Module 7 Med Admin Overview & Intra Muscular Injections (Week of 10/9)

Question 1

When preparing to administer a new medication, what would the nurse do first to ensure the patient’s safety?

Answer 1

Perform hand hygiene.

Question 2

What is the most important step the nurse can take to ensure that the patient is getting the correct medication?

Answer 2

Compare the medication label with the MAR three times.

Question 3

Which statement or question best illustrates the nurse’s understanding of the role of nursing assistive personnel (NAP) in medication administration?
A. “Does the patient need her pain medication?”
B. “Let me know if she complains of any nausea.”
C. “What is the quality of her pain now?”
D. “Tell her she doesn’t have an order for the drug she’s asking for.”

Answer 3

B. “Let me know if she complains of any nausea.”

Question 4

As the nurse is administering medication to a patient, the patient states, “I’ve never seen that pill before.” What is the nurse’s most appropriate response?
A. Reassure the patient that the pharmacy sent the right medication.
B. Tell the patient that it is probably a different brand than what he takes at home and not to worry.
C. Tell the patient that you will review the physician’s order to clarify any discrepancies.
D. Tell the patient that the doctor probably ordered a new medication.

Answer 4

C. Tell the patient that you will review the physician’s order to clarify any discrepancies.

Question 5

What is the nurse’s best response after noticing that the route of administration has been omitted from a medication order?

Answer 5

B. Immediately notify the prescriber to request that the order be completed.

Question 6

Which example reflects effective documentation of medication administration by a nurse?
A. Comparing the written order with the medication administration record (MAR) three times
B. Providing patient education regarding a medication
C. Obtaining a BP before giving a blood pressure medication
D. Including the location of an injection site on the MAR

Answer 6

Including the location of an injection site on the MAR

Question 7

What is the best way for the nurse to ensure that a patient receives the correct dose of a medication?

Answer 7

Compare the prescriber’s order with the MAR before dispensing the medication.

Question 8

Which statement best illustrates the nurse’s understanding of the role of nursing assistive personnel (NAP) in documenting medication administration?

A. “Make a note that the patient just received her PM dose of pain medication.”
B. “Let me know if the patient says her nausea is getting worse.”
C. “Can you check the MAR and see when this patient had her pain medication last?”
D. “Ask the patient if I need to get another order from the provider.”

Answer 8

B. “Let me know if the patient says her nausea is getting worse.”

Question 9

4. The patient refuses a scheduled dose of an antibiotic, saying that the medication makes him feel nauseated. What it the nurse’s best response?

Answer 9

Notify the prescriber of the patient’s reason for refusing the medication

Question 10

While reviewing a new medication order, the nurse notes that the frequency of administration has been omitted. What is the nurse’s best response?

Answer 10

Immediately contact the prescriber to complete the order.

Question 11

As the nurse is at the bedside preparing to administer a new medication, the patient mentions that he is allergic to the drug. What will the nurse do first?

Answer 11

Review the medication administration record (MAR) for allergies.

Question 12

As the nurse prepares to administer oral acetaminophen, the patient refuses to accept the drug because it doesn’t look like the Tylenol she takes at home. After verifying that the medication and dosage are correct, what is the nurse’s best response?

Answer 12

Explain that drugs often come in different physical forms, depending on the manufacturer.

Question 13

What is the nurse’s first response when a patient requests another dose of narcotic pain medication before it is time for the next dose?

Answer 13

Work with the patient to find alternative nonpharmacologic means of pain management.

Question 14

The patient has requested a PRN medication for nausea. Which of the following should the nurse do first?

A. Offer dry crackers and ice chips if not contraindicated.
B. Ask the patient about his allergies.
C. Explain the specific purpose of the medication.
D. Check to see when the medication was given last, and make sure the time interval is up.

Answer 14

D. Check to see when the medication was given last, and make sure the time interval is up.

Question 15

After requesting a narcotic pain medication, the patient refuses it after the nurse prepares the injection. What is the nurse’s best initial response?

A. Ask the patient the reason for his refusal.
B. Notify the physician and ask for a different type of pain medication.
C. Have another registered nurse witness the proper discarding of the drug.
D. Explain to the patient the need to manage pain effectively.

Answer 15

A. Ask the patient the reason for his refusal.

Question 16

When is a patient at a higher risk for a medication administration error?

Answer 16

During a care transition point, such as transfer to another unit

Question 17

As the nurse is giving a patient his medications, he remarks, “I’ve never seen this blue pill before.” What is the nurse’s correct response?

Answer 17

“Don’t take it. Let me double-check the doctor’s order to make sure this is the correct medication for you.”

Question 18

What is the best way for the nurse to ensure that the patient does not receive the wrong dose because of a calculation error?

Answer 18

Ask another registered nurse (RN) to verify the calculation.

Question 19

Which of the following nursing actions will reduce the risk of “wrong route” when administering a medication?

A. Only splitting pills or tablets that have been prescored by the manufacturer
B. Using an oral dosing syringe when administering oral liquid medication
C. Transcribing a fractional dose of less than one with a leading zero (e.g., 0.5 mg)
D. Crushing an oral medication that is difficult to swallow

Answer 19

Using an oral dosing syringe when administering oral liquid medication

Question 20

What is the most appropriate way for the nurse to split an unscored tablet?

Answer 20

B. Ask the pharmacy if it is appropriate to split the pill and if so, ask them to split and repackage it with the adjusted dose given on the label.

Question 21

What is the nurse’s first step in preparing to administer a prescribed medication using an automated medication dispensing system?
A. Establish the patient’s ID using two identifiers.
B. Review the medication administration record (MAR).
C. Provide patient education.
D. Review applicable nursing considerations.

Answer 21

B. Review the medication administration record (MAR).

Question 22

Which precaution should the nurse observe to ensure patient safety when using an automated medication dispensing system?

Answer 22

Prepare medications for one patient at a time.

Question 23

Which statement or question best illustrates the nurse’s understanding of the role of nursing assistive personnel (NAP) in using automated medication dispensing systems?
A. “Does the patient need her pain medication?”
B. “Let me know if she complains of any nausea.”
C. “Ask her to describe her pain and show you where it is.”
D. “Remember to log off of the system when you are finished.”

Answer 23

B. “Let me know if she complains of any nausea.”

Question 24

Which action by the nurse is most important in protecting the safety of patients and staff when using an automated medication dispensing system?

A. Refusing to share his or her individual security log-in code for the dispensing system
B. Having another registered nurse check his or her mathematical calculations
C. Reviewing a current drug book for dosing information
D. Using two different mathematical formulas to cross-check a dosage calculation

Answer 24

A. Refusing to share his or her individual security log-in code for the dispensing system

Question 25

5. While preparing a patient’s oral medication dispensed from an automated medication dispensing system, the nurse realizes that the pill dispensed is twice the correct dose. What is the nurse’s best action at this time?

A. Notify the health care provider and ask if the higher dose could be given.
B. Access the dispenser again for the correct dose.
C. Notify the pharmacy to determine if the accurate dose is available.
D. Split the pill in half.

Answer 25

C. Notify the pharmacy to determine if the accurate dose is available.

Question 26

A nurse is preparing to withdraw medication from an open multi-dose vial. After confirming that the vial contains the appropriate medication and checking the expiration date, what would the nurse do next?

Answer 26

C. Wipe the rubber seal of the vial with an alcohol swab.

Question 27

What would the nurse do to remove air trapped in a syringe before withdrawing the syringe from the vial?

Answer 27

Position the tip of the needle in the vial’s airspace, and tap the barrel of the syringe.

Question 28

How can the nurse prevent negative pressure from building up in the vial when preparing an injection?

Answer 28

Inject a volume of air into the vial equivalent to the volume of medication to be withdrawn.

Question 29

How can the nurse ensure that medication from a single-dose vial is used appropriately?

Answer 29

D. Discard the vial and any remaining medication in the vial directly after use.

Question 30

What will the nurse do after opening a multi-dose vial and withdrawing a dose of medication from it?

Answer 30

. Label the vial with the date it was opened and your initials.

Question 31

When preparing an injection from an ampule, what will the nurse do if liquid is trapped in the neck of the ampule?

Answer 31

Use quick, light finger taps on the top of the ampule to move the liquid.

Question 32

What is the greatest safety concern when withdrawing medication from an ampule?

Answer 32

Withdrawing glass particles into the syringe

Question 33

How does the nurse minimize the risk of patient infection when preparing medication from an ampule?

Answer 33

Preserving the sterility of the needle while preparing the medication

Question 34

Which action minimizes the risk of introducing glass particles into the syringe when drawing medication from an ampule?

Answer 34

Using a filter needle or straw to draw the medication from the ampule

Question 35

Which action might the nurse take when drawing up medication from an ampule?

Answer 35

Hold the ampule upside down while inserting the filter needle.

Question 36

When administering an intradermal injection, which outcome would require the nurse to withdraw the needle and begin again?

A. Aspiration of blood prior to injecting the medication
B. Inability to feel resistance when injecting the medication
C. Formation of a 6-mm bleb at the injection site
D. Appearance of a lesion resembling a mosquito bite at the injection site

Answer 36

B. Inability to feel resistance when injecting the medication

Question 37

2. Which statement might the nurse make to nursing assistive personnel (NAP) when caring for a patient who is prescribed an intradermal injection?

A. “Be sure to wear clean gloves during the injection.”
B. “Tell him it’s OK; the site should look like a mosquito bite.”
C. “Immediately report any patient complaints of itching or dyspnea.”
D. “Remind the patient to come back in 48 to 72 hours so we can evaluate the site.”

Answer 37

C. “Immediately report any patient complaints of itching or dyspnea.”

Question 38

Which finding tells the nurse that a patient may have had a positive reaction to a tuberculin test?

Answer 38

A hard, raised area 15 mm or greater in diameter

Question 39

In which site would it be inappropriate to administer an intradermal injection?

A. Lower abdomen of an obese patient
B. Upper back of a patient who is on bed rest
C. Right deltoid of a high school softball pitcher
D. Left forearm of a patient with right-sided weakness

Answer 39

C. The deltoid area is not an acceptable intradermal injection site for any patient.

Question 40

How can the nurse determine that the needle tip for an intradermal injection is in the dermis?

A. A bleb the size of a mosquito bite will appear.
B. The needle will enter at a 5- to 15-degree angle.
C. The bulge of the needle tip will be visible through the skin.
D. The needle will penetrate through the epidermis to a depth of about ⅛ inch.

Answer 40

C. The bulge of the needle tip will be visible through the skin.

Question 41

Which action by the nurse ensures patient safety when administering an intramuscular injection?

Answer 41

Rotating injection sites is important in order to prevent hypertrophy of tissue.

Question 42

When preparing an intramuscular injection, what can the nurse do to reduce the patient’s risk for infection?

Answer 42

Clean the injection site with an alcohol swab.

Question 43

What can the nurse do to minimize the patient’s risk for injury when delivering an intramuscular injection?

Answer 43

Pull back on the plunger after inserting the needle.

Question 44

Which site is most commonly used for intramuscular injections?

Answer 44

Ventrogluteal

Question 45

Which action by the nurse helps to ensure that the medication is delivered into the muscle when administering an intramuscular injection?

Answer 45

Aspirating for blood return before injecting the medication