Chapter 29: Medications 1. The charge nurse has just completed an in-service with a group of nursing students. One nurse student asks, “Why do I have to give medications in different ways? I thought the unlicensed assistive personnel (UAP) perform those skills?” What is the BEST response by the charge nurse? a. Entry-level nurses will perform basic skills appropriate to the scope of practice and that includes administering medications through various routes.” 2. Which statement BEST describes the nurse’s rationale for selecting the ventrogluteal site when using the Z-track technique for administering an injection? a. The ventrogluteal site provides a location with the capacity for depositing and absorbing the drug. 3. A nurse is administering medication to a client via a gastric tube and finds that the medicine enters the tube and then the tube becomes clogged. What is the appropriate intervention in this situation? a. Use a syringe to plunge the tube to try to dislodge the medication. 4. An acute care facility follows the unit dose supply method to supply medication to the clients. What is meant by the unit dose supply method? a. Self-contained packets that hold one tablet or capsule for individual clients 5. Regarding medication administration, what must occur at the change of shifts? a. The opioids for the division are counted. 6. The nurse is educating a client on how to self-administer subcutaneous insulin injections. The client asks why the needle must be removed at the same angle as that of insertion. How will the nurse respond? a. It minimizes tissues trauma 7. A nurse brings a client the prescribed dose of medication and finds that the client is not in the unit. What should the nurse do in this case? a. Return the medication to the medication cart or medication room 8. The nurse has given a client an injection. How will the nurse prevent an accidental needle stick? a. Immediately activate the safety needle and place the syringe and needle into a sharp’s container. 9. A nurse is preparing to irrigate an intermittent infusion device. What size syringe would the nurse use? a. 10 mL 10. A nurse is administering a hepatitis B shot intramuscularly. What would be the appropriate site for administration? a. Deltoid 11. A client reports itching and shortness of breath 15 minutes after receiving ceftriaxone 500 mg intravenously. The nurse recognizes that the client is experiencing which type of reaction? a. Allergic reaction 12. The nurse is administering morphine oral solution 5 mg to a client requesting medication for pain. The preparation is delivered as a morphine solution of 10mg/5mL. Calculate the amount, in milliliters, the nurse will administer. Record your answer to one decimal place. a. 2.5 13. A client has been prescribed 300 mg of metronidazole. The supply is metronidazole 200 mg tablets. How many tablets will the nurse administer? Record your answer to one decimal place. a. 1.5 14. The nurse is preparing to administer a tuberculin test. Which route will the nurse select to administer this injection? a. Intradermal 15. A client with a new diagnosis of glaucoma (increased pressure within the eye) has been prescribed a medication that is to be administered by an eye drop. Which action should the nurse perform? a. Ensure that drops of the medication fall into the client’s conjunctival sac. 16. The nurse is teaching a client about metformin SA. when the client asks, “What does the SA mean?” What is the appropriate nursing response? a. Sustained action 17. When instructing a client regarding sublingual application, the nurse should inform the client that which action is contraindicated when administering the drug? a. Swallowing the medication 18. The nurse is educating a client on how to use an insulin pen. Which steps reflect the recommended procedure? Select all that apply. a. Hold the pen upright and tap to force any air bubbles to the top b. Dial the selector to 2 unites to perform an “air shot” to get rid of bubbles c. Clean injection site and administer injection by holding pen like a dart 19. The nurse has inadvertently administered medication ordered for Client A to Client B. What is the appropriate nursing action? Select all that apply. a. Assess Client B thoroughly b. Complete an incident report c. Contact the provider to report the error 20. The nurse is preparing to administer an allergy test intradermally. At what angle will the nurse plan to insert the needle into the client? a. 10 to 15 degrees 21. The nurse is to start providing care for an older adult client who sees several different health care providers and specialists. Which question should the nurse prioritize on assessment? a. “Do you get all of your medications filled at the same pharmacy?” 22. A client has an order for an intermittent infusion of 250 mL of 0.9 normal saline. The nurse understands that this type of infusion is used for which situation? a. Medications that need to be infused over 20 to 60 minutes 23. A nurse is using an 18-gauge needle to administer medication to a client. The nurse knows that when compared with a 27-gauge needle, an 18-gauge needle has which feature? a. Larger diameter 24. An emergency room nurse is ordered to administer nitroglycerin to a client being treated for acute pulmonary hypertension. Which means of drug administration would the nurse use to achieve rapid results in this emergency? a. IV infusion 25. The client cannot swallow and just had an enteral tube placed for feeding and medications. Medications will have to be in liquid form or crushed for administration. The client has the following medications prescribed. Which medication will the nurse withhold and consult with the health care provider? a. Oxycodone extended-release tablet 26. The nurse administers the client’s scheduled morning medications. The previous dose of antihypertensive was held due to a blood pressure that was too low according to the health care providers parameters. What does the nurse do with this upcoming dose of scheduled unit-dose packaged antihypertensive medication? a. Set the antihypertensive dose aside pending assessment 27. What is the BEST response by the nurse when a client asks about the side effects of using nasal spray? a. “Long term use of nasal sprays can cause rebound nasal congestion” 28. The nurse is preparing to give medications to a client with anxiety. The order indicates that the client is to have bupropion, 7.5 mg by mouth twice daily. What is the appropriate nursing action? a. Contact the health care provider for order clarification 29. The nurse is teaching a client how to take medications on discharge. The client is alert and oriented but unable to articulate the teaching back to the nurse. What is the appropriate nursing action? a. Give written instructions to the client and caregivers. 30. When administering heparin subcutaneously, the nurse should: a. Never aspirate 31. A physician at a health care facility suggests the use of a metered-dose inhaler for an asthmatic client. Which describes the mechanism of a metered-dose inhaler? a. A canister containing medication that is released when the container is compressed 32. The nurse is caring for a client who is taking nitroglycerin. Which client statement requires immediate nursing intervention? a. “I am taking tadalafil in addition to nitroglycerin.” 33. The nurse is preparing to administer a liquid form of medication to a client. What action will the nurse take to ensure that administration of the drug is at the desired potency? a. Check the expiration date 34. The primary reason for the Controlled Substances Act is: a. To prevent drug use and independence 35. The nurse is caring for a client who has problems coordinating his breathing with the inhaler use. Therefore, the client is unable to receive the full dose. Which would help maximize drug absorption in this client? a. Spacer 36. The nurse is educating a client on how to self-administer subcutaneous insulin injections. The client asks why the needle must be removed at the same angle as that of the insertion. How will the nurse respond? a. It minimizes tissue trauma 37. The nurse is preparing to administer an allergy test intradermally. At what angle will the nurse plan to insert the needle into the client? a. 10 to 15 degrees 38. A nurse is in the process of converting a continuous IV infusion to an intermittent infusion device. The nurse has clamped off the primary IV tubing, donned clean gloves, clamped the extension tubing and disconnected the primary IV tubing. The nurse is now cleansing the port on the extension tubing with an antiseptic swab. The nurse cleanses the port for which duration of time? a. 15 seconds 39. The nurse is preparing to administer nasal medication via a dropper to a client with severe congestion. Into which position will the nurse place the client? a. Supine 40. A nurse educator is teaching a student nurse how to choose the correct needle for an injection. Which guidelines for needle selection might they discuss? a. As the gauge number becomes larger, the diameter of the needle and the lumen become smaller. 41. The nurse is preparing to administer insulin to an obese client. At what angle will the nurse plan to insert the needle into the client? a. 90 degrees 42. The nurse is preparing to administer prescribed intravenous antibiotics to a client. While assessing the medication lock, the nurse notes that there is resistance when administering the saline flush solution. What would be the BEST action by the nurse? a. Insert a new IV medication lock and remove the old one. 43. The nurse is teaching a client with heart failure about taking digoxin safely. Which statement by the client indicates teaching was effective? a. “I will call the health care provider if I develop dizziness, blurred vision, or nausea.” 44. To which client would the nurse be most likely to administer a PRN medication? a. A client who is reporting pain near the surgical site 45. A nurse is caring for a client undergoing IV therapy. The nurse knows that intravenous administration of medication is appropriate in which situation? a. When the client has disorders that affect the absorption of medications 46. The nurse is preparing to administer the second dose of ordered antibiotics to a client and notes that the first dose of medication is still in the automated medicationdispensing system. The medication administration record (MAR) does not show that the initial dose was given. What is the appropriate nursing action? a. Notify the health care provider 47. The nurse is teaching a client how to take medications on discharge. The client is alert and oriented but unable to articulate the teaching back to the nurse. What is the appropriate nursing action? a. Give written instructions to the client and caregivers 48. The nurse is preparing to apply nitroglycerin paste. After checking the order, washing hands, checking the clients identity, and applying gloves, which is the next nursing action? a. Removing prior application and any remaining residue from skin 49. A client with a complex cardiac history has been prescribed digoxin 0.0625 mg PO. the drug is available as 125 mcg tablets. How many of the tablets will the nurse administer? a. 0.5 50. The nurse is preparing to withdraw medication from an unbroken glass ampule. Which nursing actions are appropriate? Select all that apply. a. Tap the top of the ampule b. Avoid allowing the needle to touch the outside of ampule c. Invert the ampule to withdraw medication 51. A client reports itching and shortness of breath 15 minutes after receiving ceftriaxone 500 mg intravenously. The nurse recognizes that the client is experiencing which type of reaction? a. Allergic reaction 52. What is the term used for the concentration of drug in the blood serum that produces the desired effect without causing toxicity? a. Therapeutic range 53. A nurse is explaining to a client the correct method of using a metered-dose inhaler when self-administering a prescribed dose of medication. What is a feature of a metered-dose inhaler? a. It is a canister that contains pressurized medication 54. The nurse has a prescription to administer 25 mg of furosemide IV to a client. The drug is supplied in a vial 40 mg/4 mL. How many milliliters will the nurse administer of the medication? Record your answer using one decimal place. a. 2.5 55. A nurse needs to administer a prescribed injection to a toddler. Which injection site is most suitable for the client? a. Vastus lateralis site 56. A client is taking numerous eyes drops to prepare for cataract surgery. While teaching about ophthalmic application will the nurse provide? a. “Wait 5 minutes between the installation of different types of eye drops.” 57. The nurse is preparing to administer an IM injection in the vastus lateralis site. Where will the nurse administer the medication? a. In the anterolateral aspect of the thigh 58. A nurse is caring for a client who is being tube fed. What care should the nurse taken when administering medications through an enteral tube? a. Avoid crushing sustained-release pellets 59. The nurse is preparing to administer a tuberculin test. At which angle is the nurse expected to instill the drug? a. 15-degree angle 60. A client is ordered to receive an intramuscular injection of medication. When preparing to administer the injection, the nurse selects the ventrogluteal site based on which reason? a. The area is free of major blood vessels and fat. 61. Which assessment should be conducted by the nurse before the nurse administers tuberculin intradermal injection? a. Checking for documented allergies to food or drugs 62. What is the BEST response by the nurse when a client asks about the side effects of using nasal spray? a. “Long-term use of nasal sprays can cause rebound nasal congestion.” 63. The nurse beginning a shift has received a report from the previous nurse, who reports that a client has a catheter inserted into the subclavian vein. The oncoming nurse will plan to assess which type of catheter? a. Peripherally inserted cutaneous catheter 64. A nurse at the health care facility needs to administer an otic application for a client with an earache. What should the nurse do after instilling the prescribed ear drops in the client’s ear? a. Ask the client to maintain the position for some time 65. A nurse is assessing a client’s lower arm for insertion of an IV catheter. The nurse palpates the vein and notes that it feels hard. Which action by the nurse would be MOST appropriate? a. Select another site 66. The nurse is preparing to administer a bolus of an intravenous medication. How should the medication be administered? a. All at once 67. The nurse is preparing to administer an IM injection in the vastus lateralis site. Where will the nurse administer the medication? a. In the anterolateral aspect of the thigh 68. A client who has been receiving a secondary infusion of a new antibiotic for several minutes’ reports itching and a sensation of throat tightness. What is the PRIORITY nursing intervention? a. Stop the infusion of the antibiotic 69. Which situation accurately describes a recommended guideline when administering oral medications to clients? a. If a child refuses to take medication, crush the medication, if allowable, and add to a small amount of food. 70. The nurse is caring for a client who is receiving a prescribed intravenous (IV) infusion of an antibiotic to treat an infection. The client asks the nurse, “Can I just take a pill?” What is the BEST response by the nurse? a. “An IV infusion maintains a therapeutic level of the medication in your blood.” 71. Which medication administration task will the registered nurse (RN) appropriately delegate to a licensed practical nurse (LPN)? a. Antibiotic piggyback via peripheral IV 72. A client receiving a secondary infusion of a new antibiotic through a peripherally inserted central line (PICC) suddenly reports itching and flushing. Which action should the nurse prioritize for this client? a. Clamp the antibiotic infusion