Nonparenteral Medication Administration Quiz

1. List four acceptable sites for applying an antianginal paste. (An antianginal is any drug used in
the treatment of angina pectoris, a symptom of ischaemic heart disease.)
a. chest
b. back
c. upper arms
d. legs

2. List three acceptable sites for applying an estrogen patch.

a. Flat areas of the stomach
b. thigh
c. hip * NEVER on the breast

3. It is not necessary to alternate sites for the application of topical medications.

False. Different sites should be used for the next doses of topical medications.

4. List four considerations when choosing an appropriate site for a topical application.
a. Never apply on the breast
b. Do not select a hairy area
c. Avoid skin that is irritated
d. Avoid areas of bruising

5. The nurse applying a transdermal medication patch performs all of the following actions
except:
a. Removing the old patch prior to placing the new patch.
b. Donning gloves prior to administering the medication.
c. Applying the patch to the same area where the old patch was removed.
d. Cleansing the site where the patch is to be applied with soap and water.

Answer: C. Applying the patch to the same area where the old patch was removed.

Rationale: Transdermal patches should always be applied to a different area in order to

improve absorption of the medication. The old patch should be removed prior to placing the
new patch in order to avoid the risk of forgetting and having two patches in place with the
same medication. The nurse should wear gloves when working with transdermal patches to avoid
getting medication on her skin. The site where the new patch will go should be cleaned to
prevent oils from interfering with adherence of the patch.

6. Medications dispensed with a metered-dose inhaler are intended to penetrate the upper
airway.

False. Medications dispensed with a metered-dose inhaler are intended to penetrate the
lower airway.
7. What is the purpose of using a “spacer device” with an inhaler?

Answer: A spacer device is used if the patient has difficulty controlling breathing and
difficulty with coordination.

8. After the inhaler has dispensed the medication, the patient should be instructed to hold the
breath for 10 seconds.

Rationale: Holding the breath allows tiny drops of aerosol spray to reach deeper branches of
the airway.

9. The nurse is teaching the client to use a metered-dose inhaler. Which of the following would
be correct information to provide to the client?

a. Take a deep breath, hold it, and then gently squeeze the inhaler to dispense the
medication.
b. Take several slow deep breathes in through the nose and out through the mouth, then
squeeze the inhaler while taking a deep breathe.
c. Exhale comfortably, squeeze the canister to discharge the medication, and inhale slowly
and deeply through the mouth, then hold the breath for 10 seconds, or as long as possible.
d. Exhale deeply, squeeze the canister to discharge the medication, and inhale slowly and
deeply through the mouth, hold the breath for 10 seconds, and exhale through the nose.

Answer: c
Rationale: The client should be taught to breathe normally, exhale comfortably, and then
take a deep slow breath through the mouth while dispensing the medication. Holding the
breath for 10 seconds allows the medication to reach deeper airways. The client then
breathes out through the mouth with the lips pursed. The other options describe incorrect
techniques.

10. The nurse is administering a vaginal cream. After inserting the applicator and administering
the cream, the nurse would instruct the client to:
a. Wash the perineal area.
b. Remain supine for 5–10 minutes.
c. Sit in the chair for 5–10 minutes.
d. Lie in a side-lying position for 5–10 minutes.

Answer: b. Remain supine for 5-10 minutes

Rationale: After administering the vaginal cream, the nurse would instruct the client to
remain supine for 5–10 minutes to allow absorption of the medication and prevent gravity
from evacuating the cream.
11. The nurse is acting as medication nurse for the unit. The nurse would document medication
administration:
a. Every two hours for all clients.
b. Every four hours for all clients.
c. At the end of the shift for all clients.
d. After each client receives a medication.

Answer: d. After each client receives a medication.

Rationale: The nurse carries the client’s MARs (medication administration records) for any

client receiving medications on the medication cart, and records medications as they are

administered. Waiting to document medications can lead to medication errors, and waiting until

the end of the shift is an invitation to forget what PRN medications were administered and

when the medications were administered.

12. The provider prescribes aluminum hydroxide gel 2 ounces. The nurse has aluminum hydroxide in
30-ml containers in the client’s medication drawer. How many containers does the nurse
administer to the client?
a. 1 container
b. 2 containers
c. ½ container
d. 1 ½ containers

Answer: 2 containers
Rationale: The nurse administers two containers at 30 ml per container because
1 ounce = 30 ml. The prescription calls for aluminum hydroxide 60 ml, so to administer
60 ml the nurse needs two containers.

13. Which of the following is the proper notation of the dose of the drug ordered?

A. Digoxin .125 mg
B. Digoxin .1250 mg
C. Digoxin 0.125 mg
D. Digoxin 0.1250 mg

Answer: Digoxin 0.125 mg

Rational: Option C illustrates the correct notation with a leading zero before the decimal
point. Omitting the leading zero may cause the order to be misread, resulting in a large drug
overdose. Options A and B do not have the leading zero before the decimal point. Option D has
a trailing zero, which is also not correct.
14. Hospital regulations now require that the nurse write out the name “daily” instead of using the
abbreviation QD. What is the best rationale for this requirement?

a. The hospital has placed QD on its list of do not sue abbreviations.

b. Joint Commission requires that the abbreviation QD not be used.

c. Using the abbreviation QD puts the patient at risk of medication error.

d. Computerized charting systems will not accept the abbreviation QD.

Answer: Using the abbreviation QD puts the patient at risk of medication error.
Rationale: The best answer is that using the abbreviation QD puts the patient at risk of
medication error. Although the hospital has probably placed QD on its list of do not use
abbreviations, Joint Commission does require that the abbreviation not be used, and come
computerized charting systems are set up not to accept the abbreviation, those considerations
are secondary to the safety of the patient.

15. The nurse instructs the patient to tilt the head ______ when administering nasal sprays.

Answer: the nurse instructs the patient to tilt the head forward when administering nasal
sprays.
ROUTE VOLUME/ GAUGE LENGTH ANGLE LANDMARKS

AMOUNT

INTRADERMAL 0.1L or less 25-27 G 3/8-5/8 5-15 ° Place the arm on a flat
surface.
inch The site should be 3-4
fingerbreadths below the
antecubital space & one
hand width above the
wrist.
Stretch the skin with the
forefinger or thumb
SUB Q < 2ml 25-27G 1/2 -5/8 90 °/ 45 Upper arm, outer aspect
Abdomen: Avoiding a 2
Less than
e.g heparin, insulin inch inch radius around the
2ml umbilicus
Anterior aspect of thigh
IM DELTOID 2ml or less 20 – 25 G 1 -1.5 90 ° Find the lower edge of the
acromion process.
Intramuscular inch Place 1-2 inches below the
acromion process; this
Furosemide forms the base of the
triangle.
Ancef Draw an imaginary line
from the axilla across the
arm; this will form the
apex of the triangle.
Inject into the center of
the imaginary triangle.
IM VASTUS 3ml 20 – 25 G 5/8-1 90 Place one hand above the
lateral femoral condyle;
LATERALIS Viscous inch degree place the other hand
below the greater
Intramuscular Solutions: angle trochanter of the femur.
Your thumbs should point
18-21 G towards each other.
The injection site is the
middle third, anterior
lateral (side) aspect of
the thigh
Caution – To locate the
 lateral side of the thigh
(vastus lateralis muscle)
the leg must remain
straight.

VENTROGLUTEA 3mL 20 – 25 G 1.5 90 Using the right hand for

the left hip & the left
L Viscous inches degree hand for the right hip,
place the heel or palm of
Intramuscular Solutions: angle the hand over the
patient’s greater
18-21 G trochanter. Point thumb
toward the client’s groin.
Point the index finger
towards the anterior
superior iliac spine and the
middle finger
towards the iliac crest
forming a V shape
The injection site is
between the V (move your
fingers before injection).
Caution – make sure that
your fingers are never
above the iliac crest