St.

Paul College of Ilocos Sur

(Member, St. Paul University System)
St. Paul Avenue 2727, Bantay, Ilocos Sur

DEPARTMENT OF NURSING

PRE-LEARNING ACTIVITY

PRE-TEST EXAMINATION: MODULE 4

NCM 106: Pharmacology
Second Semester A.Y. 2020-2021

Melanio P. Rojas Jr. MAN

(Clinical Instructor)

Name: MACARAIG, MARIE KELSEY A. Score: ___________________

Course/Year: BSN 2A Date: FEBRAURY 28, 2020

I. Give specific situation based on the items given below. Please rank from 1- is the
most important and rank 10 is the least.

Rank Rights of Medication Importance Specific Situation

6 Right dose
To ensure that the The nurse reviewed the MAR of
patient receives the the patient (Medication
required right, and administration record) and
correct calculated calculated the desired dosage to
amount of the be given to an adult patient.
medication.

3 Right client/patient To ensure that the The nurse identified/verified the

medications to be patient by using two identifying
administered will be and compared to the MAR of the
given to the right patient before administering the
client/patient. medication.

7 Right frequency To determine the time The nurse will be administering

and how frequent two medications that are ordered
should the medication by the physician, one q8h (every 8
to administered as the hours) and the other 3 times a
patient requires. day. Both medications are
scheduled for 3 times within a 24-
hour period. The nurse give the
q8h medication every 8 hours
ATC to maintain therapeutic blood
levels of the medication.

8 Right route
Every route has The nurse injected insulin using
different rate of the subcutaneous route to a
absorption. Also, some patient with Diabetes.
medication if
administered in a

MELANIO 1
 wrong route, possible
the medication will be
ineffective, inactive and
may cause risks to the
patient.

1 Right documentation Right documentation The nurse documents upon

identifies who administering each medication.
administered the
medication, to whom it
was administered, the
time, date, route, dose
that was administered.
Also, to identify any
medication errors.

10 Right approach To establish rapport to The nurse approach and talked to

the patient. his/her patient in a kind manner
and explained the medication to
be administered.

4 Right assessment To determine and The nurse assessed that the

contribute to the patient have dysphagia which
diagnosis specifically to may interfere in administering oral
the medication to be medication.
administered of based
on the patient’ s
condition

3 Right to refuse It is in the Patient’s Bill
of rights that they have
the right to refuse any
treatment, procedure,
including medication.
Therefore, if the patient
refuse to take the
medication.
The patient refused to take the
medication for Hyperthyroidism
because it will gain weight and
requires physical exercise and
balanced diet.

5 Right evaluation To determine if the After the medication

medication
administration is done
safely or not. Also,
assess the patient’s
response to the
medication.
administration, the nurse observe
that the patient’s having positive
changes in response to the
medication. The patient is getting
better.

2 Right nurse clinician It should be the right
nurse clinician to
administer every
medication, if not it
may cause several
medication errors.
The nurse clinician prepared,
calculate, administered the
medication safely to the client
without committing any
medication error.

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 *Rank 1: Right Documentation
*Rank 10: Right Approach
For me I ranked the right documentation as the first one. I think it is vital to have the right
documentation because it includes the nurse who administered it, the physician who ordered it,
the medication administered, the time, frequency, dose, and route without the right
documentation it concludes that the medication administration did not happen. Assuming that
the nurse did not document the administration of medication however the nurse did administer
the medication. It will be questioned because you do not have the proof the nurse administered
the medication. Therefore, it is a medication error and considered malpractice.
I ranked the right approach the least, it is important to have a right approach but I think
you can administer the medication safely with or without the right approach.

St. Paul College of Ilocos Sur

(Member, St. Paul University System)
St. Paul Avenue 2727, Bantay, Ilocos Sur

MELANIO 3
 DEPARTMENT OF NURSING

PRE-LEARNING ACTIVITY

PRE-TEST EXAMINATION: MODULE 4

NCM 106: Pharmacology
Second Semester A.Y. 2020-2021

Melanio P. Rojas Jr. MAN

(Clinical Instructor)

Name: MACARAIG, MARIE KELSEY A. Score: ___________________

Course/Year: BSN 2A Date: FEBRAURY 28, 2020

I. Identification
STAT ORDER 1. It is type of order that is to be carried out immediately.
Anaphylactic reaction 2. A severe allergic reaction following administration of drug

Drug Habituation 3. It is the psychological reliance on a drug to maintain a sense of

well-being
Liver 4. The organ primarily responsible for metabolism of drugs.
Elixir 5. It is an alcohol-based liquid medication.
Sublingual 6. It is a method of drug administration involves placing the
medication under the tongue.
Intravenous 7. It is a route of administration of drug that results from rapid IV of
medications
Liver 8. Is the principal site of drug metabolism.
Topical Administration 9. It is the application of medications to a circumscribed area of
the body.
10–15-degree angle 10. How many degree angles for intradermal injection?

II. Multiple Choice

1. The type of physician’s order that is carried upon judgement of the nurse, as required by
the physician.
A. Standing order C. Stat order
B. Single order D. PRN order
2. The most accurate method of identifying a client before drug administration is by:
A. Asking the client state his name. C. Asking a relative to identify the
B. Calling the client by his name. client
D. Checking the identification band.
3. Which of the following route is usually the safest and most convenient?
A. Oral C. Sublingual
B. Topical D. Buccal
4. What injection site that is recommended for a 9 months baby?
A. Ventrogluteal site C. Vastus lateralis
B. Dorsogluteal site D. Rectus femoris
5. For diabetic patient what parental injection in administering insulin is the most
recommended?

MELANIO 4
A. SC
B. ID
C. IM
D. IV

MELANIO 5
III. Please rationalize the following items stated below. (28 points)
Procedure
1. Never administer an unfamiliar
medication.
2. Return liquid that are cloudy in
color to the pharmacy.
3. Do not leave the medication at
the bedside.
4. Clarify the doctor’s order if the
order of the medication is more
than dosage.
5. The nurse who prepares the drug
administers it.
6. Never crush enteric-coated or
Rationalization
Reduce of causing risks to
the patient.
The nurse should not
administer medicine that
are unusual and differ in
color, texture, odor and
consistency.
The nurse is responsible for
safekeeping of drugs. Also,
to ensure or confirm that
the patient took the
medication.
Reduce the risks of error.
To minimize medical errors.
The nurse who prepared
the drug knows more about
the drug to be
administered.
Enteric coated or sustained
Consequences
If the nurse is
unfamiliar with the
drugs to be
administered, it is
possible that nurse
might administer the
drug incorrectly such
administering the
wrong medication,
wrong dose, route,
time, and frequency.
If the nurse administer
a medication that are
unusual may cause
risks to the patient.
If the medication is left
unattended, the
tendencies are the
medication might get
lost, or may not be
taken, and may not be
taken correctly.
If the nurse
administered more
than the required
dosage of the
medication the nurse
and the physician are
both liable.
If there is a patient
injury or death because
of an incorrect drug or
an incorrect amount
given, both the nurse
and the colleague will
be held accountable.
Crushing enteric
MELANIO 6
 sustained-release tablets.
7. Avoid hitting the sciatic nerve.
release tablets have a
different specific
formulations and their
pharmacokinetic properties,
The sciatic nerve primarily
supplies the muscles of the
lower leg, including the calf,
ankle, and the back portion
of the knee. It also supplies
sensation to the sole of the
foot, the ankle, the entire
lower leg, and the back of
the thigh.
coatings may result in
the drug being
released too early,
being destroyed by
stomach acid, or
irritating the stomach
lining.
When you hit the
sciatic nerve of the
patient may will severe
pain worst case
scenario the patient
may experience
paralysis or neuropathy
in the lower leg.

St. Paul College of Ilocos Sur

(Member, St. Paul University System)
St. Paul Avenue 2727, Bantay, Ilocos Sur

DEPARTMENT OF NURSING

POST LEARNING ACTIVITY

MELANIO 7
 POST-TEST EXAMINATION: MODULE 4
NCM 106: Pharmacology
Second Semester A.Y. 2020-2021

Melanio P. Rojas Jr. MAN

(Clinical Instructor)

Name: _______________________________ Score: ___________________

Course/Year: Date: ____________________

Case Scenario: (30 points)

Nurse Milka is readily to prepare and administer paracetamol for fever STAT to patient Susa.
Patient had an episode of seizure 1 hour ago due to hyperpyrexia. As she goes to the room of
patient Susa, one of her patient suddenly had a cardiac arrest that Nurse Milka must attend
immediately. Ms. Momo is the supervising nurse and presently the chief training officer of the
hospital. She conducted training to nurses specializing in safety administration of medication
and she is been awarded multiple times as the best medication nurse, best computation nurse
and best in drug study. Ms. Milka considered Ms. Momo one of her mentors in the nursing
profession.
1. What must be the initial intervention of Ms. Milka?
- The initial intervention of Nurse Mika is to administer first the paracetamol for fever since
it is a STAT order which means it should be carried out at once and immediately. I
gnoring the medication order or rights of medication is considered a medication error
and the nurse will be held liable for her action.

2. Can Nurse Milka delegate to Nurse Supevisor Momo in administering the medication?
- Yes, however it is very unlikely because it is prone in committing medication errors.
According to the safety administration medication, the one who prepared the medication,
should be the one to administer the medication. The nurses should not accept
delegation and endorsement of medication because this is for the safety of the patient as
well as the nurse in charge.

3. If Nurse Momo is administering the paracetamol and suddenly she found out the dosage is
incorrect. Who will be accountable?
- Both Nurse Momo and Nurse Mika should be held accountable due to these reasons.
First, Nurse Mika should have been the one to administer the drug to the patient
because she is the one prepared it. There is a guideline in safe medication
administration that the Nurse who prepared the medication administers it. Second,
Nurse Momo should have known that it is important to always check the medication
order followed by checking the right patient, medication, DOSE, route, time, and reason.
She failed to check the right dose.

4. If you are Ms. Momo, will you inform your patient for the wrong dosage? or Inform the
doctor?

MELANIO 8
 - I will report to the patient’s doctor immediately to implement necessary measures and
provide care to the patient for less harm and risks.

5. Is Nurse Milka do not have the liability since only prepared the medication and not directly
administered the medication or both have the liability?
- Both Nurse Mika and Nurse Momo have the liability. (refer explanation to number 3)

6. Besides the 14 rights of medication, how can you prevent medication error?
- Reading labels at 3 times
- Do not allow any other activity to interrupt administration of medication to patient such as
phone calls, discussion with other staffs.
- Double check all calculations
- Do not interpret illegible handwriting.
- Follow established agency policies.
- Asking for the full cooperation of the patients.

St. Paul College of Ilocos Sur

(Member, St. Paul University System)
St. Paul Avenue 2727, Bantay, Ilocos Sur

DEPARTMENT OF NURSING

POST LEARNING ACTIVITY

POST-TEST EXAMINATION: MODULE 4

NCM 106: Pharmacology

Second Semester A.Y. 2020-2021

Melanio P. Rojas Jr. MAN

(Clinical Instructor)

Name: MACARAIG, MARIE KELSEY A. Score:

_____________________________________
Course/Year: BSN2A Date:
FEBRUARY 28, 2021

I. Explain the given items below. ( 93 points)

Parenteral

Intradermal Needle gauge: gauge 25, 26,27, needle length 3/8”, 5/8” or ½
Needle angle: 10–15-degree angle; bevel up.
Indication/Purpose: Indicated for allergy and tuberculin testing and for vaccinations.
Subcutaneou Needle gauge: 5/8, ½

MELANIO 9
s

Needle angle: 45-degree angle; 90-degree angle.

Indication/Purpose: Drugs administered subcutaneously are as follows vaccines, pre-operativ
insulin.
Intramuscular Needle gauge: needle gauge 20,21,22,23.
Needle angle: 90 degrees angle
Indication/Purpose: Inject medication to the muscle.

Oral Advantages:
most convenient
usually less expensive
safe, does not break skin barrier
Disadvantages: Inappropriate for client with nausea and vomiting.
- Drugs may have unpleasant taste or odor.
- Inappropriate if client cannot swallow and if GIT has been reduced.
- Drug may discolor the teeth.
- Drug may irritate the gastric mucosa.
- Drug may be aspirated by seriously ill patient.
Sublingua Advantages:
l
- Same as oral.
- Drug can be administered for local effect.
- Drug is rapidly absorbed in the bloodstream.
Disadvantages:
- If swallowed, drug may be inactivated by gastric juices
- Drug can remain under the tongue until dissolved and absorbed.
Buccal Advantages:
- Same as oral.
- Drug can be administered for local effect.
- Ensures greater potency because drug directly enters the blood and bypass the liver.

MELANIO 10
 Disadvantages:
- If swallowed, drug may be inactivated by gastric juice.
Vaginal Advantages:
- Provides local therapeutic effect.
Disadvantages:
- Has limited use.
Rectal Advantages:
- Can be used when the drug has objectionable taste or odor.
Disadvantages:
- Dose absorbed is unpredictable

Ventrogluteal site Uses:

- Use gluteus- medius which lies over the gluteus minimus muscle.
Location:
- The area contains no large nerves or blood vessels and less fat. It is farther from
it less contaminated
Position: prone or side lying.
Dorsogluteal site Uses: Uses of the gluteus medius muscle
Position: Position of the client is similar to ventrogluteal site.
Location from the greater trochanter to the
posterior superior iliac spine. The injection site is lateral and superior to this line.
Vastus Lateralis Uses: Recommended site injection for infants.
Location: Located at the middle third of the anterior aspect of the thigh.
Position: back-lying or sitting position.
Deltoid Site Uses: Not used often for IM injection because it is very close to the radial nerve and rad
artery.
Location: To locate the site, palpate the lower edge of the acromonion process and the
the lateral aspect of the arm that is in line with the axilla.
Position: approximately 5 cm (2
inches) or 2 to 3 fingerbreadths below the acromonion process.

MELANIO 11
 Nasal Position: Assume back-lying position, or sit up and lean head back.
Sinus instillation: Nasal instillations usually are instilled for their astringent effect (to shr
swollen mucous membrane), to loosen secretions and facilitate drainage or treat
infections of the nasal cavity or sinuses.
Otic Position:
Positon- 0–3-year-old: pull pinna downward and backward.
Older 3 year old: pull down the pinna backward and backward.
Inhalation Position: Semi or high-fowler’s position or standing position.
Position of mouthpiece: Position the mouthpiece 1 to 2 inches from the client’s open mo
Hold breath (seconds): hold breath for 10 seconds.
Maximum puff and interval: maximum of 2 puffs, for at least 30 seconds interval.
Minutes for the second dose: 1 minute before administration of the second dose

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MELANIO 13