Chapter 3 Medication Administration and the Nursing

1. An infant’s current weight indicates that the maximum safe dose of Tylenol is 30 mg by mouth. The physician orders 65 mg to be given, and the nurse administers Tylenol 65 mg. Who is legally responsible in the event that the infant has a toxic reaction to the medication?

1. A)  The nurse
2. B)  The pharmacist
3. C)  The physician
4. D)  The pharmacy technician

Ans: A
Feedback:
When giving medications, the nurse is legally responsible for safe and accurate administration. This regulation means that the nurse may be held liable for not giving a drug or for giving a wrong drug or dose. The pharmacist is responsible for filling the medication order, but if an error exists in the order and the medication is still administered by the nurse, the nurse is the most responsible. If the physician writes the order but does not administer the medication, then the physician is not legally responsible. The pharmacy technician is not legally responsible.

2. An 80-year-old patient with risk factors for thrombophlebitis is to be administered heparin 5000 units subcutaneously. The heparin vial is labeled 10,000 units/mL. How many milliliters will the nurse administer to the patient?

1. A)  50 mL
2. B)  1.5 mL
3. C)  5 mL
4. D)  0.5 mL

Ans: D
Feedback:
5000 units/X = 10,000 units/1 mL.

3. The physician orders potassium chloride 40 mEq to be added to the patient’s IV solution. The vial reads 10 mEq/5 mL. How many milliliters will be added to the IV solution?

1. A)  0.25 mL
2. B)  20 mL
3. C)  200 mL
4. D)  40 mL

Ans: B
Feedback:
40 mEq/X mL = 10 mEq/5 mL.

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4. You have received an order for a medication to be administered buccally. Where is the medication administered?

1. A)  Eye
2. B)  Vagina
3. C)  Cheek
4. D)  Nose

Ans: C
Feedback:
A medication that has been ordered to be administered buccally is given in the patient’s cheek. The eye, vagina, and nose are not considered part of the buccal mucosa.

5. The nurse is repeatedly unsuccessful in starting an IV on a patient who requires antibiotic therapy. The physician then orders the patient to receive an oral antibiotic. What is the major disadvantage of the oral route over the parenteral route?

1. A)  Slower rate of action
2. B)  Greater adverse effects
3. C)  Increased risk of tolerance
4. D)  Dose must be larger.

Ans: A
Feedback:
The oral route of administration has a slower rate of action. Oral antibiotics do not produce greater adverse effects. The risk of tolerance is equal in intravenous and oral antibiotics. The dose is not necessarily larger in oral versus intravenous antibiotics.

6. A patient has a gastrostomy tube, and the pharmacy has delivered an extended-release tablet. What is the most appropriate action taken by the nurse?

1. A)  Administer the medication orally.
2. B)  Administer the medication through the tube.
3. C)  Crush the medication and administer half of it at a time.
4. D)  Call the pharmacy to obtain an immediate-release form.

Ans: D Feedback:

The most important nursing action is to call the pharmacy to determine whether a liquid or a nonextended-release tablet can be substituted. Extended-release tablets should never be crushed—the patient would be placed at risk for overdose or potentially serious adverse effects or death. If the patient has a gastrostomy tube, then he or she cannot swallow and cannot take the pill orally. The medication cannot be administered through the tube because it will obstruct the tube.