Chapter 21 Oral and Topical Medications

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Chapter 21  Oral and Topical Medications

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. The nurse is administering a buccal medication. Which instruction should be given to the patient?
a.
Hold the medication under the tongue.
b.
Swallow the medication after 30 seconds.
c.
Chew the medication before swallowing.
d.
Hold the medication against the cheek membranes.

ANS: D
Buccal medication is placed between the upper or lower molar teeth and the cheek area and is allowed to dissolve. The sublingual route is used to administer medication under the tongue. Medication is dissolved rather than swallowed using the buccal route.

DIF: Cognitive Level: Applying REF: Text reference: p. 493 |Text reference: p. 499
OBJ: Correctly administer a medication by oral, enteral, and topical routes.
TOP: Buccal Medication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

2. The nurse is preparing to administer a medication. Which of the following is the most critical to assess before medication administration?
a.
Diet history
b.
Allergy history
c.
Surgical history
d.
Drug tolerance

ANS: B
Drug allergies should be listed on each page of the MAR, prominently displayed on the patient’s medical record, and the patient should be wearing the facility’s allergy bracelet. Assessment for drug allergies is necessary before medication is administered. A patient’s diet, surgical, and drug histories are important to assess, but they are not as critical as allergy history, which can reveal life-threatening conditions.

DIF: Cognitive Level: Applying REF: Text reference: p. 495
OBJ: Identify guidelines for administering oral, enteral, and topical medications.
TOP: Allergy History KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

3. The nurse is preparing oral medications for administration. Which action by the nurse is appropriate?
a.
Using a cutting device to cut scored tablets
b.
Unwrapping all of the medications to be given and placing them together in a cup
c.
Crushing capsules and enteric-coated medication for easier swallowing
d.
Holding the medication cup at eye level to pour a liquid dosage

ANS: A
If you have to break a medication to administer half the dosage, use a clean, gloved hand to break the tablet or cut it with a cutting device. Tablets that are to be broken in half must be pre-scored by a manufactured line that transverses the center of the tablet. Tablets that are not pre-scored cannot be broken into equal halves, and the result will be an inaccurate dose. Using a cutting device results in a more even split of the tablet. Wrappers maintain the cleanliness of medications and identify drug name and dose. Not all drugs can be crushed (e.g., capsules, enteric-coated, long-acting/slow-release drugs). The coating of these drugs protects the stomach from irritation or protects the drug from destruction by stomach acids. Liquid medications poured from a stock bottle should be poured into a medication cup that is placed at eye level on a flat surface.

DIF: Cognitive Level: Applying REF: Text reference: p. 496
OBJ: Correctly administer a medication by oral, enteral, and topical routes.
TOP: Cutting Tablets KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

4. The nurse is caring for four patients who require medications at 0900. Which action by the nurse adheres to the six rights of medication administration?
a.
Prepare medications for all of the patients at once and keep the cups separate.
b.
Ask the supervisor to clarify an unclear medication order.
c.
Give the prescribed anticonvulsant between 0830 and 0930.
d.
Leave each patient’s medications at the bedside and return within 30 minutes to make sure they have been taken.

ANS: C
Time-critical medications such as anticonvulsants must be given within 30 minutes of the prescribed time. Prepare medications for one patient at a time. Keep all pages of the MAR for one patient together. This prevents preparation errors. Unclear orders should be clarified with the prescriber before administration. Stay with each patient until the medication is swallowed completely or is taken by the prescribed route.

DIF: Cognitive Level: Applying REF: Text reference: p. 498
OBJ: Correctly administer a medication by oral, enteral, and topical routes.
TOP: Administering Oral Medication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

5. What should the nurse do to assist a patient who is having difficulty swallowing tablets?
a.
Administer the medication with less fluid.
b.
Insert a nasogastric tube and instill the medication.
c.
Crush the medications and administer with a small amount of food.
d.
Administer the tablets one at a time with plenty of water.

ANS: C
If the patient has difficulty swallowing, use a pill-crushing device to crush the tablets. Mix the ground tablet in a small amount of soft food (custard or applesauce). Large tablets are often difficult to swallow. A ground tablet mixed with palatable soft food is usually easier to swallow. Not all drugs can be crushed (e.g., capsules, enteric-coated, long-acting/slow-release drugs). The coating of these drugs protects the stomach from irritation or protects the drug from destruction by stomach acids. Administration of medication with less fluid could make it more difficult for the patient to swallow. Insertion of a nasogastric tube requires an order from the health care provider. A patient who is having difficulty swallowing may not be safe when swallowing large capsules or tablets even one at a time. Thin liquids such as water are more readily aspirated than thickened liquids.

DIF: Cognitive Level: Applying REF: Text reference: p. 496
OBJ: Correctly administer a medication by oral, enteral, and topical routes.
TOP: Crushing Medications KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

 

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