Deck 26: Administering Medications

Question 1

The nurse administered the narcotic meperidine, 50 mg orally (PO) at 1400 to a patient with nausea, vomiting, and pain rated as 9 on a 0-to-10 scale. At 1430, the patient stated that the medication was not working and requested to have intravenous (IV) morphine, which the provider had prescribed for severe pain. What is the nurse's best evaluation of this situation?
1)The patient needs to understand that it takes time for the medication to reduce pain.
2)Administering meperidine PO was not the best nursing intervention in this situation.
3)The provider should be notified if the patient's pain is not relieved in 2 hours.
4)Meperidine PO was the best intervention because morphine IV can cause drug addiction.

Answer 1

2

Question 2

A patient with terminal cancer requires increasing doses of an opioid pain medication to obtain relief from pain. This patient is exhibiting signs of drug:
1)Abuse
2)Misuse
3)Tolerance
4)Dependence

Answer 2

3

Question 3

The nurse is preparing to administer a medication for a client with cystic fibrosis. The nurse is not familiar with the drug. Which is the best action that the nurse should take?
1)Administer the drug.
2)Ask another nurse.
3)Refer to the Physician's Desk Reference.
4)Review a nursing care plan textbook.

Answer 3

3

Question 4

The primary care provider orders peak and trough levels for a patient who is receiving intravenous vancomycin every 12 hours. When should the nurse obtain a blood specimen to measure the trough?
1)With the morning routine laboratory studies
2)Approximately 30 minutes before the next dose
3)Two hours after the next dose infuses
4)While the drug is infusing

Question 5

A patient who just returned from the postanesthesia care unit is reporting severe incision pain. Which drug contained in the medication administration record will offer the patient the fastest relief?
1)Liquid acetaminophen with codeine
2)Intravenous morphine sulfate
3)Intramuscular meperidine
4)Oral oxycodone tablets

Question 6

A surgeon prescribes heparin 2,500 mEq intramuscularly (IM) every 12 hours (q12hr). What is the nurse's best action?
1)Administer the medication as prescribed.
2)Clarify the medication dose with the surgeon.
3)Administer the medication subcutaneously.
4)Clarify the dose and route with the surgeon.

Question 7

A patient is given furosemide 40 mg orally at 0900. The duration of action for this drug is approximately 6 hours after oral administration. At which time in military hours should the nurse no longer expect to see the effects of this drug?
1)0930
2)1000
3)1100
4)1500

Question 8

While receiving an intravenous dose of an antibiotic, levofloxacin, a patient develops severe shortness of breath, wheezing, and severe hypotension. Which action should the nurse take first?
1)Administer epinephrine intramuscularly (IM).
2)Give a bolus dose of intravenous fluids.
3)Stop the infusion of medication.
4)Prepare for endotracheal intubation.

Question 9

After receiving diphenhydramine, a patient reports experiencing a very dry mouth. This is not uncommon in patients taking this medication. Which drug effect is this patient experiencing?
1)Side effect
2)Adverse reaction
3)Toxic reaction
4)Supportive effect

Question 10

A nurse is preparing a medication that is supplied in ounces but the prescription is in milliliters. How many milliliters equal 1 ounce?
1)5
2)15
3)30
4)45

Question 11

A patient with end-stage cancer is prescribed morphine sulfate to reduce pain. For which effect is this medication prescribed?
1)Supportive
2)Restorative
3)Substitutive
4)Palliative

Question 12

Which factor in a patient's medical history is most likely to prolong the half-life of certain drugs?
1)Heart disease
2)Liver disease
3)Rheumatoid arthritis
4)Osteoarthritis

Question 13

Before administering a medication, the nurse must verify the six rights of medication administration, which are:
1)Right patient, right room, right drug, right route, right dose, and right time
2)Right drug, right dose, right route, right time, right physician, and right documentation
3)Right patient, right drug, right route, right time, right documentation, and right equipment
4)Right patient, right drug, right dose, right route, right time, and right documentation

Question 14

Teratogenic drugs should be avoided in which patient population?
1)Pregnant women
2)Elderly
3)Children
4)Adolescents

Question 15

The nurse receives a laboratory report that states the patient's digoxin level is 1.2 mg/mL; therapeutic range for this drug is 0.5 to 2.0 mg/mL. Which action should the nurse take?
1)Notify the prescriber to reduce the dose.
2)Withhold the next dose of digoxin.
3)Administer the next dose as prescribed.
4)Ask the prescribing healthcare provider to increase the dose.

Question 16

An insulin-dependent diabetic female patient tells the nurse that she has been giving herself injections in the same location in her right thigh for the past several months because it is easier. What is the nurse's best action?
1)Provide patient teaching on rotating injection sites.
2)Tell the patient to make sure the dose is in milliliters.
3)Check the type of insulin the patient receives to ensure that it is compatible with the vastus lateralis site.
4)Document the patient's comments, as the patient understands the treatment regimen.

Question 17

Laboratory test results indicate that warfarin anticoagulant therapy is suddenly ineffective in a patient who has been taking the drug for an extended period of time. The nurse suspects an interaction with herbal medications. What type of interaction does the nurse suspect?
1)Antagonistic drug interaction
2)Synergistic drug interaction
3)Idiosyncratic reaction
4)Drug incompatibility

Question 18

A patient develops urticaria and pruritus 5 days after beginning phenytoin for treatment of seizures. Which type of reaction is the patient most likely experiencing?
1)Mild allergic reaction
2)Dose-related adverse reaction
3)Toxic reaction
4)Anaphylactic reaction

Question 19

Which expected outcome is best for a patient with a nursing diagnosis of Deficient Knowledge related to new drug treatment regimen?
1)After an explanation and written materials, verbalizes the expected actions and adverse reactions of the medication
2)In 1 week after instructional session, describes the expected actions and adverse reactions of the medications
3)Follows the treatment plan as prescribed
4)Experiences no adverse effect from the prescribed treatment plan

Question 20

Which term refers to the movement of a drug from the site of administration to the bloodstream?
1)Absorption
2)Distribution
3)Metabolism
4)Excretion

Question 21

Which documentation entry related to prn (as needed) medication administration is complete?
1)6/5/20 0900 morphine 4 mg IV given in right antecubital fossa for pain rated 8 on a 1-10 scale, J. Williams RN
2)0600 famotidine 20 mg IV given in right hand, S. Abraham RN
3)9/2/20 0900 levothyroxine 50 mcg PO given
4)1/16/20 furosemide 40 mg PO given, J. Smith RN

Question 22

The nurse is teaching parents ways to give oral medication to their child. Which action would the parents implement to improve compliance?
1)Crush time-release capsules to put in their child's favorite food.
2)Give medication quickly before the child knows what is happening.
3)Allow the child to eat a frozen pop before receiving the medication.
4)Mask the flavor of medication in a toddler cup with orange juice.

Question 23

When the nurse enters a male patient's room to administer a medication, he calls out from the bathroom, telling the nurse to leave his medication on the bedside table. He reassures the nurse that he will take the medication as soon as he is finished. How should the nurse proceed?
1)Inform the patient that the nurse will return when he is finished in the bathroom.
2)Wait outside the bathroom door until the patient is ready for the dose.
3)Withhold the dose until the next administration time later in the day.
4)Leave the medication at the bedside so that the patient can take it later.

Question 24

The nursing student has registered for a class on pharmacokinetics. Which phrase reflects the student's accurate understanding of what the focus in this class will be?
1)The study of drug actions and their various side effects
2)A classification system for organizing brand names and generic names of drugs
3)The absorption, distribution, metabolism, and excretion of drugs
4)The study of how medications achieve their effects at various sites in the body

Question 25

The nurse mixes two medications together in one syringe and is preparing to administer the mixture to the patient. On entering the patient's room, the nurse notices that the medication looks cloudy and there are some particles floating in the mixture. What is the most appropriate action by the nurse?
1)Notify the pharmacist before proceeding.
2)Check for medication compatibility.
3)Discard the medications and syringe.
4)Remix the medications in a different syringe.

Question 26

Which action should the nurse take to relax the vastus lateralis muscle before administering an intramuscular injection into the site?
1)Apply a warm compress.
2)Massage the site in a circular motion.
3)Apply a soothing lotion.
4)Have the client assume a sitting position.

Question 27

The physician prescribes warfarin 5 mg orally (PO) at 1800 for a patient. After administering the medication, the female nurse realizes that she administered a 10 mg tablet instead of the prescribed 5 mg PO. Which action by the nurse is appropriate?
1)No action is necessary because an extra 5 mg of warfarin is not harmful.
2)Call the prescriber and ask the order to be changed to 10 mg.
3)Document on the chart that the drug was given, and indicate the drug was given in error.
4)Complete an incident report according to the facility's policy.

Question 28

What is the most essential action by the nurse prior to delegating the administration of an intravenous (IV) medication to a licensed practical nurse (LPN)?
1)Review the state's nurse practice act for LPN scope of practice.
2)Examine the unit policy and procedure for IV medication administration.
3)Determine whether the LPN has previously performed this procedure.
4)Demonstrate the procedure; then allow the LPN to administer the IV medication.

Question 29

What are the primary roles of the Food and Drug Administration (FDA)? Select all that apply.
1)Regulate the testing, manufacture, and sale of all medications
2)Monitor safety and effectiveness of medications available to consumers
3)Manage the storage and handling of controlled substances
4)Manage the sale and regulation of all herbal remedies
5)Regulate the administration and disposal of controlled substances

Question 30

The nursing student is preparing to administer an intramuscular (IM) injection to the patient. The student states to the instructor, "I'm going to administer this medication in my patient's buttocks at the dorsogluteal site." What is the most appropriate response by the instructor?
1)"Okay. Explain the procedure to me and you are good to go."
2)"This may not be the best site owing to proximity of the sciatic nerve."
3)"I agree this is a good site for thin patients such as this one."
4)"Okay, but first be sure to locate the bony landmarks carefully."

Question 31

The nurse must administer hepatitis B (HB) immunoglobulin 0.5 mL intramuscularly to a newly born infant of a hepatitis B antigen (HB Ag)-positive mother. Which injection site should the nurse choose to administer this injection?
1)Ventrogluteal
2)Vastus lateralis
3)Deltoid
4)Dorsogluteal

Question 32

How should the nurse dispose of a contaminated needle after administering an injection?
1)Place the needle in a specially marked, puncture-proof container.
2)Recap the needle, and carefully place it in the trashcan.
3)Recap the needle, and place it in a puncture-proof container.
4)Place the needle in a biohazard bag with other contaminated supplies.

Question 33

Which body organ is primarily responsible for the metabolism of medications?
1)Kidney
2)Skin
3)Liver
4)Large intestine

Question 34

The primary care provider prescribes nitroglycerin 1/150 grains sublingually for a patient experiencing chest pain. How should the nurse administer the drug?
1)Put the drug in the cheek area, and allow it to dissolve.
2)Place the drug under the tongue, and allow it to dissolve.
3)Inject the drug superficially into the subcutaneous tissue.
4)Have the patient swallow the pill with water.

Question 35

The nursing student is preparing to administer lisinopril to the patient but does not know what lisinopril is used for. What is the most appropriate action by the student to obtain the information?
1)Consult the pharmacist.
2)Ask the primary nurse.
3)Question the nursing instructor.
4)Look up the drug in a medication reference text.

Question 36

Which body organ is primarily responsible for medication excretion?
1)Liver
2)Kidney
3)Lungs
4)Exocrine glands

Question 37

Which action should the nurse take immediately after administering a medication through a nasogastric tube?
1)Verify correct nasogastric tube placement in the stomach.
2)Auscultate the abdomen for presence of bowel sounds.
3)Immediately administer the next prescribed medication.
4)Flush the tube with water using a needleless syringe.

Question 38

An adult patient admitted with lower gastrointestinal bleeding is prescribed a unit of packed red blood cells. Which gauge needle should be inserted to administer this blood product?
1)18
2)22
3)24
4)26

Question 39

The nurse must administer ear drops to an infant. How should the nurse proceed?
1)Pull the pinna down and back before instilling the drops.
2)Position the pinna upward and outward before instilling the drops.
3)Instill the drops directly; no special positioning is necessary.
4)Position the patient supine with the head of the bed elevated 30°.

Question 40

A patient has difficulty taking liquid medications from a cup. How should the nurse administer the medications?
1)Request that the physician change the order to the intravenous (IV) route.
2)Administer the medication by the intramuscular (IM) route.
3)Use a needleless syringe to place the medication in the side of the mouth.
4)Add the whole capsule to a small amount of food or beverage to facilitate swallowing.

Question 41

The new nurse is beginning orientation on a medical-surgical unit. What is most important for the nurse to know regarding hospital policies concerning controlled substances? Select all that apply.
1)Controlled substances are stored in a double-locked area.
2)A count of all controlled substances is performed at specific times, usually monthly.
3)The facility must keep a record of every dose of a controlled substance that is administered.
4)Schedule 1 are drugs used commonly in the healthcare field.
5)RNs can prescribe controlled substances to clients in the nursing home, but not in the hospital.

Question 42

The home health nurse is caring for a 75-year-old patient with severe arthritis of the hands and fingers. The patient states, "I can't use these childproof safety lock caps because I can't open them." What are the most appropriate responses by the nurse? Select all that apply.
1)"I see this is difficult for you. Do you have any family members or friends who can help you?"
2)"We can ask the pharmacist not to put childproof caps on your medications; you may need to sign a form."
3)"You can transfer your medications to different containers that are easier for you to open."
4)"All medications come in childproof containers, so there isn't much we can do about this."
5)"Why can't you open those types of medication containers? You should be able to."

Question 43

The nurse is preparing to administer otic medications to a 35-year-old patient. What are the most appropriate actions by the nurse? Select all that apply.
1)Pull the pinna up and back.
2)Position the pinna down and back.
3)Place the patient in the side-lying position with the appropriate ear up.
4)Instruct the patient to remain in the side-lying position for at least 20 minutes.
5)Cool the solution to slightly below body temperature.

Question 44

The nurse educator in the local hospital is preparing a teaching plan for staff nurses on using medication abbreviations in nursing documentation. What is most important for the nurse to include in the teaching plan concerning acceptable abbreviations? Select all that apply.
1)They are based on The Joint Commission recommendations.
2)They are commonly used by the pharmacy department.
3)They are most commonly used by nurses.
4)They are based on policies of the facility.
5)They are determined by the individual nurse who is charting.

Question 45

The nurse is preparing to administer ophthalmic eye drops to the patient. What are the most appropriate actions for administering eye drops? Select all that apply.
1)Place the patient in the high-Fowler's position.
2)Administer the ointment from the inner to the outer canthus of the eye.
3)Position the eyedropper 1 to 2 inches above the eye.
4)Apply the medication into the conjunctival sac.
5)Allow the medication to drop gently on the cornea.

Question 46

The nurse is preparing to administer a subcutaneous dose of insulin to a patient with diabetes. Which two sites might the nurse use that would provide the fastest absorption of the injection? Select all that apply.
1)Arm
2)Abdomen
3)Thigh
4)Upper buttocks
5)Ventral forearm