KAPLAN NCLEX-RN Medication Administration PREP
EXAM 2026 EDITION Q&A
1 A nurse is preparing to administer medication to a patient.
Which action represents the MOST critical step in preventing
medication errors?
A. Checking the medication label against the medication
administration record (MAR)
B. Verifying the patient's identity using two identifiers
C. Calculating the dosage carefully before administration
D. Washing hands before handling medications
Correct Answer: B
Explanation: Verifying patient identity using two identifiers is
the most critical step because administering medication to the
wrong patient is the most serious error. While all options are
important, the Seven Rights include "right patient" as
paramount. Checking the label (A) is part of "right medication,"
dosage calculation (C) is part of "right dose," and hand hygiene
(D) prevents infection but doesn't prevent medication errors
directly.
2 A patient is receiving vancomycin via IV infusion and develops
flushing, pruritus, and an erythematous rash on the face, neck,
and upper torso. What is the nurse's FIRST priority action?
A. Stop the infusion immediately and notify the physician
B. Slow the infusion rate and monitor the patient
C. Administer diphenhydramine as prescribed
D. Continue the infusion and document the findings
Correct Answer: A
,Explanation: These symptoms indicate Red Man Syndrome, a
reaction to rapid vancomycin infusion. The FIRST priority is to
stop the infusion immediately to prevent progression to more
severe reactions. Slowing the infusion (B) is inappropriate once
symptoms appear. Diphenhydramine (C) may be given after
stopping the infusion. Continuing the infusion (D) could cause
life-threatening complications.
3 When administering a subcutaneous injection of insulin, which
technique is MOST appropriate for a patient with limited
subcutaneous tissue?
A. Use a 90-degree angle without pinching the skin
B. Pinch the skin and use a 45-degree angle
C. Use a 90-degree angle with skin pinched
D. Spread the skin taut and use a 45-degree angle
Correct Answer: B
Explanation: For patients with limited subcutaneous tissue,
pinching the skin and using a 45-degree angle prevents
intramuscular injection. A 90-degree angle (A, C) is appropriate
for patients with adequate subcutaneous tissue. Spreading skin
taut (D) is used for intramuscular injections, not subcutaneous.
4 A nurse is preparing to administer 40 mEq of oral potassium
chloride to a patient with hypokalemia. What is the MOST
important safety measure?
A. Administer the medication diluted in at least 4 ounces of water
or juice
B. Give the medication undiluted for faster absorption
C. Administer with antacids to reduce gastric irritation
,D. Give the medication immediately after breakfast without fluid
Correct Answer: A
Explanation: Oral potassium must always be diluted in at least 4
ounces of fluid to prevent gastric irritation and esophageal
damage. Undiluted potassium (B) causes severe gastrointestinal
damage. Antacids (C) may interfere with absorption. Giving
without fluid (D) increases risk of irritation.
5 Which patient requires the nurse to double-check the
medication dosage with another licensed nurse before
administration?
A. A patient receiving routine metoprolol for hypertension
B. A patient receiving high-alert medication like insulin or
heparin
C. A patient receiving multivitamins daily
D. A patient receiving acetaminophen for mild pain
Correct Answer: B
Explanation: High-alert medications such as insulin, heparin,
concentrated electrolytes, and opioids require double-checking
by another licensed nurse to prevent catastrophic errors.
Routine medications (A, C, D) do not require this additional
safety measure unless there's a specific concern.
6 A nurse is administering medication through a
percutaneous/endoscopic gastrostomy (PEG) tube. Which action
is MOST appropriate?
A. Crush all medications and mix with 15 mL of water
B. Check tube placement, flush with 30 mL water, give
medications separately, then flush again
, C. Give all medications together to save time, then flush once
D. Use scheduled medications only; avoid emergency medications
Correct Answer: B
Explanation: Proper PEG tube medication administration
requires checking placement, flushing before and after, and
giving medications separately to prevent clogging. Crushing all
medications (A) is incorrect as some cannot be crushed. Giving
together (C) causes clogging. Emergency medications can and
should be given via PEG tube when needed.
7 When administering an intramuscular injection to an adult,
which anatomical site is MOST appropriate for a 3 mL
medication?
A. Deltoid
B. Dorsal gluteal
C. Ventrogluteal
D. Subscapular
Correct Answer: C
Explanation: The ventrogluteal site is the safest and most
appropriate for 3 mL intramuscular injections in adults because
it has thick muscle tissue and is远离 major nerves and blood
vessels. Deltoid (A) is limited to 1 mL. Dorsal gluteal (B) is
avoided due to proximity to the sciatic nerve. Subscapular (D) is
not an IM injection site.
8 A patient is prescribed warfarin (Coumadin). Which patient
statement indicates a NEED FOR ADDITIONAL TEACHING?
A. "I will use a soft toothbrush and floss gently"
B. "I will avoid kale and spinach because they contain vitamin K"
EXAM 2026 EDITION Q&A
1 A nurse is preparing to administer medication to a patient.
Which action represents the MOST critical step in preventing
medication errors?
A. Checking the medication label against the medication
administration record (MAR)
B. Verifying the patient's identity using two identifiers
C. Calculating the dosage carefully before administration
D. Washing hands before handling medications
Correct Answer: B
Explanation: Verifying patient identity using two identifiers is
the most critical step because administering medication to the
wrong patient is the most serious error. While all options are
important, the Seven Rights include "right patient" as
paramount. Checking the label (A) is part of "right medication,"
dosage calculation (C) is part of "right dose," and hand hygiene
(D) prevents infection but doesn't prevent medication errors
directly.
2 A patient is receiving vancomycin via IV infusion and develops
flushing, pruritus, and an erythematous rash on the face, neck,
and upper torso. What is the nurse's FIRST priority action?
A. Stop the infusion immediately and notify the physician
B. Slow the infusion rate and monitor the patient
C. Administer diphenhydramine as prescribed
D. Continue the infusion and document the findings
Correct Answer: A
,Explanation: These symptoms indicate Red Man Syndrome, a
reaction to rapid vancomycin infusion. The FIRST priority is to
stop the infusion immediately to prevent progression to more
severe reactions. Slowing the infusion (B) is inappropriate once
symptoms appear. Diphenhydramine (C) may be given after
stopping the infusion. Continuing the infusion (D) could cause
life-threatening complications.
3 When administering a subcutaneous injection of insulin, which
technique is MOST appropriate for a patient with limited
subcutaneous tissue?
A. Use a 90-degree angle without pinching the skin
B. Pinch the skin and use a 45-degree angle
C. Use a 90-degree angle with skin pinched
D. Spread the skin taut and use a 45-degree angle
Correct Answer: B
Explanation: For patients with limited subcutaneous tissue,
pinching the skin and using a 45-degree angle prevents
intramuscular injection. A 90-degree angle (A, C) is appropriate
for patients with adequate subcutaneous tissue. Spreading skin
taut (D) is used for intramuscular injections, not subcutaneous.
4 A nurse is preparing to administer 40 mEq of oral potassium
chloride to a patient with hypokalemia. What is the MOST
important safety measure?
A. Administer the medication diluted in at least 4 ounces of water
or juice
B. Give the medication undiluted for faster absorption
C. Administer with antacids to reduce gastric irritation
,D. Give the medication immediately after breakfast without fluid
Correct Answer: A
Explanation: Oral potassium must always be diluted in at least 4
ounces of fluid to prevent gastric irritation and esophageal
damage. Undiluted potassium (B) causes severe gastrointestinal
damage. Antacids (C) may interfere with absorption. Giving
without fluid (D) increases risk of irritation.
5 Which patient requires the nurse to double-check the
medication dosage with another licensed nurse before
administration?
A. A patient receiving routine metoprolol for hypertension
B. A patient receiving high-alert medication like insulin or
heparin
C. A patient receiving multivitamins daily
D. A patient receiving acetaminophen for mild pain
Correct Answer: B
Explanation: High-alert medications such as insulin, heparin,
concentrated electrolytes, and opioids require double-checking
by another licensed nurse to prevent catastrophic errors.
Routine medications (A, C, D) do not require this additional
safety measure unless there's a specific concern.
6 A nurse is administering medication through a
percutaneous/endoscopic gastrostomy (PEG) tube. Which action
is MOST appropriate?
A. Crush all medications and mix with 15 mL of water
B. Check tube placement, flush with 30 mL water, give
medications separately, then flush again
, C. Give all medications together to save time, then flush once
D. Use scheduled medications only; avoid emergency medications
Correct Answer: B
Explanation: Proper PEG tube medication administration
requires checking placement, flushing before and after, and
giving medications separately to prevent clogging. Crushing all
medications (A) is incorrect as some cannot be crushed. Giving
together (C) causes clogging. Emergency medications can and
should be given via PEG tube when needed.
7 When administering an intramuscular injection to an adult,
which anatomical site is MOST appropriate for a 3 mL
medication?
A. Deltoid
B. Dorsal gluteal
C. Ventrogluteal
D. Subscapular
Correct Answer: C
Explanation: The ventrogluteal site is the safest and most
appropriate for 3 mL intramuscular injections in adults because
it has thick muscle tissue and is远离 major nerves and blood
vessels. Deltoid (A) is limited to 1 mL. Dorsal gluteal (B) is
avoided due to proximity to the sciatic nerve. Subscapular (D) is
not an IM injection site.
8 A patient is prescribed warfarin (Coumadin). Which patient
statement indicates a NEED FOR ADDITIONAL TEACHING?
A. "I will use a soft toothbrush and floss gently"
B. "I will avoid kale and spinach because they contain vitamin K"
