Deck 34: Administering Oral, Topical, and Inhalant Medications

Question 1

For an adult patient who has an order to receive an otic medication, the nurse should plan to administer it by pulling the pinna:

A) down and forward.
B) up and forward.
C) down and back.
D) up and back.

Answer 1

up and back.

Question 2

To reduce the systemic absorption of eye drops, the nurse should:

A) use finger pressure to close the eyelid tightly.
B) apply slight finger pressure over the lacrimal duct.
C) request the patient tilt the head slightly to the side of the unaffected eye.
D) instruct the patient to widen the eyes in order to increase access to the lacrimal duct.

Answer 2

apply slight finger pressure over the lacrimal duct.

Question 3

The nurse receives an order to give vitamin D 10 mcg bid. The nurse recognizes that the abbreviation mcg refers to a measurement in:

A) milligrams.
B) milliequivilants.
C) millileters.
D) micrograms.

Answer 3

micrograms.

Question 4

The licensed nurse who is responsible for doing the narcotic count for the shift should count the medications:

A) alone for accuracy.
B) with any licensed person.
C) with another nurse working on the shift.
D) with a nurse coming on duty for the next shift.

Question 5

For easier insertion of a rectal suppository, the nurse should position the patient in the __________ position.

A) knee chest
B) prone
C) left Sims'
D) dorsal lithotomy

Question 6

When administering medications to a patient with a feeding tube, the nurse should dissolve each crushed medication in at least:

A) 30 to 60 mL of water.
B) 20 to 30 mL of water.
C) 15 to 20 mL of water.
D) 5 to 15 mL of water.

Question 7

A patient complains about the taste of the sublingual nitroglycerin and admits that he swallows it rather than holding it under his tongue. The nurse explains that sublingual medications:

A) should not be swallowed because it alters the absorption potential.
B) can be inserted rectally without loss of absorption potential.
C) can be held against the roof of the mouth with the tongue to reduce taste.
D) can be taken between the cheek and tongue to diminish taste.

Question 8

A patient of the Cambodian culture reports that a new medication is not adequate for treatment because it is:

A) colored red.
B) a smaller size than the older medication.
C) offered before a meal.
D) is in liquid form.

Question 9

A nurse is administering oral medications to a patient who is having intake and output (I&O) measured. When giving medications, it is most important to:

A) give the medication with a small piece of cracker or cookie.
B) give the medication with as much fluid as possible.
C) record the fluid taken on the MAR or eMAR.
D) record the fluid taken on the intake record.

Question 10

A patient is attempting to put pills in his mouth from a medicine cup and drops one pill on the bed sheet. The nurse should:

A) retrieve the pill from the linens and allow the patient to take it.
B) scoop up the pill in a soufflé cup and hand the cup to the patient.
C) discard the pill and get another from the dose pack.
D) report the loss of the pill as a medication error.

Question 11

The nurse administering a nasal medication via an atomizer bottle should:

A) leave the other nostril open while giving the medication.
B) have the patient squeeze the bottle while inhaling.
C) have the patient sit up straight.
D) have the patient tilt the head forward.

Question 12

Before the nurse administers a dose of digoxin (Lanoxin) to a patient, the nurse should assess:

A) blood pressure.
B) respiratory rate.
C) apical heart rate.
D) level of consciousness.

Question 13

Data pertaining to a patient's medication therapy that the nurse should document in the nurses' notes, in addition to documenting in the medication administration record (MAR or eMAR), is:

A) medication name and dose.
B) the route of the medication.
C) the time of the medication.
D) medication side effects experienced.

Question 14

An older adult patient is having difficulty swallowing an enteric-coated tablet for which there is no liquid form available. To help the patient swallow the dose more easily, the nurse should:

A) request the patient to tilt the chin down slightly to swallow.
B) crush the pill and administer it in applesauce.
C) use a spoon to place the tablet at the back of the tongue.
D) take only a small sip of water to swallow the tablet.

Question 15

Before the nurse administers a liquid medication to an 83-year-old male patient, the nurse should:

A) assess the swallowing reflex by offering a sip of water.
B) ask the patient if he would prefer to give the medication to himself.
C) mix thoroughly in applesauce or pudding.
D) assess the ability to understand information relative to the medication.

Question 16

A patient has an order for a nitroglycerin transdermal patch. The best way to ensure proper administration of this medication is to:

A) apply it behind the ear.
B) rotate sites to avoid skin irritation.
C) place it over a hairy skin area.
D) put the initials on patch when applied.

Question 17

The nurse administering nitroglycerin ointment to a patient will:

A) apply with gloves or tongue blade.
B) apply in same area as the old patch.
C) place the paste on the chest and massage it in the skin.
D) inform the patient that the medicinal effect will take about 45 minutes.

Question 18

The nurse explains that the patient with a respiratory disorder can open small airways to ease respiration effort with the use of:

A) albuterol (Proventil).
B) montelukast (Singulair).
C) ipratropium (Atrovent).
D) beclomethasone (Vanceril).

Question 19

A nurse is providing instructions to a patient about how to use a metered dose inhaler with a spacer. The nurse should instruct the patient to:

A) lie down while taking the medication.
B) gently roll the canister in the hands to mix the medication.
C) place the mouthpiece of the chamber in the mouth between the teeth and seal the lips around it. Completely exhale from the nose.
D) try to hold the breath for at least 3 seconds after inhaling the medication.

Question 20

When the nurse sees the order for "Milk of Magnesia 2 tablespoons, qod, hs," the nurse translates to mean he should give:

A) 1 ounce of Milk of Magnesia every other day at bedtime.
B) 1 1/2 ounces of Milk of Magnesia every day.
C) 2 tablespoons of Milk of Magnesia whenever necessary.
D) 2 ounces of Milk of Magnesia every night.

Question 21

When applying ophthalmic ointments, the nurse should: (Select all that apply.)

A) fill only the center of the conjunctival sac.
B) ask the patient to roll the eye around and from side to side.
C) remove excess ointment from the lid with a cotton ball.
D) ask the patient to close the eyelids tightly to distribute ointment.
E) remove gloves and perform hand hygiene.

Question 22

A patient on the long-term care unit receives the wrong medication. The charge nurse should instruct which staff member to complete the incident report?

A) The nurse who administered the wrong medication.
B) The nursing supervisor for the day.
C) The nurse who discovered the error.
D) No one, because the charge nurse should do it.

Question 23

There is an order to give a patient 45 mL of Maalox. The nurse should administer ____ ounces.

Question 24

In the event of a discrepancy in the count of the narcotics between the day shift and the evening shift, the day nurse is required to:

A) correct the count to the number of pills counted and sign full name.
B) write a report and give it to the charge nurse with signatures of both nurses.
C) notify the pharmacy of the discrepancy.
D) remain on duty until the miscount is resolved.

Question 25

The nurse is to administer a dissolved medication via feeding tube. After donning gloves and attaching the irrigation syringe to the tube, the nurse should next:

A) instill the medication into the syringe slowly.
B) draw the medication into the syringe and gently push into the tube.
C) flush the tubing with 15 to 30 mL of tap water and add the medication just as the water is about to finish.
D) flush the tubing with 15 to 30 mL of sterile water and add the medication just as the water is about to finish.

Question 26

The nurse is aware that a medication error event that causes a patient death or causes serious injury to a patient is classified as a(n)_________ event.

Question 27

The nurse is aware that medications that should not be crushed and administered through a feeding tube include: (Select all that apply.)

A) enteric coated.
B) liquid.
C) sublingual.
D) buccal.
E) sustained release.
F) antineoplastics.

Question 28

The nurse checking the MAR or eMAR finds that an order for an antibiotic is now 8 days old. The nurse should:

A) check the medications, performing three medication checks.
B) give the ordered medication.
C) contact the primary care provider for a new order.
D) give the medication, then notify the primary care provider.

Question 29

When administering several medications via feeding tube, the nurse should:

A) dilute each medication with at least 40 mL of water.
B) mix each medication individually.
C) mix all medications together to facilitate administration.
D) use sterile gloves for the procedure.

Question 30

The primary care provider writes a medication order on the order sheet of the patient. The order that includes all the necessary information is:

A) 1/5/13 at 0900: warfarin (Coumadin) 1 mg p.o. qd A. Primary Care Provider
B) 1/5/13 Give warfarin 1 tab qd A. Primary Care Provider
C) 1/5/13 Coumadin 1 tab p.o. A. Primary Care Provider
D) 0900 Give warfarin (Coumadin) 1 mg p.o. A. Primary Care Provider