Medication Administration in Clinical Settings - NURS 121L-A (2026
Update) WCU
1. A nurse is preparing to administer digoxin to a client with heart failure. Which
assessment finding requires the nurse to withhold the medication and notify the
provider?
A. Blood pressure 110/70 mmHg
B. Potassium level 4.2 mEq/L
C. Respiratory rate 18 breaths per minute
D. Apical heart rate 54 beats per minute
Answer: D
Rationale: Digoxin is a cardiac glycoside that slows the heart rate; it should be withheld if
the apical pulse is less than 60 bpm in adults to prevent bradycardia.
2. When administering insulin, the nurse knows that which type of insulin
should never be mixed in the same syringe with any other insulin?
A. NPH insulin
B. Insulin glargine
C. Regular insulin
D. Insulin lispro
Answer: B
Rationale: Insulin glargine (Lantus) is a long-acting insulin with a low pH that can
precipitate if mixed with other insulins, altering its absorption and peak.
,3. A client is prescribed 1,000 mL of 0.9% Normal Saline to infuse over 8 hours.
The drop factor is 15 gtt/mL. What is the correct flow rate in drops per minute
(gtt/min)?
A. 25 gtt/min
B. 31 gtt/min
C. 42 gtt/min
D. 125 gtt/min
Answer: B
Rationale: Calculation: (1000 mL / 480 min) * 15 gtt/mL = 31.25, rounded to 31 gtt/min.
4. The nurse is teaching a client about a new prescription for a transdermal
nitroglycerin patch. Which instruction is most important?
A. Apply the patch to the same site every day.
B. Shave the area before applying the patch.
C. Remove the old patch before applying a new one.
D. Massage the patch after application to increase absorption.
Answer: C
Rationale: Removing the old patch prevents medication overlap and potential toxicity;
sites should be rotated, and hair should be clipped, not shaved, to avoid irritation.
5. Which route of medication administration provides the most rapid onset of
action?
A. Intramuscular (IM)
B. Intravenous (IV)
C. Subcutaneous (Subcut)
D. Oral (PO)
Answer: B
Rationale: The intravenous route enters the systemic circulation immediately, bypassing
the absorption process required by other routes.
, 6. A client is to receive 5,000 units of Heparin subcutaneously. The vial is labeled
10,000 units/mL. How many mL should the nurse administer?
A. 1.0 mL
B. 2.0 mL
C. 0.5 mL
D. 0.25 mL
Answer: C
Rationale: Calculation: 5,000 units / 10,000 units/mL = 0.5 mL.
7. According to the 2026 clinical updates, which is the preferred site for an
intramuscular injection of 2 mL of medication in a well-developed adult?
A. Dorsogluteal
B. Ventrogluteal
C. Vastus Lateralis
D. Deltoid
Answer: B
Rationale: The ventrogluteal site is the preferred site for IM injections because it is away
from major nerves and blood vessels and can accommodate larger volumes.
8. While administering medications, the nurse realizes a medication error has
occurred. What is the nurse’s first priority action?
A. Assess the client’s vital signs and status.
B. Notify the healthcare provider.
C. Complete an incident report.
D. Inform the nurse manager.
Answer: A
Rationale: The first priority after a medication error is the safety and assessment of the
client to determine if any adverse effects have occurred.
Update) WCU
1. A nurse is preparing to administer digoxin to a client with heart failure. Which
assessment finding requires the nurse to withhold the medication and notify the
provider?
A. Blood pressure 110/70 mmHg
B. Potassium level 4.2 mEq/L
C. Respiratory rate 18 breaths per minute
D. Apical heart rate 54 beats per minute
Answer: D
Rationale: Digoxin is a cardiac glycoside that slows the heart rate; it should be withheld if
the apical pulse is less than 60 bpm in adults to prevent bradycardia.
2. When administering insulin, the nurse knows that which type of insulin
should never be mixed in the same syringe with any other insulin?
A. NPH insulin
B. Insulin glargine
C. Regular insulin
D. Insulin lispro
Answer: B
Rationale: Insulin glargine (Lantus) is a long-acting insulin with a low pH that can
precipitate if mixed with other insulins, altering its absorption and peak.
,3. A client is prescribed 1,000 mL of 0.9% Normal Saline to infuse over 8 hours.
The drop factor is 15 gtt/mL. What is the correct flow rate in drops per minute
(gtt/min)?
A. 25 gtt/min
B. 31 gtt/min
C. 42 gtt/min
D. 125 gtt/min
Answer: B
Rationale: Calculation: (1000 mL / 480 min) * 15 gtt/mL = 31.25, rounded to 31 gtt/min.
4. The nurse is teaching a client about a new prescription for a transdermal
nitroglycerin patch. Which instruction is most important?
A. Apply the patch to the same site every day.
B. Shave the area before applying the patch.
C. Remove the old patch before applying a new one.
D. Massage the patch after application to increase absorption.
Answer: C
Rationale: Removing the old patch prevents medication overlap and potential toxicity;
sites should be rotated, and hair should be clipped, not shaved, to avoid irritation.
5. Which route of medication administration provides the most rapid onset of
action?
A. Intramuscular (IM)
B. Intravenous (IV)
C. Subcutaneous (Subcut)
D. Oral (PO)
Answer: B
Rationale: The intravenous route enters the systemic circulation immediately, bypassing
the absorption process required by other routes.
, 6. A client is to receive 5,000 units of Heparin subcutaneously. The vial is labeled
10,000 units/mL. How many mL should the nurse administer?
A. 1.0 mL
B. 2.0 mL
C. 0.5 mL
D. 0.25 mL
Answer: C
Rationale: Calculation: 5,000 units / 10,000 units/mL = 0.5 mL.
7. According to the 2026 clinical updates, which is the preferred site for an
intramuscular injection of 2 mL of medication in a well-developed adult?
A. Dorsogluteal
B. Ventrogluteal
C. Vastus Lateralis
D. Deltoid
Answer: B
Rationale: The ventrogluteal site is the preferred site for IM injections because it is away
from major nerves and blood vessels and can accommodate larger volumes.
8. While administering medications, the nurse realizes a medication error has
occurred. What is the nurse’s first priority action?
A. Assess the client’s vital signs and status.
B. Notify the healthcare provider.
C. Complete an incident report.
D. Inform the nurse manager.
Answer: A
Rationale: The first priority after a medication error is the safety and assessment of the
client to determine if any adverse effects have occurred.
