NRS 281 - Exam #3 QUESTIONS AND ANSWERS
ALL CORRECT|Medication Administration
A nurse is preparing to administer an IM injection to a client who is overweight. Which of the
following sites should the nurse select for the injection?
a. the lower, medial quadrant of the buttock near the coccyx
b. the side hip between the iliac crest and anterior iliac spine
c. the tissue of the posterior upper arm
d. the lower, inner thigh 4 finger widths above the patella Correct Answer: b. the side hip
between the iliac crest and anterior iliac spine
Ventrogluteal injection: the nurse should prepare for injection by placing a hand on the client's
greater trochanter (right hand on left hip, for example) with the first two fingers touching the
iliac crest and anterior superior iliac spine, forming a "V" shape.
a. dorsogluteal site poses greater risks (sciatic nerve)
c. this site would appropriate for subQ injections
d. to inject in the vastus laterals site, the nurse should select one hand width below the greater
trochanter and one hand width above the patella
Classification of medications Correct Answer: Based on:
- effects on body system
- symptoms relieved by medication
- medication's desired effect
Pharmacokinetics Correct Answer: The study of how medications enter the body, reach their site
of action, metabolize, and exit the body.
ADME
Absorption Correct Answer: Passage of medication molecules into the blood from the site of
administration
Factors that alter absorption:
- route
- ability of medication to dissolve
- blood flow to site of administration
- body surface area (increased surface area = increased absorption)
- lipid solubility of medication (BBB)
Distribution Correct Answer: After absorbed, the medication is distributed to body
tissues/organs (the site of action)
,Rate/extent depends on:
- physical/chemical properties of medication
- physiology of client
** circulation (blood flow to liver decreases with age)
** membrane permeability
** protein binding (decreased albumin with age)
Metabolism Correct Answer: Metabolized into a less potent/inactive form
Biotransformation: enzymes detoxify, break down, & remove active chemicals
Occurs mostly in the liver, but also in the kidneys, blood, intestines, & lungs
Excretion Correct Answer: Medications are excreted by the:
- kidneys
- liver
- bowel
- lungs
- exocrine glands
Chemical makeup of medication determines organ of excretion
Therapeutic effect Correct Answer: expected or predicted physiological response that a
medication causes
Side effects Correct Answer: predictable and often unavoidable secondary effects produced at a
usual therapeutic dose
Adverse effects Correct Answer: unintended, undesirable, and often unpredictable severe
responses to medication
Toxic effects Correct Answer: develop after prolonged intake of a medication or when a
medication accumulates in the blood because of impaired metabolism or excretion
Idiosyncratic reaction Correct Answer: unpredictable effects
a patient overreacts or underreacts to a medication or has a reaction different from normal
Synergistic effect Correct Answer: combined effect of two medications is greater than the effect
of medications given separately
Mild allergic reaction symptoms Correct Answer: Urticaria
Rash
Pruritus
Rhinitis
, Peak Correct Answer: time it takes for a medication to reach its highest effective concentration
Trough Correct Answer: minimum blood serum concentration of medication reached just before
the next scheduled dose
Onset Correct Answer: time it takes after a medication is administered for it to produce a
response
Duration Correct Answer: time during which the medication is present in concentration great
enough to produce a response
Plateau Correct Answer: blood serum concentration of a medication reached and maintained
after repeated fixed doses
Administration of otic medications Correct Answer: Children: upward & backward pulling of
pinna
Adults: downward & backward pulling of pinna
Oral route Correct Answer: easiest and most commonly used
have a slower onset of action and a prolonged effect than parenteral medications
food may interfere or be helpful
protect against aspiration
enteral feedings
Intraocular administration Correct Answer: Into conjunctiva
What is included in all drug orders? Correct Answer: client name
order date
medication name
dosage
route
time of administration
prescriber's name AND signature
types of medication orders Correct Answer: standing/routine
PRN
single/one time
STAT
ALL CORRECT|Medication Administration
A nurse is preparing to administer an IM injection to a client who is overweight. Which of the
following sites should the nurse select for the injection?
a. the lower, medial quadrant of the buttock near the coccyx
b. the side hip between the iliac crest and anterior iliac spine
c. the tissue of the posterior upper arm
d. the lower, inner thigh 4 finger widths above the patella Correct Answer: b. the side hip
between the iliac crest and anterior iliac spine
Ventrogluteal injection: the nurse should prepare for injection by placing a hand on the client's
greater trochanter (right hand on left hip, for example) with the first two fingers touching the
iliac crest and anterior superior iliac spine, forming a "V" shape.
a. dorsogluteal site poses greater risks (sciatic nerve)
c. this site would appropriate for subQ injections
d. to inject in the vastus laterals site, the nurse should select one hand width below the greater
trochanter and one hand width above the patella
Classification of medications Correct Answer: Based on:
- effects on body system
- symptoms relieved by medication
- medication's desired effect
Pharmacokinetics Correct Answer: The study of how medications enter the body, reach their site
of action, metabolize, and exit the body.
ADME
Absorption Correct Answer: Passage of medication molecules into the blood from the site of
administration
Factors that alter absorption:
- route
- ability of medication to dissolve
- blood flow to site of administration
- body surface area (increased surface area = increased absorption)
- lipid solubility of medication (BBB)
Distribution Correct Answer: After absorbed, the medication is distributed to body
tissues/organs (the site of action)
,Rate/extent depends on:
- physical/chemical properties of medication
- physiology of client
** circulation (blood flow to liver decreases with age)
** membrane permeability
** protein binding (decreased albumin with age)
Metabolism Correct Answer: Metabolized into a less potent/inactive form
Biotransformation: enzymes detoxify, break down, & remove active chemicals
Occurs mostly in the liver, but also in the kidneys, blood, intestines, & lungs
Excretion Correct Answer: Medications are excreted by the:
- kidneys
- liver
- bowel
- lungs
- exocrine glands
Chemical makeup of medication determines organ of excretion
Therapeutic effect Correct Answer: expected or predicted physiological response that a
medication causes
Side effects Correct Answer: predictable and often unavoidable secondary effects produced at a
usual therapeutic dose
Adverse effects Correct Answer: unintended, undesirable, and often unpredictable severe
responses to medication
Toxic effects Correct Answer: develop after prolonged intake of a medication or when a
medication accumulates in the blood because of impaired metabolism or excretion
Idiosyncratic reaction Correct Answer: unpredictable effects
a patient overreacts or underreacts to a medication or has a reaction different from normal
Synergistic effect Correct Answer: combined effect of two medications is greater than the effect
of medications given separately
Mild allergic reaction symptoms Correct Answer: Urticaria
Rash
Pruritus
Rhinitis
, Peak Correct Answer: time it takes for a medication to reach its highest effective concentration
Trough Correct Answer: minimum blood serum concentration of medication reached just before
the next scheduled dose
Onset Correct Answer: time it takes after a medication is administered for it to produce a
response
Duration Correct Answer: time during which the medication is present in concentration great
enough to produce a response
Plateau Correct Answer: blood serum concentration of a medication reached and maintained
after repeated fixed doses
Administration of otic medications Correct Answer: Children: upward & backward pulling of
pinna
Adults: downward & backward pulling of pinna
Oral route Correct Answer: easiest and most commonly used
have a slower onset of action and a prolonged effect than parenteral medications
food may interfere or be helpful
protect against aspiration
enteral feedings
Intraocular administration Correct Answer: Into conjunctiva
What is included in all drug orders? Correct Answer: client name
order date
medication name
dosage
route
time of administration
prescriber's name AND signature
types of medication orders Correct Answer: standing/routine
PRN
single/one time
STAT
