NRSG 200 Exam 2: Medication Administration UPDATED ACTUAL Questions
and CORRECT Answers
Routes of Administration Enteral (GI tract) : oral, sublingual, buccal
Parenteral (alternative to GI tract): IV, IM, SubQ, ID,
Other: Topical, Transdermal Patch, Inhalation, Otic, Ophthalmic, Nasal, Vaginal,
Rectal, NG/ Gastronomy Tube
Oral Route & Considerations most common, convenient, slow onset
Cons: First-pass metabolism, NPO, N/V, GI issues, inability to swallow, crush only
scored tablets
Factors: stability, solubility, GI pH, emptying time, presence of food, concurrent
med, forms of med.
Types: Solid: tablet, capsules, gel caps Liquid: solutions, suspensions, elixir
syrups
Enteric-coated: dissolves in SI rather than other organs due to irritation
Sustained-release: prolonged effects Ex. SR,XR,ER,XL,CR
Sublingual Route & Considerations in pocket under the tongue -> fast absorption (high vascularity & bypass first-pass)
-> dissolve for systematic effect
Cons: Don’t swallow, eat, drink, or crush
Buccal Route & Considerations upper & lower molars between gum & cheek
-> fast absorption (high vascularity & bypass first-pass) -> dissolve for systematic
effect
Cons: Don’t swallow, eat, drink, crush
IV Route & Considerations fastest, full effect
Cons: risk of infection/ irritation
Types: Continuous: directly, consistently controlled in vein over period of time
Bolus: large fluid over time (30min-1hour)
Push: undiluted drug slowly pushed, rapid predictable absorption
Piggyback:
Equipment: 16-gauge (thiccc): clients w/ trauma
18-gauge: surgery & blood administration
22-24 gauge: children, older adults clients w/ medical issues/ stable postop
IM Route & Considerations moderate speed, predictable rate of absorption
Purpose: vaccines, immunizations, hormones, pain, antiemetics
Cons: risk of tissue injury, painful
Location:
Deltoid: 3-5cm below acromion process
Vastus lateralis: center between trochanter and knee, infants <1
Gluteus medius: hands on anterior iliac spine
, SubQ Route & Considerations slow, steady absorption, prolonged effect, don't aspirate
Cons: rotate site (irritation)
Location: outer behind forearm, abdomen (avoid umbilicus), anterior thigh
Equipment: 1 mL ⅜-⅝ inch needle, 90 degree angle (more fat), 45 degree angle
(less fat)
Insulin: measured in units (18-20 gauge)
Factors: solubility of medication in water, blood perfusion at site of injection >
large holes in capillaries
Intradermal Route & Considerations very slow, little under skin
Indication: TB/ skin allergy testing
Equipment: 0.1 mL 0.25-⅝ inch of needle small gauge: 25/27, 5-15 degree angle
bevel up
Technique: Clean 2 inch area w/ alcohol pad in circular motion
Cons: Avoid areas with scar, bruises, tenderness
Injection Technique & Equipment Z-track to decrease pain/ irritation and seal medication in, 10 seconds for every 1
mL (non-dominant hand pull skin over 1 inch) -> inject -> aspiration (not hit blood
vessels) -> inject -> remove & add pressure
Vials: using blunt needle, inject same amount of air the same amount of med you
withdraw (vacuum)
Ampoules: using filter needle (prevents shards of glass), withdraw amount (one-
time use)
Topical Higher concentration -> prolonged contact
-> more absorption (systemic/local)
Ex. dermatologic creams, ointments, lotions, gels, powders, transdermal patch
Transdermal patch sustained effect
-Make sure skin is clean, dry, intact, not impaired, no hairs, and rotate the site
-Note/ Write: Date, Time, Initial on Patch
-Document: Location of patch
Inhalation fastest absorption (alveolar vascularity & large surface area), small dose needed,
technique important
Types: Metered dose inhalers, dry powder, nebulizer
Ex. Adrenocorticosteroids, bronchodilators, antiallergic meds
Technique: Inhale & exhale -> press & inhale 3-5 seconds -> hold breath for 10
seconds -> exhale through purse lips-> steroid rinse
Cons: Oral thrush (med on cheek, mouth, lips) if no rinse
Otic (ear) Pull the pinna up and outwards
local effect; blocked by wax/ cold solution
Ophthalmic (eye) pocket of inner cantus
local effect; self-administration may be tricky
Nasal easy; treats congestion/allergies
Cons: blocked nose reduces absorption
and CORRECT Answers
Routes of Administration Enteral (GI tract) : oral, sublingual, buccal
Parenteral (alternative to GI tract): IV, IM, SubQ, ID,
Other: Topical, Transdermal Patch, Inhalation, Otic, Ophthalmic, Nasal, Vaginal,
Rectal, NG/ Gastronomy Tube
Oral Route & Considerations most common, convenient, slow onset
Cons: First-pass metabolism, NPO, N/V, GI issues, inability to swallow, crush only
scored tablets
Factors: stability, solubility, GI pH, emptying time, presence of food, concurrent
med, forms of med.
Types: Solid: tablet, capsules, gel caps Liquid: solutions, suspensions, elixir
syrups
Enteric-coated: dissolves in SI rather than other organs due to irritation
Sustained-release: prolonged effects Ex. SR,XR,ER,XL,CR
Sublingual Route & Considerations in pocket under the tongue -> fast absorption (high vascularity & bypass first-pass)
-> dissolve for systematic effect
Cons: Don’t swallow, eat, drink, or crush
Buccal Route & Considerations upper & lower molars between gum & cheek
-> fast absorption (high vascularity & bypass first-pass) -> dissolve for systematic
effect
Cons: Don’t swallow, eat, drink, crush
IV Route & Considerations fastest, full effect
Cons: risk of infection/ irritation
Types: Continuous: directly, consistently controlled in vein over period of time
Bolus: large fluid over time (30min-1hour)
Push: undiluted drug slowly pushed, rapid predictable absorption
Piggyback:
Equipment: 16-gauge (thiccc): clients w/ trauma
18-gauge: surgery & blood administration
22-24 gauge: children, older adults clients w/ medical issues/ stable postop
IM Route & Considerations moderate speed, predictable rate of absorption
Purpose: vaccines, immunizations, hormones, pain, antiemetics
Cons: risk of tissue injury, painful
Location:
Deltoid: 3-5cm below acromion process
Vastus lateralis: center between trochanter and knee, infants <1
Gluteus medius: hands on anterior iliac spine
, SubQ Route & Considerations slow, steady absorption, prolonged effect, don't aspirate
Cons: rotate site (irritation)
Location: outer behind forearm, abdomen (avoid umbilicus), anterior thigh
Equipment: 1 mL ⅜-⅝ inch needle, 90 degree angle (more fat), 45 degree angle
(less fat)
Insulin: measured in units (18-20 gauge)
Factors: solubility of medication in water, blood perfusion at site of injection >
large holes in capillaries
Intradermal Route & Considerations very slow, little under skin
Indication: TB/ skin allergy testing
Equipment: 0.1 mL 0.25-⅝ inch of needle small gauge: 25/27, 5-15 degree angle
bevel up
Technique: Clean 2 inch area w/ alcohol pad in circular motion
Cons: Avoid areas with scar, bruises, tenderness
Injection Technique & Equipment Z-track to decrease pain/ irritation and seal medication in, 10 seconds for every 1
mL (non-dominant hand pull skin over 1 inch) -> inject -> aspiration (not hit blood
vessels) -> inject -> remove & add pressure
Vials: using blunt needle, inject same amount of air the same amount of med you
withdraw (vacuum)
Ampoules: using filter needle (prevents shards of glass), withdraw amount (one-
time use)
Topical Higher concentration -> prolonged contact
-> more absorption (systemic/local)
Ex. dermatologic creams, ointments, lotions, gels, powders, transdermal patch
Transdermal patch sustained effect
-Make sure skin is clean, dry, intact, not impaired, no hairs, and rotate the site
-Note/ Write: Date, Time, Initial on Patch
-Document: Location of patch
Inhalation fastest absorption (alveolar vascularity & large surface area), small dose needed,
technique important
Types: Metered dose inhalers, dry powder, nebulizer
Ex. Adrenocorticosteroids, bronchodilators, antiallergic meds
Technique: Inhale & exhale -> press & inhale 3-5 seconds -> hold breath for 10
seconds -> exhale through purse lips-> steroid rinse
Cons: Oral thrush (med on cheek, mouth, lips) if no rinse
Otic (ear) Pull the pinna up and outwards
local effect; blocked by wax/ cold solution
Ophthalmic (eye) pocket of inner cantus
local effect; self-administration may be tricky
Nasal easy; treats congestion/allergies
Cons: blocked nose reduces absorption
