The speed which the drug is absorbed and / or released helps to choose the route Show
Onset rate varies with route of administration: Oral medications for systemic use must proceed through a series of steps before they exert their therapeutic effect Tablets placed under tongue or between cheek and gums work quickly medication bypasses stomach and liver, goes directly into bloodstream Drugs injected/infused directly into bloodstream are carried immediately throughout the body Topical routes work quickly: localized therapeutic effects, especially those applied to the skin, inhaled into the lungs, or instilled into the eye Which nursing action reduces the patient's risk of an allergic drug response? - Checking the patient's name, medication name, and dosage Factors that influence absorption are the route of administration, ability of the medication to dissolve, blood flow to the site of administration, body surface area (BSA), and lipid solubility of medication. The absorption of drugs depends on the route of administration; oral route has the least absorption, and the intravenous route has the highest absorption. The human body absorbs medications in a liquid state more readily than tablets and capsules. Higher blood flow to the site of administration favors faster absorption of drugs. Because the cell membrane has a lipid layer, highly lipid-soluble medications cross cell membranes easily and are absorbed quickly. Absorption of drugs depends on body surface area, not on body weight. Body temperature does not affect the absorption of drugs. STUDY TIP: Regular exercise, even if only a 10-minute brisk walk each day, aids in reducing stress. Although you may in the past have been able to enjoy regular sessions at the health club or at an exercise class several times a week, you now may have to cut down on that time without giving up a set schedule for an exercise routine. Using an exercise bicycle that has a book rack on it at home, at the YMCA, or at a health club can help you accomplish two goals at once. You can exercise while beginning a reading assignment or while studying notes for an exam. Listening to lecture recordings while doing floor exercises is another option. At least a couple of times a week, however, you should do the exercise routine without the mental connection to school; time for the mind to unwind is necessary, too. A diabetic patient has been switched from oral antidiabetic drugs to insulin. Which information would help the patient to ensure correct self-administration of insulin? Select all that apply. 1, 4, 5 Insulin is given as a subcutaneous injection for slower absorption. The rate of absorption of insulin differs in various sites. The abdomen has the quickest absorption. The recommended sites of insulin injection include the upper arms, anterior and lateral part of the thighs, buttocks, and abdomen. These sites have the appropriate amount of subcutaneous tissue for absorption of insulin. The injection site should not be chosen again for a month. The injection site should be rotated with each injection. Repeated injection at the same site may lead to lipodystrophy. The nurse is responsible for the storage and safe usage of drugs. Which guidelines should the nurse follow for the safe use of narcotics? Select all that apply. 1, 3, 5 All narcotics should be stored in a locked, secure cabinet or container to ensure safe storage. The narcotics should be counted with the opening of narcotic drawers and/or at shift change to ensure that narcotics are not missing. The patient's name, date, time of medication administration, name of medication, dose, and signature of the nurse dispensing the medication should be recorded. Documentation is necessary to keep a proper count of drug usage. Discrepancies in narcotic counts should be immediately reported, because they may be a result of theft or illegal drug use. Any unused portion should be disposed of to prevent abuse. Which statements are true regarding routes of
medication administration? Select all that apply. 2, 3 Medications are absorbed slowly through the skin due to the makeup of the skin. The oral route of administration is contraindicated in patients with gastrointestinal disorders. The administration of medications through the parenteral route often causes anxiety in patients, especially in children. The intramuscular and intravenous routes have higher absorption rates. The oral route is contraindicated in patients with reduced gastrointestinal motility. A patient's prescription order calls for 30 mL of the medication to
be taken. What should the nurse instruct the patient regarding the administration of the medication according to household measurement? 1 Household measurement is most familiar and includes drops, teaspoons, tablespoons, and cups for volume, pints, and quarts for weight. The prescription order containing 30 mL indicates that 2 tablespoons of the medication should be taken. 240 mL indicates 1 cup of the medication. 960 mL indicates 1 quart of the medication. 5 mL indicates 1 teaspoon of the medication. Which medication route is absorbed slowly after administration? 4 Every route of administration has different rates of absorption. The physical makeup of the skin makes the absorption slow for medications placed on the skin. Medications placed under the tongue have quick absorption. Respiratory airways and mucous membranes have many blood vessels. Therefore, medications placed in the oral mucosa, on the respiratory airways, and on the mucous membranes are absorbed most quickly after administration. Which statement about various routes of drug administration requires correction? 1 Chemotherapeutic agents are the most common medications administered through intrapleural injection. Subcutaneous injection deposits the medication just below the dermis of the skin. The intraosseous method of medication administration involves the infusion of medication directly into the bone marrow. It is used most commonly in infants and toddlers who have poor access to their intravascular space. Patients taking medication through the sublingual route are instructed not to swallow or drink water until the tablet dissolves. A patient reports severe vomiting, diarrhea, and abdominal cramps to the nurse. Which form of medication is contraindicated in the patient? 1 Vomiting, diarrhea, and abdominal cramps are suggestive of the disturbed gastrointestinal tract. The oral route of drug administration is contraindicated in patients with gastrointestinal disturbance, because there will not be effective drug absorption. The astopial route, intravenous route, and transdermal route do not require gastrointestinal system for drug metabolism, so these routes of drug administration are safe for this patient. The primary health care provider prescribes pain medication to a patient with the notation "prn" in the prescription. What should the nurse interpret from the prescription? 4 The notation "prn" in the prescription indicates that the medication can be taken as and when required, maintaining a specific time interval between doses. The notation "qh" indicates that the medication should be taken every hour. The notation "ac" indicates that the medication should be taken before meals. "bid" indicates that the medication should be taken twice a day. The primary health
care provider prescribes a suppository form of medication to a patient. What are the probable routes of administration advised for the patient? Select all that apply. 2, 4 The suppository form of medication involves the insertion of pellets of medications in body cavities such as the vagina and rectum. The oral route, topical route, and intravenous route of drug administration do not use the suppository form of medications. The nurse is reviewing a medication order for a patient. What are the components of medication orders? Select all that apply. 2, 3, 5 The components of a medication order include dose and frequency of the medication, route of administration, and generic name of the medication. The dose and frequency are decided based on the patient's weight and the amount of medication required to obtain the therapeutic effect. The route of administration depends on the types of medication and the condition of the patient. The medication can be given via enteral or parenteral route. The generic name of the drug is an important component of the medication order and is used to identify the drug. The chemical name of the medication and the name of the nurse in charge are not components of the medication order. A patient is admitted to the emergency unit with hypertension. Which prescription order would the primary health care provider use in this situation? 4 A STAT order indicates that the single dose of medication should be given immediately and only once. When a patient with high blood pressure is admitted to an emergency unit, then a STAT order is used by the primary health care provider. A now order is used when the patient requires the medication within the next 90 minutes, but not immediately. A single order is used for preoperative medications or medications given before diagnostic examinations; these medications are given at once in a specified time. A standing order is an order that is carried out until the primary health care provider cancels it. The nurse has been asked to administer a rectal suppository to a patient. In what position should the nurse place the patient? 4 For rectal administration of a suppository, the patient should be placed in the Sims' position. Neither the patient nor the nurse would be comfortable if the patient were placed in the prone position, lateral position, or dorsal recumbent position. The nurse on night shift explains a patient's condition to the healthcare provider, who in turn provides the verbal order of medication over the phone. Which accurately describe the roles of nurse and health care provider in executing telephone orders? Select all that apply. 2, 3, 5 In a hospital setting, whenever a verbal order is given, the nurse should read back the order to the prescriber to confirm it. The order should be entered in the computer. The nurse should receive confirmation of the order from the prescriber for validation. The nurse should enter the time and the prescriber's name and then sign the order, indicating that it was read back. The prescriber should countersign the order within 24 hours, not 48 hours. After seeing a patient, the physician gives the nursing student a verbal order for a new medication. What should the nursing student do first? 3 Nursing students cannot take orders from physicians. Thus, there is no need to refer to the ISMP for abbreviation guidelines, write down the order, and ensure the six rights of medication administration are followed in this instance. The nurse works in a postoperative unit. Under which order should the nurse perform an assessment to determine whether the patient needs medication? 1 When there is a prn order, the nurse may use his or her own discretion for administering or withholding medication based on a subjective or objective assessment. Stat orders refer to single doses of medication to be given immediately or only once. Standing orders and routine medication orders are the same; in either case, the nurse continues the medication as directed by the prescriber until the prescriber asks the nurse to stop the medication. The nurse has been asked to administer a
rectal suppository to an adult patient. Where should the nurse place the medication? 3 A rectal suppository for an adult should be placed against the rectal wall about 10 cm into the rectum. For children and infants, the suppository should be placed 5 cm deep into the rectum against the rectal wall. The inner aspect of the anal orifice is not the right position for suppository administration. The suppository has to be placed past the internal anal sphincter. Which statement about a patient's rights of medication is incorrect? 2 The nurse should inform the patient about the nature of a drug being administered if it is an experimental drug or a standard drug. Labeled medications should be administered to patients. Any patient of consenting age has the right to refuse medicine; the nurse should not forcefully administer medication to the patient in such situations. Transparency should be maintained regarding the medication administration. While administering medication to an older patient, the nurse finds that the patient has difficulty in swallowing a tablet; however, after assessment, a physical problem is ruled out. Which nursing intervention is appropriate in this condition? 1 When an older patient has a difficult time swallowing a medication and a physical problem has been ruled out, the nurse should report the situation to the primary health provider in order to have him or her change the medication form. The nurse should be patient and should not insist the patient to take the tablet by explaining its benefits. Holding onto the tablet until the patient is ready to swallow the tablet is not an appropriate intervention, because the medication may be required immediately. If a physical problem has not been ruled out, the patient should be taught to keep the tablet on the front of the tongue, and he or she may be able to swallow by washing it back off the throat. A nursing student takes a patient's antibiotic to his room. The patient asks the nursing student what it is and why he should take it. How should the nursing student respond to the patient? 3 Patients need to know information about their medications so they can take them correctly and safely. The nursing student can provide the name of the medication and a description of its desired effect. The student should not dismiss the patient's concerns by telling the patient that he should speak with the physician or assigned nurse. After reading the prescription order of a patient, the nurse prepares to administer the medication in the patient's right ear. Which abbreviation in the prescription reflects the nurse's action? 3 AD in the prescription order indicates that the medication should be administered in the right ear. AS in the prescription order indicates that the medication should be administered in the left ear. OD indicates that the medication should be administered in the right eye. OS indicates that the medication should be administered in the left eye. The registered nurse is teaching the nursing student about the administration of oral analgesic medications in the pediatric patients. Which of the student's actions indicates the need for further teaching? 3 Mixing the medication in the pediatric patient's favorite drink should be avoided, because the child may later refuse the same drink. A pediatric patient may accidentally aspirate a pill, which could be fatal. Therefore, liquids or elixirs are safer in children. Offering the child juice after he or she has swallowed the medication will help get rid of any bad taste in the child's mouth and incentivize the child to take the next dose if he or she is promised juice afterward. Droppers are indicated for the administration of tablet solution to infants. The registered nurse is teaching a nursing student about prescription orders. Which statement if made by the nursing student indicates the need
for further teaching? 3, 4 Hydralazine is an emergency drug that should be administered as per the STAT order of prescription that is written in emergencies when a patient's condition changes suddenly. Lorazepam is an example of a drug that is administered following a one-time prescription order. A single order prescription necessitates the administration of medication at one specific time. A prn order prescription necessitates the administration of medication only when a patient requires it. Which statements regarding the guidelines to be followed for telephone and verbal order require correction? Select all that apply. 1, 3, 5 Nursing students cannot take medication orders of any kind, and so their initials do not have to appear on the order because they won't have taken it. The primary health care provider must countersign the telephone order given by that provider at a later time, usually within 24 hours after giving it. This type of prescription order given by the primary health care provider is referred to as a telephone order. The nurse should sign on the telephone order and indicate the time and the name of the health care provider who gave the order. The nurse should document the telephone order given by the primary health care provider. A diabetic patient is prescribed insulin. Which interventions should the nurse perform
to teach the patient how to self-administer insulin? Select all that apply. 2, 3, 4, 5 Self-administration of insulin requires proper visual acuity to ensure drawing the appropriate amount of insulin. Insulin must be stored as directed by the manufacturer to maintain vitality. The site of insulin injection must be rotated to prevent local changes of the skin. The nurse should demonstrate the proper preparation of a single insulin preparation. Insulin doses may be adjusted based on home-based blood glucose estimation of capillary blood or per the health care provider's instructions. The nurse is preparing a teaching plan for safe insulin administration. Which interventions included in the plan is appropriate for the patient? Select all that apply. 1, 2, 5 The interventions for safe insulin administration include teaching the patient how to determine the expiration date of insulin. The nurse should help the patient to determine the amount of insulin required based on the home capillary glucose monitoring results. Insulin should be administered as a subcutaneous injection. The nurse should instruct the patient to refrigerate the medication whenever needed. Insulin should be self-administered; however, when necessary, a caregiver can assist in rotating injection sites. Which route of medication administration is easiest and most desirable? 4 The easiest and most desirable route for administering medications is oral. Rectal and vaginal routes may cause discomfort. The intravenous route of medication administration may be painful to the patient. The nurse prepares to administer a solid form of oral medications. Which action made by the nurse indicates a need for correction? 4 Splitting tablets in half, even if they are prescored with a line down the middle, leads to medication errors. If a pill must be split within inpatient settings, the pharmacist splits the pill with a splitting device, repackages and labels it, and sends it to the nurse for administration. Nurses should not split pills. When using a blister pack, the nurse should pop medications through the foil or paper backing into a medication cup. To prepare tablets or capsules from a floor stock bottle, the nurse should pour the required amount into a bottle cap and transfer the medication to the medication cup without touching the medication with his or her fingers. To prepare unit-dose tablets or capsules, place the packaged tablet or capsule directly into the medicine cup without removing the wrapper. Which statement related to enteral feeding needs correction? 4 Positioning a patient in a seated position at a 90-degree angle when administering oral medications reduces the risk of aspiration, but this is not the case during enteral feeding. Special consideration is needed while administering medication to patients with enteral feeding tubes to help avoid increased risk of medication toxicity. Failing to follow recommendations may lead to reduced medication effectiveness and tube obstruction. A registered nurse teaches a nursing student about the precautionary measures to be taken while caring for a patient with enteral tubes. Which statement made by the nursing student indicates the need for further teaching? 1 Only oral syringes should be used when preparing medications for the enteral route to prevent accidental parenteral administration. If liquid medications are not available, the nurse can crush simple tablets or open capsules and dilute them in water before administering them. Enteral tubes should be flushed with at least 30 mL of water before and after giving medications. The incompatibility of the location of the tube with the medication being administered may lead to poor bioavailability of the drug administered. A patient is prescribed a sublingual nitroglycerin drug. Which instructions should the nurse provide to the patient? Select all that apply. 4, 5 A patient is prescribed a sublingual nitroglycerin drug. Which instructions should the nurse provide to the patient? Select all that apply. What are the advantages of administering medications by the oral route? Select all that apply. 3, 4, 5 The advantages of the oral route of medication administration are that the medications are easy to administer, this method rarely causes anxiety, and this method is convenient and comfortable. The disadvantages of the oral route are that it cannot be used when a patient has gastric suction or reduced gastric mobility. A
registered nurse evaluates the actions of a nursing student who is administering oral disintegrating tablets to a patient. Which actions made by the nursing student indicate a need for correction? Select all that apply. 2, 4, 5 Oral disintegrating tablets begin to dissolve immediately. Therefore, they should not be pushed through the foil. Oral disintegrating medications should be placed on the patient's tongue and should not be chewed. Because these tablets dissolve when placed on the tongue, water is not necessary. Oral disintegrating medications should be placed on top of the patient's tongue. Oral disintegrating medications should be removed from the blister packet just before use. A patient has a bleeding tendency due to hemophilia. Which route of drug administration is appropriate for this patient? 4 The route of administration appropriate for a patient with a bleeding tendency is the oral route, because it does not involve the use of needles. Any mode of administration that uses needles may increase the risk of bleeding. Therefore, intradermal, intramuscular, and subcutaneous routes should be avoided in this case to prevent bleeding. Which oral medication is available in liquid form? 4 An elixir is a clear fluid containing water; this medication is available in liquid form and administered orally. Tablets, capsules, and lozenges are available in solid form. Which topical medication may lead to respiratory depression in the case of an overdose? 4 The overuse of transdermal patches such as a fentanyl transdermal patch may lead to respiratory depression, coma, or even death. Lotion, liniment, and ointment do not cause serious adverse effects such as respiratory depression. The primary health care provider ordered the nurse to administer eardrops to a 2-year-old patient. Which action of the nurse would be effective specifically for this patient? 1 For patients younger than 3years of age, the nurse should straighten the ear canal by pulling the auricle down and back. For patients3years of age and older, the nurse should straighten the ear canal by pulling the auricle upward and outward. The nurse should help patients of every age to remain in the side-lying position for 2-3 minutes so that the medication completely enters the ear canal. For patients of every age, the nurse should apply gentle massage or pressure to the tragus of the ear with a finger after the administration of medication unless contraindicated because of pain. The nurse should instill prescribed drops by holding the dropper at 1 cm (1/2 inch) above the ear canal for patients of every age group. The nurse administers a rectal suppository to a patient with
constipation. Which action of the nurse would be most effective in preventing expulsion of the suppository? 2 After administering a rectal suppository to a patient, the nurse should instruct the patient to lay flat for at least 5 minutes to prevent expulsion of the suppository. Before administering a rectal suppository, the nurse should help the patient into the Sims' position. The nurse should instruct the patient to take slow, deep breaths through the mouth and relax the anal sphincter before administration. The nurse should lubricate the rounded end of the suppository with a sterile water-soluble lubricant before administration to make it easier to insert the suppository. Which nursing intervention would be beneficial and safe for a patient who has an existing transdermal patch? 4 The nurse should remove the old patch before administering a new transdermal patch to avoid an overdose; this is because the medicine remains in the patch even after its prescribed duration of use. Placing the new patch over the old patch could cause an overdose which may result in potential adverse effects. A noticeable label is not applied to the old patch. If the new patch is difficult to see, then a noticeable label should be applied to the new patch. Applying the new patch next to the old patch could cause an overdose. While administering a rectal suppository in a patient, the nurse finds that anal sphincter is not relaxed. Which intervention of the nurse would help the patient relax the anal sphincter? 3 While administering a rectal suppository, asking a patient to take slow, deep breaths through the mouth will help in relaxing the anal sphincter. The third accuracy check is performed to confirm or ensure that the desired patient is being treated. Applying gentle pressure on buttocks and holding them together will be helpful in keeping the medication in place. Instructing the patient to remain in the side position for 5 minutes will help in preventing expulsion of the suppository. While applying a transdermal patch to a patient with pain, the nurse finds an existing patch on the skin. Which action of the nurse would be appropriate in this situation? 4 Before applying a new patch, the existing one should be removed. When old transdermal patches are left in place it may result an overdose of the medication in the patient. This may lead to toxic reaction. Applying half of the new patch is not appropriate because this may also lead to an increased amount of the drug in the body. Applying the new patch on top of the existing patch may cause an overdose of medication. Applying the new patch adjacent to the existing patch is not appropriate, because the patch should be applied only on the desired affected area. The registered nurse is teaching a nursing student how to administer eardrops to a 3-year-old patient with otitis media. Which action of the nursing student needs further correction? 1 While administering eardrops, the ear canal should be straightened by pulling the auricle down and back in children younger than 3 years of age. The cotton ball should be placed in the outermost part of the ear canal, if needed after instilling the drops. The ear canal should be straightened by pulling the auricle upward and outward in children over 3 years of age and older adults. The prescribed eardrops should be instilled by holding a dropper 1 cm (½ inch) above the ear canal. The primary health care provider ordered the nurse to administer eardrops to a 5-year-old patient with an ear infection and a latex allergy. Which action of the nurse indicates a need for improvement? Select all that apply. 2, 4 During the administration of eardrops in a 5-year-old patient with a latex allergy, the nurse should use latex-free gloves for cleaning the outer ear. For patients 3 years of age and older, the nurse should straighten the ear canal by pulling the auricle upward and outward. For patients of every age the nurse should remove the cotton ball after 15 minutes, hold the dropper 1 cm (1/2 inch) above the ear canal before administering eardrops, and help the patient to remain in the side-lying position for 2 to 3 minutes. Which topical dosage form may show systemic side
effects? 4 Transdermal patches may show systemic side effects. Paste, lotion, and liniment may not show systemic side effects; these show local effects. Which positioning of the patient would be appropriate while administering rectal suppositories? 1 In Sims' position, the patient lies on the left side with the left thigh slightly flexed. The right thigh is acutely flexed on the abdomen; the left arm is behind the body with the body inclined forward. The right arm is positioned according to the patient's comfort. This is also called lateral position. This positioning is helpful while administering rectal suppositories in a patient. Sitting position is best while administering intravenous injections. The supine position will be helpful while instilling nasal drops. The dorsal recumbent position will be helpful while administering vaginal suppositories in the patient. The nurse wears disposable gloves while removing and applying transdermal patches for a patient. What is the most appropriate reason behind this nursing intervention? 4 Many locally applied medications create systemic and local effects; therefore, these medications are applied with gloves and applicators. The nurse should wear disposable gloves while removing and applying transdermal patches for a patient, to prevent the absorption of medications by the skin. Infections may not occur due to the application of patch without the use of gloves. Using sterile techniques will help in preventing contamination of the patch. To prevent contact with the body fluids of the patient, wearing gloves may be appropriate. The nurse finds a STAT order in the medication administration record of a patient. What action of the nurse is appropriate in this situation? 3 STAT medications are given once and at the time the medication is ordered. Therefore, it requires administration immediately and only once. Medications that are not time-critical can be administered within 1 to 2 hours of the scheduled dose. Prn medications require administration as needed. STAT orders do not indicate administering the medication before the surgical procedure. A patient reports vertigo, dizziness, and nausea after administering eardrops. What could be the reason for these symptoms in the patient? 1 Internal ear structures are very sensitive to temperature extremes. Therefore, the eardrops instilled should be at room temperature. Extremes in the temperature of eardrops may cause vertigo, dizziness, or nausea. Use of nonsterile eardrops may lead to infection of the eardrum. Forcing the medication into an occluded ear canal creates pressure that injures the eardrum. Occluding or blocking the ear canal with the dropper or irrigating syringe is not associated with symptoms such as nausea, dizziness, vertigo. Which interventions should the nurse follow while administering topical medications? Select all that apply. 1, 2, 5 Many locally applied medications such as lotions, pastes, and ointments create systemic and local effects. Therefore, these medications should be applied with gloves and applicators. Different types of topical medication should be applied according to the directions to ensure proper penetration and absorption. Documenting the location on the patient's body where the medication was placed will help to prevent multiple dosing in the patient. The medications should be applied using sterile techniques in the case of open wounds. Before applying medications to the injured area, the skin should be thoroughly cleaned by washing the area gently with soap and water, and ensuring the soaking of the involved site. The primary health care provider
ordered the nurse to administer eardrops to a 2-year-old patient. Which action of the nurse would be effective specifically for this patient?
1 For patients younger than 3 years of age, the nurse should straighten the ear canal by pulling the auricle down and back. For patients 3 years of age and older, the nurse should straighten the ear canal by pulling the auricle upward and outward. The nurse should help patients of every age to remain in the side-lying position for 2-3 minutes so that the medication completely enters the ear canal. For patients of every age, the nurse should apply gentle massage or pressure to the tragus of the ear with a finger after the administration of medication unless contraindicated because of pain. The nurse should instill prescribed drops by holding the dropper at 1 cm (1/2 inch) above the ear canal for patients of every age group. Which action of the nurse indicates instillation of fluids into a body cavity? 1 Topical medications can be applied by instillation of fluids into a body cavity such as administering an eardrop. Topical medications are also applied by inserting medication into a body cavity such as placing a suppository in the rectum. Topical medications can be applied by irrigating a body cavity such as flushing the vagina with medicated fluid. Inserting medicated packing into the vagina is an example of inserting medication into a body cavity. Which positions are most suitable for administering intramuscular medications in the ventrogluteal muscle site? Select all that apply. 3, 4 In order to inject medication in the ventrogluteal muscle site, the patient is placed into the supine or the lateral position. The prone position is unsuitable for intramuscular injections at the ventrogluteal muscle site. The sitting position is appropriate for vastus lateralis intramuscular injections. The standing position is suitable for intramuscular injections at the deltoid muscle site. The nurse has to administer a subcutaneous injection to a patient. Which precautions should the nurse follow when administering the subcutaneous injection? Select all that
apply. 1, 2 Administering a subcutaneous injection for an average-size patient involves pinching the skin with the nondominant hand and injecting the needle quickly and firmly at a 45- to 90-degree angle. The medication has to be injected slowly to minimize pain. The skin is pinched with the nondominant hand, because the dominant hand is used for administering the injection. Piercing a blood vessel during a subcutaneous injection is very rare, so aspiration is not necessary. Injecting the needle should be quick. Inserting the needle with bevel up at a 5- to 15-degree angle is done for intradermal injection. The nurse is mixing
two types of insulin in one syringe. Which action is associated with the third accuracy check? 2 After verifying the insulin dosages with the medication administration record (MAR) a third time, the nurse should show the insulin prepared in the syringe to another nurse to verify that the correct dosage is prepared. This is considered part of the third accuracy check. The nurse should review the patient's medical history and any allergies to various medications; this is unrelated to the third accuracy check. While mixing the two types of insulin in one syringe, the first step is to check the accuracy and completeness of each MAR ordered by the primary health care provider. The nurse should verify the insulin dosages against the medication administration (MAR) before wiping the insulin vials tops with alcohol as part of the second accuracy check. What is the significance of the deltoid muscle site in parenteral
administration? 2 The deltoid muscle site is easily accessible and is used to administer small volumes of a medication. It is mainly used for giving immunizations such as hepatitis B and flu shots. Heparin is most likely to be administered via the subcutaneous route of administration. Medications that are more than 2 mL would be administered through the ventrogluteal muscle site. The ventrogluteal site is also preferred for medications that are viscous and irritating. Which injection is given to a patient attending a tuberculin screening
test? 2 Tuberculin may be potent and a patient may have a severe anaphylactic reaction when tuberculin enters the circulation too rapidly. Therefore, tuberculin is administered through the intradermal route. An intrathecal injection is given to the spinal canal and is very painful. An intravenous injection may cause the patient to experience anaphylactic reactions. A subcutaneous injection may lead to unwanted reactions. Which action may cause the contamination of the solution during an injection? 1 The nurse should draw up the medication quickly, not slowly, to prevent contamination. The nurse should cover the tip of the syringe with a cap or needle to prevent contamination. The syringe needle also should not touch the outer edges of the ampule. The nurse should not touch the plunger length or inner part of the barrel. The nurse is teaching self-administration of insulin to a patient. Which instruction should the nurse include in the
teaching? 3 Cloudy insulin preparations should be rolled between the palms to resuspend them before drawing into injections. The insulin vial should not be shaken, because shaking can create bubbles that can interfere with correct dosage administration. Regular insulin is given subcutaneously, not intramuscularly. If insulin is taken after meals, it cannot control the rise of blood sugar levels that occurs due to food intake. A nursing student communicates with the registered nurse after administering an intradermal medication to the patient. Which statement made by the nursing student causes the registered nurse to suspect that the medication has entered the subcutaneous
tissue? 1 If the site bleeds after the medication administration, the medication might have been administrated into the subcutaneous tissue. The intradermal site is chosen because blood supply is reduced and absorption is slow. An anaphylactic reaction may occur when the medication enters the circulation too rapidly. To avoid this circumstance, skin-testing sites should be chosen that allow the nurse to easily assess for change in color. The sites should be lightly pigmented. Changes in tissue integrity are also assessed to prevent an anaphylactic reaction. The appearance of a small bleb that resembles a mosquito bite indicates that the medication has been correctly administered. A registered nurse
teaches a student nurse about preventing infections during the administration of an injection via the parenteral route. Which statement made by the student nurse shows ineffective learning? 2 Parenteral administration is an invasive procedure performed using aseptic techniques. The nurse should prevent infection by using friction and a circular motion while cleaning the area with the antiseptic swab. Before injecting the medication, the nurse should use alcohol to cleanse the patient's skin. The nurse should avoid having the needle touch the outer edges of the ampule because this action may cause contamination. The antiseptic should be swabbed from the center of the site and move outward in a 5-cm radius. Which route provides the most rapid absorption of a medication? 4 The intravenous (IV) administration of medication produces the most rapid absorption because it directly facilitates the entry of the medication into the systemic circulation. Oral medications have to pass through the gastrointestinal (GI) tract; therefore, the overall rate of absorption is usually slow. Topical medications may be absorbed slowly due to the physical makeup of the skin. Intradermal administrations provide sustained release delaying the absorption. The nurse prepares to administer a multivitamin from an ampule to a patient. Which nursing action indicates a need
for correction? 4 The nurse should check and discard any unclosed, leftover ampules to prevent the chance of infection. The nurse should draw the multivitamin solution quickly out of the ampule to prevent contamination of the medication. The nurse should clean the patient's skin with an antiseptic cotton swab to maintain asepsis. The nurse should apply friction in a circular motion from the center of the site outward in a 5-cm (2-inch) radius to prevent the chances of infection. A registered nurse evaluates the actions made by a nursing student who is preparing an injection from
a vial. Which nursing action needs correction? 4 The nursing student should hold the vial between the thumb and middle fingers of the nondominant hand. The dominant hand should be used to grasp the end of the syringe barrel and plunger to counteract pressure in the vial. Injecting air into the vial with the syringe creates a vacuum needed to get the medication into the syringe. This action also helps prevent the formation of bubbles and inaccuracy in the dose. The nursing student should wipe the vial cap with alcohol to maintain asepsis. Application of pressure to the tip of the needle during insertion prevents coring of the rubber seal. Which site
is frequently recommended for administering heparin injections? 2 Heparin is administered subcutaneously at the abdominal site. This site has the best absorption. The thigh, upper arm, and dorsal gluteal areas are other sites for subcutaneous injection that are not widely recommended to administer heparin The nurse has to
administer a medication via intramuscular (IM) injection. Which are the various sites that can be used for an IM injection? Select all that apply. 1, 3, 4 The three common sites for administering intramuscular (IM) injections are the deltoid, vastus lateralis, and ventrogluteal muscles. The deltoid site is easily accessible and is used for injecting small volumes. The vastus lateralis is a thick and well-developed muscle, located on the anterior lateral aspect of the thigh. The ventrogluteal muscle is the safest site for injection. It is deep and away from major nerves and blood vessels. The brachioradialis is a muscle of the arm and is not used for injecting medications. The sternocleidomastoid is a muscle of the neck and is not a favorable site for administering IM injections. What
is a disadvantage of the parenteral route of medication administration? 4 The parenteral route of administration involves injecting the medication into the body tissues; this route places patients at a high risk of reactions. The oral route of medication administration may cause discoloration of the teeth. The parenteral route can be safely given to both unconscious and conscious patients, depending upon their medical condition. Before some tests or surgery, the oral route of medication administration is contraindicated. Which statement is true regarding parenteral medications? 4 Parenteral medications are sterile preparations that contain water with one or more dissolved compounds. Transdermal medications are medicated disks that are slowly absorbed through the skin. Concentrated sugar solutions are medications dissolved in sugar solutions are referred to as syrup. Lotions are semi-liquid suspensions that usually protect, cool, or cleanse skin. A nurse is about to withdraw medication from an ampule. Which nursing action reduces the patient's risk for an allergic drug response? 4 The nurse should assess the patient's medical history, medication history, and history of allergies to reduce the risk of an allergic drug response. The nurse should check the patient's name, medication name, and dosage to ensure that the patient receives the correct medication. Assessing the patient's body build, muscle size, and weight helps to determine the type and size ofthe syringe and needles for injection. The nurse should review all pertinent information regarding medication action, dose, purpose, and route of administration to administer the medication properly and to monitor the patient's response. What is the best way for the nurse to make sure that
the right patient is receiving a prescribed drug when the patient is alert and oriented? d. have the patient state his or her name and birth date. when is it acceptable for the nurse to take a verbal order from the prescriber before
giving a drug to a patient? b. in an emergency situation such as a cardiac arrest The nurse is giving morning medications to a patient who refuses to take an oral dose of docusate (Colace).What is the
nurse's best response? d. can you tell me why you do not want to take the docusate? what is the most important role of the nurse
in preventing drug errors? b. always following the "six rights" of drug administration A patient is to receive nitroglycerin ointment, 1 inch STAT,
for elevated blood pressure. What must the nurse do before giving this drug? c. put on a pair of disposable gloves A sublingual drug is administered by placing the drug in what part of the body? b. under the tongue What administration technique does the nurse use to give a 2 yr old child ear drops? a. pull the earlobe down and back When giving a drug to a patient who is awake but confused, what is the best way for the nurse to identify the patient? c. check the name on the patient's wristband. The physician orders all of the following drugs for a patient who had surgery 2 days ago. Which drug order does the nurse administer first? c. compazine (prochlorperazine) 10 mg orally STAT The nurse is interviewing a patient. Which action by the nurse indicates active listening? d. restating what the patient said to ensure the nurse understands what the patient meant. The nurse is preparing to teach a patient about a newly prescribed drug therapy. What time is best for improving teaching effectiveness? b. after the patient wakes up from a nap and no visitors are present. Which statement by the nurse is more likely to motivate a patient to adhere to a drug therapy regimen for hypertension? c. as an artist, your eyes are important, and taking this drug daily helps prevent eye damage from high blood pressure. Which of the following represents the proper way for a nurse to administer an oral capsule? a. tell the patient to swallow it whole When giving a medicine through a
nasogastric (NG) tube, the nurse will first do which of the following? b. Check placement of the tube Which of the following is done after giving medication through a nasogastric tube that is connected to suction? c. the tube is clamped for 30min then reconnected to suction In which of the following ways can a nurse prevent injury from a needlestick? c. immediately discard the needle and syringe in a puncture-proof container which of the following is the correct needle for an intramuscular (Im) injection? d. 21 G, 1 1/2 in Which of the following principles of medication administration will be taught to a patient who will be administering his own subcutaneous (SC) injections? b. Rotate sites among the upper arm, abdomen, and anterior thigh An elderly patient is scheduled to take six medications each morning. The nurse administering these medications knows to do which of the following? a. allow extra time to administer all of the medications Before the nurse administers a liquid medication to an 83 yr old male patient, the nurse should: a. assess the swallowing reflex by offering a sip of water The nurse receives an order to give vitamin D 10 mcg bid. The nurse recognizes that the abbreviation mcg refers to a measurement in: d. micrograms The licensed nurse who is responsible for
doing the narcotic count for the shift should count the drugs. d. with a nurse coming on duty for the next shift. A patient complains about the taste of the the sublingual nitroglycerin and admits that the swallows it rather then holding it under his
tongue. The nurse explains that sublingual medications. a. should not be swallowed because it alters the absorption potential. To
reduce the systemic absorption of eye drops, the nurse should: b. apply slight finger pressure over the lacrimal duct For an
adult patient who has an order to receive an otic medication, the nurse should plan to administer it by pulling the pinna: d. up and back. when administering medications to a patient with a feeding tube, the nurse should dissolve each crushed medication in at least ___ mL of water. b. 20 to 30 A patient on the long-term care unit receives the wrong medication. The charge nurse should instruct which staff member to complete the incident report? c. the nurse who discovered the error The nurse checking the MAR finds that an order for an antibiotic is now 8 days old. The nurse should: c. contact the physician for a new order. Examples
of medications that are given by enteral routes include which of the following: SELECT ALL THAT APPLY b. oral tablets A clinet is nauseated, has been vomiting for several hours, and needs to receive an antiemetic (anti-nausea) medication. Which of the following is accurate? A. An enteric-coated medication should be given. C. A parenteral route is the route of choice. The client is to receive a sedative via the buccal route. Which of the following is true? A. The medication is placed under the tongue. D. This method of administration would be avoided in the event of facial injuries.
The nurse uses a mortar and pedestal to crush a medication before giving it to one of her clients. Which of the five rights is the nurse ensuring? A. The right route A. The right route A 76-year-old client lives alone and takes medications without supervision. Which of the following is the most appropriate question for his home health nurse to ask in regard to his medication regimen? A. "How much do you weigh?" D. "Have you been taking other substances than those ordered by the physician?" You are a new graduate nurse completing your orientation on a very busy intensive care unit. You cannot read a health care provider's order for one of your patient's medications. You have heard from more experienced nurses that this health care provider does not like to be called, and you know that another of the health care provider's patients is very unstable. What is the most appropriate next step for you to take? A. Call the health care provider to clarify the order A. Call the health care provider to clarify the order What statement made by a 2-year-old patient's mother indicates that she understands how to administer her son's eardrops? A. "To straighten
his ear canal, I need to pull the outside part of his ear down and back." B. "I need to straighten his ear canal before administering the medication by pulling his ear upward and outward." A nursing student is administering ampicillin PO. The expiration date on the medication wrapper was yesterday. What is the appropriate action for the nursing student to take next? A. Ask the nursing professor for advice B. Return the medication to pharmacy and get another tablet A nursing student is administering medications to a patient through a gastric tube (G-tube). Which of the following actions taken by the nursing student requires the nursing instructor to intervene? A. The nursing
student places all the patient's medications in different medicine cups. D. The nursing student crushes a nifedipine extended-release tablet and mixes it with water before administering it. A pediatric nurse takes a medication to a 12-year-old female patient. The patient tells the nurse to take it away because she is not going to take it. What is the nurse's next action? A. Ask the patient's reason for refusal A. Ask the patient's reason for refusal After seeing a patient, the health care provider starts to give a nursing student a verbal order for a new medication. The nursing student first needs to: A. Follow ISMP guidelines for safe medication abbreviations. B. Explain to the health care provider that the order needs to be given to a registered nurse. A nurse accidently gives a patient the medications that were ordered for the patient's roommate. What is the nurse's first priority? A. Complete an occurrence report. D. Assess the patient for adverse effects. After receiving an intramuscular (IM) injection in the deltoid, a patient states, "My arm really hurts. It's burning and tingling where I got my injection. What should the nurse do next? (Select all that apply.) A. Assess the injection site A. Assess the injection site You are working in a health clinic on a college campus. You need to administer medroxyprogesterone acetate intramuscularly (IM) to a female patient for birth control. You look up this medication in a reference manual and determine that it is viscous and injections can be painful. On the basis of this information, you plan which of the following when administering this medication? (Select all that apply.) A. Inject the medication over 3 minutes to reduce pain associated with the injection B. Administer the medication in the ventral gluteal site Which injection site is used for the intrathecal route of medication administration?For the intrathecal route, a needle is inserted between two vertebrae in the lower spine and into the space around the spinal cord. The drug is then injected into the spinal canal.
Which route is generally preferred for the administration of anesthetic?General anesthetics are usually given by inhalation or by injection into a vein. However, certain anesthetics may be given rectally to help produce sleep before surgery or certain other procedures.
Which position is suitable for administering intramuscular medication?The patient can be standing, sitting, or lying down. To locate the landmark for the deltoid muscle, expose the upper arm and find the acromion process by palpating the bony prominence. The injection site is in the middle of the deltoid muscle, about 1 inch to 2 inches (2.5 cm to 5 cm) below the acromion process.
Which site is frequently recommended for administering heparin injections?To minimize the pain and bruising associated with low molecular weight (LMW) heparin, the medication is given subcutaneously on the right or left side of the abdomen, at least 5 cm (2 in) away from the umbilicus.
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Which injection site is used for the intrathecal route of medication administration Quizlet
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