NURS 103: Medication Administration & Dosage Calculations
Comprehensive Exam 2026 |WCU
1. A nurse is preparing to administer an intramuscular (IM) injection to a 6-
month-old infant. Which site is the most appropriate for this patient?
A. Dorsogluteal site
B. Ventrogluteal site
C. Deltoid muscle
D. Vastus lateralis
Answer: D
Rationale: The vastus lateralis is the preferred site for IM injections in infants under 12
months because it is the most developed muscle at that age.
2. When mixing regular insulin and NPH insulin in the same syringe, what is the
correct sequence of withdrawal?
A. Withdraw NPH first, then regular insulin
B. It does not matter which is withdrawn first as long as the dose is correct
C. Withdraw regular insulin first, then NPH insulin
D. Withdraw half of the NPH, then all of the regular, then the rest of the NPH
Answer: C
Rationale: Regular insulin (clear) should be drawn up before NPH insulin (cloudy) to
prevent contaminating the clear insulin vial with the cloudy, longer-acting protein.
,3. A physician orders 1,000 mL of 0.9% Normal Saline to infuse over 8 hours. At
what rate in mL/hr should the nurse set the infusion pump?
A. 100 mL/hr
B. 120 mL/hr
C. 150 mL/hr
D. 125 mL/hr
Answer: D
Rationale: Total volume (1,000 mL) divided by total time (8 hours) equals 125 mL/hr.
4. Which action should the nurse take first if a medication error is discovered?
A. Complete an incident or occurrence report
B. Notify the healthcare provider
C. Assess the patient’s condition and vital signs
D. Notify the nurse manager
Answer: C
Rationale: The nurse’s priority is always patient safety; therefore, assessing the patient for
adverse effects is the immediate first step.
5. The nurse is administering ear drops to a 2-year-old child. How should the
nurse manipulate the auricle?
A. Pull the auricle upward and outward
B. Pull the auricle straight back
C. Pull the auricle downward and backward
D. Pull the auricle upward and backward
Answer: C
Rationale: For children under 3 years old, the ear canal is straightened by pulling the
auricle down and back. For adults, it is pulled up and back.
, 6. What is the primary purpose of using the Z-track technique for an
intramuscular injection?
A. To reduce the pain of the injection
B. To ensure the medication reaches the bone
C. To prevent medication from leaking back into the subcutaneous tissue
D. To speed up the absorption of the medication
Answer: C
Rationale: The Z-track method creates a zigzag path that seals the medication in the
muscle and prevents it from tracking back into sensitive subcutaneous tissue or staining
the skin.
7. An order reads: ‘Digoxin 0.125 mg PO daily.’ The pharmacy provides Digoxin
0.25 mg tablets. How many tablets will the nurse administer?
A. 2 tablets
B. 0.5 tablets
C. 1 tablet
D. 1.5 tablets
Answer: B
Rationale: 0.125 mg (desired) divided by 0.25 mg (have) equals 0.5 tablets.
8. Which of the following is considered a ‘High-Alert’ medication requiring
double-checking by another nurse?
A. Acetaminophen
B. Multivitamins
C. Amoxicillin
D. Subcutaneous Heparin
Answer: D
Rationale: Heparin, along with insulin and chemotherapy agents, is a high-alert medication
because it has a high risk of causing significant patient harm when used in error.
Comprehensive Exam 2026 |WCU
1. A nurse is preparing to administer an intramuscular (IM) injection to a 6-
month-old infant. Which site is the most appropriate for this patient?
A. Dorsogluteal site
B. Ventrogluteal site
C. Deltoid muscle
D. Vastus lateralis
Answer: D
Rationale: The vastus lateralis is the preferred site for IM injections in infants under 12
months because it is the most developed muscle at that age.
2. When mixing regular insulin and NPH insulin in the same syringe, what is the
correct sequence of withdrawal?
A. Withdraw NPH first, then regular insulin
B. It does not matter which is withdrawn first as long as the dose is correct
C. Withdraw regular insulin first, then NPH insulin
D. Withdraw half of the NPH, then all of the regular, then the rest of the NPH
Answer: C
Rationale: Regular insulin (clear) should be drawn up before NPH insulin (cloudy) to
prevent contaminating the clear insulin vial with the cloudy, longer-acting protein.
,3. A physician orders 1,000 mL of 0.9% Normal Saline to infuse over 8 hours. At
what rate in mL/hr should the nurse set the infusion pump?
A. 100 mL/hr
B. 120 mL/hr
C. 150 mL/hr
D. 125 mL/hr
Answer: D
Rationale: Total volume (1,000 mL) divided by total time (8 hours) equals 125 mL/hr.
4. Which action should the nurse take first if a medication error is discovered?
A. Complete an incident or occurrence report
B. Notify the healthcare provider
C. Assess the patient’s condition and vital signs
D. Notify the nurse manager
Answer: C
Rationale: The nurse’s priority is always patient safety; therefore, assessing the patient for
adverse effects is the immediate first step.
5. The nurse is administering ear drops to a 2-year-old child. How should the
nurse manipulate the auricle?
A. Pull the auricle upward and outward
B. Pull the auricle straight back
C. Pull the auricle downward and backward
D. Pull the auricle upward and backward
Answer: C
Rationale: For children under 3 years old, the ear canal is straightened by pulling the
auricle down and back. For adults, it is pulled up and back.
, 6. What is the primary purpose of using the Z-track technique for an
intramuscular injection?
A. To reduce the pain of the injection
B. To ensure the medication reaches the bone
C. To prevent medication from leaking back into the subcutaneous tissue
D. To speed up the absorption of the medication
Answer: C
Rationale: The Z-track method creates a zigzag path that seals the medication in the
muscle and prevents it from tracking back into sensitive subcutaneous tissue or staining
the skin.
7. An order reads: ‘Digoxin 0.125 mg PO daily.’ The pharmacy provides Digoxin
0.25 mg tablets. How many tablets will the nurse administer?
A. 2 tablets
B. 0.5 tablets
C. 1 tablet
D. 1.5 tablets
Answer: B
Rationale: 0.125 mg (desired) divided by 0.25 mg (have) equals 0.5 tablets.
8. Which of the following is considered a ‘High-Alert’ medication requiring
double-checking by another nurse?
A. Acetaminophen
B. Multivitamins
C. Amoxicillin
D. Subcutaneous Heparin
Answer: D
Rationale: Heparin, along with insulin and chemotherapy agents, is a high-alert medication
because it has a high risk of causing significant patient harm when used in error.
