Deck 32: Medication Administration

Question 1

A 2-year-old child is ordered to have eardrops daily. Which action will the nurse take?

A) Pull the auricle down and back to straighten the ear canal.
B) Pull the auricle upward and outward to straighten the ear canal.
C) Sit the child up for 2 to 3 minutes after instilling drops in ear canal.
D) Sit the child up to insert the cotton ball into the innermost ear canal.

Answer 1

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

Question 2

While preparing medications, the nurse knows one of the drug is an acidic medication. In which area does the nurse anticipate the drug will be absorbed?

A) Stomach
B) Mouth
C) Small intestine
D) Large intestine

Answer 2

Stomach

Question 3

The nurse is planning to administer a tuberculin test with a 27-gauge, 5/8-inch needle. At which angle will the nurse insert the needle?

A) 15 degree
B) 30 degree
C) 45 degree
D) 90 degree

Answer 3

15 degree

Question 4

A nurse is teaching a patient about medications. Which statement from the patient indicates teaching is effective?

A) "My parenteral medication must be taken with food."
B) "I will rotate the sites in my left leg when I give my insulin."
C) "Once I start feeling better, I will stop taking my antibiotic."
D) "If I am 30 minutes late taking my medication, I should skip that dose."

Question 5

The nurse is preparing to administer an injection into the deltoid muscle of an adult patient. Which needle size and length will the nurse choose?

A) 18 gauge * 1 1/2 inch
B) 23 gauge * 1/2 inch
C) 25 gauge * 1 inch
D) 27 gauge * 5/8 inch

Question 6

The nurse administers a central nervous system stimulant to a patient. Which assessment finding indicates to the nurse that an idiosyncratic event is occurring?

A) Falls asleep during daily activities
B) Presents with a pruritic rash
C) Develops restlessness
D) Experiences alertness

Question 7

A patient has an order to receive 0.3 mL of U-500 insulin. Which syringe will the nurse obtain to administer the medication?

A) 3-mL syringe
B) U-100 syringe
C) Needleless syringe
D) Tuberculin syringe

Question 8

The patient is to receive phenytoin (Dilantin) at 0900. When will be the ideal time for the nurse to schedule a trough level?

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

Question 9

A health care provider orders lorazepam (Ativan) 1 mg orally 2 times a day. The dose available is 0.5 mg per tablet. How many tablet(s) will the nurse administer for each dose?

A) 1
B) 2
C) 3
D) 4

Question 10

The nurse is giving an IM injection. Upon aspiration, 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 11

A health care provider prescribes aspirin 650 mg every 4 hours PO when febrile. For which patient will this order be appropriate?

A) 7 year old with a bleeding disorder
B) 21 year old with a sprained ankle
C) 35 year old with a severe headache from hypertension
D) 62 year old with a high fever from an infection

Question 12

A nurse is preparing to administer an injection to a patient. Which statement made by the patient is an indication for the nurse to use the Z-track method?

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

Question 13

An order is written for phenytoin 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 health care provider meant to write hydromorphone. What should the nurse do?

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

Question 14

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) Health care provider
B) Pharmacist
C) Hospital
D) Nurse

Question 15

A patient is receiving vancomycin. Which function is the priority for the nurses to assess?

A) Vision
B) Hearing
C) Heart tones
D) Bowel sounds

Question 16

A patient has an order to receive 12.5 mg of hydrochlorothiazide. The nurse has on hand a 25 mg tablet of hydrochlorothiazide. How many tablet(s) will the nurse administer?

A) 1/2 tablet
B) 1 tablet
C) 1 1/2 tablets
D) 2 tablets

Question 17

When the nurse administers an IM corticosteroid injection, the nurse aspirates. What is the rationale for the nurse aspirating?

A) Prevent the patient from choking.
B) Increase the force of the injection.
C) Ensure proper placement of the needle.
D) Reduce the discomfort of the injection.

Question 18

A patient is in need of immediate pain relief for a severe headache. Which medication will the nurse administer to be absorbed the quickest?

A) Acetaminophen 650 mg PO
B) Hydromorphone 4 mg IV
C) Ketorolac 8 mg IM
D) Morphine 6 mg SQ

Question 19

The nurse closely monitors an older adult for signs of medication toxicity. Which physiological change is the reason for the nurse's action?

A) Reduced glomerular filtration
B) Reduced esophageal stricture
C) Increased gastric motility
D) Increased liver mass

Question 20

A patient is to receive a proton pump inhibitor through a nasogastric (NG) feeding tube. Which is the most important nursing action to ensure effective absorption?

A) Thoroughly shake the medication before administering.
B) Position patient in the supine position for 30 minutes to 1 hour.
C) Hold feeding for at least 30 minutes after medication administration.
D) Flush tube with 10 to 15 mL of water, after all medications are administered.

Question 21

A nurse has withdrawn a narcotic from the medication dispenser and must waste a portion of the medication. What should the nurse do?

A) Have another nurse witness the wasted medication.
B) Return the wasted medication to the medication dispenser.
C) Place the wasted portion of the medication in the sharps container.
D) Exit the medication room to call the health care provider to request an order that matches the dosages.

Question 22

A nurse is caring for a patient who is receiving pain medication through a saline lock. After obtaining a good blood return when the nurse is flushing the patient's peripheral IV, the patient reports pain. Upon assessment, the nurse notices a red streak that is warm and tender to the touch. What is the nurse's initial action?

A) Do not administer the pain medication.
B) Administer the pain medication slowly.
C) Apply a warm compress to the site.
D) Apply a cool compress to the site.

Question 23

The supervising nurse is watching nurses prepare medications. Which action by one of the nurses will the supervising nurse stop immediately?

A) Rolls insulin vial between hands
B) Administers a dose of correction insulin
C) Draws up glargine (Lantus) in a syringe by itself
D) Prepares NPH insulin to be given intravenously (IV)

Question 24

The nurse is preparing to administer medications to two patients with the same last name. After the administration, the nurse realizes that did not check the identification of the patient before administering medication. Which action 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 25

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) 6 weeks from the start of using the inhaler
B) As soon as the patient leaves the hospital
C) When the inhaler is half empty.
D) 50 days after discharge

Question 26

The nurse prepares a pain injection for a patient but had to check on another patient and asks a new nurse to give the medication. Which action by the new nurse is best?

A) Do not give the medication.
B) Administer the medication just this once.
C) Give the medication for any pain score greater than 8.
D) Avoid the issue and pretend to not hear the request.

Question 27

A nurse is preparing to administer a medication from a vial. In which order will the nurse perform the steps, starting with the first step?
1) Invert the vial.
2) Fill the syringe with medication.
3) Inject air into the airspace of the vial.
4) Clean with alcohol swab and allow to dry.
5) Pull back on the plunger the amount to be drawn up.
6) Tap the side of the syringe barrel to remove air bubbles.

A) 4, 1, 5, 3, 6, 2
B) 1, 4, 5, 3, 2, 6
C) 4, 5, 3, 1, 2, 6
D) 1, 4, 5, 3, 6, 2

Question 28

A nurse is attempting to administer an oral medication to a child, but the child refuses to take the medication. A parent is in the room. Which statement by the nurse to the parent is best?

A) "Please hold your child's arms down, so I can give the full dose."
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 your 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 29

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

A) A 15 year old with a repaired cleft palate who is alert
B) A 25 year old with limited coordination of the extremities
C) A 50 year old with hearing impairment who uses a hearing aid
D) A 72 year old with left-sided hemiparesis using a dry powder inhaler

Question 30

A patient needs assistance in eliminating an anesthetic gaseous medication (nitrous oxide). Which action will the nurse take?

A) Encourage the patient to cough and deep-breathe.
B) Suction the patient's respiratory secretions.
C) Suggest voiding every 2 hours.
D) Increase fluid intake.

Question 31

The supervising nurse is observing several different nurses. Which action will cause the supervising nurse to intervene?

A) A nurse administers a vaccine without aspirating.
B) A nurse gives an IV medication through a 22-gauge IV needle without blood return.
C) A nurse draws up the NPH insulin first when mixing a short-acting and intermediate-acting insulin.
D) A nurse calls the health care provider for a patient with nasogastric suction and orders for oral meds.

Question 32

An older-adult patient needs an IM injection of antibiotic. Which site is best for the nurse to use?

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

Question 33

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

A) Give the patient a straw to control the flow of liquids.
B) Have the patient self-administer the medication.
C) Thin out liquids so they are easier to swallow.
D) Turn the head toward the stronger side.

Question 34

The prescriber wrote for a 40-kg child to receive 25 mg of medication 4 times a day. The therapeutic range is 5 to 10 mg/kg/day. What is the nurse's priority?

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

Question 35

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

A) Reading medication labels at least 3 times before administering
B) Administering as many of the medications as possible at one time
C) Asking anxious family members to leave the room before giving a medication
D) Checking the patient's room number against the medication administration record

Question 36

A patient refuses medication. Which is the nurse's first action?

A) Educate the patient about the importance of the medication.
B) Discreetly hide the medication in the patient's favorite gelatin.
C) Agree with the patient's decision and document it in the chart.
D) Explore with the patient reasons for not wanting to take the medication.

Question 37

The nurse is caring for two patients with the same last name. In this situation which right of medication administration is the priority to reduce the chance of an error?

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

Question 38

Which patient does the nurse most closely monitor for an unintended synergistic effect?

A) The 4 year old who has mistakenly taken a half bottle of vitamins
B) The 35 year old who has ingested meth mixed with several household chemicals
C) The 50 year old who is prescribed a second blood pressure medication
D) The 72 year old who is seeing four different specialists

Question 39

A patient prefers not to take the daily allergy pill this morning because it causes drowsiness throughout the day. Which response by the nurse is best?

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 see if we can change the time you take your pill to 9 PM, 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 40

A nurse teaches the patient about the prescribed buccal medication. Which statement by the patient indicates teaching by the nurse is successful?

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

Question 41

A nurse is performing the three accuracy checks before administering an oral liquid medication to a patient. When will the nurse perform the second accuracy check?

A) At the patient's bedside
B) Before going to the patient's room
C) When checking the medication order
D) When selecting medication from the unit-dose drawer

Question 42

A nurse is preparing to administer an antibiotic medication at 1000 to a patient but gets busy in another room. When should the nurse give the antibiotic medication?

A) By 1030
B) By 1100
C) By 1130
D) By 1200

Question 43

The nurse is administering 250 mg of a medication elixir to the patient. The medication comes in a dose of 1000 mg/5 mL. How many milliliters should the nurse administer? Record your answer using two decimal places. ____ mL

Question 44

The nurse is administering medications to several patients. Which action should the nurse take?

A) Advise a patient after a corticosteroid inhaler treatment to rinse mouth with water.
B) Administer an intravenous medication through tubing that is infusing blood.
C) Pinch up the deltoid muscle of an adult patient receiving a vaccination.
D) Aspirate before administering a subcutaneous injection in the abdomen.

Question 45

The patient is to receive amoxicillin 500 mg q8h; the medication is dispensed at 250 mg/5 mL. How many milliliters will the nurse administer for one dose? Record your answer using a whole number. ___ mL

Question 46

Which methods will the nurse use to administer an intravenous (IV) medication that is incompatible with the patient's IV fluid? (Select all that apply.)

A) Start another IV site.
B) Administer slowly with the IV fluid.
C) Do not give the medication and chart.
D) Flush with 10 mL of sterile water before and after administration.
E) Flush with 10 mL of normal saline before and after administration.

Question 47

A nurse is following safety principles to reduce the risk of needlestick injury. Which actions will the nurse take? (Select all that apply.)

A) Recap the needle after giving an injection.
B) Remove needle and dispose in sharps box.
C) Never force needles into the sharps disposal.
D) Use clearly marked sharps disposal containers.
E) Use needleless devices whenever possible.

Question 48

A nurse is preparing an intravenous IV piggyback infusion. In which order will the nurse perform the steps, starting with the first one?
1) Compare the label of the medication with the medication administration record at the patient's bedside.
2) Connect the tubing of the piggyback infusion to the appropriate connector on the upper Y-port.
3) Hang the piggyback medication bag above the level of the primary fluid bag.
4) Clean the main IV line port with an antiseptic swab.
5) Connect the infusion tubing to the medication bag.
6) Regulate flow.

A) 5, 2, 1, 4, 3, 6
B) 5, 2, 1, 3, 4, 6
C) 1, 5, 4, 3, 2, 6
D) 1, 5, 3, 4, 2, 6

Question 49

A nurse is administering oral medications to patients. Which action will the nurse take?

A) Remove the medication from the wrapper, and place it in a cup labeled with the patient's information.
B) Place all of the patient's medications in the same cup, except medications with assessments.
C) Crush enteric-coated medication, and place it in a medication cup with water.
D) Measure liquid medication by bringing liquid medication cup to eye level.

Question 50

A patient is taking 1 tablet of hydrocodone bitartrate 5 mg and acetaminophen 500 mg (Vicodin) every 4 hours. The patient is also taking 2 tablets of acetaminophen (Tylenol) 325 mg every 12 hours. How many grams of acetaminophen is the patient taking daily? Record your answer using one decimal place. ______ g