Chapter 4: Medication Administration Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 4: Medication Administration

Test Bank

MULTIPLE CHOICE

1. The nurse is preparing to administer an intramuscular injection to an infant. What is the most accurate site for the nurse to select for this administration?

a.

Ventrogluteal

b.

Vastus lateralis

c.

Dorsogluteal

d.

Deltoid

ANS: B

The vastus lateralis is the most appropriate site to utilize for an IM injection in an infant.

DIF: Cognitive Level: Comprehension REF: p. 44

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. What is an appropriate nursing intervention to use to meet the psychiatric needs of a hospitalized infant?

a.

Move slowly while conducting care.

b.

Explain procedures carefully.

c.

Use the oral route for medications.

d.

Allow the child to express feelings.

ANS: A

The nurse should move slowly and maintain a nonthreatening attitude in order to prevent stranger anxiety from developing in the infant.

DIF: Cognitive Level: Application REF: p. 45

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. During administration of eye drops, the nurse should teach the client to prevent systemic absorption of the drug by performing which action?

a.

Use the ointment form of the drug.

b.

Apply the drug directly on the cornea.

c.

Have the client look straight ahead.

d.

Gently press on the lacrimal duct.

ANS: D

By applying pressure on the inner canthus of the eye, the medication is less likely to be systemically absorbed.

DIF: Cognitive Level: Application REF: p. 37

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A nurse is preparing to administer a deep IM injection to a client. Which site is suited for a deep IM injection?

a.

Abdomen

b.

Dorsogluteal

c.

Deltoid

d.

Vastus lateralis

ANS: B

The dorsogluteal site is suited for deep IM or Z-track injections.

DIF: Cognitive Level: Comprehension REF: p. 44

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. A nurse administers an injection using the Z-track method. The nurse instructs the patient that the Z-track technique is designed to accomplish what?

a.

Allow the client to accept at least 5 mL of medication.

b.

Prevent medication from leaking into subcutaneous tissue.

c.

Decrease the possibility of self-sticks.

d.

Take less time to administer.

ANS: B

The Z-track method displaces the tissue during medication injection and replaces the tissue when withdrawn. This prevents leaking.

DIF: Cognitive Level: Comprehension REF: p. 44

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A nurse is applying nitroglycerin ointment to a client. When applying medication topically, what is the highest priority nursing intervention?

a.

Apply medication liberally.

b.

Avoid contact of the medication with the nurses skin.

c.

Massage the area.

d.

Have client apply medication.

ANS: B

Because this medication is topically absorbed, contact with the nurses skin may cause the nurse to feel the effects of the medication.

DIF: Cognitive Level: Application REF: p. 37

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. A nurse prepares to administer an ear medication to a 2-year-old child. What is the correct action by the nurse?

a.

Position the child with the ear down on the bed.

b.

Pull the ear upward and backward.

c.

Put the child in high-Fowlers position.

d.

Pull the ear downward and backward.

ANS: D

This is the correct method for a child younger than 3 years. For a child older than 3 years, the ear is pulled up and back.

DIF: Cognitive Level: Application REF: p. 38

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. The nurse is teaching the client how to administer a sublingual tablet in the home setting. What is the highest priority instruction?

a.

Take nothing by mouth for one hour before taking the medication.

b.

Avoid taking fluid with the medication.

c.

Gently place the tablet between the teeth and gums.

d.

Take the medication with food so as to avoid gastrointestinal irritation.

ANS: B

Food and fluids should be avoided when taking a sublingual tablet to avoid moving the tablet from under the sublingual region.

DIF: Cognitive Level: Application REF: p. 36

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. A client has been using his inhaler at home. He tells the nurse that the medication doesnt seem to work as well as it did. What should the nurse assess for first?

a.

Tolerance to the medication

b.

Unhealthy drug-seeking behaviors

c.

Physical addiction

d.

Poor tolerance of pain

ANS: A

Overuse of the medication can lead to the development of tolerance.

DIF: Cognitive Level: Analysis REF: p. 40

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. A client with chronic angina is ordered to receive nitroglycerin via patch. What is the highest priority nursing action regarding this method of administration?

a.

Cut the patch to provide the correct dose of medication.

b.

Use sterile technique when applying the patch.

c.

Remove the old patch before applying the new patch.

d.

Cover the patch with an airtight dressing after application.

ANS: C

The old patch must be removed before the new patch is applied in order to prevent overdosing the client and also to prevent irritation to the skin.

DIF: Cognitive Level: Application REF: pp. 36-37

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. A nurse is administering an intradermal PPD to test for client exposure to the tuberculosis bacterium. Which method is the correct one for administering this injection?

a.

Use a 5-degree angle to insert a 20-gauge needle.

b.

Use a 10-degree angle to insert a 25-gauge needle.

c.

Use a 45-degree angle to insert a 26-gauge needle.

d.

Use a 90-degree angle to insert an 18-gauge needle.

ANS: B

This is the correct procedure for an intradermal injection.

DIF: Cognitive Level: Analysis REF: p. 41

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. A client returns to the nursing unit from conscious sedation after having a fracture set and placed in a cast. The client expresses pain 3 hours after the procedure. The choice of medication and route will be based on which information?

a.

The client should not receive pain medication because of his previous sedation.

b.

The client will need to void before receiving any pain medication in order to avoid urinary retention.

c.

The client should receive intravenous medication only for pain because of the operative procedure.

d.

The clients ability to swallow should be evaluated before he or she receives oral medication.

ANS: D

Before providing oral medication, it is essential for the nurse to evaluate the clients level of consciousness and ability to swallow.

DIF: Cognitive Level: Analysis REF: p. 36

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. The nurse is preparing to administer a subcutaneous injection of morphine sulfate (MSO4) to a client. The clients height, weight, and muscle mass are within normal limits. What are the appropriate needle size and angle for this injection?

a.

27-gauge needle, 10-degree angle

b.

20-gauge needle, 90-degree angle

c.

23-gauge needle, 20-degree angle

d.

25-gauge needle, 45-degree angle

ANS: D

This is the correct angle and size for a subcutaneous injection.

DIF: Cognitive Level: Application REF: pp. 41-42

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. The nurse is preparing to administer an ointment to the clients eye and is gathering the needed supplies. What supplies are needed to complete this task? (Select all that apply.)

a.

Clean gloves

b.

Medication ointment

c.

Sterile gauze

d.

Sterile gloves

e.

30-mL syringe

f.

5-mL syringe

g.

Tissues

ANS: A, B, C, G

Although the eyes are considered sterile, clean gloves are all that are needed, and care should be taken to keep the medication sterile. The syringes are not needed. The sterile gauze is needed in case the eye must be touched. The tissues allow for removal of excess medication.

DIF: Cognitive Level: Application REF: p. 38

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

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