Deck 36: Medications

Question 1

The client is to receive an intramuscular injection of a medication that is supplied in a 2 mL cartridge and a second medication that is supplied in a vial. The total amount to be administered of these medications exceeds the volume of the cartridge by 0.5 mL. How should the nurse proceed?

A) Call the pharmacy for advice on administering these medications.
B) Administer the cartridge medication in one injection and the vial medication in a separate injection.
C) Add as much of the vial medication to the cartridge as possible prior to injection, giving the balance in a separate injection.
D) Draw both of the medications up into a syringe for administration.

Answer 1

Draw both of the medications up into a syringe for administration.

Question 2

Match the following terms with its examples.
1. BD
2. TDS
3. PRN
4. QID
5. MANE
A. Morning
B. Four times a day
C. Three times a day
D. When required
E. Twice a day

Answer 2

1E, 2C, 3D, 4B, 5A

Question 3

The nurse has discontinued suction to a nasogastric tube to administer medication. For how long should the nurse plan to leave this suction discontinued?

Answer 3

20-30 minutes

Question 4

Match the terms with its descriptions.
1. Side effect
2. Adverse effect
3. Therapeutic range
4. Drug allergy
A. Reaction to a drug causing swelling in mouth
B. Secondary effect from desired effect
C. Justifies discontinuing a drug
D. Effective without toxicity

Answer 4

1B, 2C, 3D, 4A

Question 5

The doctor has written an incorrect drug dosage for one of the patients. The nurse follows the order and administers the incorrect dose. Who is deemed as accountable?

A) The Doctor.
B) The Nurse.
C) The Doctor and the Nurse.
D) No-one.

Answer 5

The Doctor and the Nurse.

Question 6

The nurse is preparing a small amount of medication for oral administration. Which nursing action is essential?

A) Label the syringe with the medication name, amount, and route.
B) Measure the medication at the top of the meniscus.
C) Dilute the medication with water before measuring.
D) Draw up the medication in a syringe with a large-gauge needle.

Question 7

The nurse is preparing to administer a medication to a 6-year-old. What is the nurse's priority action?

A) Administer the exact dosage as ordered.
B) Verify that the dosage is within the safe range for this child.
C) Administer no more than one-half of the safe adult dosage.
D) Give the dosage supplied by the pharmacy.

Question 8

The nurse is preparing to administer a medication that the agency designates as "high alert". What action should the nurse take?

A) Call the pharmacist to check the efficacy of the medication.
B) Decline to administer the medication unless there is a physician present.
C) Ask another Registered Nurse to verify the medication.
D) Request that the nursing supervisor administer the medication.

Question 9

Which of the following would the nurse assess as a factor reducing medication action? (Tick as many as required.)

A) Vitamin K.
B) Taking medication after meals.
C) Slow liver metabolism.
D) Physiological changes with older age.
E) High environmental temperatures.

Question 10

The student nurse is to administer some medications. What are the 10 'rights' to ensure safe administration?

Question 11

A client is being tested to determine allergies. This route of administration is called:

A) intramuscular.
B) intravenous.
C) intradermal.
D) intrathecal.

Question 12

The nurse is planning to administer medications to a new client. What is the nurse's greatest priority in administering these medications?

A) Be certain the medications are given within 15 minutes of the time they are scheduled.
B) Document the administration accurately so the reimbursement is correct.
C) Assess the client's knowledge of the action of the medications.
D) Before giving the medications, know what the intended effects are for this client.

Question 13

At which point of preparing medication from an ampoule does the nurse anticipate using a filter needle?

A) Filter needles are not used for this preparation.
B) When drawing the medication from the ampoule.
C) Both for drawing up the medication and for administering the medication.
D) When administering the medication to the client.

Question 14

The nurse identifies that the ordered dose for a medication is twice the amount generally administered. What action should the nurse take?

A) Administer only the standard dose of the medication.
B) Administer the medication as it was ordered.
C) Collaborate with the prescriber about the order.
D) Check to see if previous shift nurses gave the medication.

Question 15

The nurse who is to administer 2.5 mL of intramuscular pain medication to an adult client notes that the previous injection was administered in the right ventrogluteal site. In which site should the nurse plan to administer this injection?

A) The same site.
B) The rectus femoris.
C) The left ventrogluteal.
D) The deltoid.

Question 16

The nurse is planning to administer a bitter-tasting oral medication to a 4-year-old. What strategy should this nurse plan?

A) Tell the child that the medication tastes good.
B) Ask the parents how they give medications at home.
C) Get another nurse to assist by holding the client down.
D) Give the medication in orange juice or milk to mask the taste.

Question 17

Before administering medications, the nurse must use at least two client identifiers. What would be the best way for the nurse to verify the client's name?

A) Ask the client to state their full name and check their client identification band.
B) Check their room number and client identification band and then read from the MAR to confirm all details are correct.
C) Read out the client's name from the MAR and ask them to confirm whether or not it is correct.
D) Check the name on their client identification band first and then confirm this is their name by asking, "Is ________ your correct name?"

Question 18

The nurse is caring for a team of four clients who are seriously ill. One of the clients has just received a new cardiac medication. How should the nurse instruct the Assistant in Nursing (AIN) who is also caring for this client?

A) Tell the AIN to teach the client's family what to expect from the medication.
B) Give the AIN specific instructions regarding what drug actions or side effects to report to the nurse.
C) Have the AIN look the medication up in a drug reference book to read about drug actions and possible side effects.
D) Have the AIN assess for any unexpected effects from the medication.

Question 19

The client has been ordered morphine 7.5 mgs intramuscular injection. The morphine stock available is 10 mgs/2 mls. What volume is required to be administered?

Question 20

The nurse is to administer four oral medications to the client via a nasogastric tube. One of the medications is a tablet that has been crushed, one is a capsule that has been opened and the powder removed, and two are supplied in liquid form. How should the nurse administer these medications?

A) Mix the crushed tablet and capsule powder individually in warm water. Administer each medication separately, flushing the tube before and after each administration.
B) Flush the tube with the mixed liquids first, then administer the crushed tablet and capsule powder mixed in cold water.
C) Mix the crushed tablet and capsule powder in warm water and administer. Flush the tube and administer the mixed liquids.
D) Flush the tube, mix the crushed tablet and the capsule powder into the two liquids for administration, and follow by flushing the tube.

Question 21

Most institutions have lists of abbreviations officially accepted for use in the institution. A hospital's regulations now require that the nurse write out the name of the drug morphine instead of using the abbreviation M. What is the best rationale for this requirement?

A) The hospital has placed MS on its list of do not use abbreviations.
B) Using the abbreviation MS puts the client at risk of medication error.
C) The Joint Commission on Accreditation of Healthcare Organisations (JCAHO) recommends the abbreviation M never be used.
D) Computerised charting systems will not accept the abbreviation M.

Question 22

Older people may require lower doses of drugs because:

A) their organ sensitivity is stronger than younger people.
B) they don't remember to take it.
C) they metabolise the drugs faster.
D) their organ responsiveness is altered.

Question 25

The client who regularly uses a metered-dose inhaler four times a day tells the nurse that it is difficult to tell when the canister is empty. What instruction should the nurse give this client?

A) Place the canister in a bowl of water. If the canister floats, it is not empty.
B) You can tell that the canister is empty when you can no longer smell the medication when you activate the plunger.
C) When you feel like you are no longer getting maximum effect from the medication, your canister is empty.
D) When you get a new canister, divide the number of puffs that is listed on the label by four. That will tell you how many days the canister will last.

Question 26

The nurse is preparing to administer eardrops to a 6-year-old. What nursing action is correct?

A) Insert the tip of the applicator into the ear canal.
B) Pull the earlobe down and back to straighten the ear canal.
C) Press gently on the tragus of the ear a few times after administration.
D) Put the eardrops in the refrigerator for 10 minutes prior to administration.

Question 27

The nurse is adding medication to an existing intravenous set-up. Which nursing action is indicated?

A) Ensure that the IV bag is full prior to adding medication.
B) Close the infusion clamp.
C) Do not remove the IV bag from the standard.
D) Briskly shake the IV bag after injecting the medication.

Question 28

The diabetic client asks the practice nurse at their Family Medical Centre about not having to rotate the injection sites. The nurse also knows the client has motor skill problems. What instruction should the nurse give this client?

A) "No problem at all. It absorbs the same wherever you put it."
B) "Rotating sites creates less discomfort, protects your skin and helps absorb the insulin."
C) "Only people who practice good personal hygiene can use the same site."
D) "We will have to organise someone to come and give it to you."

Question 29

The nurse has just injected insulin subcutaneously into the client's abdomen. What action should the nurse take at this point?

A) Remove the needle rapidly by pulling it quickly from the skin.
B) Cover the injection site with a pressure dressing for at least 15 minutes or until the bleb disappears.
C) Leave the needle embedded in the client's skin for five seconds after administration.
D) Massage the site to encourage absorption.

Question 30

While preparing to administer an eye ointment, the nurse inadvertently squeezes the tube, discarding the first bead of medication. What action should the nurse take at this point?

A) Have a second licensed nurse witness the waste and sign the chart.
B) Administer the eye ointment as ordered, as the first bead of ointment should be discarded anyway.
C) Continue to squeeze the tube until a clear line of ointment has been discarded from the tip.
D) Notify the pharmacy and request a new, unopened tube of ointment.

Question 31

Upon aspirating a saline lock prior to administering intravenous medication, the nurse notes that there is no blood return. What nursing action should be taken?

A) Slowly infuse 1 mL of saline into the lock, assessing for infiltration.
B) Pull the intravenous catheter out 0.3175 cm and attempt aspiration.
C) Reinsert the needle into the lock and aspirate using more pressure.
D) Discontinue this infiltrated lock and restart another site for medication administration.

Question 32

During administration of an intradermal injection, the nurse notices that the outline of the needle bevel is visible under the client's skin. How should the nurse proceed?

A) Turn the needle so that the bevel is down and inject the medication slowly, looking for development of a bleb.
B) Recognise that this is an expected finding in a properly administered intradermal injection.
C) Insert the needle further into the skin at a deeper angle.
D) Withdraw the needle, prepare a new injection, and start again.

Question 33

The nurse is providing discharge teaching for a client who is being dismissed with prescriptions for a bronchodilator inhaler and a corticosteroid inhaler. What information should the nurse provide regarding the dosage schedule for these two medications?

A) Always use the corticosteroid inhaler first.
B) Use the bronchodilator first.
C) Use the inhalers on alternate days, not on the same day.
D) It makes no difference which inhaler is used first.

Question 34

While preparing to administer a transdermal oestrogen patch, the nurse finds the previously applied patch in the client's bed linens. How can the nurse avoid this situation with the patch now being applied?

A) Place a heating pad over the area where the patch is applied for 10 minutes after application.
B) Shave the area where the patch is being applied.
C) Run a finger around the adhesive edges of the new patch before placing it on the client's skin.
D) Press firmly over the patch with the palm of the hand for about 10 seconds after applying it to the skin.

Question 35

While administering an intramuscular injection, the nurse notes blood return in the syringe barrel after aspirating. What action should the nurse take?

A) Inject the medication as planned.
B) Notify the physician immediately.
C) Discard the medication and start over.
D) Pull the needle out 0.635 cm and inject the medication.