Medication Administration Techniques and Considerations, Exams of Nursing

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lab 3 test bank questions with complete solutions

. The nurse is planning to administer a tuberculin test with a 27- gauge, 3/8-inch needle. The nurse should insert the needle at an angle of _____ degrees. a. 15 b. 45 c. 90 d. 180 Correct Answer a A 2-year-old child is ordered to have ear irrigation performed daily. The nurse correctly performs the procedure by 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. Correct Answer a

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 Correct Answer d 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 Correct Answer a A nurse is caring for a patient who is in hypertensive crisis. When the nurse is flushing the patient's peripheral IV, the patient complains of pain. Upon assessment, the nurse notices a

red streak that is warm to the touch. What is the nurse's initial action? a. Notify the physician. b. Administer pain medication. c. Discontinue the IV. d. Apply a cool compress to the site. Correct Answer d A nurse is caring for a patient who is to be discharged with a prescription for eye drops. The nurse knows that the patient understands how to administer eye drops correctly when the patient states that eye drops should be instilled on the: a. sclera. b. cornea. c. conjunctival sac. d. area between the iris and lower eyelid. Correct Answer c A nurse is caring for a patient with kidney disease. The nurse needs to make more focused assessments when administering medications to this patient because the patient may experience problems with the process of: a.

excretion. b. absorption. c. distribution. d. metabolism. Correct Answer a A nurse is preparing to administer eardrops to an adult patient. Which action should be taken by the nurse? a. Warm the medication to room temperature using warm water. b. Pull the pinna down and back to straighten the ear canal. c. Apply gentle pressure or massage to the pinna of the ear. d. Remove cerumen from the inner ear canal with a cotton-tipped applicator. Correct Answer a A nurse is working in a newborn special care unit that has numerous premature infants. She recently transferred to this unit from an adult intensive care unit. The nurse is very cautious in administering medications because premature newborns are especially vulnerable to medication errors. Why is this true? a. Premature infants excrete urine more quickly than older infants. b.

Premature infants metabolize medications more quickly than older children. c. Premature infants require more frequent dosing to achieve desired effects. d. Premature infants have less mature livers and kidneys. Correct Answer d A nurse is working with the pharmacist to determine when a patients medications should be given. Several medications are due to be given in the morning. What is the most important reason to appropriately schedule the patients medications? a. Some medications are absorbed more quickly on an empty stomach. b. All medications are hindered by the presence of gastric contents. c. If given at the same time, all medications will be absorbed at the same rate. d. The nurse must schedule medications to fit the pharmacys schedule. Correct Answer a A nurse knows that patient education has been effective when the patient states 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." Correct Answer c 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 a large muscle b. Into the connective tissue beneath the dermis c. Into a vein using a pump d. Between the epidermis and dermis Correct Answer b 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. Correct Answer d A patient is hospitalized with a central nervous system infection that needs to be treated with water-soluble antibiotics. The medications will be instilled into the subarachnoid space via an epidural catheter. Why is this the best route of administration for this patient? a. Intravenous water-soluble antibiotics cannot pass through the blood-brain barrier. b. Only water-soluble medications can pass into the brain and cerebrospinal fluid. c. Older patients better tolerate lipid soluble medications than younger patients. d. Lipid soluble medications are safer for patients who are pregnant. Correct Answer a 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 Correct Answer d A patient is to receive a medication that is irritating to muscle tissue. The most appropriate injection technique involves which of the following? a. Z-track technique of injection b. Subcutaneous technique of injection c. Use of the vastus lateralis in adults d. Use of the deltoid muscle in children less than 12 months old Correct Answer a 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. Correct Answer d A patient is to receive two different kinds of insulin. What is the nurses most appropriate action? a. Prepare the regular (clear) insulin first. b. Mix Lantus and Lente insulin in the same syringe. c. Administer the rapid-acting insulin within 30 minutes of a meal. d. Verify insulin dosage with another nurse after administration. Correct Answer a A patient states that aspirin upsets her stomach. This is known as a(n): a. allergic response. b. toxic effect. c. idiosyncratic reaction. d. side effect. Correct Answer d A patient who is being discharged today is going home with an inhaler. The patient is to administer 2 puffs of his inhaler twice daily. The inhaler contains 200 puffs. When should the nurse appropriately advise the patient to refill his medication?

a. As soon as he leaves the hospital b. When the inhaler is half empty c. 6 weeks from the start of using the inhaler d. 50 days after discharge Correct Answer c 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. Attached 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. Correct Answer a A patient with a respiratory infection asks the nurse why some antibiotics are prescribed to be taken every 12 hours and some have to be taken 4 times a day. What is the nurses best response?

a. The time between doses changes because any medications half- life varies so much. b. We need to vary the times to keep the blood values fluctuating. c. We try to give the next dose of medication only after the last dose is gone. d. Regular doses are given based on the half-life to maintain a therapeutic plateau. Correct Answer d A postoperative patient is receiving morphine sulfate from a patient-controlled analgesia device. On assessment, the nurse notes that the patients respirations are depressed. The nurse realizes the effect of morphine sulfate infusion can be labeled as which of the following? a. Toxic b. Allergic c. Therapeutic d. Idiosyncratic Correct Answer a A postoperative patient is undergoing antibiotic therapy. She has never had any problems taking medications in the past. When the nurse hung the second dose of IV antibiotics, the patient suddenly developed shortness of breath and had difficulty breathing. The nurse recognized this was most likely a(n):

a. idiosyncratic reaction. b. toxic effect. c. side effect. d. anaphylactic reaction. Correct Answer d A(n) ______ effect is a predictable and often unavoidable adverse effect produced at a usual therapeutic dose. a. adverse b. side c. therapeutic d. toxic Correct Answer b Aspirin is an analgesic, antipyretic, antiplatelet, and anti- inflammatory agent. A physician writes for aspirin 650 mg every 4 to 6 hours prn: febrile. For which patient would this order be appropriate? a. 7-year-old with hemophilia b. 21-year-old with a sprained ankle c.

35-year-old with a severe headache d. 62-year-old female with pneumonia Correct Answer d How should the nurse position the ear when performing ear irrigation for a 2-year-old patient? a. Instill the irrigating solution quickly and forcefully. b. Pull the pinna up and back. c. Direct the fluid toward the anterior aspect of the ear canal. d. Pull the pinna down and back. Correct Answer d How should the nurse position the patient to administer nose drops to the maxillary sinus? a. Sitting upright with the head tilted backward toward the side to be treated b. Supine with a small pillow under the shoulders and the head tilted backward c. Supine with the head tilted backward and turned to the unaffected side d.

Head tilted back over the edge of the bed and turned toward the side to be treated Correct Answer d https://nursingtestbank.info/chapter-22-parenteral-medications/ question 6 Correct Answer Several patients have been prescribed inhalation medications. The nurse is aware that a spacer will be beneficial for which patient? a. A young child using a dry powder inhaler b. An elderly patient who uses a metered-dose inhaler c. A teenager who has just started using a nebulizer d. A young child who needs medication several times per day Correct Answer b The intended or desired physiological response of a medication is known as a(n) _____ effect. a. adverse b. side c. therapeutic d. toxic Correct Answer c

The nurse administers eardrops in the patient's left ear. Which of the following positions is appropriate after instillation of the drops? a. Prone b. Upright c. Right lateral d. Dorsal recumbent with hyperextension of the neck Correct Answer c The nurse is administering a parenteral medication to the patient. Which action by the nurse demonstrates proper technique? a. Using strict aseptic technique b. Using work-arounds to administer medications in a timely manner c. Injecting the medication smoothly but rapidly d. Inserting the needle into the patient's skin smoothly and slowly Correct Answer a

The nurse is administering an intravenous medication that is to be administered over 10 minutes. Which method should the nurse choose to efficiently administer the medication? a. Place the medication in a large-volume cath-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. Correct Answer c The nurse is applying a new nitroglycerin transdermal patch. Which action by the nurse is appropriate? a. Instructing the patient to wear the patch 24 hours a day every day b. Applying the new patch to the same site as the previous patch c. Cutting the patch in half when a change of dose is ordered d. Instructing the patient to avoid heat sources over the patch Correct Answer d

The nurse is caring for four patients who require medications at

900. Which action by the nurse adheres to the eight rights of medication administration? a. Prepare medications for all of the patients at once and keep the cups separate. b. Ask the supervisor to clarify an unclear medication order. c. Give the prescribed anticonvulsant between 0830 and 0930. d. Leave each patient's medications at the bedside and return within 30 minutes to make sure they have been taken. Correct Answer c 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. Correct Answer b

The nurse is medicating the patient daily with warfarin (Coumadin). The patient is having blood levels drawn daily to determine the dose needed. The nurse realizes that the goal is to reach which of the following? a. The minimum effect concentration (MEC) in the plasma b. Reach the peak concentration level of the medication c. The level that falls between the MEC and toxic level d. An adequate trough level in the plasma Correct Answer c The nurse is preparing a medication that comes in an ampule. Which action by the nurse is appropriate? a. Tapping the ampule so fluid moves from the bottom of the ampule to the neck b. Avoiding inversion of the ampule after opening to prevent spillage of the medication c. Using a filter needle long enough to reach the bottom of the ampule d. Guiding the needle against the rim of the ampule to access the medication Correct Answer c

The nurse is preparing an injection of 0.45 mL of medication for a pediatric patient. Which syringe is most appropriate? a. Tuberculin syringe b. Insulin syringe c. 3-mL syringe d. 10-mL syringe Correct Answer a The nurse is preparing oral medications for a patient. In preparing these medications the nurse is aware of which of the following? a. Acidic medications are absorbed slowly by the gastric mucosa. b. Alkaline medications are absorbed rapidly by the gastric mucosa. c. Solutions and suspensions are more difficult to absorb than capsules. d. Alkaline medications are absorbed in the small intestine. Correct Answer d The nurse is preparing oral medications for administration. Which action by the nurse is appropriate?

a. Using a cutting device to cut scored tablets b. Unwrapping all of the medications to be given and placing them together in a cup c. Crushing capsules and enteric-coated medication for easier swallowing d. Holding the medication cup at eye level to pour a liquid dosage Correct Answer a The nurse is preparing to administer a 0.5-mL rabies vaccine into the deltoid muscle of a patient. Which needle size is best for the procedure? a. 20 gauge ´ 1 1/2 inch b. 23 gauge ´ 1/2 inch c. 25 gauge ´ 5/8 inch d. 27 gauge ´ 3/8 inch Correct Answer c The nurse is preparing to administer a 0.5-mL rabies vaccine into the deltoid muscle of a patient. Which needle size is best for the procedure? a.

Chemotherapy is irritating to the vascular system and may cause the vein to infiltrate. b. Two medications should never be placed into the same IV site. c. Once chemotherapy is in a patient's system, any additional medicine given will cause a synergistic effect. d. Chemotherapy treatments require a special pump designed solely for chemotherapy Correct Answer a The nurse is preparing to administer a medication via a jejunostomy tube to a patient who is receiving continuous tube feedings. The medication needs to be given on an empty stomach and comes only in tablet form. What action should the nurse take first? a. Add the medications directly to the tube feeding. b. Flush the tubing before the medication is given. c. Stop the feeding 30 minutes before medication administration. d. Dissolve the medication in cold water. Correct Answer c The nurse is preparing to administer a medication. Which of the following is the most critical to assess before medication administration?

a. Diet history b. Allergy history c. Surgical history d. Drug tolerance Correct Answer b The nurse is preparing to administer a rectal suppository to a patient. The patient should be assisted to which position for insertion of the rectal suppository? a. Prone b. Supine c. Dorsal recumbent d. Left Sims' position Correct Answer d The nurse is preparing to administer a rectal suppository to an adult patient. Which action should be taken by the nurse? a. Apply sterile gloves before handling the suppository. b.

Apply extra lubricant to the suppository if there is active rectal bleeding. c. Insert the suppository past the internal sphincter, against the rectal wall, about 6 to 10 inches. d. Instruct the patient to remain lying flat or on the side for 5 minutes after insertion of the suppository. Correct Answer d The nurse is preparing to administer an intramuscular (IM) injection to a 6-month-old infant. Which injection site is the most appropriate for this patient? a. Deltoid muscle b. Dorsogluteal injection site c. Vastus lateralis d. Abdomen 2 inches away from the umbilicus Correct Answer c The nurse is preparing to give an intramuscular (IM) injection of pain medication. The nurse prepares this medication knowing which of the following? a. Intramuscular (IM) medications are absorbed faster than subcutaneous medications. b. Medication absorption is faster with subcutaneous medications.

c. Blood supply to the subcutaneous tissue is richer than to muscle. d. Muscle tissue has a less developed vascular system than subcutaneous tissue. Correct Answer a The nurse is preparing to give sublingual nitroglycerin to a patient complaining of chest pain. The nurse instructs the patient not to swallow the medication. Why is this instruction important? a. The effects of the medication will be nullified if swallowed. b. Sublingual drugs begin to dissolve when placed on the tongue. c. The medication needs to be held against the cheek membranes until dissolved. d. The patient may aspirate on the water used for these medications. Correct Answer a The nurse is teaching a patient how to mix 5 units of regular insulin and 15 units of NPH insulin in the same syringe. The nurse determines that further instruction is needed if the patient does which of the following? a.

Injects 5 units of air into the regular insulin vial first and withdraws 5 units of regular insulin b. Injects 15 units of air into the NPH insulin vial but does not withdraw the medication c. Withdraws 5 units of regular insulin before withdrawing 15 units of NPH insulin d. Calculates the combined total insulin dose as 20 units after withdrawing the regular insulin from the Correct Answer a The nurse is teaching a patient how to use a metered-dose inhaler without a spacer. Which action by the patient demonstrates correct use of the device? a. Being careful not to shake the canister b. Positioning the mouthpiece in front of the mouth while not touching the lips c. Depressing the canister fully, waiting 3 to 5 seconds, then inhaling slowly and deeply d. Taking another puff of the medication within 10 seconds Correct Answer b The nurse is teaching a patient how to use a topical medication. Which statement indicates an understanding of the procedure?