Unit 3 Fundamentals (Medication Administration Ch.31)

troche

Flat, round tablets that dissolve in the mouth to release medication

intrathecal

Medication administration into a catheter placed in the subarachnoid space or one of the ventricles of the brain

c) Physician's signature

What information must a medication order include? a) Drug class b) Possible adverse reactions c) Physician's signature d) Client allergies

c) Crush the tablets and prepare a liquid form; then insert the liquid into the NG tube.

18. A client has a nasogastric (NG) tube. How should the nurse administer oral medication to this client? a) Crush the tablets and wash the powder down the NG tube, using a syringe filled with saline solution. b) Cut the tablets in half and wash them down the NG tube, using a water-filled syringe. c) Crush the tablets and prepare a liquid form; then insert the liquid into the NG tube. d) Heat the tablets until they liquefy; then pour the liquid down the NG tube.

a) Check for availability of a liquid preparation.

A client complains of difficulty swallowing when the nurse tries to administer a medication in capsule form. What action should the nurse take next? a) Check for availability of a liquid preparation. b) Break the capsule and mix the contents with applesauce. c) Dissolve the capsule in a full glass of water. d) Withhold the medication.

b) Return to the client's room a few minutes later and remain there until the client takes the medication.

A client is in the bathroom when a nurse enters to give him a prescribed medication. What should the nurse do? a) Wait for the client to return to bed; then leave the medication at the bedside. b) Return to the client's room a few minutes later and remain there until the client takes the medication. c) Tell the client to be sure to take the medication; then leave it at the bedside. d) Leave the medication at the client's bedside.

a) "I'll place the disk on the same spot each day."

A client is to be discharged on daily medication delivered by a transdermal disk. Which statement indicates the need for further medication teaching? a) "I'll place the disk on the same spot each day." b) "I'll avoid touching the gel in the disk." c) "I'll wash my hands after applying the disk." d) "I'll change the disk at the same time every day."

c) Applying a lubricant to the suppository

A client is to receive a glycerin suppository. Which nursing action is appropriate when administering a suppository? a) Dissolving the suppository in 3 ml of warm water b) Removing the suppository from the refrigerator 30 minutes before insertion c) Applying a lubricant to the suppository d) Instructing the client to bear down during insertion

D. Instruct the patient to put medications in a weekly organizational pill container

A home care nurse is helping a patient with short term memory loss how to remember to take multiple drugs throughout the day. What should the nurse do when teaching this patient? A.Suggest that the patient wear a watch with an alarm B.Ask a family member to call the patient when medications are due to be taken C.Design a chart of medications the patient takes each day during the week D.Instruct the patient to put medications in a weekly organizational pill container

C. Inserts the suppository while the patient bears down Rationale: Bearing down increases intra-abdominal pressure which impedes the insertion of the suppository. The patient should be instructed to relax and breathe deeply and slowly while the suppository is inserted.

A home care nurse observes the spouse of a patient inserting a rectal suppository. What behavior indicates that the nurse must provide teaching about suppository administration? A.Lubricates the tip of the suppository B.Inserts the suppository while wearing gloves C.Inserts the suppository while the patient bears down D.Places the suppository a finger length into the rectum

a). Use the Z-track technique (for all intramuscular injections to keep the medication from leaking out of the muscle into surrounding tissues)

A nurse has an order to administer iron dextran (INFeD) 50 mg I.M. injection. When carrying out this order, the nurse should: a) use the Z-track technique. b) wipe the needle immediately after injection. c) insert the needle at a 45-degree angle. d) pull the skin laterally toward the injection site.

A.Limits corneal irritation Rationale: Closing the eyes moves the medications over the conjunctiva and eyeball and helps ensure an even distribution of medication.

A nurse instructs a patient to close the eyes after the administration of eye drops. What rationale for this instruction should the nurse explain to the patient? A.Limits corneal irritation B.Squeezes excess medication from the eyes C.Disperses the medication over the eyeballs D.Prevents medication from entering the lacrimal duct

C.Disperse the medication

A nurse instructs a patient to inhale deeply and hold each breath for a second when using a hand-held nebulizer. The patient asks, "Why do I have to hold my breath?" A.Prolong treatment B.Limit hyperventilation C.Disperse the medication D.Prevent bronchial spasms

d). 15 degree angle

A nurse is administering an intradermal injection. At what angle should the nurse insert the needle? 90 degree angle 45 degree angle 30 degree angle 15 degree angle

B.Unconsciousness Rationale: Nothing that needs to be swallowed should ever be placed into the mouth of an unconscious patient because of the risk of aspiration.

A nurse is assessing a patient for the appropriateness of administering a medication via the oral route. What clinical manifestation indicates that the nurse should ask the practitioner for a change in route? A.Nausea B.Unconsciousness C.Gastric suctioning D.Difficulty swallowing

b) Remove the patch every night.

A nurse is instructing a client about the use of nitroglycerin patches. The nurse should instruct the client to: a) Apply the patch only on alternate days. b) Remove the patch every night. c) Use the patch only when chest pain occurs. d) Change the site of the patch every day.

a) "The spacer traps medicine from the inhaler, then breaks up and slows down the medication particles, so you get more medication."

A nurse is instructing a client with asthma on the use of an inhaler with a spacer. The client asks what the purpose of the spacer is. The nurse's best response is: a) "The spacer traps medicine from the inhaler, then breaks up and slows down the medication particles, so you get more medication." b) "You should ask your physician to explain the purpose of the spacer." c) "The spacer is a better way for you to receive the medication from the inhaler and you don't have to inhale when using it." d) "The physician has ordered the spacer and wants me to show you how to use it."

D.. Abdomen

A nurse is preparing to administer a SQ injection of insulin. What site should the nurse use to best promote its absorption? A.Upper lateral arms B.Anterior thighs C.Upper chest D.Abdomen

B.At the patient's bedside

A nurse is preparing to administer a tablet to a patient. When should the nurse remove the medication from its unit dose package? A.Outside the door to the patient's room B.At the patient's bedside C.In the medication room D.At the medication cart

A.Instilling an accurate amount of diluent into the vial Rationale: The required amount of diluent must be followed exactly in a multi-dose formulation to ensure accurate dosage preparation. The diluent for a single-dose formulation also must be exact so that the medication is diluted enough not to injure body tissues.

A nurse is preparing to reconstitute a medication in a multiple-dose vial. What is the most essential step in the preparation of this medication? A.Instilling an accurate amount of diluent into the vial B.Using a filtered needle when drawing up the medication from the vial C.Instilling air into the vial before withdrawing the reconstituted solution D.Wiping the rubber seal of the vial with alcohol before and after each needle insertion

A.Direct the flow of solution from the inner to the outer canthus

A nurse is to administer an eye irrigation to a patient's right eye. What should the nurse do first? A.Direct the flow of solution from the inner to the outer canthus B.Irrigate with an asepto syringe several inches from the eye C.Don sterile gloves before beginning the procedure D.Position the patient in a right lateral position

A. Warm the solution to body temperature

A nurse must administer a medication into the ear of an adult. What should the nurse do to limit patient discomfort when administering ear drops? A.Warm the solution to body temperature B.Place the patient in a comfortable position C.Pull the pinna of the ear upward and backward D.Instill the fluid in the center of the auditory canal

A.Inject the same amount of air as the fluid to be removed

A nurse must administer a medication that is supplied in an ampule. What should the nurse do first to access the ampule? A.Inject the same amount of air as the fluid to be removed B.Wipe the constricted neck with an alcohol wipe C.Break the constricted neck using a barrier D.Insert the needle into the rubber seal

B.Instill the solvent that is consistent with the manufacturer's directions

A nurse must reconstitute a powdered medication. What should the nurse do? A.Keep the needle below the initial fluid level as the rest of the fluid is injected B.Instill the solvent that is consistent with the manufacturer's directions C.Score the neck of the ampule before breaking it D.Shake the vial to dissolve the powder

A.Deltoid

A nurse plans to administer a 3 mL intramuscular injection. Which muscle is the least desirable to use for the administration of this medication? A.Deltoid B.Dorsogluteal C.Ventrogluteal D.Vastus lateralis

a) Sims' left lateral

A nurse prepares to administer a cleansing enema. What is the most common client position used for this procedure? a) Sims' left lateral b) Dorsal recumbent c) Prone d) Supine

a) Between the client's cheek and gum

A nurse prepares to administer medication by the buccal route. Where should the nurse place this medication? a) Between the client's cheek and gum b) On the client's skin c) Under the client's tongue d) In the client's conjunctival sac

a) Verify the order by repeating it to the physician over the phone.

A nurse receives a medication order over the telephone. What is the best way for the nurse to handle this situation? a) Verify the order by repeating it to the physician over the phone. b) Request that a second physician repeat the order to the nurse over the telephone. c) Insist that the physician sign the medication order within 1 hour. d) Tell the physician that the nurse practice act prohibits taking medication orders over the telephone.

A. rinses the mouth with water after the treatment Rationale: Rinsing the mouth removes any remaining medication. This prevents irritation to the oral mucosa and tongue and prevents oral fungal infections.

A nurse teaches a patient how to self-administer a corticosteroid via a metered-dose inhaler with an extender. Which behavior indicates to the nurse that the patient understands the teaching? A.Rinses the mouth with water after the treatment B.Rolls the canister between the hands slowly before using the inhaler C.Positions the mouthpiece directly in front of the mouth while inhaling D.Assumes the semi-fowlers position with the head supported on a pillow

A.Start breathing in while compressing the canister

A patient has a prescription for 2 puffs of a bronchodilator via a metered-dose inhaler. What should the nurse teach the patient to do when self-administering the medications? A.Start breathing in while compressing the canister B.Hold the inspired breath for several seconds C.Deliver 2 puffs with each inspiration D.Inhale slowly for 8 to 10 seconds

a) a standing order.

A physician orders ampicillin (Omnipen), 500 mg by mouth every 6 hours. This medication order is an example of: a) a standing order. b) a stat order. c) a single order. d) an as-needed order.

c) clarify the order with the physician.

A physician writes a medication order for meperidine (Demerol) 500 mg. The nurse's appropriate action would be to: a) clarify the order with another nurse on the unit. b) give the medication as ordered. c) clarify the order with the physician. d) clarify the order with the pharmacy.

A.Ensure that the skin surface is dry

A practitioner prescribes a medicated powder to be applied to a patient's skin. What is most essential for the nurse to do when applying the medicated powder? A.Apply a thin layer in the direction of hair growth B.Protect the patient's face with a towel C.Dress the area with dry sterile gauze D.Ensure that the skin surface is dry

D. Dorsogluteal The dorsogluteal site has the highest risk for injury because of the close proximity of the sciatic nerve, blood vessels, and bone.

A practitioner prescribes a medication that must be administered via the intramuscular route. Which site should the nurse eliminate from consideration because it has the highest potential for injury when administering an IM injection? A.Vastus lateralis B.Rectus femoris C.Ventrogluteal D.Dorsogluteal

A.Place the patient in the supine position with the head tilted backward Rationale: This ensures that gravity will promote the flow of medication to the posterior pharynx.

A practitioner prescribes nose drops to be administered twice a day. What should the nurse do when instilling nose drops? A.Place the patient in the supine position with the head tilted backward B.Pinch the nares of the nose together briefly after the drops are instilled C.Instruct the patient to blow the nose 5 minutes after the drops are instilled D.Insert the drop applicator 1/8 inch into the nose toward the base of the nasal cavity

d) With one hand, use the needle to scoop up the cap. Holding the barrel in one hand, carry the syringe to the closest sharps-disposal container.

After administering an I.M. injection, a nurse notices there isn't a sharps-disposal container nearby. Which action should the nurse take? a) Hold the barrel of the syringe in one hand. With the other hand, push the cap into place over the needle. b) With one hand, use the needle to scoop up the cap. Holding the barrel in one hand, carry the syringe to the closest trash container. c) Hold the barrel of the syringe in one hand. With the other hand, push the cap into place over the needle. Carry the syringe to the closest sharps-disposal container. d) With one hand, use the needle to scoop up the cap. Holding the barrel in one hand, carry the syringe to the closest sharps-disposal container.

d) discard the uncapped needle and syringe in a puncture-proof container.

After administering an I.M. injection, a nurse should: a) recap the needle and discard the needle and syringe in a puncture-proof container. b) recap the needle and discard the needle and syringe in any medical waste container. c) break the needle using the facility-approved device and discard the needle and syringe in any medical waste container. d) discard the uncapped needle and syringe in a puncture-proof container.

aerosol

Aqueous medication sprayed and absorbed in the mouth and upper airway

now order

Can be administered within 90 minutes

enteric coated tablet

Coated tablet that does not dissolve in the stomach

B.Two times a day

How often should docusate sodium (Colace) 100 mg BID be given? A.Three times a day B.Two times a day C.Every other day D.At bedtime

intraosseous

Infusion of medication directly into bone marrow

A.Is supplied in an ampule

It is most important for a nurse to use a filtered needle when preparing a parenteral medication that A.Has to be reconstituted B.Is supplied in an ampule C.Appears cloudy in the vial D.Is to be mixed with another medication

idiosyncratic reaction

Patient overreacts or underreacts to a medication or has a reaction different from normal

pharmacokinetics

Study of how medications enter the body, reach their site of action, metabolize, and exit the body

a) Evidence of a bleb or wheal.

The nurse administers an intradermal injection to a client. Proper technique has been used if the injection site demonstrates which of the following? a) Evidence of a bleb or wheal. b) Minimal leaking. c) Tissue pallor. d) No swelling.

D. .Inject the medication slowly

What should the nurse do to limit discomfort when administering an injection? A.Pull back on the plunger before injecting the medication B.Apply ice to the area before the injection C.Pinch the area while inserting the needle D.Inject the medication slowly

B. 25 gauge needle

What should the nurse use when administering a subcutaneous injection? A.5 mL syringe B.25 gauge needle C.Tuberculin syringe D.1 ½ inch long needle

a) Placing uncapped, used needles and syringes immediately in the universal precaution container in the client's room.

The nurse should dispose of a used needle and syringe by: a) Placing uncapped, used needles and syringes immediately in the universal precaution container in the client's room. b) Recapping the needle and placing the needle and syringe in the universal precaution container in the client's room. c) Cutting the needle at the hilt in a needle cutter before disposing of it in the universal precaution container in the client's room. d) Separating the needle and syringe and placing both in the universal precaution container in the client's room

C.Mouth

The provider prescribes a troche. The nurse should administer it by placing it in the patient's A.Ear B.Eye C.Mouth D.Rectum

b) Clarify the order by calling the physician.

The unit secretary who transcribes the physicians' prescriptions asks the nurse to interpret an illegible order. The nurse should: a) Interpret the order according to the client's previous medication record. b) Clarify the order by calling the physician. c) Clarify the client's medications with the client's family. d) Clarify the order with the pharmacist.

liniment

Usually contains alcohol, oil, or soapy emollient applied to the skin

b) Withhold the amoxicillin.

When a client reports being allergic to amoxicillin even though the medication administration record and armband do not indicate medication allergies, the nurse should: a) Administer another, similarly acting antibiotic. b) Withhold the amoxicillin. c) Administer the prescribed medication. d) Call the family to verify the client's statement.

c) Recheck the name and strength of the medication.

When a nurse brings prescribed medication to a client, the client says she usually takes a white tablet, not the yellow tablet that the nurse has brought. What should the nurse do first? a) Tell the client that the white tablet must be from a different manufacturer. b) Reassure the client that the white tablet is the correct medication. c) Recheck the name and strength of the medication. d) Withhold the medication and notify the physician.

d) 90 degrees.

When giving an I.M. injection, the nurse should insert the needle into the muscle at an angle of: a) 45 degrees. b) 30 degrees. c) 15 degrees. d) 90 degrees.

a) Repeating the order back to the physician.

When taking a telephone order from a physician, the nurse verifies that he or she understands the order by: a) Repeating the order back to the physician. b) Asking the physician to summarize the orders given. c) Confirming the order with the nurse manager. d) Faxing the written order to the physician's office.

d) on the floor of the mouth.

When teaching a client how to take a sublingual tablet, the nurse should instruct the client to place the tablet: a) on the top of the tongue. b) on the roof of the mouth. c) inside the cheek. d) on the floor of the mouth.

C. Use the paper cup to introduce the pills into the patient's mouth Rationale: The patient needs assistance. Keep medication in the cup rather than touching it with the hands; maintains medical asepsis.

When the nurse brings pills to a patient, the patient is unable to hold the paper cup with the medications. What should the nurse do? A.Crush the pills and mix it with applesauce B.Have the practitioner prescribe the liquid form of the drug C.Use the paper cup to introduce the pills into the patient's mouth D.Put the pills into the patient's hand and have the patient self-administer the pills

D. ac

Which abbreviation indicates that the practitioner wants a medication administered before meals? A. pc B. qh C. po D. ac

C. Inserting the needle with the bevel upward Rationale: When medication is injected with the bevel up, a small wheal will form under the skin. This technique is used only with intradermal injections.

Which intervention is uniquely related to the administration of an intradermal injection? A.Using the air-bubble technique B.Pinching the skin during needle insertion C.Inserting the needle with the bevel upward D.Massaging the area after the fluid is instilled

D.Seek a new prescription after 2 doses that do not achieve a tolerable level of relief

Which nursing action is most appropriate when administering an analgesic? A.Reassess drug effectiveness every 8 hours B.Follow the prescription exactly for the first 24 hours C.Ask the provider to include a medication prescription for breakthrough pain D.Seek a new prescription after 2 doses that do not achieve a tolerable level of relief

A.Buccal

Which route is unrelated to the parenteral administration of medications? A.Buccal B.Z-track C.Intravenous D.Intradermal

c) Standing order

Which type of medication order might read "Vitamin K 10 mg I.M. daily × 3 days?" a) As-needed order b) One-time order c) Standing order d) Stat order

pc

after meals

detoxify

break down

standing order

carried out until cancelled or prescribed number of days has elapsed

therapeutic response

expected or predicted response

subcutaneous

injection just below the dermis

Intraarticular

injection of medication into a joint

trough

lowest level of drug concentration

caplet

oblong solid dosage form for oral use