1. D.

The chemical name identifies the drug’s chemical composition and molecular
structure. The generic name is assigned by the manufacturer who develops the drug.
The official name is the name that identifies the drug in the official publication.
2. A. Distribution,metabolism, and extretion occur after the drug has been absorbed.
3. C .Drug tolerance results when the body becomes accustomed to the drug over
time. A cumulative effect occurs when the body cannot metabolize one dose of a
drug before another one is given. An anaphylactic reaction is a life-threatening,
immediate response to a drug.
4. B. The abbreviation ”qud” refers to every-other-day administration.
5. A. A sign over a patient’s bed may not always be current. The roommate is an unsafe
source of information. The patient may not hear is name but may reply in the
affirmative any-way (eg, a person with hearing deficit).
6. B. Tube placement should al-ways be checked before administering any medication
to prevent the possibility of aspiration if the tube is not in the stomach. Enteric-
coated pills should be never be crushed, and very warm water may injure stomach
mucosa. Taking vital signs is not necessary unless a particular medication requires it
before administration.
7. C. Many cartridges are over-filled, and some of the medication needs to be
discarded. Giving the excess medication in the cartridge may result in adverse
effects for the patient. For this dose, it is not necessary to call the pharmacy or
refuse to give the medication, provided the order is written correctly.
8. B. The nurse is responsible for any medications her or she gives and must contact
the doctor to inform her of the patient’s allergy to the drug. The nurse should not
give the medication and might speak with the supervisor only if he or she is
uncomfortable with physician’s answer once she is notified. The nurse is legally
unable to order a replacement medication, as in the pharmacist.
9. C. Nurses should never give medication prepared by someone else because they are
responsible for what they administer.
10. D. The intravenous route is a direct access to the bloodstream, and medications act
quickly when given intravenous. The condition of the vein is not as important as the
rapid effect of the medication administered intravenously.
11. C. When giving heparin sub-cutaneously , do not aspirate or message, so as not to
cause trauma or bleeding in the tissues.
12. D. The patient has the right to refuse medications,but the nurse should assess the
patient’s reasons for refusal,documentthem,and report them to the physician.
13. C. The nurse first responsibility is the patient,and careful observation is necessary to
assess for any effect of the medication error. The other nursing actions are
pertinent, but only after checking the patient’s welfare.
14. C. Safe nursing practice requires that a medication never be left at the patient’s
bedside. It is not correct to say that the patient has refused medication in this
situation.
15. C. Antagonistic effect is the combined effect of two or more drugs acting
simultaneously produces an effect either less that that of each drug alone.
16. C. “Digoxin 0.125 mg P.O. once daily”. The nurse should always place a zero before
a decimal point so that no one misreads the figure, which could result in a dosage
error. The nurse should never insert a zero at the end of a dosage that includes a
decimal point because this could be misread, possibly leading to a tenfold increase
in the dosage.
17. B. Standard written order Prescribers write a single order for medications given only
once. A stat order is written for medications given immediately for an urgent client
problem. A standing order, also known as a protocol, establishes guidelines for
treating a particular disease or set of symptoms in special care areas such as the
coronary care unit. Facilities also may institute medication protocols that specifically
designate drugs that a nurse may not give.
18. C. Pulling down and back. To instil antibiotic ear drops on a child, the nurse grasps
the ear and pulls it down and back to straighten the ear canal. For an adult, the
nurse grasps the ear and pulls it up to straighten the ear canal. Pulling the lobule in
any direction wouldn't straighten the ear canal for visualization.
19. D. Rolling the vial gently between the palms produces heat, which helps dissolve the
medication. Doing nothing or inverting the vial wouldn't help dissolve the
medication. Shaking the vial vigorously could cause the medication to break down,
altering its action.
20. B. It is placed between under the patient’s cheek and gum. This area is rich in
superficial blood vessels, which allows the drug to be absorbed relatively rapidly into
the bloodstream for quick systemic effect.
21. A. Initial sensitivity to penicillin is commonly manifested by a skin rash, even in
individuals who have not been allergic to it previously. Because of the danger of
anaphylactic shock, he nurse should withhold the drug and notify the physician, who
may choose to substitute another drug. Administering an antihistamine is a
dependent nursing intervention that requires a written physician’s order. Although
applying corn starch to the rash may relieve discomfort, it is not the nurse’s top
priority in such a potentially life-threatening situation.
22. D. The Z-track method is an I.M. injection technique in which the patient’s skin is
pulled in such a way that the needle track is sealed off after the injection. This
procedure seals medication deep into the muscle, thereby minimizing skin staining
and irritation. Rubbing the injection site is contraindicated because it may cause the
medication to extravasate into the skin.
23. D. The vastus lateralis, a long, thick muscle that extends the full length of the thigh,
is viewed by many clinicians as the site of choice for I.M. injections because it has
relatively few major nerves and blood vessels. The middle third of the muscle is
recommended as the injection site. The patient can be in a supine or sitting position
for an injection into this site.
24. A. The mid-deltoid injection site can accommodate only 1 ml or less of medication
because of its size and location (on the deltoid muscle of the arm, close to the
brachial artery and radial nerve).
25. D. A 25G, 5/8” needle is the recommended size for insulin injection because insulin
is administered by the subcutaneous route. An 18G, 1 ½” needle is usually used for
 I.M. injections in children, typically in the vastus lateralis. A 22G, 1 ½” needle is
usually used for adult I.M. injections, which are typically administered in the vastus
lateralis or ventrogluteal site.
26. D. Because an intradermal injection does not penetrate deeply into the skin, a small-
bore 25G needle is recommended. This type of injection is used primarily to
administer antigens to evaluate reactions for allergy or sensitivity studies. A 20G
needle is usually used for I.M. injections of oil-based medications; a 22G needle for
I.M. injections; and a 25G needle, for I.M. injections; and a 25G needle, for
subcutaneous insulin injections.
27. C. 100ml/60 min X 15 gtt/ 1 ml = 25 gtt/minute
28. D. Phlebitis, the inflammation of a vein, can be caused by chemical irritants (I.V.
solutions or medications), mechanical irritants (the needle or catheter used during
venipuncture or cannulation), or a localized allergic reaction to the needle or
catheter. Signs and symptoms of phlebitis include pain or discomfort, edema and
heat at the I.V. insertion site, and a red streak going up the arm or leg from the I.V.
insertion site.
29. D. Return demonstration provides the most certain evidence for evaluating the
effectiveness of patient teaching.
30. D. Capsules, enteric-coated tablets, and most extended duration or sustained
release products should not be dissolved for use in a gastrostomy tube. They are
pharmaceutically manufactured in these forms for valid reasons, and altering them
destroys their purpose. The nurse should seek an alternate physician’s order when
an ordered medication is inappropriate for delivery by tube.
31. D. A drug-allergy is an adverse reaction resulting from an immunologic response
following a previous sensitizing exposure to the drug. The reaction can range from a
rash or hives to anaphylactic shock. Tolerance to a drug means that the patient
experiences a decreasing physiologic response to repeated administration of the
drug in the same dosage. Idiosyncrasy is an individual’s unique hypersensitivity to a
drug, food, or other substance; it appears to be genetically determined. Synergism,
is a drug interaction in which the sum of the drug’s combined effects is greater than
that of their separate effects.
32. A. A rate of 50 cc/hr. The child is to receive 400 cc over a period of 8 hours = 50
cc/hr.
33. A. To determine the number of milliliters the client should receive, the nurse uses
the fraction method in the following equation.
75 mg/X ml = 100 mg/1 ml
To solve for X, cross-multiply: 75 mg x 1 ml = X ml x 100 mg
75 = 100X
75/100 = X
0.75 ml = X
34. B. Giving 1,000 ml over 8 hours is the same as giving 125 ml over 1 hour (60
minutes). Find the number of milliliters per minute as follows:
125/60 minutes = X/1 minute
60X = 125 = 2.1 ml/minute
 To find the number of drops per minute:
2.1 ml/X gtt = 1 ml/ 15 gtt
X = 32 gtt/minute, or 32 drops/minute
35. B. An infusion prepared with 25,000 units of heparin in 500 ml of saline solution
yields 50 units of heparin per milliliter of solution. The equation is set up as 50 units
times X (the unknown quantity) equals 1,500 units/hour, X equals 30 ml/hour.
36. B. This is the correct flow rate; multiply the amount to be infused (2000 ml) by the
drop factor (10) and divide the result by the amount of time in minutes (12 hours x
60 minutes)
37. B. 3000 x 10 divided by 24 x 60 = 21.
38. B. 0.05 mg/ 1 ml = .12mg/ x ml, .05x = .12, x = 2.4 ml
39. D
40. C
41. B
42. B
43. A
44. B
45. C