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Test Bank for Pharmacology: A Patient-Centered Nursing Process Approach 9th Edition

Test Bank for Pharmacology: A Patient-Centered


Nursing Process Approach 9th Edition

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Chapter 10: Drug Administration
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 9th Edition

MULTIPLE CHOICE

1. The nurse is assisting the parent of a 6-month-old infant to administer an oral liquid
medication. The parent asks why the medication can’t be given in a bottle of formula to
make it taste better. How will the nurse respond?
a. “Adding a medication to the formula will cause the formula to curdle.”
b. “Formula and medications can form toxic compounds if mixed together.”
c. “The infant may not always take the entire bottle of formula.”
d. “This may cause the infant to refuse formula in the future.”
ANS: C
Medications should not be mixed with a large amount of food or beverage because patients
may miss the full dose if they do not consume the entire amount. If the entire bottle is not
consumed, the nurse will have difficulty determining how much dose was received. If
medications interact with formula in vivo, package information will indicate this.

DIF: Cognitive Level: Applying (Application) REF: p. 97


TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A patient asks the nurse if an enteric-coated tablet can be crushed and put in pudding to
make it easier to swallow. How will the nurse respond to the patient?
a. “Crushing the medication can lead to a possibly toxic medication dose.”
b. “Crushing the medication is safe and can prevent gagging on pills.”
c. “The tablet may be done if a small amount of pudding is used.”
d. “The tablet may be dissolved in liquid but not crushed and put in food.”
ANS: A
Enteric-coated tablets must be swallowed whole to maintain a therapeutic drug level since
they are designed to be absorbed in the small intestine. If crushed, an initial excessive
release of the drug may occur, causing toxicity. Enteric-coated tablets should not be
dissolved in liquid.

DIF: Cognitive Level: Applying (Application) REF: p. 97


TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A patient is ordered to take an extended-release medication twice daily but has difficulty
swallowing the tablet because of its size. The nurse will perform which action?
a. Contact the provider to discuss an alternate form of the medication.
b. Crush the tablet and put it in applesauce to help the patient swallow it.
c. Cut the tablet in half so the patient can take it more easily.
d. Dissolve the tablet in liquid.
ANS: A
Enteric-coated and extended-release tablets must be swallowed whole to maintain a
therapeutic drug level since they are designed to be absorbed in the small intestine. If
crushed, an initial excessive release of the drug may occur, causing toxicity. Enteric-coated
or extended-release tablets should not be dissolved in liquid. The nurse should contact the
provider to discuss another form of the medication.

DIF: Cognitive Level: Applying (Application) REF: p. 97


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The nurse is teaching a patient about using sublingual nitroglycerin at home. Which
statement by the patient indicates understanding of the teaching?
a. “I may put the tablet in food if I don’t like the taste.”
b. “I may take a sip of water after placing the tablet in my mouth.”
c. “I will place the tablet between my cheek and gum.”
d. “I will place the tablet under my tongue and let it absorb.”
ANS: D
Drugs given sublingually should be placed under the tongue. No foods or fluids should be
given, since the tablet must remain under the tongue until it is fully absorbed. Medications
ordered to be given “buccally” should be placed between the cheek and gum.

DIF: Cognitive Level: Applying (Application) REF: p. 97


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

5. The nurse is teaching a nursing student about giving liquid medications. Which statement by
the student indicates understanding of the teaching?
a. “A suspension is a mixture in which drug particles are dissolved in solution.”
b. “I will line up the bottom of the medication curve with the line in the syringe.”
c. “I will need to shake an elixir before measuring the dose.”
d. “I will not need to refrigerate liquids once they are reconstituted.”
ANS: B
To measure liquid medications accurately, line up the bottom of the curve of the medication
with the desired line on the syringe. Suspensions are liquids in which particles are mixed but
not dissolved. As a general rule, elixirs do not require shaking; shaking may suspend air into
the liquid and affect accurate dosing by volume. Many liquids require refrigeration.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 97


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A patient asks the nurse why the provider has ordered a transdermal form of a medication.
How will the nurse respond?
a. “The patch can always be cut when dosage adjustments are needed.”
b. “Drug levels fluctuate less with the patch.”
c. “There are fewer systemic side effects with transdermal patches.”
d. “There is less risk of toxicity when using a patch.”
ANS: B
Transdermal patches provide more consistent blood levels. Cutting the patch is not
recommended. Drugs given transdermally can still produce side effects and toxicity.

DIF: Cognitive Level: Applying (Application) REF: p. 97


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. When administering topical medications, which is an important nursing action?


a. Applying the medication liberally
b. Cleaning skin with alcohol before applying
c. Using sterile technique
d. Wearing gloves
ANS: D
To avoid contact with the medication, nurses should wear gloves when applying topical
medications. Some topical medications are applied sparingly. Skin should be clean and dry,
but it is not necessary to use alcohol. It is not always necessary to use sterile technique.

DIF: Cognitive Level: Applying (Application) REF: p. 98


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A patient who has asthma will begin taking an inhaled corticosteroid medication to be used
with a spacer. The patient asks why the spacer is necessary. The nurse will explain that the
spacer
a. allows a larger dose to be given safely.
b. distributes medication to target tissues.
c. minimizes adverse effects of the steroid.
d. prevents contamination of the metered-dose inhaler.
ANS: B
Spacers are used to enhance the delivery of medication to the lower, smaller airways. They
do not allow higher dosing or minimize drug side effects.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 100


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The nurse is teaching a parent to administer medications using a child’s gastrostomy tube.
The parent asks why it is necessary to give water after each medication. The nurse explains
that the water is given for which purpose?
a. To decrease gastrointestinal upset
b. To dilute the medication and enhance absorption
c. To ensure that all medication is infused into the stomach
d. To improve overall hydration
ANS: C
Flushing the tube after the medication is instilled ensures that the medication reaches the
stomach, to maintain patency of the tubing. It is not always given to decrease
gastrointestinal upset, to dilute the medication, or to improve hydration.

DIF: Cognitive Level: Understanding (Comprehension) REF: p. 100


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The nurse is preparing to administer a rectal suppository antipyretic medication. Which
action by the nurse is correct?
a. Allowing the suppository to soften at room temperature before inserting
b. Asking the patient to lie on the right side during insertion of the medication
c. Having the patient remain in a side-lying position for at least 5 minutes after
insertion
d. Using a lubricant such as petrolatum gel (Vaseline) to lubricate the medication
ANS: C
Patients should remain on their side for at least 5 minutes after insertion of suppositories.
Softening the suppository is not indicated. Patients should lie on their left side, not the right.
A water-soluble lubricant should be used.

DIF: Cognitive Level: Applying (Application) REF: p. 101


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The nurse is performing tuberculin testing on a patient. Which action by the nurse is
correct?
a. Insert the needle, bevel up, at a 30-degree angle.
b. Massage the area gently after the injection.
c. Measure the diameter of the area of erythema when reading the result.
d. Use a 25-gauge, 3/8” needle.
ANS: D
Intradermal injections should be given with a 25- to 27-gauge, 3/8”- to 5/8”-long needle.
The needle should be inserted at a 10- to 15-degree angle. The area should not be massaged.
The nurse measures the area of induration, not erythema.

DIF: Cognitive Level: Applying (Application) REF: p. 102


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

12. The nurse is teaching an overweight patient to administer subcutaneous heparin. Which
statement by the patient indicates understanding of the teaching?
a. “I should insert the needle and inject the medication without aspirating for blood.”
b. “I should put firm pressure on the injection site to decrease the risk for bleeding.”
c. “I will insert the needle at a 10-degree angle when injecting.”
d. “The subcutaneous route is used because absorption is faster this way.”
ANS: A
Patients giving subcutaneous medication should be taught not to aspirate after inserting the
needle. They should not apply pressure. The needle should be inserted at a 45- to 90-degree
angle. Absorption is slower with this route than with the intramuscular and intravenous (IV)
routes.

DIF: Cognitive Level: Applying (Application) REF: p. 103


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

13. The nurse is preparing to administer an intramuscular injection to a 14-month-old toddler.


To help with site selection for this injection, what will the nurse ask the child’s parent?
a. “How long has your child been walking?”
b. “How much does your child weigh?”
c. “Is your child afraid to look at needles?”
d. “Is your child right- or left-handed?”
ANS: A
The ventrogluteal muscle is the preferred injection site for toddlers who have gluteal muscle
development associated with firmly established walking. The muscle development, and not
the child’s weight, is more important. Asking if a patient is right- or left-handed is necessary
if deltoid muscles are used.

DIF: Cognitive Level: Applying (Application) REF: p. 104


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

14. The nurse is demonstrating the Z-track injection technique to a nursing student on a patient
who is receiving iron dextran. Which statement by the student indicates understanding of the
teaching?
a. “This is necessary to prevent staining of the patient’s skin.”
b. “This technique allows slower, more sustained absorption.”
c. “You may use the deltoid site when using this method.”
d. “I should use a 27-gauge needle to minimize discomfort with this method.”
ANS: A
The Z-track method is used to prevent staining of the skin. It does not affect absorption. The
ventrogluteal site is preferred, and, generally, the needle is a larger bore.

DIF: Cognitive Level: Applying (Application) REF: p. 104


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

15. The nurse is preparing to start an IV line in a preschool-age child. After applying a eutectic
mixture of local anesthetics, what will the nurse do to prepare the child?
a. Describe what the IV line will feel like and how long it will be in place.
b. Explain the purpose of the procedure.
c. Give the child equipment to handle and practice on a doll.
d. Reassure the child that the pain will only last a few minutes.
ANS: C
Test Bank for Pharmacology: A Patient-Centered Nursing Process Approach 9th Edition

Preschool children should be allowed to play with and handle equipment and give “play”
injections using a doll or stuffed animal. Describing the procedure or discussing pain will
only heighten anxiety.

DIF: Cognitive Level: Applying (Application) REF: p. 107


TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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