Chapter 36 Administering Oral, Topical, and Mucosal Medications

Chapter 36  Administering Oral, Topical, and Mucosal Medications

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. The nurse is providing care to a patient who is being treated for colorectal cancer and who typically takes sustained-release morphine (MS Contin), furosemide (Lasix), and metoprolol (Lopressor). The patient’s wife reports that the patient has had bad mouth sores since chemotherapy last week, and has had a hard time swallowing pills; as a result, she has crushed the pills and given him his medications in ice cream. The best statement by the nurse is
A.
“Giving the blood pressure medications with milk products reduces their absorption.”
B.
“I’m sure it has been hard for him to swallow. Has he lost any weight?”
C.
“The morphine tablets shouldn’t be crushed since that releases all of the medication at once.”
D.
“We usually tell people with mouth sores to suck on ice or popsicles before they try to swallow pills.”

____ 2. The nurse is providing acetaminophen (Tylenol) suspension to a patient via percutaneous gastrostomy tube. First the nurse should
A.
Measure the appropriate dose of medication using a medicine cup.
B.
Draw up the medication into a catheter-tipped syringe.
C.
Uncap the bottle while wearing clean gloves.
D.
Shake the bottle of medication gently.

____ 3. While preparing a dose of liquid famotidine (Pepcid) for administration through a gastrostomy tube for a 40-year-old, the nurse measures 15 mL into a plastic medicine cup. Which of the following indicates the appropriate dose of medication?
A.
When held at eye level, the lowest level of the medication meniscus rests on the 15-mL calibration line.
B.
When held up to the light, the middle of the medication meniscus rests on the 15-mL calibration line.
C.
When sitting on a level table, the top of the medication meniscus rests on the 15-mL calibration line.
D.
When placed on the countertop, any part of the medication meniscus rests on the 15-mL calibration line.

____ 4. The nurse is providing Demerol (meperidine) to a patient who reports postsurgical pain 8/10. The order is for 25 mg intramuscular (IM); the syringe contains 50 mg. The best action by the nurse is to
A.
Call the doctor to request that the order be changed to 50 mg.
B.
Provide half of the injection to the patient and then discard the syringe and remaining medication in the sharps container.
C.
Waste 25 mg from the syringe prior to administration and record the amount wasted.
D.
Draw up half of the medication into another syringe and save the rest for the next dose.

____ 5. The nurse is providing medications to a patient who is currently receiving continuous tube feeding via gastrostomy tube. The patient has a dose of phenytoin (Dilantin) due. The best action of the nurse is to
A.
Determine if the patient is experiencing any pain.
B.
Flush the gastrostomy tube with 30 mL of water prior to administration.
C.
Hold the medication for the day.
D.
Stop the tube feeding for at least 1 hour prior to administration.

Chapter 36. Administering Oral, Topical, and Mucosal Medications
Answer Section

MULTIPLE CHOICE

1. ANS: C

Feedback
A
There is not contraindication to use dairy products with these medications.
B
This is a psychosocial response and is not the highest priority.
C
Safety: Do not crush or break sustained- release or enteric-coated tablets. Chapter Objective: Describe special considerations for administration of narcotic medications.
D
These actions may be soothing, but do not address the concern of crushing sustained-release medications.

PTS: 1 REF: Chapter: 36 | Page: 853 OBJ: Chapter Objective: 36-5
KEY: Content Area: Medication Administration | Integrated Process: Teaching/Learning | Client Need: Pharmacological and Parenteral Therapies | Cognitive Level: Application

2. ANS: D

Feedback
A
The medications should be shaken prior to measuring or dispensing.
B
The medications should be shaken prior to measuring or dispensing.
C
The medications should be shaken prior to measuring or dispensing.
D
Safety: Always shake a suspension prior to administering it to mix the drug with the liquid. Chapter Objective: Explain how to prepare liquid medications.

PTS: 1 REF: Chapter: 36 | Page: 853 OBJ: Chapter Objective: 36-4
KEY: Content Area: Medication Administration | Integrated Process: Nursing Process/Implementation | Client Need: Pharmacological and Parenteral Therapies | Cognitive Level: Application

3. ANS: A

Feedback
A
Safety: When reading the amount of liquid in a medicine cup, it is important to read it at the lowest level of the meniscus; to do so, one must hold the measuring device at eye level. Chapter Objective: Explain how to prepare liquid medications.
B
This is not the correct way to measure liquid dosing.
C
This is not the correct way to measure liquid dosing.
D
This is not the correct way to measure liquid dosing.

PTS: 1 REF: Chapter: 36 | Page: 854 OBJ: Chapter Objective: 36-4
KEY: Content Area: Medication Administration | Integrated Process: Nursing Process/Implementation | Client Need: Pharmacological and Parenteral Therapies | Cognitive Level: Application

4. ANS: C

Feedback
A
The highest priority is to provide pain medication at this time; additional orders can be sought at a later time if indicated.
B
The medication should be wasted prior to administration to prevent error and potential excessive dosing to the patient.
C
If a full dose of a narcotic is not used, the unused narcotics should be discarded and the waste should be recorded according to facility policies. Chapter Objective: Describe special considerations for administration of narcotic medications.
D
Unused doses of narcotics are to be discarded according to policy.

PTS: 1 REF: Chapter: 36 | Page: 855 OBJ: Chapter Objective: 36-5
KEY: Content Area: Medication Administration | Integrated Process: Nursing Process/Implementation | Client Need: Pharmacological and Parenteral Therapies | Cognitive Level: Application

5. ANS: D

Feedback
A
This is a seizure medication; pain assessment will not help direct patient care or nursing actions related to the medication.
B
The tube feeding should be held to optimize medication absorption.
C
This medication should be given daily to prevent seizures.
D
If this antiseizure medication is given through an enteral tube and mixes with the formula in the patient’s stomach, its absorption may be decreased by nearly 70%. It is recommended that the nurse stop the feeding for 1 to 2 hours prior to administering the phenytoin. Chapter Objective: Describe special precautions needed when administering medications to patients on tube feedings.

PTS: 1 REF: Chapter: 36 | Page: 855 OBJ: Chapter Objective: 36-6
KEY: Content Area: Medication Administration | Integrated Process: Nursing Process/Implementation | Client Need: Pharmacological and Parenteral Therapies | Cognitive Level: Application