Medication Administration PrepU
A nurse is preparing a prescribed dosage of a steroid inhalant medication for a client with asthma. Which action should the nurse take after administering the medication?
Instruct the client to rinse the mouth following inhalation.
The nurse is reviewing a medication prescription for a client prior to administration and observes that the route of administration is not present in the prescription. What is the appropriate action by the nurse to address this omission?
Notify the health care provider to add the route and then administer the medication when complete.
A nurse is assessing a client's lower arm for insertion of an IV catheter. The nurse palpates the vein and notes that it feels hard. Which action by the nurse would be most appropriate?
Select another site.
The nurse is teaching a client how to use nasal spray. What will the nurse include in the teaching plan? Select all that apply.
Sit up comfortably in the bed. Insert the tip of the nose piece into one nostril. Hold the breath for a few seconds after administering the spray.
The nurse is discussing epidural analgesia with the nursing student. Which of statement by the nursing student indicates a need for additional education?
"Epidural analgesia is always administered in a continuous infusion to prevent or treat pain
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?
0.5
A client is to take Demerol 35 mg IM. You have Demerol 50 mg per ml. How many ml will you administer?
0.7 ml
The nurse is to administer levothyroxine 0.125 mg PO at 0600. The package is labeled levothyroxine 125 mcg. Calculate the number of tablets the nurse will administer. Record your answer as a whole number.
1
he nurse is to administer levothyroxine 0.125 mg PO at 0600. The package is labeled levothyroxine 125 mcg. Calculate the number of tablets the nurse will administer. Record your answer as a whole number.
1
A nurse is administering a subcutaneous injection to a client. What is the common maximum volume of a subcutaneous injection?
1 mL
A pediatric client has a fever for which the provider has prescribed ibuprofen 200 mg orally every 6 hours. The instructions on the bottle indicate there is 100 mg/5ml. How many milliliters should the nurse give? Record your answer using a whole number.
10
The nurse has an order to infuse 1000 mL of dextrose 5% with 0.45 normal saline. The infusion is ordered over 8 hours. The solution set delivers 10 gtt/cc. How many drops per minute will the nurse need to infuse the intravenous fluids?
21 gtts/minute
The 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
The client has a prescription for 1000 mL of normal saline IV over 4 hours and following that an additional 1000 mL IV over 8 hours. Which are the correct drip rates with a drop factor of 20 drops per milliliter?
83 drops/min followed by 42 drops/min
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?
90 degrees
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
It is particularly important for the nurse to use this technique when administering intramuscular (IM) medication to which client? (Z track method)
A 70-year-old demonstrating muscle wasting prescribed chlorpromazine
Which medication interaction illustrates a synergism?
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 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?
Apply the medication to clean, dry skin of the affected area using gloves.
The nurse observes a prescription written for a client for a medication that does not correlate with the client's diagnosis or comorbid factors. What is the best action for the nurse to take?
Call the provider to obtain a rationale for the use of the medication for the client
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 the health care provider for order clarification.
A nurse is administering a hepatitis B shot intramuscularly. What would be the appropriate site for administration?
Deltoid
The nurse prepares to administer a fentanyl transdermal patch and discovers two transdermal patches are on the client's back and upper right chest. Which best action should the nurse take next?
Determine what transdermal patches are currently on the skin. The best next action the nurse should take is to determine what the transdermal patches found on the skin are used to treat. Then, if the patches are also fentanyl, the nurse would need to take them off since the client would experience a cumulative drug effect and increased side effects. If the transdermal patches are other drugs that are ordered, then the nurse would only search for the old fentanyl patch and remove it. The nurse would assess vital signs comparing the results with the baseline before administering medications. The nurse would complete an incident report if there were multiple transdermal patches of the same kind found on the client.
The hospital recently adopted a self-administration medication system. Which is an important consideration for safe self-administration of medications?
Does the client have cognitive and functional ability to self-administer medication?
A nurse needs to administer an injection to a client in the deltoid site. Which action should the nurse perform to avoid the risk of damaging the radial nerve and artery?
Draw an imaginary line at the axilla between the acromion and brachial vessels.
A client with a new diagnosis of glaucoma (increased pressure within the eye) has been prescribed a medication that is to be administered by an eye drop. Which action should the nurse perform?
Ensure that drops of the medication fall onto the client's conjunctival sac.
The nurse is preparing to administer dimenhydrinate 50 mg intramuscular to a client. Place in order, the steps the nurse will follow when using the Z-track technique to administer the drug? Use all options.
Fill the syringe with the prepared drug and then change the needle. Select the ventrogluteal site. Use the side of the hand to pull the tissue laterally about 1 inch (2.5 cm) until the tissue is taut. Insert the needle at a 90-degree angle while continuing to hold the tissue laterally. Aspirate for blood return and instill the medication. Withdraw the needle and apply pressure to the site.
Which actions would the nurse perform when administering a subcutaneous injection correctly? Select all that apply.
Grasp and bunch the area surrounding the injection site or spread the skin taut at the site. Inject the needle quickly at an angle of 45 to 90 degrees. After removing the needle, do not massage the area to prevent hematoma formation.
A client with a percutaneous endoscopy tube is prescribed the following medication: metoprolol 25mg, phenytoin 100 mg, gabapentin 400 mg and acetylsalicylic acid 81 mg, tube feeding formula at 100 mL/hr continuously. How should the nurse proceed?
Hold the tube for 1 hour before and after medication has been administered
A nurse instills ear drops into a client's ear to soften a wax buildup. Which guideline should the nurse follow?
If both ears are to be treated, wait 5 minutes before instilling drops in the second ear.
The charge nurse is observing a new nurse administer an intramuscular (IM) medication to an adult client for the first time. After reviewing the image, what should the charge nurse do next?
Inform the new nurse to spread the fingers outward to visualize landmarks for the injection
A nurse is administering a client's analgesic by the subcutaneous route. What should guide the nurse's action?
Inject into the adipose tissue layer just below the epidermis and dermis.
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?
It is a canister that contains pressurized medication.
Which nursing action is appropriate in the care of a client with an implanted vascular access device?
Maintain patency by routine flushing with a heparinized solution. Most central line catheters and implanted vascular devices are flushed with a heparinized solution.
To convert 0.8 grams to milligrams, the nurse should do which of the following?
Move the decimal point 3 places to the right.
Nurses who will soon complete their 12-hour shift are preparing to account for controlled substances. Which nursing action is appropriate? Select all that apply.
One nurse counts the supply; another nurse checks the record of administration. Two nurses must ensure that the counts of controlled substances agree.
The nurse is caring for a client who has had a stroke. Prior to administering oral medications, what is the appropriate nursing action?
Request that the provider obtain a speech therapist's evaluation.
The nurse is preparing to administer a bolus of furosemide 0.8 mg to a client with congestive heart failure and kidney disease. Which right of drug administration would the nurse question and confirm in this client?
Right drug
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?
Stop the infusion for 30 minutes before and after administration of the thyroid medication.
Which nursing action best exemplifies proper drug-diversion prevention of client medications?
The nurse does not share the personal automated medication-dispensing system password.
Nitroglycerin ointment 2% 1/2 inch is prescribed every 6 hours for the client. Nitroglycerin ointment is supplied in a foil package containing one dose and labeled 1 inch equal to 1 gram. The package contains 1 gram. How does the nurse provide a 1/2-inch dose to the client?
The nurse places the entire contents within the 1-inch markings on the applicator paper and with the edge of a medicine cup removes 1/2 inch of the ointment.
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.
A client has been ordered nasal drops, which the nurse will administer. How should the nurse best position the client?
Upright, with head tilted back
Which action(s) by a licensed practical nurse (LPN) will illicit immediate intervention by the registered nurse (RN)? Select all that apply.
administering packed red blood cells to a client with anemia flushing an implanted central venous access device LPNs are generally not permitted within their scope of practice to administer IV chemotherapy, blood, or blood products; to push IV medications; or to administer medications and flushes through tunneled or implanted central venous access devices. Other actions are generally within the scope of practice of an LPN and do not require immediate RN intervention.
The nurse is preparing to administer a bolus of an intravenous medication. How should the medication be administered?
all at once
At what point should the nurse perform the first of the three checks of medication administration?
as the nurse reaches for the drug package or container
The nurse is teaching a client about the proper use of transdermal patches. Which location will the nurse teach the client to apply the patch? Select all that apply.
chest abdomen upper arms buttock
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 has to administer a subcutaneous injection to a client. For which client can the nurse administer a subcutaneous injection at a 90-degree angle?
obese client
Which medications are dropped into the ear to treat ear infections or to soften and remove ear wax?
otic
The nurse is administering a rectal suppository. How far will the nurse insert the suppository?
past the internal sphincter
The nurse beginning a shift has received a report from the previous nurse, who reports that a client has a catheter inserted into the subclavian vein. The oncoming nurse will plan to assess which type of catheter?
peripherally inserted cutaneous catheter A peripherally inserted cutaneous catheter is a type of nontunneled percutaneous catheter that is inserted into a peripheral vein with the distal end terminating in the axillary vein, subclavian vein, or superior vena cava. Hickman, Broviac, and Groshong catheters are types of tunneled catheters that are inserted into a central vein with part of the catheter secured in the subcutaneous tissue.
A nurse is administering a prescribed intramuscular injection to a client by the Z-track method. Which action ensures that the medicine remains sealed?
pulling the tissue laterally until the tissue is taut
The nurse recognizes which routes for parenteral medication administration? Select all that apply.
subcutaneous intramuscular intradermal intravenous
The nurse is teaching a client with diabetes about insulin dosing. Which teaching will the nurse include? Select all that apply.
"Insulin needles are very short in length." "Insulin injections are usually less painful than other injections." stable for up to 30 days
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.
The nurse has finished teaching a client about medications that have been prescribed for administration. Which client statement reflects that teaching about a piggyback infusion of antibiotics has been successful?
"When I am out of bed the small IV bag must not be lower than the large IV bag."
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 teaching a client about zolpidem CR for sleep. When the client asks, "What does the CR mean?" what is the appropriate nursing response?
"continuous release"
The nurse is teaching a client about metformin SA. When the client asks, "What does the SA mean?" what is the appropriate nursing response?
"sustained action"
The charge nurse on the medical/surgical unit is reviewing physician orders for a client with a diagnosis of congestive heart failure. Which infusion orders would the nurse question?
1000 D5W to run in 30 minutes Medications administered by intermittent infusion are supplied either in bags that contain 50 to 250 mL of IV fluid (0.9 normal saline or 5% dextrose in water) or in 20- to 60-mL syringes to be used with an infusion pump.
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?
1500 Peak levels are drawn shortly after the drug is administered. The best choice is 1500 because it closely follows the time of infusion, which is when the drug concentration would be highest.
Which gauge needle is the nurse expected to use to administer dimenhydrinate 50 mg?
22-gauge The 22-gauge needle is correct, as this size is long enough to reach the client's muscle. Gauges 27, 26, and 25 are not long enough to reach the muscle and therefore are used to administer injectables, such as insulin.
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?
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?
Ask the client to remain lying down for at least 5 minutes.
The client is to receive an oral antihypertensive medication. Parameters for the medication are to hold if the blood pressure is less than 100 mm Hg systolic and less than 60 mm Hg diastolic. The client's blood pressure is 92/64 mm Hg. The nurse administered the antihypertensive and realized the error after administration. Place the actions in order that the nurse will perform them. Use all options.
Assess the client. Notify the supervising nurse and health care provider. Document actions in the nurse's notes. Complete an incident report.
The nurse administered 0900 medications to the team of clients. The nurse notes that a medication error was made. One client received a medication that was prescribed for the roommate. What action(s) does the nurse perform?
Complete an incident report. Document the error in the nurse's notes. Notify the health care provider. Perform an assessment of the client.
Which actions would a nurse perform when instilling eardrops correctly? Select all that apply
Invert and hold the dropper in the ear with its tip above the auditory canal. Clean the external ear with cotton balls moistened with normal saline solution. Straighten the auditory canal by pulling the cartilaginous portion of the pinna up and back in an adult (or down and back in an infant or child under 3 years). Hold the dropper in the ear with its tip above the auditory canal.
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.
Keep insulin refrigerated until the vial is opened Roll 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
A nurse works for a facility that does not utilize modified safety injection equipment. After use, how will the nurse prevent needlesticks? Select all that apply.
Leave the needle uncapped and dispose of it in a puncture-resistant container. Scoop the cap back onto a used needle with one hand without touching the cap.
A nurse works for a facility that does not utilize modified safety injection equipment. How will the nurse prevent needlesticks? Select all that apply.
Leave the needle uncapped and dispose of it in the nearest biohazard container. Scoop the cap back onto a used needle with one hand without touching the cap.
A client calls the office and reports to the nurse that the prescribed medications are not working. What is the best response from the nurse?
Let's schedule an appointment for you to bring in all your medications. The best response is to visit with the client in person and check the actual bottles of medications against the prescriptions. It will also give the nurse the opportunity to see how much is in the bottles to see if the client is following instructions. The other responses would not be appropriate and could potentially harm the client. Asking about the pill box would be following up on teaching and would be discussed later.
A client is prescribed an HMO-CoA reductase inhibitor for the treatment of elevated cholesterol and triglyceride levels. Which education will the nurse provide to the client regarding the medication prescribed?
Liver function and glucose levels will be checked periodically.
What action should the nurse take when giving an intramuscular injection using the Z-track method?
Do not massage the site because it may cause irritation.
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.
The experienced nurse is teaching a new nurse about chemotherapy administration. What teaching will the experienced nurse include? Select all that apply.
Double-glove when administering these drugs. Pharmacists must be specifically trained to prepare chemotherapy agents. Central venous catheters (CVCs) are often used to administer antineoplastic drugs
In which order should the nurse instruct the client to follow when inserting vaginal medication?
Empty your bladder just before inserting the medication. Lubricate the applicator tip with water-soluble lubricant. Lie down, bend your knees, and spread your legs. Separate the labia and insert the applicator into the vagina, and insert the medication. Remain recumbent for at least 30 minutes. Wash and store the reusable applicator properly.
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?
Engage safety shield on needle guard and discard needle appropriately.
A client admitted with an acute exacerbation of asthma requires immediate intravenous medication. Which intervention(s) does the nurse include when administering intravenous medication by the intermittent infusion technique? Select all that apply.
Ensure that the medication supplied is the medication prescribed Confirm that the medication, as prescribed, is safe for the client Verify that the intravenous catheter is in the vein and not clotted Ensure that medication infusion begins immediately for the required therapeutic effect
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.
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
An emergency room nurse is ordered to administer nitroglycerin to a client being treated for acute pulmonary hypertension. Which means of drug administration would the nurse use to achieve rapid results in this emergency situation?
IV Infusion
When preparing medications to provide to a client via enteral tube administration, which nursing action(s) is appropriate? Select all that apply.
Mix powdered drugs with warm water. Finely crush non-enteric-coated medications. Open the shell of capsules to release the powdered drug. Refrain from adding bulk-forming laxatives to the mix.
A nurse who is administering a piggyback intermittent intravenous infusion of medication to a client observes that there is a cloudy, white substance forming in the IV tubing. Which actions should the nurse take in this situation? Select all that apply.
Stop the IV from flowing and stop administering the medication. Clamp the IV at the site nearest to the client. Replace tubing on primary and secondary infusions.
A client requests more medication for pain at the surgical site rated 8 out of 10. There is a PRN prescription for 10 mg PO of oxycodone for pain greater than 6 out of 10 on the pain scale. Which action should the nurse take first?
Verify clients name and date of birth
A client has an order for an intermittent infusion of 250 mL of 0.9 normal saline. The nurse understands that this type of infusion is used for which situation?
medications that need to be infused over 20 to 60 minutes Intermittent infusions are used for medications that need to be administered for an intermediate length of time, usually 20 to 60 minutes. The intravenous push technique is used for medications that can be given over 1 minute for rapid therapeutic effect, and may be given into a continuously infusing IV set or into a capped IV port. The continuous infusion technique is used for medications that are toxic if given over short periods.
A nurse needs to administer a subcutaneous injection to a client. How far from the previous injection site to the area should the nurse administer the injection?
at least 1 inch (2.5 cm)
A client with chronic obstructive pulmonary disease has been prescribed a bronchodilator to be administered by small-volume nebulizer. The nurse should ensure that the client:
breathes through his or her mouth until all the medication has been inhaled.
The client cannot swallow and just had an enteral tube placed for feeding and medications. Medications will have to be in liquid form or crushed for administration. The client has the following medications prescribed. Which medication will the nurse withhold and consult with the health care provider?
oxycodone extended release tablet
Which action describes buccal medication administration?
placing a medication underneath the upper lip or in the side of the mouth
The nurse is caring for a client who has normal saline infusing through a peripheral intravenous catheter with a prescription for a secondary infusion of antibiotic. Which technique would be most appropriate for the nurse to administer the secondary infusion by gravity?
placing the secondary infusion higher than the primary solution
The nurse is caring for a client who is having a central venous access line inserted into the subclavian vein. The client becomes short of breath and the nurse doesn't hear breath sounds on the left side of the chest. What complication from the procedure does the nurse identify has occurred?
pneumothorax
When preparing to start an intravenous infusion on an adult, the nurse should:
prepare the skin with 70% alcohol and povidone-iodine.
A client with an infection is receiving intravenous antibiotic therapy. The client has an intermittent infusion device in place. The nurse flushes the device with normal saline solution before administering the antibiotic based on which rationale?
to prevent blood clot formation
The primary reason for the Controlled Substances Act is:
to prevent drug use and dependence.
The nurse is caring for a confused client who requires a transdermal patch application. Which location will the nurse choose to apply the patch?
upper back
The nurse is preparing to withdraw liquid medication from an ampule for injection into an IV. What is the appropriate action for the nurse to take when withdrawing the medication?
use a filter needle to withdraw the medication
Which actions by the nurse will prevent injury while withdrawing medication from an ampule? Select all that apply.
using a gauze square to hold the ampule while breaking it snapping the neck of the ampule away from his/her body discarding the ampule in a puncture-resistant container
During a visit to the clinic, the health care provider prescribes an intramuscular injection of a medication for an 8-month-old. At which site should the nurse administer the medication to the infant?
vastus lateralis
The nurse is preparing to give a vaccination to an infant. At which site should the nurse plan to administer the injection?
vastus lateralis
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?
ventrogluteal This site has the potential of retaining greater muscle mass longer than other sites
The nurse is preparing to administer an allergy test intradermally. At what angle will the nurse plan to insert the needle into the client?
10 to 15 degrees
The health care provider has prescribed the use of transdermal patch. Which information should the nurse tell the client regarding application?
Apply the patch to a clean, dry, hairless location on the skin.
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?
bolus administration
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
The nurse has received new medication orders for a client that has had a condition change. What components of the medication order's should be present prior to administering the medication? Select all that apply.
the full name of the client the date and time when the order is written or placed in the order entry on the computer the dosage of the drug, stated in either the apothecary or metric system the route by which the drug is to be administered
A client at a health care facility has been prescribed scopolamine, to be administered transdermally. Which statement describes transdermal application?
drugs bonded to an adhesive and applied to the skin
The nurse is caring for a client who just returned from the postanesthesia care unit and rates current pain as "9 out of 10." Which prescribed medication would provide the fastest relief from pain?
Intravenous morphine sulfate
Which instruction should the nurse give to a client to ensure that a 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 caring for a client who is receiving a prescribed intravenous (IV) infusion of an antibiotic to treat an infection. The client asks the nurse, "Can I just take a pill?" What is the best response by the nurse?
"An IV infusion maintains a therapeutic level of the medication in your blood."
The nurse is preparing a client newly prescribed digoxin for discharge. Which safety consideration should the nurse include in the client teaching?
"Check your radial pulse before taking the medication each day."
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?
"Crushing the medication may cause the medication to irritate the stomach, so it must be swallowed whole."
The nurse is to start providing care for an older adult client who sees several different health care providers and specialists. Which question should the nurse prioritize on assessment?
"Do you get all of your medications filled at the same pharmacy?"
The nurse is beginning to administer oral medications to a client. The client states, "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 who is taking nitroglycerin. Which client statement requires immediate nursing intervention?
"I am taking tadalafil in addition to nitroglycerin."
The nurse is teaching a client with arthritis about taking medications at home. Which client statement indicates that nursing teaching has been effective?
"I will ask my pharmacist about an easy-to-open lid."
The nurse is teaching a client with heart failure about taking digoxin safely. Which statement by the client indicates teaching was effective?
"I will call the health care provider if I develop dizziness, blurred vision, or nausea."
The nurse has just completed a teaching session with clients on safety precautions to take when applying a transdermal patch. Which statement made by the client indicates that the teaching was effective?
"I will dispose of the patch with adhesive sides sticking together."
The nurse is instructing a client with xerostomia (dry mouth) about taking several pills and capsules that have been prescribed. What statement made by the client indicates to the nurse that the client understood the instructions?
"I will take a sip or two of water prior to taking my pills."
A client with a new diagnosis of asthma has been prescribed a corticosteroid by metered-dose inhaler (MDI). What teaching point should the nurse include in health education?
"Rinse your mouth with water after each dose of your medication."
A client with diabetes who requires the new placement of an insulin pump asks the nurse how it works. What teaching will the nurse provide?
"Settings can be adjusted for exercise and illness, and bolus doses can be delivered related to meals."
The client is being discharged, and the nurse is reviewing the newly prescribed medications with the client. Which statement(s) will allow the nurse to evaluate the client's understanding of the medications? Select all that apply.
"Tell me what time of day you are to take your medications." "What is the reason you are taking each medication?"
Which statements made by the nurse indicate how insulin pens simplify self-administered insulin for clients? Select all that apply.
"The cylinder of the insulin pen contains a prefilled reservoir of insulin." "The dose of insulin in an insulin pen is displayed in a window of the syringe." "The insulin pen automatically resets the dose window to zero, following the injection
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 nursing student is teaching the client regarding insertion of a central line catheter. Which statement by the student would cause the nurse to intervene?
"The risks are the same for a central line as they are for peripheral lines." Clot formation, pneumothorax, and bacteremia risks are higher with a central line. As a result, the risks associated with central line placement are higher than those associated with a peripheral IV. Other options are correct regarding central lines.
Which nursing techniques should the nurse use to assist a client who is having difficulty using the metered-dose inhaler correctly? Select all that apply.
-re-demonstrating the correct use of a metered-dose inhaler -observing the client's technique when using the metered-dose inhaler at least four times -monitoring the client's saturated oxygen with a pulse oximeter before and after the use of the metered-dose inhaler
The nurse is preparing supplies for a tuberculosis screening. The nurse should choose which syringes and needles?
1 mL syringe; ½-inch (1.25-cm), 26-gauge needle
A bolus administration of medication has been ordered for a client. How will the nurse prepare to administer this drug?
1 mL/min
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?
1-inch; 22-gauge
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 that have 30 g in 45 ml. How many milliliters is the nurse going to administer every 6 hours to the client?
30 mL
The client has a prescription for 1,000 mL 5% D/NS IV every 8 hours. Which is the correct drip rate for a gravity infusion with a drop factor of 20 drops per milliliter? Record your answer using a whole number.
42
The client is prescribed ear drops to be given in both ears. After administering the ear drops in one ear, how long would the nurse wait before administering the ear drops in the other ear?
5 minutes
A nurse is administering intramuscular injections to clients. What needle size(s) has the nurse used correctly? Select all that apply.
5/8-inch (2-cm) needle for the vastus lateralis site 1 1/2-inch (3.75-cm) needle for an adult in the deltoid site 5/8-inch (2-cm) needle for a child in the deltoid site
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?
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 is preparing to irrigate an intermittent infusion device. Which size syringe would the nurse use?
A nurse is preparing to irrigate an intermittent infusion device. Which size syringe would the nurse use? To prevent blood clot formation, the devices are irrigated with a small quantity (3 mL) of sterile, preservative-free sodium chloride (NaCl) from a large-barrel (10 mL) syringe. The large-barrel syringe is used to decrease pressure during irrigation and hence decrease the risk of catheter damage.
The nurse has administered a glycerin suppository to a client who has not had a bowel movement for several days. One minute after the nurse inserted the suppository, the client told the nurse that she involuntarily expelled the suppository. What is the nurse's best action?
Apply more lubricant to the suppository and reinsert it.
A nurse has administered an injection to a client. Which intervention should the nurse perform to reduce discomfort and provide quick relief?
Apply pressure to the site during needle withdrawal. To reduce the discomfort associated with an injection, the nurse should apply pressure to the site during needle withdrawal. Applying a eutectic mixture of local anesthetic to the site will not help because it only provides relief after 1 or 2 hours. The nurse should numb the skin with an ice pack not after the injection, but before it. The nurse should not massage the site following an injection because, in some clients, it could lead to further complications and discomfort.
A nurse is caring for a client with pancreatic cancer who is receiving continuous morphine for pain. Which intervention would be the most effective method to administer this medication?
Administer a continuous subcutaneous infusion of morphine.
The nurse is preparing a medication from a vial and contaminates the plunger after the medication is drawn into the syringe. What should the nurse do next?
Administer the medication as prescribed
The nurse is caring for a client who has a history of asthma. The client has been admitted to a hospital unit for treatment of shortness of breath related to asthma exacerbation. The client tells the nurse, "I have been using my metered-dose inhalers but I still feel tightness in my chest." Which action(s) will the nurse take in response to the client's statement? Select all that apply.
Assure the client that using inhaled medications can be challenging and provide a demonstration of proper inhaled medication use. Assess the client's SpO2 levels before and after the inhaled medications have been properly administered. Contact the client's provider and recommend the use of a spacer to aid effective administration of inhaled medications. Conduct a thorough review of effective breathing techniques with the client and encourage the client to practice.
A nurse needs to administer a prescribed dosage of oral medication to a client with influenza. Which action should the nurse perform when administering oral medication to the client?
Avoid administering medication prepared by another nurse.
A medication order has ac written after the medication dosage. What does ac stand for?
Before meals
The client is to receive his third dose of vancomycin IV and an order for peak and trough levels is to be done. What is the correct way of doing trough level?
Blood is drawn before the third dose is administered.
The nurse is preparing to administer oral medication to a client. Which is the first action the nurse will take?
Compare the medication administration record (MAR) with the written medical order. The nurse will first compare the MAR with written orders, then wash hands, read and compare labels, and prepare medications.
After inserting an intravenous catheter into a client's vein, the nurse does not obtain blood return. What is the appropriate nursing action?
Change the catheter insertion site. If a blood return is not obtained, the IV catheter is not appropriately placed. The nurse will remove the IV catheter and change the site. Other actions are incorrect.
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?
Check the expiration date.
A nurse is applying a nitroglycerine transdermal patch to a client. What is the preferred site to use?
Chest Nitroglycerin may be placed on any hairless surface except on extremities below the knees or elbows, with the chest being the preferred site. It is reapplied every 12 to 14 hours, and clients should have a nitrate-free interval of 10 to 12 hours each day to ensure tolerance does not develop (Ball & Smith).
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
The nurse reviews the following prescription in the client's medical record: Morphine sulfate 3 mg every four hours as needed for postoperative pain. Which action by the nurse is correct?
Clarify the prescription with the health care prescriber. The nurse clarifies the prescription with the health care provider as the prescription, as written, is incomplete. There is no route of administration indicated and morphine may be given orally, intramuscularly, or intravenously. Administering the morphine as prescribed would be a medication error, as the route of administration is not identified in the prescription. Using a "trailing 0" is incorrect, as the dosage could be misinterpreted as 30 mg. Leading 0's are used for doses less than 1 mL. Drawing up the dose in a 3-mL syringe is inappropriate, as the route of administration is missing from the prescription.
The nurse needs to prepare an insulin pen for injection of a prescribed dose of insulin. Place the following steps in the correct order. Use all options.
Clean the tip of the reservoir with alcohol. Screw the correct needle onto the reservoir. Dial the dose selector to 2 units. Hold the pen upright and press the plunger firmly. Watch for a drop of insulin at the needle tip. Verify the dose selector returned to "0."
The nurse is administering a subcutaneous injection of insulin to a client. Which action would the nurse take after choosing the appropriate administration site?
Cleanse the area around the injection site with alcohol.
The nurse is preparing to administer two IV medications. What is the appropriate nursing action?
Consult a current drug reference book for IV compatibility.
The nurse is caring for a client who has had a cerebrovascular accident. Prior to administering oral medications, what is the nurse's appropriate action?
Consult with a speech therapist for dysphagia.
The nurse is preparing to give medications to a client with high blood pressure. The prescription indicates that the client is to have the combination drug dextroamphetamine saccharate-amphetamine aspartate monohydrate-dextroamphetamine sulfate-amphetamine sulfate 40 mg by mouth twice daily. What is the appropriate nursing action?
Contact the health care provider for clarification of the prescription.
A nurse is administering an adult client's ordered antipsychotic drug intramuscularly. What would be the most appropriate site for administration?
Deltoid
The nurse is preparing to administer two types of insulin by mixing in one syringe. What is the first action by the nurse?
Determine compatibility of the insulins by checking a drug compatibility table.
A client's EHR states that two medications are due at the same time, both of which are available in vials and are to be administered by injection. What is the nurse's most appropriate action?
Determine the compatibility of the two drugs by consulting clinical resources.
While receiving a medication IV piggyback, the client reports discomfort at the IV site. Upon assessment, the site is cool to the touch and slightly swollen. What is the best action by the nurse?
Discontinue the IV site and restart IV in a new location.
A nurse is preparing to administer a client's medication via a peripheral venous access device. Before administering the drug, which actions should the nurse take? Select all that apply.
Flush the device with a small amount of normal saline. Assess the client's allergy status. Identify the client according to institutional protocol.
The nurse is preparing to administer a medication through a peripheral intravenous line. What should the nurse do when administering the medication to ensure safe delivery? Select all that apply.
Flush with small amounts of saline pushed through the device on a routine basis to ensure patency. Flush the access device before the infusion is begun and after the infusion is completed. Don't start administering the medication until intravenous placement is confirmed. Observe for signs of infiltration or phlebitis prior to administration.
The nurse prepares to administer heparin subcutaneous to a client 5 ft 4 in (1.63 m) who weighs 300 lb (136 kg). What should guide the nurse's actions? Select all that apply.
Gather a 25-gauge 1-in (2.5-cm) needle. Rotate sites and chart the location of the injection.
The nurse is preparing to administer a nasal spray. Place the nurse's actions in order, from first to last. Use all options.
Identify the client using two identifiers and verify any allergies. Offer the client a tissue and ask the client to blow the nose. Insert the tip of the nasal spray into one nostril and close the other nostril with a finger. Compress the nasal spray while the client breathes in through the nose. Remove the tip of the spray from the client's nostril and release the compression. Instruct the client to not blow the nose for 5 to 10 minutes.
Which situation accurately describes a recommended guideline when administering oral medications to clients?
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?
Immediately activate the safety needle and place the syringe and needle into a Sharps container.
The nurse is preparing to administer an allergy test via an intradermal injection. Which injection site would be most appropriate in this situation?
Inner surface of the forearm
The nurse is preparing to administer prescribed intravenous antibiotics to a client. While assessing the medication lock, the nurse notes that there is resistance when administering the saline flush solution. What would be the best action by the nurse?
Insert a new IV medication lock and remove the old one.
The nurse prepares to administer an intravenous medication. Which action should the nurse perform when administering a medication from an ampule?
Insert the tip of the filter needle into the center of the ampule and invert the ampule
Which is an accurate guideline for client teaching regarding the use of a dry powder inhaler (DPI)?
Instruct the client that if mist can be seen from the mouth or nose, the DPI is being used incorrectly.
Which parenteral route of administration has the longest absorption time?
Intradermal
A 2-year-old child has been injured in a motor vehicle accident and is in immediate need of a blood transfusion for profuse bleeding. Which access site might the nurse expect to use for the infusion?
Intraosseous access
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
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?
PRN order
When administering oral medications, which practices should the nurse follow? Select all that apply.
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.
Which actions by the nurse are appropriate when administering a vaginal cream? Select all that apply.
Perform perineal care cleansing from just above the vaginal orifice downward. Keep the plunger applicator fully depressed until removed from the client. Insert the vaginal applicator directing it downward and backward.
The physiologic and biochemical effects of a drug on the body defines:
Pharmacodynamics
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?
Place the date on the vial and retain for future use.
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?
Provide education on taking all antibiotics for effective treatment
The nurse is administering morphine 5 mg oral solution, which is located in a locked drawer in the medication room. The medication is provided in a unit-dose container that is labeled 10 mg/5 ml. What action(s) are required for the nurse to perform?
Provide written documentation for the removal of the medication dose. Obtain another nurse to witness the waste of the unused medication. Count the number of the morphine unit-dose containers prior to removal. Document each shift by two nurses that an opioid count was performed.
The nurse is preparing to administer an intramuscular (IM) injection into a client. Which procedure should the nurse use to administer the injection?
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.
Which technique should the nurse employ when instilling otic medication in an adult ear?
Pull the client's ear up and back.
The nurse is teaching a client about insulin. What teaching will the nurse include? Select all that apply.
Rapid-acting insulin and short-acting insulin are often combined with intermediate-acting insulin. Humulin 50/50 contains equal amounts of intermediate-acting and short-acting insulin.
Which nursing actions should be performed in the required checks for safe medication administration? Select all that apply.
Read the medication label when reaching for the unit dose package. Read the medication label after retrieving the medication from the drawer. Read the medication label just before administering a unit dose medication to the client.
Which teaching will the nurse provide to a client with the NANDA-I nursing diagnosis of "Ineffective Protection related to cancer and chemotherapy treatment"?
Refrain from using aspirin while undergoing chemo treatment. The nurse will teach that aspirin and products containing salicylates should be avoided during chemo treatment, since these interfere with clotting. Teeth should be brushed with a soft-bristle brush; chemotherapy may be delayed if platelets are low or for other reasons; urine and stool should be tested daily for occult blood.
A new resident at the memory care unit has been prescribed a nitroglycerin patch. Which action should the nurse take for this resident?
Remove any hair from the upper back before applying the patch.
A nurse who is administering an injection to a client has an accidental needlestick injury after withdrawing the needle from the client's tissue. Which action(s) will the nurse take? Select all that apply.
Report the injury to a supervisor immediately. Perform hand hygiene per agency protocol. Document the injury per agency protocol in a timely manner. Seek a medical assessment and follow up as needed.
While administering a medication via a syringe, a client sharply moves and the nurse accidentally encounters a needlestick. What is the priority nursing action?
Report the needlestick to the nurse manager.
Which nursing action(s) promotes safety in the preparation of medication? Select all that apply.
Return medications with obscured labels to the pharmacy. Note the expiration dates on liquid medications. Prepare medications in well-lit conditions.
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?
Return the medication to the medication cart or medication room.
The nurse is teaching a client with diabetes how to withdraw insulin from a vial. In which order should the nurse explain the steps to the client?
Select appropriate syringe and needle. Remove the metal cover from the rubber stopper. Fill the syringe with a volume of air equal to the volume that will be withdrawn from the vial. Pierce the rubber stopper with the needle and instill the air. Invert the vial, hold, and brace it while pulling on the plunger. Date and initial the vial for future use.
In which order should the nurse instruct the client to use an inhaler?
Shake the canister to distribute the drug in the pressurized chamber. Place the inhaler in your mouth and close your lips around the mouthpiece. Press down on the canister once to release the medication. As the medication is released, breathe in slowly through your mouth for 3-5 seconds. Hold your breath for 10 seconds. Clean the inhaler daily by rinsing it in warm water daily.
The nurse is administering the first dose of an intravenous infusion of an antibiotic. What action would the nurse take next?
Stay with the client during the first 15 minutes of infusion.
The nurse is administering medication to a client through a drug-infusion lock using the saline flush. During the process, the client complains of pain at the site. Which interventions are appropriate in this situation? Select all that apply.
Stop the medication and assess the site for signs of infiltration and phlebitis. Flush the medication lock with normal saline again to recheck patency. If site is within normal limits, resume medication administration at a slower rate.
A nurse is caring for a 6-year-old client on the hematology-oncology floor. During a packed red blood cell (PRBC) transfusion, the client reports of pain at the peripheral IV site. The nurse assesses the site and notices that the site is purple. What is the nurse's best course of action?
Stop the transfusion and insert peripheral IV at a new site.
Sit up comfortably in the bed. Insert the tip of the nose piece into one nostril. Hold the breath for a few seconds after administering the spray.
Stop the transfusion and insert peripheral IV at a new site.
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?
Subcutaneous injections are administered into the adipose tissue layer just below the epidermis and dermis.
A client has a central venous catheter inserted. The nurse understands that the tip of the catheter would be found at which location? Select all that apply.
Superior vena cava Right atrium
A nurse needs to administer a subcutaneous injection to a client. Which techniques should the nurse use to reduce discomfort? Select all that apply.
Support the client's tissue when withdrawing the needle. Numb the skin with an ice pack before the injection. Insert and withdraw the needle without hesitation. Instill the medication slowly but steadily.
A client is prescribed an opioid analgesic. The nurse is teaching the client about the need to avoid ingesting alcohol with the drug to prevent an interaction which would potentiate the effects of the analgesic. The nurse is describing which event?
Synergism
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?
Tactfully request the provider to input the order into the computerized provider order system.
A nurse needs to withdraw a prescribed medication from an ampule and administer it to a client. Which action should the nurse perform to ensure that all the medication is equally distributed when withdrawing?
Tap the top of the ampule before withdrawing the medicine.
A nurse needs to instill eye medication in a client with conjunctivitis. Which action is best to distribute the medication over the surface of the eye?
The client should blink the eye.
The nurse correlates the metric system as the most accurate method utilized to administer medications for which reason?
The dosage prescriptions of medications most often use this system as it is measured in 10s and can be easily converted between measurements
Which parts of the syringe and needle must be kept sterile when preparing and administering an injection? Select all that apply.
The needle hub The needle Inside the barrel
Which strategy should the nurse use to assist a visually impaired client to distinguish between eye medications?
The nurse should advise the client to use rubber bands on the containers.
Which nursing strategy should the nurse employ to enhance the teaching/learning process for a client who is noncompliant with inhalers?
The nurse should provide simple written instructions with each medication.
The nurse is preparing to administer nasal medications to a client. In which order is the nurse is expected carry out the procedure?
The nurse will help the client to a sitting position with the client's head tilted backward. The nurse will aim the tip of the container towards the nasal passage and squeeze the number of drops prescribed. The nurse will instruct the client to breathe through the mouth as the drops are instilled. The nurse will advise the client to remain in the position for approximately 5 minutes.
Regarding medication administration, what must occur at the change of shifts?
The opioids for the division are counted.
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 the drug.
The nurse is preparing to administer an injection to a client. What factor(s) will the nurse consider when deciding which type of syringe and needle to use for administration? Select all that apply
The viscosity of the fluid to be injected. The volume of the drug that needs to be injected into the client. The prescribed drug dosage to be injected. The height and weight of the client receiving the injection. The location of the body where the drug will be injected.
A nurse is administering medication to a client via a gastric tube and finds that the medicine enters the tube and then the tube becomes clogged. What is the appropriate intervention in this situation?
Use a syringe to plunge the tube to try to dislodge the medication.
The nurse is preparing medications for enteral tube administration. Which nursing action(s) is appropriate? Select all that apply.
Use the liquid form of the drug if available. Verify safety and open capsules to release the powdered drug.
A client has been receiving frequent injections. Which instruction(s) to reduce discomfort at the injection site will the nurse provide? Select all that apply.
Use the smallest-gauge needle that is appropriate. Select a site that is free of irritation.
The nurse has just finished injecting a medication intramuscularly, and needle is still in the client's arm. Which is the correct immediate next step?
Wait 10 seconds and then withdraw the needle The immediate next step would be to wait 10 seconds and then withdraw the needle. Waiting allows the medication to begin to diffuse into the surrounding muscle tissue. Aspiration, or pulling back on the plunger to check that a blood vessel has been entered, is not necessary nor recommended. Moving the syringe could cause damage to the tissues and inadvertent administration into incorrect area, so this should not be done.
Which set of instructions the nurse should give to a client who is going home with eye drops? Select all that apply.
Wait for 5 minutes between instillation of eye drops. Apply the drops along the lower lid margin of the eye. Keep the application tip of the medication container sterile.
Which actions would the nurse take when instilling eyedrops correctly? Select all that apply.
Wash hands and put on gloves. Tilt the client's head back slightly if sitting, or place the head on a pillow if lying down. Have the client look up and focus on something on the ceiling.
The client states "I think my IV dressing needs to be changed." In which instance should the nurse change the dressing?
When the dressing is loose, bloody or wet.
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?
Withhold the medication and notify the health care provider that ordered the medication
The nurse is preparing to draw up a medication that is supplied in a glass ampule. Place, in order, the steps the nurse will take. Use all options.
Wrap a small gauze pad around the neck of the ampule. Break off the top of the ampule. Attach the filter needle to the syringe. Withdraw the medication. Discard the filter needle. Attach a sterile administration device to the syringe.
Which client would most likely require placement of an implantable port?
a 58-year-old woman with stage 3 breast cancer requiring weekly chemotherapy This client needs frequent IV access. A central port is easily accessed for chemotherapy sessions, then the access is discontinued even though the port remains in place subcutaneously. A central port also allows for the infusion of chemotherapy into a central vessel; this is important because chemotherapy is caustic and severely damages peripheral vessels.
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 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 client who is reporting pain near the surgical site
What is required to manually regulate an IV drip? Select all that apply.
a clock tubing with a roller clamp
The rapid response team is present while a client is receiving cardiopulmonary resuscitation (CPR). The health care provider informs the nurse to administer a dose of epinephrine IV. Which method of medication will the nurse obtain?
a stock supply The nurse will need to obtain the medication rapidly because this is an emergency situation. The fastest method in this scenario is the stock supply, which is a large number of stored drugs that remain on the unit for emergency use. A unit dose supply is a packet that has one pill or capsule for client consumption. An individual supply is a container with enough of the prescribed drug for several days or weeks, which is common in long-term care facilities such as nursing homes. The automated medication dispensing system requires the nurse to access the machine with a specific code and withdraw the one item that is needed. This is a time consuming procedure that is not appropriate for an emergency situation.
A client has an intermittent infusion device inserted for the administration of antibiotic therapy every 6 hours. The nurse would expect to flush the device at which frequency?
before and after each medication administration
Which assessment should be conducted by the nurse before the nurse administers tuberculin intradermal injection?
checking for documented allergies to food or drugs
A client is receiving a secondary infusion of a new antibiotic through a peripherally inserted central line (PICC) suddenly reports itching and flushing. Which action should the nurse prioiritize for this client?
clamp the antibiotic infusion The client may be experiencing a life-threatening reaction to the antibiotic. The nurse should clamp the secondary infusion line which is infusing the antibiotic and notify the primary care provider immediately. It would be inappropriate for the nurse to flush the PICC line as this will increase the amount of antibiotic getting into the client's body. Slowing the infusion rate will also not correct or prevent further adverse effects. The nurse should not remove the PICC line as this may be outside the nurse's scope of practice as it requires special training and certification to do that. The nurse should leave the PICC line open, however, unless otherwise instructed.
Which client does the nurse recognize will require an intramuscular administration of the medication instead of an intravenous administration?
client who is low risk for hemorrhage and prescribed the Hepatitis B vaccination
The nurse has given medications to four clients. Which client will the nurse monitor most closely for a possible reaction to occur?
client with infection who received a bolus of Lactated Ringer's solution nurses carefully monitor all clients and know that reactions are more likely to occur when something is given intravenously. Therefore, the nurse will most closely monitor the client who received a bolus of Lactated Ringer's solution. The other clients will not be monitored as closely because they are not receiving anything intravenously.
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?
decreased irritation and pain in subcutaneous tissue
Which physiologic change should the nurse take into consideration when administering topical application to older adults?
decreased subcutaneous fat Decreased subcutaneous fat is correct, as this could lead to more rapid absorption of topical medications. Increased subcutaneous fat, decreased elasticity, and increased elasticity are incorrect and are less significant as they relate to older adults.
There have been an increase of needlestick injuries in the intensive care unit. When preparing to address this occurrence in a staff meeting, what should the nurse manager include in an education presentation to prevent needlestick injuries? Select all that apply.
disposing of used needles in sharps container using self-retracting safety needles Using needleless adapters for medication administration
A nurse is assessing the reading on a volume-control set when administering an IV drug to a client. Which of the following functions is performed by a volume-control set?
eliminates the need for an additional bag of fluid A volume-control set eliminates the need for additional fluid by substituting for the separate secondary container of solution. It is used to administer IV medication in a small volume of solution at intermittent intervals and to avoid accidentally overloading the circulatory system. A medication lock, not a volume-control set, allows instant access to the venous system. A volume-control set is a chamber in IV tubing that holds a portion of the solution from a larger container, not a smaller container.
The nurse is administering a client's scheduled intramuscular injection. What is the nurse's most appropriate action?
gloves, 90 degrees use the triangle method via ventrogluteal
The nurse is preparing to attach a label to an intravenous medication that is being administered by continuous infusion. Which component will the nurse include on the label? Select all that apply
identification of drug dose time drug was added initials of nurse
Following an allergic reaction to a medication, the nurse should:
instruct the client to wear an identification bracelet addressing the allergy.
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?
intradermal
implantable port
intravenous access device that is completely under the skin, is placed in the vein on the upper chest wall, and exits the body near the xyphoid process, axilla, or abdominal wall
Which organ is the primary site for drug metabolism?
liver
The nurse has provided a client with a sublingual medication. Which is the most appropriate nursing intervention to ensure proper administration of this medication?
looking under the client's tongue to verify administration
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
The 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.
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?
self-contained packets that hold one tablet or capsule for individual clients
The health care provider has prescribed a subcutaneous injection to a client. Which factors should the nurse consider when selecting a syringe and needle? Select all that apply.
size of the client type of medication viscosity of the drug amount of adipose tissue
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 would help maximize drug absorption in this client?
spacer
The nurse is preparing to administer nasal medication via a dropper to a client with severe congestion. Into which position will the nurse place the client?
supine