Deck 17: Administering Medications

Question 1

Which of the following drug orders will provide the fastest pain relief for the patient?

A) Morphine 30 mg
B) Hydromorphone 1 mg IV
C) Fentanyl transdermal 25 mcg/hour
D) Acetaminophen with oxycodone 10 mg/325 mg

Answer 1

Hydromorphone 1 mg IV

Question 2

Which of the following patients is most at risk for liver damage after taking acetaminophen regularly for arthritis pain?

A) Patient with a history of alcohol abuse and hepatitis C
B) Patient with type 2 diabetes and end-stage renal disease
C) Patient with prostate enlargement and urinary frequency
D) Patient with COPD and a 20 pack-year history of smoking

Answer 2

Patient with a history of alcohol abuse and hepatitis C

Question 3

The nurse administers a medication to the patient.Which symptoms indicate that the patient is having an allergic reaction rather than a side effect?

A) Alopecia and diaphoresis
B) Nausea and constipation
C) Heartburn and flatulence
D) Itchy rash and difficulty breathing

Answer 3

Itchy rash and difficulty breathing

Question 4

The patient's respirations dropped from 14 breaths/minute to 8 breaths/minute after receiving a large dose of morphine.Which term accurately describes the patient's reaction to the morphine?

A) Toxic
B) Allergic
C) Therapeutic
D) Idiosyncratic

Question 5

The nurse is to administer a nephrotoxic medication to the patient.Which assessment finding indicates to the nurse that the patient should receive a reduced dosage of the drug?

A) The patient has a 35 pack-year history of cigarette smoking.
B) The patient follows a low-carbohydrate,low-protein,high-fat diet.
C) The patient has a history of hypertension and diabetic kidney disease.
D) The patient is unable to exercise due to severe osteoarthritis in both hips.

Question 6

The nurse suspects that the patient is experiencing a drug toxicity rather than a side effect.Which question will the nurse ask to help confirm this suspicion?

A) "Are you taking any other medications?"
B) "Have you ever taken this medication in the past?"
C) "When did you take your last dose of the medication?"
D) "Have you been taking extra doses of the medication?"

Question 7

Which agency determines which training is required for nurses to start intravenous lines for patients?

A) The US Food and Drug Administration (FDA)
B) The MedWatch program
C) Employee Assistance Program (EAP)
D) State Nurse Practice Acts

Question 8

The nurse notes that the patient is scratching and has hives 2 hours after receiving a dose of antibiotic medication.The patient soon starts having difficulty breathing and his blood pressure drops.What is the correct analysis of the patient's condition?

A) The patient is having a mild reaction that can be treated easily with an antihistamine.
B) The patient is experiencing a moderate allergic reaction and should improve shortly.
C) These symptoms are probably due to food poisoning because very few patients have true allergic responses.
D) The patient is having an anaphylactic reaction and emergency interventions should be started.

Question 9

The patient develops constipation after taking the daily iron supplement that was prescribed by the physician.Which term accurately describes the patient's reaction to the supplement?

A) Therapeutic effect
B) Adverse reaction
C) Side effect
D) Toxicity

Question 10

How will the nurse administer a nitroglycerin sublingual tablet to the patient?

A) Place the tablet under the patient's tongue.
B) Place the tablet in the patient's mouth next to the cheek.
C) Have the patient swallow the tablet with a sip of water.
D) Crush the tablet and dissolve it in a teaspoon of water.

Question 11

The patient's medication order is for transdermal fentanyl.How will the nurse administer this medication?

A) Apply the medication patch to a clean,dry intact area of skin.
B) Inject the medication into the soft tissue behind the patient's arm.
C) Carefully place the medication between the patient's cheek and teeth.
D) Have the patient swallow the medication with a small sip of water.

Question 12

Which medication order is written appropriately?

A) Morphine 2.5 mg PO
B) Methotrexate 15.0 mg PO
C) Meropenem 1.0 g IV
D) Metformin .5 g PO

Question 13

The nurse notes that the patient is to receive diprivan to treat the patient's vaginal yeast infection.What is the appropriate action of the nurse?

A) Immediately contact the prescriber to clarify the order.
B) Check with the pharmacy to confirm that the order was received.
C) Ensure that the order appears on the patient's medication sheet.
D) Confirm that the dosage is appropriate for the patient's body weight.

Question 14

The patient crushes extended-release pain medication tablets in order to obtain relief immediately.Which term describes the action of this patient?

A) Medication dependence
B) Medication abuse
C) Medication misuse
D) Medication underuse

Question 15

A patient has an order for a subcutaneous injection of insulin.The nurse will prepare to give this injection into which of the following tissues?

A) Into the patient's deltoid
B) Into the patient's vastus lateralis
C) Into the patient's intravenous line
D) Into the fatty tissue of the patient's abdomen

Question 16

The nurse administers enteric-coated aspirin to the patient.Where will this medication be absorbed into the body?

A) In the stomach
B) Through the skin
C) In the small intestine
D) Through the oral mucosa

Question 17

The nurse is to administer 250 mg of amoxicillin PO every 6 hours.
Amoxicillin for oral suspension USP
125 mg per 5 mL
How many mL of medication will be given to the patient for each dose?

A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL

Question 18

Which statement is correct about patient tolerance to medications?

A) Tolerance only develops when the patients do not take the medication as it is prescribed.
B) The patient will continually require higher doses of the drug for the same effect to be achieved.
C) The patient will require a stable dose of the medication until the drug is discontinued.
D) Tolerance occurs when the liver or kidneys are no longer able to metabolize the drug.

Question 19

Why does the nurse administer lorazepam intramuscularly (IM)to the patient rather than into the subcutaneous tissue?

A) The medication will be absorbed and begin to work more quickly when given IM.
B) The patient does not have enough body fat to give the medication subcutaneously.
C) Intramuscular injections require smaller needles than subcutaneous injections.
D) Intramuscular injections are preferred for patients with high risk of bleeding.

Question 20

The patient's insurance company refuses to pay for the brand name formulation of a prescribed drug.Which formulation of the drug will the patient receive instead?

A) Trade
B) Generic
C) Chemical
D) Proprietary

Question 21

The patient's rheumatoid arthritis symptoms were not adequately controlled with methotrexate so adalimumab was prescribed as well.What is the rationale for prescribing both medications?

A) To obtain a synergistic effect
B) To prevent an anaphylactic reaction
C) To reduce medication interactions
D) To avoid an iosyncratic reaction

Question 22

The patient is admitted to the cardiac unit.Everyone admitted to the cardiac unit will have an EKG done unless otherwise ordered.This is an example of which type of order?

A) prn
B) Standing
C) One-time
D) STAT

Question 23

The patient states "I don't take that medication" when the nurse hands the pill to the patient.What is the nurse's best response?

A) "It is probably the generic form of the medication you normally take."
B) "I will check your chart to see if your medication was changed."
C) "The other nurse drew up the medication so I am sure it is correct."
D) "I will chart that you refused to take the medication as it is ordered."

Question 24

A patient is to receive insulin aspart and insulin detemir.How will the nurse draw up the insulins for administration?

A) Mix the detemir and aspart in the same syringe,drawing up the aspart first.
B) Mix the detemir and aspart in the same syringe,drawing up the detemir first.
C) Administer the two insulins using different syringes and different sites of the body.
D) Roll the bottles between the palms of the hands before drawing up the insulins.

Question 25

Which is the priority action of the nurse immediately after administration of an intramuscular injection?

A) Engage the safety sheath over the needle.
B) Ensure that there is no bleeding at the injection site.
C) Assess the patient's level of comfort.
D) Inform the patient that the injection is complete.

Question 26

Which is an IV bolus order?

A) 1 L 0.9% normal saline IV infuse over 4 hours
B) Primaxin 750 mg IVPB infuse over 30 minutes Q 12 hours
C) Naloxone 300 mcg IV push over 2 minutes STAT
D) 0.9% normal saline IV infusion at 125 mL/hour

Question 27

The nurse is to administer insulin lispro to the patient using an injection pen.Which is the correct action of the nurse?

A) The nurse primes the pen with 2 units of insulin before each injection.
B) The nurse always injects into the same spot to minimize discomfort.
C) The nurse uses the same pen for multiple patients with a new needle each time.
D) The nurse aspirates immediately prior to injecting the medication.

Question 28

What is wrong with this picture of a nurse administering eyedrops to a patient?

A) The tip of the eyedropper should touch the inner canthus.
B) The nurse should be applying pressure to the nasolacrimal duct.
C) The medication will land in the center of the patient's cornea.
D) The nurse should have gloves on when administering eyedrops.
E) The patient's eye should be closed during administration of eyedrops.

Question 29

The nurse is to administer acetaminophen to an unconscious patient.Which medication formulations may safely be administered to the patient?

A) Acetaminophen tablet
B) Acetaminophen elixir
C) Acetaminophen IV
D) Acetaminophen suppository
E) Acetaminophen suspension

Question 30

Which medication may be administered using a 3-mL syringe with a 23- gauze, -inch needle?

A) Methotrexate 20 mg subcut
B) Lorazepam 2 mg IM
C) Lidocaine 2 mg of 2% solution ID
D) Enoxaparin 30 mg subcut

Question 31

Which pain medication may be administered to the patient as needed?

A) Ketorolac 10 mg IV Q 4 hours prn
B) Fentanyl transdermal patch 25 mcg Q 3 days
C) Acetaminophen with oxycodone 10 mg/325 mg PO Q 6 hours
D) Morphine-extended release 60 mg PO Q 12 hours

Question 32

The nurse is to administer 10 mg/kg of acetaminophen to a patient who weighs 70 pounds (32 kg).
Acetaminophen elixir
160mg per 5 mL
How many mL of medication will be given to the patient for each dose?

A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL

Question 33

The nurse draws up a medication from a glass ampule before injection.Which technique is correct?

A) The nurse wipes the top of the ampule with an isopropyl alcohol swab after removing the metal cap.
B) The nurse attaches a new needle to the syringe before administration as the needle was dulled by the rubber stopper.
C) The nurse injects air into the ampule before withdrawing the medication in order to avoid creating a vacuum.
D) The nurse draws up the medication from the ampule using a filter needle and attaches an injection needle before administration.

Question 34

The nurse is to administer enoxaparin 40 mg subcutaneously to the patient.Which technique is correct?

A) The nurse injects the medication into the soft tissue of the patient's abdomen.
B) The nurse aspirates immediately prior to injecting the medication.
C) The nurse gently massages the injection site immediately afterward.
D) The nurse draws up the medication into a 1-mL syringe with a 32-gauze needle.

Question 35

The nurse is to administer heparin 5000 units to an adult patient with a BMI of 15.1.Which is the appropriate technique for the injection?

A) Pinch the skin tissue and inject at a 90-degree angle.
B) Spread the skin tissue and inject at a 45-degree angle.
C) Pinch the skin tissue and inject at a 45-degree angle.
D) Spread the skin tissue and inject at a 90-degree angle.

Question 36

The nurse is to administer 3 mL of medication intramuscularly to an adult patient.Which is the appropriate site for the injection?

A) Dorsal gluteal
B) Vastus lateralis
C) Deltoid
D) Lateral piriformis

Question 37

Which medication order is written correctly?

A) Zolpidem 10 mg PO Q HS prn insomnia
B) Vitamin E 1000 IU PO QD with food
C) Conjugated estrogens 300 µg daily
D) Phenytoin 200 mg PO daily × 4 days

Question 38

Which medication is to be administered immediately to the patient?

A) Acetaminophen 325 mg PO prn
B) Insulin aspart 12 units subQ AC
C) Metronidazole 500 mg PO BID
D) Nitroglycerin 0.4 mg sublingual STAT

Question 39

Which medication may be injected into the deltoid?

A) Lorazepam 2 mg in 2-mL saline IM
B) Insulin aspart 2 units subcut AC meals
C) Lidocaine 2 mg of 2% solution ID
D) Cyanocobalamin (vitamin B12)500 mcg in 0.5 mL IM

Question 40

The nurse is to administer a clotrimazole troche to the patient.Which instruction will the nurse give to the patient?

A) "Your eyesight may be blurry for a short time after I give you the medication."
B) "Do not touch or remove the patch after I have applied it to your skin."
C) "Keep the tablet in your mouth until it dissolves completely.Do not chew it."
D) "Lay on your back so the medication will melt slowly in your vagina."

Question 41

Order: Potassium chloride solution 9 mL PO daily

Potassium chloride
Oral solution
USP 10%
20 mEq per 15 mL

How many mEq of medication will be administered? _____ mEq

Question 42

Order: Digoxin 1 mL PO daily

Digoxin
Oral solution USP
0.25 mg per 5 mL

How many mcg of medication will be administered per dose? _____ mcg

Question 43

Order: Enalaprilat 1.25 mg IV push
Enalaprilat injection
For IV use only
2.5 mg per 2 mL

The agency's safe IV push infusion rate for Enalaprilat is 625 mcg over 5 minutes.
How many minutes will it take to safely administer the dose? _____ minutes

Question 44

Which instructions will the nurse give to the patient prior to administering a metered-dose inhaler?

A) "Inhale deeply and then blow slowly into the inhaler while you press the canister."
B) "Open your mouth wide so that the spray will reach the back of your throat."
C) "Roll the inhaler gently for a few minutes between your palms before each use."
D) "Hold your breath for 5 to 10 seconds immediately after you inhale the medication."
E) "Exhale fully and inhale deeply through your mouth while you press the canister."

Question 45

Order: Cyanocobalamin 0.6 mg IM daily

Cyanocobalamin
Injection USP
1000mcg/mL
For injection

How many mL of medication will the patient receive per dose? _____ mL

Question 46

Order: 50% Dextrose 15 g IV push STAT

50% Dextrose
Injection USP
25 g per 50mL

How many mL of medication will be administered? _____ mL

Question 47

Which assessment finding indicates that the patient is at risk from polypharmacy?

A) The patient takes three different medications to treat hypertension.
B) The patient's daughter administers the patient's eyedrops every evening.
C) The patient uses four different pharmacies to fill his 16 prescriptions.
D) The patient has weekly laboratory tests for warfarin dosing.
E) The patient is allergic to strawberries,latex,and penicillin antibiotics.

Question 48

Which of the following orders are for topical medications?

A) Methotrexate 20 mg subcutaneously once weekly on Wednesdays
B) Latanoprost 0.005% one drop in left eye daily at bedtime
C) Acetaminophen 650 mg suppository Q 4 hours prn mild pain
D) Ofloxacin otic solution 0.3% instill drops into right ear daily
E) Calcitonin nasal spray one spray daily into alternating nostrils