the computerized provider order system. c. Refuse to implement the order and notify the nurse manager. d. Have another nurse witness and record the order into the medication administration record (MAR).

Tactfully request the provider to input the order into the computerized provider order system

The nurse correlates the metric system as the most accurate method utilized to administer medications for which reason? a. The dosage prescriptions of medications most often use this system as it is measured in 10s and can be easily converted between measurements b. It uses a system based on household measurements which are easily understood and measured c. It prevents errors by never using leading zeros for doses less than one measurement unit d. It ensures accuracy by expressing quantities in fractions and Arabic numbers

The dosage prescriptions of medications most often use this system as it is measured in 10s and can be easily converted between measurements

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

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

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

a client who is reporting pain near the surgical site

The nurse has prepared a syringe containing morphine to give to a client. The client refuses the drug, stating that pain is under control. What procedure does the nurse follow to properly dispose of the medication? a. A second and third nurse must witness the discarding of the controlled medication, and all three nurses must sign the control record. b. Waste the medication with a nurse witness present, and the nurse witness must countersign the control record. c. Two nurses must physically return the medication to the pharmacy for disposal, and both nurses are required to sign the controlled substance return log. d. Discard the controlled medication and document the amount, date, and time on the control record, then sign it.

Waste the medication with a nurse witness present, and the nurse witness must countersign the control record

A nurse needs to combine two different prescribed drugs in a syringe and then administer them to a client with influenza. Which precaution should the nurse take when combining drugs? a. Withdraw exact amounts of each drug from each container. b. Mix the two drugs together thoroughly before administering. c. Shake the two drug containers before withdrawing. d. Expel both the drugs separately in a vial before use.

Withdraw exact amounts of each drug from each container

The nurse is preparing to administer a medication to a client when the client states, "Last time I took that medication, I broke out in hives." What is the priority action by the nurse? a. Withhold the medication and notify the health care provider that ordered the medication b. Administer the medication, the reaction may not occur again c. Administer the medication and monitor the client for 30 minutes after administration d. Substitute another medication with the same action

Withhold the medication and notify the health care provider that ordered the medication

The nurse is caring for a client with pneumonia who requires administration of medications. When does the nurse document administration in the medication administration record (MAR)? a. when preparing medications for administration b. during administration at the bedside c. at the end of the nurse's shift d. after completion of administration of each drug

after completion of administration of each drug

A hospitalized client asks the nurse for "some aspirin for my headache." There is no prescription for aspirin for this client. Which assessment information should the nurse obtain prior to requesting a prescription for aspirin? a. previous use of aspirin b. tolerance to aspirin c. other medications currently taken d. allergy to aspirin

allergy to aspirin

A nurse should read the instructions stated on a vial container before reconstituting it and administering it to a client. Which instructions are stated on the label of a vial container? a. type of needle to be used for withdrawal b. directions for administering the drug c. best site for administering the drug d. amount of diluent to be added

amount of diluent to be added

Which assessment should be conducted by the nurse before the nurse administers tuberculin intradermal injection? a. checking for documented allergies to food or drugs b. preparing the syringe with the medication c. cleaning the area with an alcohol swab d. gathering all the equipment needed

checking for documented allergies to food or drugs

The nurse is preparing to administer a client's intramuscular injection and intends to use the technique shown. What potential benefit of this technique should the nurse describe? a. decreased irritation and pain in subcutaneous tissue b. less frequent administration of the medication c. more rapid administration of the medication d. decreased risk for infection

decreased irritation and pain in subcutaneous tissue

Which component of a syringe's needle does the nurse recognize that refers to width? a. lumen b. shaft c. bevel d. gauge

gauge

The nurse is preparing to administer an IM injection in the vastus lateralis site. Where will the nurse administer the medication? a. in the anterolateral aspect of the thigh b. in the lateral aspect of the upper arm c. in the lower abdomen d. in the gluteus maximus muscle in the buttocks

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? a. intradermal b. subcutaneous c. intramuscular d. intravenous

intradermal

A nurse is performing a sensitivity test on a client. What would be the best type of injection to use for this procedure? a. intradermal b. intramuscular c. subcutaneous d. intravenous

intradermal

The nurse is preparing to administer a tuberculin test. Which route will the nurse select to administer this injection? a. subcutaneous b. intramuscular c. intradermal d. intravenous

intradermal

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

intradermal

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

larger diameter

The nurse is caring for a client with a yeast infection. Which medication does the nurse anticipate will be prescribed? a. miconazole b. oxymetazoline c. bisacodyl d. timolol

miconazole

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? a. removing prior application and any remaining residue from skin b. covering application paper with plastic with transparent semipermeable dressing c. squeezing prescribed amount of paste from tube onto application paper d. using wooden applicator to spread paste over the paper

removing prior application and any remaining residue from skin

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. read and compare labels on the medication with the medical record b. review the client's medication, allergy, and medical history c. administer medication within 30 to 60 minutes of the scheduled time d. allow sufficient time to prepare the medication with minimal distraction

review the client's medication, allergy, and medical history

he nurse is administering medications to the team of clients. It is 0730. For the first client, the nurse administers the following medications: - levothyroxine 25 mcg po daily scheduled for 0600 but not administered - pantoprazole 40 mg po daily scheduled for 0800 - metformin 500 mg po two times a day scheduled for 0800 amd 1700 The nurse identified the client by asking name and client identifier while looking at the client identification band, The nurse verified the medications for drug name, dose, and route with three checks. Which right(s) did the nurse make an error? Select all that apply. a. right drug b. right dose c. right route d. right time e. right client

right time

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 container with enough prescribed medications for several days for a client b. self-contained packets that hold one tablet or capsule for individual clients c. a supply that remains on the nursing unit for use in an emergency d. systems that contain frequently used medication for that unit

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

A client taking insulin has the levels adjusted to ensure that the concentration of drug in the blood serum produces the desired effect without causing toxicity. What is the term for this desired effect? a. peak level b. trough level c. half-life d. therapeutic range

therapeutic range

What is the best explanation from the nurse as to why a client must return to the unit in 48 hours after having a tuberculin skin test intradermal? a. to determine the extent to which the client responded to the drugs b. to administer timely emergency treatment c. to implement measures to reduce the transmission of microorganisms d. to prevent interfering with test results

to determine the extent to which the client responded to the drugs

A nurse is administering a medication that is formulated as enteric-coated tablets. What is the rationale for not crushing or chewing enteric-coated tablets? a. to prevent absorption in the mouth b. to prevent absorption in the esophagus c. to facilitate absorption in the stomach d. to prevent gastric irritation

to prevent gastric irritation

A nurse needs to administer a prescribed injection to an older adult client with impaired mobility. Which intramuscular site is preferred for administering an injection to older adult clients? a. gluteus maximus b. ventrogluteal c. rectus femoris d. upper chest

ventrogluteal