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CHAPTER 2: PRINCIPLES AND METHODS OF DRUG ADMINISTRATION
TRUE/FALSE
ANS: T PTS: 1 REF: p. 40
OBJ: Cognitive Level: Application
ANS: T PTS: 1 REF: p. 50, Safe Nursing Practice 2-10
OBJ: Cognitive Level: Application
ANS: F
Feedback | |
Correct | The maximum amount of solution to be injected into the deltoid site is 1 mL. |
Incorrect |
PTS: 1 REF: p. 56, Safe Nursing Practice 2-13
OBJ: Cognitive Level: Comprehension
ANS: T PTS: 1 REF: p. 64
OBJ: Cognitive Level: Application
ANS: F
Feedback | |
Correct | Several brief teaching periods may be more effective than one long session, because the client needs time to absorb the material covered before continuing with the next topic. |
Incorrect |
PTS: 1 REF: p. 65 OBJ: Cognitive Level: Comprehension
MULTIPLE CHOICE
A second-year nursing student is preparing to administer medications to clients in a small rural hospital. The questions that follow review some of the information she will need to know in order to administer medications safely and effectively.
a. | 4 inches above the receptacle. | c. | horizontally to the receptacle. |
b. | at a 45-degree angle to the receptacle. | d. | vertically to the receptacle. |
ANS: D
Feedback | |
A | Incorrect: This would promote splashing of the medication and inaccuracy of the dosage. |
B | Incorrect: This will not promote accuracy. |
C | Incorrect: This will not promote accuracy. |
D | Correct: This will provide the nurse with an eye-level view of the medication and amount markings on the receptacle. |
PTS: 1 REF: p. 53, Table 2-6
OBJ: Cognitive Level: Application
a. | vastus lateralis. | c. | gluteus maximus. |
b. | gluteus minimus and medius. | d. | deltoid. |
ANS: B
Feedback | |
A | Incorrect: This is the muscle in the thigh. |
B | Correct: The gluteus minimus and medius muscles are used for the ventrogluteal site. |
C | Incorrect: This muscle is used for the dorsogluteal site. |
D | Incorrect: This muscle is used for the deltoid site in the upper arm. |
PTS: 1 REF: p. 57 OBJ: Cognitive Level: Knowledge
a. | may be given at either a 45- or a 90-degree angle except insulin and heparin are given at a 90-degree angle. |
b. | are given with a 5/8-inch needle, although a longer needle may be used for obese persons. |
c. | can be given in the abdomen on either side of the umbilicus. |
d. | all of the above |
ANS: D
Feedback | |
A | Incorrect: Although a true statement, it is not the most complete answer. |
B | Incorrect: Although a true statement, it is not the most complete answer. |
C | Incorrect: Although a true statement, it is not the most complete answer. |
D | Correct: This incorporates all of the other answers, so it is the best answer. |
PTS: 1 REF: p. 58, Safe Nursing Practice 2-14
OBJ: Cognitive Level: Comprehension
a. | three months of age. |
b. | one year of age. |
c. | the child has been walking for one year. |
d. | the child has been walking for six months. |
ANS: C
Feedback | |
A | Incorrect: The dorsogluteal muscle should not be used until walking has been established. |
B | Incorrect: The dorsogluteal muscle should not be used until walking has been established. |
C | Correct: Established walking helps develop the gluteal muscles, which helps provide adequate muscle tissue for accepting an injection. |
D | Incorrect: This is not long enough for adequate muscle development. |
PTS: 1 REF: p. 56, Safe Nursing Practice 2-13
OBJ: Cognitive Level: Comprehension
a. | gtt | c. | aa |
b. | O.D. | d. | p.o. |
ANS: A
Feedback | |
A | Correct: This is the approved abbreviation for drop. |
B | Incorrect: This is the abbreviation for right eye. |
C | Incorrect: This is the abbreviation for of each. |
D | Incorrect: This is the abbreviation for per os, or by mouth. |
PTS: 1 REF: p. 42, Table 2-1 OBJ: Cognitive Level: Knowledge
a. | I.U. | c. | p.r.n. |
b. | stat | d. | p.c. |
ANS: B
Feedback | |
A | Incorrect: This is no longer an approved abbreviation for international unit. |
B | Correct: Stat is the approved abbreviation for immediately. |
C | Incorrect: This is the abbreviation for as needed. |
D | Incorrect: This is the abbreviation for after meals. |
PTS: 1 REF: p. 42, Table 2-1 OBJ: Cognitive Level: Knowledge
a. | tuberculin syringe. | c. | 2 mL general purpose syringe. |
b. | insulin syringe. | d. | bulb syringe. |
ANS: A
Feedback | |
A | Correct: Tuberculin syringes are used for allergy injections, because of the small volume of medication needed and because they are calibrated to 0.01 mL. |
B | Incorrect: Insulin syringes are used for insulin administration. |
C | Incorrect: This is calibrated to the 0.1 mL. |
D | Incorrect: This is used for irrigation and nasal suction. |
PTS: 1 REF: p. 47, Table 2-4
OBJ: Cognitive Level: Application
a. | buccally. | c. | intra-articularly. |
b. | sublingually. | d. | intratracheally. |
ANS: B
Feedback | |
A | Incorrect: This is in the inner lining of the cheeks. |
B | Correct: This is under the tongue. |
C | Incorrect: This is in a joint. |
D | Incorrect: This is into the trachea. |
PTS: 1 REF: p. 21 OBJ: Cognitive Level: Comprehension
a. | 1 mL | c. | 3 mL |
b. | 2 mL | d. | any of the above |
ANS: A
Feedback | |
A | Correct: A tuberculin 1 mL syringe is used for intradermal injections. |
B | Incorrect: This is too large and does not have the necessary 0.01 calibrations needed. |
C | Incorrect: This is too large and does not have the necessary 0.01 calibrations needed. |
D | Incorrect: The 2 mL and 3 mL syringes are too large and dont have the necessary 0.01 calibrations needed. |
PTS: 1 REF: p. 60, Figure 2-15 OBJ: Cognitive Level: Knowledge
a. | it takes into account the clients cultural values. |
b. | the client must be ready to learn. |
c. | reinforcement is important. |
d. | teaching targets one of the senses intensively. |
ANS: D
Feedback | |
A | Incorrect: This is a factor in effective client teaching. |
B | Incorrect: This is a factor in effective client teaching. |
C | Incorrect: This is a factor in effective client teaching. |
D | Correct: Teaching is more effective when several senses are involved. |
PTS: 1 REF: p. 65 OBJ: Cognitive Level: Comprehension
a. | intradermal | c. | intracardiac |
b. | subcutaneous | d. | intramuscular |
ANS: A
Feedback | |
A | Correct: The most commonly used intradermal injections are for the detection of exposure to tuberculosis and allergens. |
B | Incorrect: This site generally is not used for diagnostic purposes. |
C | Incorrect: This site generally is not used for diagnostic purposes. |
D | Incorrect: This site generally is not used for diagnostic purposes. |
PTS: 1 REF: p. 59 OBJ: Cognitive Level: Comprehension
a. | intradermal | c. | intracardiac |
b. | subcutaneous | d. | intramuscular |
ANS: D
Feedback | |
A | Incorrect: Intradermal injections use 26 gauge (G) to 27 gauge (G) and 1/2 to 5/8 inch needles. |
B | Incorrect: Subcutaneous injections use 25 gauge (G) to 28 gauge (G) and 1/2 to 5/8 inch needles. |
C | Incorrect: Intracardiac needles are 26 gauge (G) and 4 inches long. |
D | Correct: Intramuscular injections require the use of 22 gauge (G), 1 1/2 inch needles. |
PTS: 1 REF: p. 55, Table 2-7
OBJ: Cognitive Level: Comprehension
a. | the top of the measuring device. | c. | the highest point of the meniscus. |
b. | the lowest point of the meniscus. | d. | the edges of the measuring device. |
ANS: B
Feedback | |
A | Incorrect: This would lead to an inaccurate reading. |
B | Correct: This provides for an accurate reading. |
C | Incorrect: This would lead to an inaccurate reading. |
D | Incorrect: This would lead to an inaccurate reading. |
PTS: 1 REF: p. 54, Figure 2-5
OBJ: Cognitive Level: Application
a. | intradermal | c. | intracardiac |
b. | subcutaneous | d. | intramuscular |
ANS: B
Feedback | |
A | Incorrect: Insulin usually is administered via subcutaneous injection. |
B | Correct: Insulin usually is administered via subcutaneous injection. |
C | Incorrect: Insulin usually is administered via subcutaneous injection. |
D | Incorrect: Insulin usually is administered via subcutaneous injection. |
PTS: 1 REF: p. 59 OBJ: Cognitive Level: Comprehension
a. | not touched. | c. | pulled back and up. |
b. | pulled back and down. | d. | pulled straight out. |
ANS: B
Feedback | |
A | Incorrect: The pinna has to be touched for ear drop instillation. |
B | Correct: This opens their ear canal. |
C | Incorrect: This is for children over 3 years of age and adults. |
D | Incorrect: This will not open the ear canal. |
PTS: 1 REF: p. 63, Figure 2-18
OBJ: Cognitive Level: Comprehension
a. | dyspnea. | c. | nausea. |
b. | pruritus. | d. | all of the above |
ANS: D
Feedback | |
A | Incorrect: Although true, this is not the best answer. |
B | Incorrect: Although true, this is not the best answer. |
C | Incorrect: Although true, this is not the best answer. |
D | Correct: Assessing for anaphylaxis involves observing the client for all of the responses. |
PTS: 1 REF: p. 20 OBJ: Cognitive Level: Application
a. | dyspnea. | c. | nausea. |
b. | pruritus. | d. | all of the above |
ANS: D
Feedback | |
A | Incorrect: Although true, this is not the best answer. |
B | Incorrect: Although true, this is not the best answer. |
C | Incorrect: Although true, this is not the best answer. |
D | Correct: Assessing for anaphylaxis involves observing the client for all of the responses. |
PTS: 1 REF: p. 20 OBJ: Cognitive Level: Application
a. | past history of allergic reaction to drugs. |
b. | no past history of exposure to the drugs. |
c. | clients currently receiving oral medications. |
d. | all of the above |
ANS: A
Feedback | |
A | Correct: Previous allergic reactions to medications places the client at higher risk for developing a hypersensitivity reaction to other medications. |
B | Incorrect: Allergic reactions do not occur unless the client has previously been exposed to the drug. |
C | Incorrect: Receiving medications via the parenteral route is a risk factor. |
D | Incorrect: b and c are incorrect. |
PTS: 1 REF: p. 20 OBJ: Cognitive Level: Comprehension
a. | ask the client about drug allergies. |
b. | ask the client why he or she is prescribed the medication. |
c. | draw laboratory specimens. |
d. | have the client empty his or her bladder. |
ANS: A
Feedback | |
A | Correct: Before administering any medication, the nurse should ask the client about all drug allergies. |
B | Incorrect: The nurse, not the patient, should provide this information, as well as the name of the drug. |
C | Incorrect: This is only necessary for certain medications. |
D | Incorrect: This is not necessary for medication administration. |
PTS: 1 REF: p. 40 OBJ: Cognitive Level: Application
a. | distribute the medication between the top and bottom of the ampule. |
b. | snap the top of the ampule with bare fingers. |
c. | save any unused medication. |
d. | use a filter needle or straw to withdraw the medication. |
ANS: D
Feedback | |
A | Incorrect: All of the medication should be in the bottom of the ampule. |
B | Incorrect: The nurse should use a dry gauze pad to prevent accidental injury. |
C | Incorrect: The unused portion must be discarded. |
D | Correct: This prevents small glass fragments from entering the syringe. |
PTS: 1 REF: p. 46 OBJ: Cognitive Level: Application
a. | medication | c. | dosage |
b. | route | d. | client |
ANS: D
Feedback | |
A | Incorrect: Checking the clients ID wrist band is done to ensure the nurse is administering the medication to the correct client. |
B | Incorrect: Checking the clients ID wrist band is done to ensure the nurse is administering the medication to the correct client. |
C | Incorrect: Checking the clients ID wrist band is done to ensure the nurse is administering the medication to the correct client. |
D | Correct: Checking the clients ID wrist band is done to ensure the nurse is administering the medication to the correct client. |
PTS: 1 REF: p. 46 OBJ: Cognitive Level: Comprehension
a. | Give it orally, because that is the most common route. |
b. | Ask the client how he or she usually takes the medication. |
c. | Call the health care provider to clarify the prescription. |
d. | Ask another nurse which route to use. |
ANS: C
Feedback | |
A | Incorrect: The route must be designated by the prescriber. |
B | Incorrect: The route must be designated by the prescriber. |
C | Correct: The route must be designated by the prescriber. |
D | Incorrect: The route must be designated by the prescriber. |
PTS: 1 REF: p. 48 OBJ: Cognitive Level: Application
a. | Ambulate to distribute the medication. | c. | Take a tub bath. |
b. | Lie in bed. | d. | Perform pericare. |
ANS: B
Feedback | |
A | Incorrect: Gravity could cause the medication to drain out. |
B | Correct: This will allow the medication to distribute and prevent it from draining out. |
C | Incorrect: This could cause the medication to be flushed out. |
D | Incorrect: This could cause the medication to be flushed out. |
PTS: 1 REF: p. 64, Figure 2-19
OBJ: Cognitive Level: Application
a. | hold the dropper vertically. |
b. | use the dropper that comes with the medication. |
c. | touch the medication with the fingers. |
d. | use the measuring scale on the dropper. |
ANS: C
Feedback | |
A | Incorrect: This is the correct position for the dropper. |
B | Incorrect: The dropper that comes with the medication should be used. |
C | Correct: Medication should never be touched with the fingers. |
D | Incorrect: The measuring scale on the dropper should be used. |
PTS: 1 REF: p. 61 OBJ: Cognitive Level: Application
a. | topical application | c. | injection |
b. | sublingual | d. | oral |
ANS: A
Feedback | |
A | Correct: Topical applications usually are used on skin or mucous membranes for local effects. |
B | Incorrect: Sublingual medications absorb rapidly into systemic circulation. |
C | Incorrect: Injections usually are used for systemic effects. |
D | Incorrect: Oral medications usually are absorbed from the GI tract into systemic circulation for routing to their intended site of action. |
PTS: 1 REF: p. 8 OBJ: Cognitive Level: Comprehension
a. | to convince the client that taking the medications is the right thing to do. |
b. | to notify the prescriber immediately. |
c. | to ask the client why he or she is not taking the medications as prescribed. |
d. | to give detailed information about the consequences of not following the prescribed orders. |
ANS: C
Feedback | |
A | Incorrect: First, the nurse needs to assess why the client is not being compliant. |
B | Incorrect: First, the nurse needs to assess why the client is not being compliant. |
C | Correct: Most refusal or noncompliance issues are based on the clients lack of knowledge or experience with adverse effects, but the nurse needs to assess why the client is not being compliant before further action is taken. |
D | Incorrect: First, the nurse needs to assess why the client is not being compliant |
PTS: 1 REF: p. 50, Safe Nursing Practice 2-11
OBJ: Cognitive Level: Application
a. | right health care provider | c. | right hospital |
b. | right client | d. | right syringe |
ANS: B
Feedback | |
A | Incorrect: The seven rights of medication administration are right client, medication, dose, route, time, documentation, and the clients right to refuse. |
B | Correct: Right client is one of the seven rights. |
C | Incorrect: The seven rights of medication administration are right client, medication, dose, route, time, documentation, and the clients right to refuse. |
D | Incorrect: The seven rights of medication administration are right client, medication, dose, route, time, documentation, and the clients right to refuse. |
PTS: 1 REF: p. 41, Safe Nursing Practice 2-4 OBJ: Cognitive Level: Knowledge
a. | PRN | c. | O.S. |
b. | O.D. | d. | O.U. |
ANS: B
Feedback | |
A | Incorrect: This means as the occasion arises or when needed or requested. |
B | Correct: This means right eye. |
C | Incorrect: This means left eye. |
D | Incorrect: This means both eyes. |
PTS: 1 REF: p. 42, Table 2-1 OBJ: Cognitive Level: Knowledge
a. | 2 tablespoons | c. | 3 teaspoons |
b. | 1/2 fluid ounce | d. | 1 gram |
ANS: A
Feedback | |
A | Correct: One tablespoon equals 15 mL, so two tablespoons equal 30 mL. |
B | Incorrect: This equals 15 mL. |
C | Incorrect: This equals 15 mL. |
D | Incorrect: Gram is a weight volume, not a liquid volume. |
PTS: 1 REF: p. 45, Table 2-3
OBJ: Cognitive Level: Application
a. | 15 milligrams | c. | 45 milligrams |
b. | 30 milligrams | d. | 60 milligrams |
ANS: D
Feedback | |
A | Incorrect: This equals 1/4 grain. |
B | Incorrect: This equals 1/2 grain. |
C | Incorrect: This equals 3/4 grain. |
D | Correct: 60 mg equal 1 grain. |
PTS: 1 REF: p. 45, Table 2-3 OBJ: Cognitive Level: Knowledge
a. | Crush all tablets into a fine powder and mix them together in warm water. |
b. | Crush tablets and place each into a separate medication administration cup diluted in warm water. |
c. | Administer only liquid medications via the nasogastric tube. |
d. | Keep the client n.p.o. as long as the nasogastric tube is in place. |
ANS: B
Feedback | |
A | Incorrect: Medications should not be mixed. |
B | Correct: Each medication should be prepared and administered separately and followed by a flush before the next medication is administered. |
C | Incorrect: Only liquids can be administered through the nasogastric tube, but tablets can be crushed and mixed with a fluid for administration. |
D | Incorrect: This is the decision of the health care provider. |
PTS: 1 REF: p. 54, Figure 2-6
OBJ: Cognitive Level: Application
a. | measure 2-3 fingerbreadths below the acromiom process. |
b. | place his or her hand on the greater trochanter and form a V with the index finger toward the anterior superior iliac spine. |
c. | This is not an appropriate site for a child so the nurse should search for a better site. |
d. | locate the abdomen and plan to inject the medication at least an inch away from the umbilicus. |
ANS: A
Feedback | |
A | Correct: This is the appropriate location for a deltoid injection. |
B | Incorrect: This describes locating the ventrogluteal site. |
C | Incorrect: A person of 16 years has sufficiently developed deltoid muscles that this is the most appropriate site for immunizations. |
D | Incorrect: This describes a subcutaneous site. |
PTS: 1 REF: p. 57 OBJ: Cognitive Level: Application
a. | request that the parents remain in the room to assist with the injection. |
b. | apply restraints to the child. |
c. | apply a local anesthetic cream or patch to the injection site. |
d. | explain to the child that he will be receiving a shot. |
ANS: C
Feedback | |
A | Incorrect: Parents should never be asked to assist with an injection. |
B | Incorrect: Children should not be placed in restraints an hour before receiving an injection. |
C | Correct: A local anesthetic should be applied to decrease or eliminate the pain of the injection. |
D | Incorrect: The age of the child determines when the child is told he or she will be receiving an injection. Shot is a term we try to avoid using. |
PTS: 1 REF: p. 56, Safe Nursing Practice 2-13
OBJ: Cognitive Level: Application
MULTIPLE RESPONSE
a. | enteric-coated medications | c. | scored tablets |
b. | sustained-action medications | d. | products containing a wax matrix |
ANS: A, B, D
Feedback | |
Correct | a, b, and d types of dosage forms should not be disrupted, because this would alter the dosage and duration. |
Incorrect | c Scored tablets can be crushed. |
PTS: 1 REF: p. 53 OBJ: Cognitive Level: Knowledge
a. | 15-degree angle. | c. | 45-degree angle. |
b. | 30-degree angle. | d. | 90-degree angle. |
ANS: C, D
Feedback | |
Correct | c and d are the correct angles for subcutaneous injection administration, except that insulin, heparin, and enoxaparin are administered only at a 90-degree angle. |
Incorrect | a and b: These angles will not allow the needle and medication to enter the subcutaneous tissue. |
PTS: 1 REF: p. 58 OBJ: Cognitive Level: Knowledge
a. | apply the medication to avoid placing the medication on the cornea. |
b. | never allow the tip of the medication dropper to touch the eye or other surface. |
c. | instruct the client to keep the eye open for at least 20 minutes after medication administration. |
d. | instruct the client that the nurse must administer any eye drops when prescribed to a hospitalized client. |
ANS: A, B
Feedback | |
Correct | a and b are principles of administration of eye medications. |
Incorrect | c and d are not appropriate interventions. |
PTS: 1 REF: p. 61, Safe Nursing Practice 2-15
OBJ: Cognitive Level: Application
CHAPTER 14: ANTIHISTAMINES AND NASAL DECONGESTANTS
TRUE/FALSE
ANS: F
Feedback | |
Correct | Unlike nasal decongestants, intranasal steroid administration does not produce immediate effects. |
Incorrect |
PTS: 1 REF: p. 367 OBJ: Cognitive Level: Knowledge
ANS: F
Feedback | |
Correct | Antihistamines and decongestants exert only a palliative effect on symptoms. |
Incorrect |
PTS: 1 REF: p. 367 OBJ: Cognitive Level: Knowledge
ANS: T PTS: 1 REF: p. 367 OBJ: Cognitive Level: Knowledge
ANS: F
Feedback | |
Correct | Dosage control is virtually impossible with nasal inhalers. |
Incorrect |
PTS: 1 REF: p. 367 OBJ: Cognitive Level: Comprehension
ANS: T PTS: 1 REF: p. 367 OBJ: Cognitive Level: Knowledge
MULTIPLE CHOICE
a. | allergic rhinitis. | c. | flu. |
b. | common cold. | d. | viral infection. |
ANS: A
Feedback | |
A | Correct: Allergic rhinitis occurs when allergens initiate the immunological response. |
B | Incorrect: This is caused by a virus. |
C | Incorrect: This is caused by a virus. |