Question 1

Which of the following are contraindications to oral medication administration? (Select all that apply.)

Accepted Answer

- Nausea/ vomiting
- Continuous gastric suction
- postoperative after gastrointestinal surgery
- inability to swallow

Question 2

The nurse administers a sublingual tablet and instructs the patient to avoid swallowing the tablet but rather to allow it to dissolve. The patient asks why. The nurse’s best response is:

Accepted Answer

"It is designed to be absorbed through the vessels of the undersurface of the tongue, and if it is swallowed, the medication will be destroyed by the gastric juices."

Question 3

The nurse is administering medication to a patient when the patient accidentally drops the tablet on the floor. What should the nurse do?

Accepted Answer

Discard the tablet and get another one.

Question 4

A patient is on a fluid restriction. When giving oral medications, which of the following considerations are needed?

Accepted Answer

Allow the patient to take medications with a small amount of water and document the amount on the patient's record.

Question 5

A patient states that she has difficulty swallowing pills and asks the nurse to crush them. Which of the following medications would it be okay to crush

Accepted Answer

A scored tablet of Lanoxin (digoxin).

Question 6

A nurse is preparing to administer medication through a feeding tube. Which of the following supplies should the nurse include, besides the medication, to perform this procedure? (Select all that apply.)

Accepted Answer

Appropriately sized medication syringe. 
  Graduated container and straw. 
  Gastric test strip. 
Water. 
  MAR.

Question 7

A family caregiver is observing a nurse preparing to administer medications through her father’s feeding tube. The caregiver asks, “What is the purpose of the pH paper?” Which of the following is the best response?

Accepted Answer

“It is used to verify correct placement of the feeding tube in the stomach.”

Question 8

The nurse is giving report to another nurse regarding a patient who receives medications through a feeding tube. The nurse states that in order to prevent clogging of the tube, preventive measures need to be continued. The nurse knows this would include w

Accepted Answer

Administering 30 to 60 mL of tepid water following the last dose of medication.

Question 9

A nurse is preparing medications to be administered through a patient’s feeding tube. The patient is to receive nifedipine XL. Which of the following would be a correct action by the nurse?

Accepted Answer

Hold the drug and notify the health care provider

Question 10

Which patient is at lowest risk for a systemic effect from a topical agent? A patient who:

Accepted Answer

is very mobile and receiving a drug in low concentration.

Question 11

A patient has been hospitalized for several days after a motor vehicle accident. The patient has several fractured bones and has cuts and scratches across the chest area. Where should you apply the fentanyl (Duragesic) patch to treat the patient's pain?

Accepted Answer

On the upper back in an area that is free of hair.

Question 12

You don clean gloves and measure the antianginal ointment onto dosage paper according to health care provider's orders. You rub the ointment off the paper directly onto the female patient's skin of the anterior chest and cover the area of ointment with pl

Accepted Answer

- You rubbed the ointment off the paper and covered with pastic wrap. 
-  You did not write the date, time, and initials on the paper wrapper.
- You did not remove the previous dosage paper

Question 13

What should the nurse do to maximize the effectiveness of medicated lotions and/or ointment?

Accepted Answer

First wash area with nondrying soap and water.

Question 14

The hospice nurse comes to the home of a patient with terminal cancer. She discovers several fentanyl (Duragesic) pain patches on the patient’s body. What should the nurse do first?

Accepted Answer

Remove the patches except for the most recent and provide patient teaching.

Question 15

The nurse is going to administer eye drops into the eye of a confused elderly patient. What safety precautions should the nurse take?

Accepted Answer

Rest hand holding the eyedropper on the patient's forehead and hold the eyedropper 1 to 2 cm (0.4 to 0.8 inches) above the conjunctival sac.

Question 16

The nurse is instilling eye drops into a patient's eye. The nurse checks the patient's identification, performs hand hygiene, and applies gloves. The nurse follows the six rights of medication administration. The nurse asks the patient to tilt the head ba

Accepted Answer

- Using the free hand to instill the drops at a distance of 2.5 to 5 cm (1 to 2 inches). 
- The method used to hold the patient’s eye open. 
- Applying the eye drops onto the patient's cornea.

Question 17

The nurse is administering eye medication. Which nursing action requires further intervention by the nurse? (Select all that apply.)

Accepted Answer

- The patient blinks and the eye drop falls on the outer lid after instillation.
- The nurse applies the ointment along the inner edge of the lower eyelid from the outer to inner canthus.

Question 18

The patient asks why the nurse applies the drops in the conjunctival sac. What is the nurse’s best response to the patient’s question?

Accepted Answer

“Applying drops to the conjunctival sac provides even distribution of medication across the eye.”

Question 19

The nurse is going to administer eye ointment in the newborn’s eyes. Which action by the nurse is the correct procedure?

Accepted Answer

The nurse applies a ribbon of ointment along the lower eyelid on the conjunctiva from inner to outer canthu

Question 20

The nurse is going to instill eardrops in a 7-year-old child. In which direction should the nurse pull the pinna of the ear?

Accepted Answer

Up and back.

Question 21

The mother of a 10-year-old child calls the doctor's office stating that she just administered eardrops to her child and the child is crying, stating that the ear hurts worse than it did before the eardrops were applied. What should the nurse tell the mot

Accepted Answer

"I will notify the health care provider. It is possible the eardrum may have ruptured."

Question 22

What is the purpose of massaging the tragus of the ear after eardrop instillation?

Accepted Answer

It helps move the medication inward.

Question 23

At what temperature should the solution be when eardrops are instilled?

Accepted Answer

Body temperature

Question 24

What is the primary danger associated with occluding the ear canal with the ear dropper during the administration of eardrops?

Accepted Answer

It can create too much pressure within the canal with subsequent injury to the eardrum

Question 25

A patient is demonstrating the use of an MDI (without a spacer device). The patient removes the mouthpiece cover and shakes the inhaler. The patient takes a deep breath and exhales, places the mouthpiece of the inhaler in the mouth, and depresses the cani

Accepted Answer

- Repeated the procedure in 10 seconds.
-  Used the wrong method of exhalation after using the MDI.
- Replaced the mouthpiece cover when finished administering puffs.

Question 26

What additional instruction should you include for the patient who is receiving steroids via an MDI? The patient:

Accepted Answer

should rinse the mouth after use of the MDI.

Question 27

When should the patient depress the canister when using an MDI?

Accepted Answer

The patient should depress the canister simultaneously with slow inhalation.

Question 28

You are planning to teach a patient about using an MDI without a spacer device. What are some points you should include in the teaching plan? (Select all that apply.)

Accepted Answer

- Instruct the patient how to time inhalation with the depression of the medication canister.
- Show the patient how the canister fits into the inhaler.
- Warn the patient about overuse of the inhaler, including drug side effects.
- Instruct the patien

Question 29

The nurse is going to insert a rectal suppository. The nurse provides privacy, performs hand hygiene, dons gloves, places the patient in the Sims' position, drapes the patient appropriately, and removes the suppository from its wrapper. The nurse tells th

Accepted Answer

- The patient was assisted onto the back with the head elevated.
- The blunt end of the suppository was inserted into the patient's rectum.
- The suppository was inserted without additional lubricant. 
- The suppository was inserted into the patient's

Question 30

How far should the nurse insert a rectal suppository in an adult? (Select all that apply.)

Accepted Answer

- Approximately 10 cm (4 inches). 
- Past the internal anal sphincter. 
.

Question 31

What position should the patient assume for insertion of a rectal suppository?

Accepted Answer

Left Sims' position.

Question 32

What can the nurse do to help the patient relax the anal sphincter before administering a rectal suppository?

Accepted Answer

Ask the patient to take slow, deep breaths through the mouth

Question 33

The nurse is instructing the patient on how to insert a vaginal suppository. Which statement if made by the patient indicates further instruction is needed? (Select all that apply.)

Accepted Answer

“I should insert the rounded end of the suppository along the side wall of the vagina approximately 1 inch or 2.5 cm (approximately to the first knuckle of the index finger).” 
  “I should warm the suppository to body temperature by putting it under warm

Question 34

How might the nurse safely administer an extended-release capsule to a patient with dysphagia?

Accepted Answer

Place the capsule in a spoonful of the patient's applesauce.

Question 35

Which statement or question best illustrates the nurse's understanding of the role of nursing assistive personnel (NAP) in administering oral medications

Accepted Answer

Please make sure the patient has plenty of fresh water to take with her pills.

Question 36

The nurse has provided a patient with a PRN oral analgesic that may be repeated as needed every 6 to 8 hours. What is the most appropriate follow-up action to ensure appropriate pain management?

Accepted Answer

Reassess the patient's pain in 30 to 40 minutes.

Question 37

A patient with a history of nighttime confusion is to receive several oral medications at bedtime. What is the best way for the nurse to ensure that the patient has swallowed the medication?

Accepted Answer

Ask the patient to open his mouth after swallowing each tablet.

Question 38

The nurse is preparing to administer several oral medications when the patient says he would like to take his pills with orange juice. What is the nurse's best response?

Accepted Answer

Establish whether the medications may be taken with orange juice.

Question	Answer
Which of the following are contraindications to oral medication administration? (Select all that apply.)	- Nausea/ vomiting - Continuous gastric suction - postoperative after gastrointestinal surgery - inability to swallow
The nurse administers a sublingual tablet and instructs the patient to avoid swallowing the tablet but rather to allow it to dissolve. The patient asks why. The nurse’s best response is:	"It is designed to be absorbed through the vessels of the undersurface of the tongue, and if it is swallowed, the medication will be destroyed by the gastric juices."
The nurse is administering medication to a patient when the patient accidentally drops the tablet on the floor. What should the nurse do?	Discard the tablet and get another one.
A patient is on a fluid restriction. When giving oral medications, which of the following considerations are needed?	Allow the patient to take medications with a small amount of water and document the amount on the patient's record.
A patient states that she has difficulty swallowing pills and asks the nurse to crush them. Which of the following medications would it be okay to crush	A scored tablet of Lanoxin (digoxin).
A nurse is preparing to administer medication through a feeding tube. Which of the following supplies should the nurse include, besides the medication, to perform this procedure? (Select all that apply.)	Appropriately sized medication syringe. Graduated container and straw. Gastric test strip. Water. MAR.
A family caregiver is observing a nurse preparing to administer medications through her father’s feeding tube. The caregiver asks, “What is the purpose of the pH paper?” Which of the following is the best response?	“It is used to verify correct placement of the feeding tube in the stomach.”
The nurse is giving report to another nurse regarding a patient who receives medications through a feeding tube. The nurse states that in order to prevent clogging of the tube, preventive measures need to be continued. The nurse knows this would include w	Administering 30 to 60 mL of tepid water following the last dose of medication.
A nurse is preparing medications to be administered through a patient’s feeding tube. The patient is to receive nifedipine XL. Which of the following would be a correct action by the nurse?	Hold the drug and notify the health care provider
Which patient is at lowest risk for a systemic effect from a topical agent? A patient who:	is very mobile and receiving a drug in low concentration.
A patient has been hospitalized for several days after a motor vehicle accident. The patient has several fractured bones and has cuts and scratches across the chest area. Where should you apply the fentanyl (Duragesic) patch to treat the patient's pain?	On the upper back in an area that is free of hair.
You don clean gloves and measure the antianginal ointment onto dosage paper according to health care provider's orders. You rub the ointment off the paper directly onto the female patient's skin of the anterior chest and cover the area of ointment with pl	- You rubbed the ointment off the paper and covered with pastic wrap. - You did not write the date, time, and initials on the paper wrapper. - You did not remove the previous dosage paper
What should the nurse do to maximize the effectiveness of medicated lotions and/or ointment?	First wash area with nondrying soap and water.
The hospice nurse comes to the home of a patient with terminal cancer. She discovers several fentanyl (Duragesic) pain patches on the patient’s body. What should the nurse do first?	Remove the patches except for the most recent and provide patient teaching.
The nurse is going to administer eye drops into the eye of a confused elderly patient. What safety precautions should the nurse take?	Rest hand holding the eyedropper on the patient's forehead and hold the eyedropper 1 to 2 cm (0.4 to 0.8 inches) above the conjunctival sac.
The nurse is instilling eye drops into a patient's eye. The nurse checks the patient's identification, performs hand hygiene, and applies gloves. The nurse follows the six rights of medication administration. The nurse asks the patient to tilt the head ba	- Using the free hand to instill the drops at a distance of 2.5 to 5 cm (1 to 2 inches). - The method used to hold the patient’s eye open. - Applying the eye drops onto the patient's cornea.
The nurse is administering eye medication. Which nursing action requires further intervention by the nurse? (Select all that apply.)	- The patient blinks and the eye drop falls on the outer lid after instillation. - The nurse applies the ointment along the inner edge of the lower eyelid from the outer to inner canthus.
The patient asks why the nurse applies the drops in the conjunctival sac. What is the nurse’s best response to the patient’s question?	“Applying drops to the conjunctival sac provides even distribution of medication across the eye.”
The nurse is going to administer eye ointment in the newborn’s eyes. Which action by the nurse is the correct procedure?	The nurse applies a ribbon of ointment along the lower eyelid on the conjunctiva from inner to outer canthu
The nurse is going to instill eardrops in a 7-year-old child. In which direction should the nurse pull the pinna of the ear?	Up and back.
The mother of a 10-year-old child calls the doctor's office stating that she just administered eardrops to her child and the child is crying, stating that the ear hurts worse than it did before the eardrops were applied. What should the nurse tell the mot	"I will notify the health care provider. It is possible the eardrum may have ruptured."
What is the purpose of massaging the tragus of the ear after eardrop instillation?	It helps move the medication inward.
At what temperature should the solution be when eardrops are instilled?	Body temperature
What is the primary danger associated with occluding the ear canal with the ear dropper during the administration of eardrops?	It can create too much pressure within the canal with subsequent injury to the eardrum
A patient is demonstrating the use of an MDI (without a spacer device). The patient removes the mouthpiece cover and shakes the inhaler. The patient takes a deep breath and exhales, places the mouthpiece of the inhaler in the mouth, and depresses the cani	- Repeated the procedure in 10 seconds. - Used the wrong method of exhalation after using the MDI. - Replaced the mouthpiece cover when finished administering puffs.
What additional instruction should you include for the patient who is receiving steroids via an MDI? The patient:	should rinse the mouth after use of the MDI.
When should the patient depress the canister when using an MDI?	The patient should depress the canister simultaneously with slow inhalation.
You are planning to teach a patient about using an MDI without a spacer device. What are some points you should include in the teaching plan? (Select all that apply.)	- Instruct the patient how to time inhalation with the depression of the medication canister. - Show the patient how the canister fits into the inhaler. - Warn the patient about overuse of the inhaler, including drug side effects. - Instruct the patien
The nurse is going to insert a rectal suppository. The nurse provides privacy, performs hand hygiene, dons gloves, places the patient in the Sims' position, drapes the patient appropriately, and removes the suppository from its wrapper. The nurse tells th	- The patient was assisted onto the back with the head elevated. - The blunt end of the suppository was inserted into the patient's rectum. - The suppository was inserted without additional lubricant. - The suppository was inserted into the patient's
How far should the nurse insert a rectal suppository in an adult? (Select all that apply.)	- Approximately 10 cm (4 inches). - Past the internal anal sphincter. .
What position should the patient assume for insertion of a rectal suppository?	Left Sims' position.
What can the nurse do to help the patient relax the anal sphincter before administering a rectal suppository?	Ask the patient to take slow, deep breaths through the mouth
The nurse is instructing the patient on how to insert a vaginal suppository. Which statement if made by the patient indicates further instruction is needed? (Select all that apply.)	“I should insert the rounded end of the suppository along the side wall of the vagina approximately 1 inch or 2.5 cm (approximately to the first knuckle of the index finger).” “I should warm the suppository to body temperature by putting it under warm
How might the nurse safely administer an extended-release capsule to a patient with dysphagia?	Place the capsule in a spoonful of the patient's applesauce.
Which statement or question best illustrates the nurse's understanding of the role of nursing assistive personnel (NAP) in administering oral medications	Please make sure the patient has plenty of fresh water to take with her pills.
The nurse has provided a patient with a PRN oral analgesic that may be repeated as needed every 6 to 8 hours. What is the most appropriate follow-up action to ensure appropriate pain management?	Reassess the patient's pain in 30 to 40 minutes.
A patient with a history of nighttime confusion is to receive several oral medications at bedtime. What is the best way for the nurse to ensure that the patient has swallowed the medication?	Ask the patient to open his mouth after swallowing each tablet.
The nurse is preparing to administer several oral medications when the patient says he would like to take his pills with orange juice. What is the nurse's best response?	Establish whether the medications may be taken with orange juice.

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