A nurse knows that patient education has been effective when the patient states - AN-
SWER "I will rotate the location where I give myself injections."
Which statement by the patient is an indication to use the Z-track method? - ANSWER
"The last shot like that turned my skin colors."
A 2-year-old child is ordered to have ear irrigation performed daily. The nurse correctly per-
forms the procedure by - ANSWER Pulling the auricle down and back to straighten the
ear canal.
A patient has an order to receive 10 units of U-50 insulin. The nurse is using a U-100 syringe.
How many units should the nurse draw up in the syringe and administer? - ANSWER 20
units
A patient has an order to receive 20 units of U-50 insulin. The nurse is using a U-100 syringe.
How many units should the nurse draw up in the syringe and administer? - ANSWER 0.4
mL
The patient is to receive phenytoin (Dilantin) at 0900. The nurse knows that the ideal time to
draw a trough level is - ANSWER 0830.
A patient who has been receiving intermittent chemotherapy through a peripheral IV site is
ordered to receive a high dose of vancomycin through the same vein. Why does this concern
the nurse? - ANSWER Chemotherapy is irritating to the vascular system and may cause
the vein to infiltrate.
A physician orders 1000 mL of normal saline to infuse at a rate of 50 mL/hr. The nurse plans
on hanging a new bag at what time? - ANSWER 20 hours
1
,The nurse is preparing to administer a 0.5-mL rabies vaccine into the deltoid muscle of a pa-
tient. Which needle size is best for the procedure? - ANSWER 25 gauge x 5/8 inch
The nurse knows that the purpose of aspiration on IM injections is to - ANSWER Ensure
proper placement of the needle.
The nurse is giving an IM injection. Upon aspiration, the nurse notices blood return in the sy-
ringe. What should the nurse do? - ANSWER Withdraw the needle and prepare the injec-
tion again.
The nurse is planning to administer a tuberculin test with a 27-gauge, 3/8-inch needle. The
nurse should insert the needle at an angle of _____ degrees. - ANSWER 15
The nurse knows to assess for signs of medication toxicity within older adults because of
which physiological change? - ANSWER Reduced glomerular filtration
A registered nurse interprets that a scribbled medication order reads 25 mg. The nurse ad-
ministers 25 mg of the medication to a patient, and then discovers that the dose was incor-
rectly interpreted and should have been 15 mg. Who is ultimately responsible for the error?
- ANSWER Nurse
A patient is to receive medication through a nasogastric tube. What is the most important
nursing action to ensure effective absorption? - ANSWER Clamp suction for 30 to 60
minutes after medication administration.
Aspirin is an analgesic, antipyretic, antiplatelet, and anti-inflammatory agent. A physician
writes for aspirin 650 mg every 4 to 6 hours prn: febrile. For which patient would this order
be appropriate? - ANSWER 62-year-old female with pneumonia
2
, A patient is in need of immediate pain relief for a severe headache. The nurse knows that
which medication will be absorbed the quickest? - ANSWER Hydromorphone (Dilaudid) 4
mg IV
A drug requires a low pH to be metabolized. Knowing this, the nurse anticipates that the
medication will be administered by which route? - ANSWER Oral
The nurse knows that an idiosyncratic event with the stimulant pseudoephedrine (Sudafed)
is occurring when the patient - ANSWER Falls asleep during daily activities.
An order is written for (phenytoin) Dilantin 500 mg IM q3-4h prn for pain. The nurse recog-
nizes that treatment of pain is not a standard therapeutic indication for this drug. The nurse
believes that the prescriber meant to write for hydromorphone (Dilaudid). What should the
nurse do? - ANSWER Call the prescriber to clarify and justify the order.
A patient needs assistance excreting a gaseous medication. What is the correct nursing ac-
tion? - ANSWER Encourage the patient to cough and deep-breathe.
A nurse has withdrawn a narcotic from the medication dispenser. Upon checking the drug
against the medication administration record, the nurse notices that the narcotic order has
expired. What should be the nurse's first action? - ANSWER Return the medication to the
medication dispenser according to protocol.
The nurse knows that patient education about a buccal medication has been effective when
the patient states - ANSWER "I should let the medication dissolve completely."
What is the nurse's priority action to protect a patient from medication error? - ANSWER
Requesting that the prescriber write out an order, rather than giving a verbal order
The patient is in severe pain and is requesting a prn medication before the prn time interval
has elapsed. The nurse's priority is to - ANSWER Call the prescriber and request a stat or-
der.
3
SWER "I will rotate the location where I give myself injections."
Which statement by the patient is an indication to use the Z-track method? - ANSWER
"The last shot like that turned my skin colors."
A 2-year-old child is ordered to have ear irrigation performed daily. The nurse correctly per-
forms the procedure by - ANSWER Pulling the auricle down and back to straighten the
ear canal.
A patient has an order to receive 10 units of U-50 insulin. The nurse is using a U-100 syringe.
How many units should the nurse draw up in the syringe and administer? - ANSWER 20
units
A patient has an order to receive 20 units of U-50 insulin. The nurse is using a U-100 syringe.
How many units should the nurse draw up in the syringe and administer? - ANSWER 0.4
mL
The patient is to receive phenytoin (Dilantin) at 0900. The nurse knows that the ideal time to
draw a trough level is - ANSWER 0830.
A patient who has been receiving intermittent chemotherapy through a peripheral IV site is
ordered to receive a high dose of vancomycin through the same vein. Why does this concern
the nurse? - ANSWER Chemotherapy is irritating to the vascular system and may cause
the vein to infiltrate.
A physician orders 1000 mL of normal saline to infuse at a rate of 50 mL/hr. The nurse plans
on hanging a new bag at what time? - ANSWER 20 hours
1
,The nurse is preparing to administer a 0.5-mL rabies vaccine into the deltoid muscle of a pa-
tient. Which needle size is best for the procedure? - ANSWER 25 gauge x 5/8 inch
The nurse knows that the purpose of aspiration on IM injections is to - ANSWER Ensure
proper placement of the needle.
The nurse is giving an IM injection. Upon aspiration, the nurse notices blood return in the sy-
ringe. What should the nurse do? - ANSWER Withdraw the needle and prepare the injec-
tion again.
The nurse is planning to administer a tuberculin test with a 27-gauge, 3/8-inch needle. The
nurse should insert the needle at an angle of _____ degrees. - ANSWER 15
The nurse knows to assess for signs of medication toxicity within older adults because of
which physiological change? - ANSWER Reduced glomerular filtration
A registered nurse interprets that a scribbled medication order reads 25 mg. The nurse ad-
ministers 25 mg of the medication to a patient, and then discovers that the dose was incor-
rectly interpreted and should have been 15 mg. Who is ultimately responsible for the error?
- ANSWER Nurse
A patient is to receive medication through a nasogastric tube. What is the most important
nursing action to ensure effective absorption? - ANSWER Clamp suction for 30 to 60
minutes after medication administration.
Aspirin is an analgesic, antipyretic, antiplatelet, and anti-inflammatory agent. A physician
writes for aspirin 650 mg every 4 to 6 hours prn: febrile. For which patient would this order
be appropriate? - ANSWER 62-year-old female with pneumonia
2
, A patient is in need of immediate pain relief for a severe headache. The nurse knows that
which medication will be absorbed the quickest? - ANSWER Hydromorphone (Dilaudid) 4
mg IV
A drug requires a low pH to be metabolized. Knowing this, the nurse anticipates that the
medication will be administered by which route? - ANSWER Oral
The nurse knows that an idiosyncratic event with the stimulant pseudoephedrine (Sudafed)
is occurring when the patient - ANSWER Falls asleep during daily activities.
An order is written for (phenytoin) Dilantin 500 mg IM q3-4h prn for pain. The nurse recog-
nizes that treatment of pain is not a standard therapeutic indication for this drug. The nurse
believes that the prescriber meant to write for hydromorphone (Dilaudid). What should the
nurse do? - ANSWER Call the prescriber to clarify and justify the order.
A patient needs assistance excreting a gaseous medication. What is the correct nursing ac-
tion? - ANSWER Encourage the patient to cough and deep-breathe.
A nurse has withdrawn a narcotic from the medication dispenser. Upon checking the drug
against the medication administration record, the nurse notices that the narcotic order has
expired. What should be the nurse's first action? - ANSWER Return the medication to the
medication dispenser according to protocol.
The nurse knows that patient education about a buccal medication has been effective when
the patient states - ANSWER "I should let the medication dissolve completely."
What is the nurse's priority action to protect a patient from medication error? - ANSWER
Requesting that the prescriber write out an order, rather than giving a verbal order
The patient is in severe pain and is requesting a prn medication before the prn time interval
has elapsed. The nurse's priority is to - ANSWER Call the prescriber and request a stat or-
der.
3
