Deck 34: Medication Administration

Question 1

A registered nurse interprets that a scribbled medication order reads 25 mg.The nurse administers 25 mg of the medication to a patient,and then discovers that the dose was incorrectly interpreted and should have been 15 mg.Who is ultimately responsible for the error?

A)Physician.
B)Pharmacist.
C)Nurse.
D)No fault.

Answer 1

Nurse.

Question 2

The nurse knows that a patient is having an idiosyncratic reaction to the stimulant pseudoephedrine (Sudafed)when what happens?

A)The patient experiences blurred vision while driving.
B)The patient falls asleep during daily activities.
C)The patient presents with a pruritic rash.
D)The patient develops xerostomia.

Answer 2

The patient falls asleep during daily activities.

Question 3

The physician orders that a 2-year-old have ear irrigation performed daily.How does the nurse correctly perform the procedure?

A)Pulling the auricle down and back to straighten the ear canal.
B)Pulling the auricle upward and outward to straighten the ear canal.
C)Instilling the irrigation solution by holding the syringe just inside the ear canal.
D)Holding the fluid in the canal for 2 to 3 minutes with a cotton swab.

Answer 3

Pulling the auricle down and back to straighten the ear canal.

Question 4

What is the nurse's priority action to protect a patient from medication error?

A)Requesting that the prescriber write out an order,rather than giving a verbal order.
B)Asking anxious family members to leave the room before a medication is administered.
C)Checking the patient's room number against the medication administration record.
D)Administering as many of the medications as possible at one time.

Question 5

A physician orders 1000 mL of normal saline to be infused at a rate of 50 mL/hr.The nurse plans on hanging a new bag at what time?

A)2 hours.
B)5 hours.
C)10 hours.
D)20 hours.

Question 6

A patient is to receive medication through a nasogastric tube.What is the most important nursing action to ensure effective absorption?

A)Thoroughly shake the medication before administering.
B)After all medications are administered,flush tube with 15 to 30 mL of water.
C)Position patient in the supine position for 30 minutes.
D)Clamp suction for 30 to 60 minutes after medication administration.

Question 7

The nurse knows to assess for signs of medication toxicity within older persons because of which physiological change?

A)Reduced blood albumin level.
B)Delayed esophageal clearance.
C)Decreased gastric peristalsis.
D)Decreased cognitive function.

Question 8

Which statement by the patient is an indication to use the Z-track method?

A)"I'm really afraid that a big needle will hurt."
B)"The last shot like that turned my skin different colours."
C)"I am allergic to many medications."
D)"My legs are too obese for the needle to go through."

Question 9

A nurse knows that patient education has been effective when the patient makes which statement?

A)"I must take my parenteral medication with food."
B)"If I am 30 minutes late taking my medication,I should skip that dose."
C)"I will rotate the location where I give myself injections."
D)"Once I start feeling better,I will stop taking my medication."

Question 10

Aspirin is an analgesic,antipyretic,antiplatelet,and anti-inflammatory agent.A physician writes for aspirin,650 mg every 4 to 6 hours,"prn [as needed]: febrile." For which patient would this order be appropriate?

A)A 7-year-old with hemophilia.
B)A 21-year-old with a sprained ankle.
C)A 35-year-old with a severe headache.
D)A 62-year-old with pneumonia.

Question 11

The patient is in severe pain and is requesting a prn medication before the prn time interval has elapsed.What is the nurse's priority?

A)Give the medication early for any pain score greater than 8.
B)Call the prescriber and request a stat order.
C)Explain to the patient why he will have to wait for the medication.
D)Document the patient's request and pain score.

Question 12

The nurse is preparing to administer a 0.5-mL rabies vaccine into the deltoid muscle of a pediatric patient.Which needle size is best for the procedure?

A)20 gauge x 3.8 cm ( inch).
B)23 gauge x 1.3 cm ( inch)
C)25 gaugex 1.6 cm (5/8 inch)
D)27 gauge x 1 cm ( inch).

Question 13

A drug requires a low pH to be metabolized.Knowing this,the nurse anticipates that the medication will be administered by which route?

A)Oral.
B)Parenteral.
C)Buccal.
D)Inhalation.

Question 14

A patient needs assistance excreting a gaseous medication.What is the correct nursing action?

A)Encourage the patient to cough and deep breathe.
B)Suction the patient's respiratory secretions.
C)Administer the antidote via inhalation.
D)Administer 100% fraction of inspired oxygen (FiO2)via simple face mask.

Question 15

The nurse is giving an intramuscular (IM)injection.The nurse notices blood return in the syringe.What should the nurse do?

A)Administer the injection at a slower rate.
B)Withdraw the needle and prepare the injection again.
C)Pull the needle back slightly and inject the medication.
D)Give the injection and hold pressure over the site for 3 minutes.

Question 16

The nurse knows that patient education about a buccal medication has been effective when the patient makes which statement?

A)"I should let the medication dissolve completely."
B)"I can only drink water,not juice,with this medication."
C)"For faster distribution,I should chew my medication first."
D)"I should place the medication in the same location."

Question 17

An order is written for phenytoin (Dilantin),500 mg IM q3-4h prn for pain.The nurse recognizes that treatment of pain is not a standard therapeutic indication for this drug.The nurse believes that the prescriber meant to write for hydromorphone (Dilaudid).What should the nurse do?

A)Give the patient Dilaudid,as it was meant to be written.
B)Call the prescriber to clarify and justify the order.
C)Administer the medication and monitor the patient frequently.
D)Refuse to give the medication and notify the nurse supervisor.

Question 18

A patient is in need of immediate pain relief for a severe headache.The nurse knows that which medication will be absorbed the quickest?

A)Tylenol,650 mg PO.
B)Morphine,4 mg SQ.
C)Ketorolac (Toradol),8 mg IM.
D)Hydromorphone (Dilaudid),4 mg IV.

Question 19

The nurse is planning to administer a tuberculin test with a 27-gauge,1-cm (³/₈-inch)needle.The nurse should insert the needle at which angle?

A)15 degrees.
B)45 degrees.
C)90 degrees.
D)180 degrees.

Question 20

The patient is to receive phenytoin (Dilantin)at 0900 hours.The nurse knows that the ideal time to measure the trough level is when?

A)0800 hours.
B)0830 hours.
C)0900 hours.
D)0930 hours.

Question 21

The physician orders 4 mg of oxycodone to be delivered every 6 hours.After 4 hours,the patient is complaining that she is in more pain.The nurse advises the physician to make which medication adjustment?

A)Add an additional narcotic on top of the oxycodone.
B)Divide the dose in half and administer 2 mg every 3 hours.
C)Give another 4 mg of oxycodone after 4 hours.
D)Change the medication being administered for pain relief.

Question 22

A patient who is being discharged today is going home with an inhaler.The patient is to administer 2 puffs of the inhaler twice daily.The inhaler contains 200 puffs.When should the nurse appropriately advise the patient to refill the medication?

A)As soon as he leaves the hospital.
B)When the inhaler is half empty.
C)Six weeks after the patient starts using the inhaler.
D)Fifty days after discharge.

Question 23

The prescriber wrote an order for a 40-kg child to receive 25 mg of medication four times a day.The therapeutic range is 5 to 10 mg/kg/day.What is the nurse's priority?

A)Administer the medication because it is within the therapeutic range.
B)Notify the physician that the prescribed dose is in the toxic range.
C)Notify the physician that the prescribed dose is below the therapeutic range.
D)Change the dose to one that is within range.

Question 24

Why does a subcutaneous injection take longer to absorb than IV injection?

A)Fewer blood vessels are found under the subcutaneous level.
B)Adipose tissue takes longer to metabolize medication.
C)Connective tissue holds medication in place longer.
D)Some medication leaks out after instillation.

Question 25

A patient is at risk for aspiration.What nursing action is most appropriate?

A)Hold the patient's cup for him so he can concentrate on taking pills.
B)Thin out liquids so they are easier to swallow.
C)Give the patient a straw to control the flow of liquids.
D)Have the patient self-administer the medication.

Question 26

A nurse is attempting to administer medication to a child,but the child refuses to take the medication.The nurse asks for the parent's cooperation by saying which of the following?

A)"Please hold your child's arms down at her sides,so I can get the full dose of medication into her mouth."
B)"I will prepare the medication for you and observe if you would like to try to administer the medication."
C)"Let's turn the lights off and give the child a moment to fall asleep before administering the medication."
D)"Since your child loves applesauce,let's add the medication to it,so your child doesn't resist."

Question 27

A confused patient refuses his medication.What is the nurse's first response?

A)Agree with the patient's decision and document it in his chart.
B)Educate the patient about the importance of the medication.
C)Discreetly hide the medication in the patient's favourite Jell-O.
D)Inform the patient that he must take the medication whether he wants to or not.

Question 28

A 64-year-old quadriplegic patient needs an IM injection of antibiotic.What is the best site for the administration?

A)Deltoid.
B)Dorsal gluteal.
C)Ventrogluteal.
D)Vastus lateralis.

Question 29

The nurse is preparing to administer medications to two patients with the same last name.After the first administration,the nurse realizes that she did not check the identification of the patient before administering medication.Which of the following actions should the nurse complete first?

A)Return to the room to check and assess the patient.
B)Administer the antidote to the patient immediately.
C)Alert the charge nurse that a medication error has occurred.
D)Complete proper documentation of the medication error in the patient's chart.

Question 30

The nurse realizes which patient is at greatest risk for an unintended synergistic effect?

A)A 72-year-old who is seeing four different specialists.
B)A 4-year-old who has mistakenly taken the entire packet of his mother's birth control pills.
C)A 50-year-old who was prescribed a second blood pressure medication.
D)A 35-year-old drug addict who has ingested "meth" mixed with several household chemicals.

Question 31

Which patient using an inhaler would benefit most from using a spacer?

A)A 3-year-old with a cleft palate.
B)A 25-year-old with multiple sclerosis.
C)A 50-year-old with hearing impairment.
D)A 72-year-old with left-sided hemiparesis.

Question 32

Which nursing action is the number one priority for ensuring that medication stays in the target therapeutic range?

A)Measuring the peak and trough levels at the same time each day.
B)Administering a double dose after a dose was missed.
C)Delivering the same amount of the drug at the same time each day.
D)Increasing absorption by holding all other medications 1 hour before administration.

Question 33

A patient states that she would prefer not to take her daily allergy pill this morning because it makes her too drowsy throughout the day.How may the nurse respond therapeutically?

A)"The physician ordered it;therefore,you must take your medication every morning at the same time whether you're drowsy or not."
B)"Let's change the time you take your pill to 9 p.m. ,so the drowsiness occurs when you would normally be sleeping."
C)"You can skip this medication on days when you need to be awake and alert."
D)"Try to get as much done as you can before you take your pill,so you can sleep in the afternoon."

Question 34

Which of the following demonstrates proper oral medication administration?

A)Removing the medication from the wrapper and placing it in a cup labelled with the patient's information.
B)Using the edge of the medicine cup to fill with 0.5 mL of liquid medication.
C)Placing all of the patient's medications in the same cup,except medications with assessments.
D)Combining liquid medications from 2 single dose cups into 1 medicine cup.

Question 35

The nurse is administering an IV medication that is to be infused over 10 minutes.Which method should the nurse choose to efficiently administer the medication?

A)Place the medication in a large-volume catheter-tipped syringe.
B)Mix the medication into the patient's maintenance fluids.
C)Attach separate tubing and set the medication syringe in a mini-infusion pump.
D)Stand at the patient's bedside and carefully watch the clock while pushing the medication.

Question 36

Which of the following are methods to reduce the risk of needlestick injury? (Select all that apply. )

A)Recap the needle after giving an injection.
B)Use needleless systems when available
C)Use two hands to dispose of sharps into the disposal.
D)Never force a needle into the sharps disposal.
E)Clearly mark sharps disposal containers.
F)Use needleless devices whenever possible.

Question 37

The nurse knows that caring for two patients with the same last name can lead to a medication error involving which right of medication administration?

A)Right medication.
B)Right patient.
C)Right dose.
D)Right route.

Question 38

A patient who is receiving IV fluids notifies the nurse that his arm feels tight.Upon assessment,the nurse notes that the arm is swollen and cool to the touch.What should the nurse's first action be?

A)Discontinue the IV site,and apply a warm compress.
B)Attach a syringe,and pull back on the plunger to aspirate the IV fluid.
C)Start a new IV site distal from the site.
D)Stop the IV fluids,and notify the physician immediately.

Question 39

A provider has ordered a STAT medication to be administered.The nurse knows that the best route of administration is

A)IV.
B)IM.
C)SQ.
D)PO.