Chapter 26 Administering Medications

Chapter 26  Administering Medications

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The nurse administered the narcotic Demerol, 50 mg PO at 1400 to a patient with pain rated as 9 on a 0 to 10 scale. At 1430, the patient stated that the medication was not working and requested to have morphine IV, which the provider had prescribed for severe pain. What is the nurse’s best evaluation of this situation?
a)
The patient needs to understand that it takes time for the medication to reduce pain.
b)
Administering Demerol PO was not the best nursing intervention in this situation.
c)
The provider should be notified if the patient’s pain is not relieved in 2 hours.
d)
Demerol PO was the best intervention because morphine IV can cause drug addiction.

ANS: B
Administering Demerol PO was not the best nursing intervention in this situation because the patient was in severe pain (9/10). The patient needed immediate pain relief, which would not occur with PO pain medication. The nurse should have been administered morphine IV. Waiting 2 hours to notify the physician does not provide patient comfort. The nurse should focus on pain relief and not worry about the patient becoming “addicted” to the morphine.

Difficulty: Difficult
Client Need: Safe and Effective Care
Cognitive Level: Application

PTS: 1

2. An insulin-dependent diabetic patient tells the nurse that she has been giving herself injections in the same location in her right thigh for the past several months because it is easier. What is the nurse’s best action?
a)
Provide patient teaching on rotating injection sites.
b)
Assess the patient for cumulative effects.
c)
Check the type of insulin the patient receives to ensure that it is compatible with the vastus lateralis site.
d)
Document the patient’s comments, as the patient understands the treatment regimen.

ANS: A
Administering medications in the same site over prolonged periods of time can cause fat deposits and skin lumps, which will interfere with absorption and thus hinder the effectiveness of the medication. Insulin is administered subcutaneously, not intramuscularly. The patient should be taught to rotate injection sites.

Difficulty: Moderate
Nursing Process: Interventions
Client Need: Safe and Effective Care
Cognitive Level: Application

PTS: 1

3. A surgeon prescribes heparin 2,500 mEq IM q 12 hr. What is the nurse’s best action?
a)
Administer the medication as prescribed.
b)
Clarify the medication dose with the surgeon.
c)
Administer the medication subcutaneously.
d)
Clarify the dose and route with the surgeon.

ANS: D
The nurse should contact the surgeon to clarify the dosage and route of administration. Heparin is measured in units and administered either subcutaneously or intravenously. The nurse should contact the provider who prescribed the medications.

Difficulty: Moderate
Nursing Process: Interventions
Client Need: Safe and Effective Care
Cognitive Level: Application

PTS: 1

4. A patient is having pain and has requested a dose of analgesic medication. The medication administration record indicates that he prescribed the narcotics hydromorphone (Dilaudid) intramuscularly and morphine sulfate intravenously. Where should the nurse first assess to determine which medication to administer?
a)
The patency of the IV site
b)
Which drug the patient prefers
c)
The patient’s pain level
d)
Skin integrity of the dorsogluteal site

ANS: C
The nurse should check the patient’s pain level. If the pain is severe, the nurse should administer IV morphine to provide the patient immediate relief. The dorsogluteal site for IM injections should be avoided.

Difficulty: Moderate
Nursing Process: Interventions
Client Need: Safe and Effective Care
Cognitive Level: Application

PTS: 1

5. Which term refers to the movement of a drug from the site of administration to the bloodstream?
a)
Absorption
b)
Distribution
c)
Metabolism
d)
Excretion

ANS: A
Absorption refers to the movement of drug from the site of administration into the bloodstream. Distribution involves the transport of the drug in body fluids, such as blood, to the tissues and organs. Metabolism is the biotransformation of the drug into a more water-soluble form or into metabolites that can be excreted from the body. Excretion, or the removal of drugs from the body, takes place in the kidneys, liver and gastrointestinal tract, lungs, and exocrine glands.

Difficulty: Moderate
Client Need: PHSI
Cognitive Level: Knowledge

PTS: 1