Test Bank for Pharmacology for Canadian Health Care Practice, 2nd Edition: Lilley

Test Bank for Pharmacology for Canadian Health

Care Practice, 2nd Edition: Lilley

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Lilley: Pharmacology for Canadian Health Care Practice, 2nd Canadian
Edition
Chapter 10: Photo Atlas of Drug Administration

Test Bank

MULTIPLE CHOICE

1. Before administering any medication, which action by the nurse is most important?
a. Verifying orders with another nurse
b. Documenting the medications given
c. Counting medications in the medication cart drawers
d. Checking the patient’s identification and allergy bracelets

ANS: D
Checking the patient’s identification and allergy bracelets are important for the patient’s
safety and reflects some of the five rights of medication administration.

Verifying orders with another nurse, documenting the medications given, or counting
medications in the medication cart drawers do not affect safety.

DIF: Cognitive Level: Comprehension REF: p. 151

2. What is the proper syringe size for an intradermal (ID) injection?

a. 3-mL syringe
b. 1-mL tuberculin
c. 2-mL tuberculin
d. 2-mL syringe

ANS: B
The proper syringe size for ID injection is 1-mL tuberculin.

DIF: Cognitive Level: Knowledge REF: p. 163

3. A patient is to receive a penicillin intramuscular (IM) injection in the ventrogluteal site.

What is the proper angle for needle insertion?
a. 15 degrees
b. 45 degrees
c. 60 degrees
d. 90 degrees

ANS: D
The proper angle for IM injections is 90 degrees.

DIF: Cognitive Level: Comprehension REF: p. 162

Copyright © 2011 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Test Bank 10-2

4. When the nurse is administering medication by intravenous (IV) bolus (push), which is
the correct procedure?
a. Occluding the IV line by folding the tubing just above the injection port
b. Clamping the tubing just above the insertion site
c. Pinching the tubing just above the injection port
d. Pinching the tubing at least 5 cm above the injection port

ANS: C
Before injecting an IV push medication, occlude the IV line by pinching the tubing just
above the injection port.

DIF: Cognitive Level: Comprehension REF: p. 174

5. The nurse is preparing to administer an intramuscular (IM) immunization to a

2-month-old infant. Which site is acceptable for this injection?
a. Deltoid
b. Dorsogluteal
c. Ventrogluteal
d. Vastus lateralis

ANS: D
The vastus lateralis is the acceptable IM site for infants younger than 7 months of age.

DIF: Cognitive Level: Comprehension REF: p. 168

6. The nurse is administering insulin subcutaneously (SC) to a patient who is obese. Which
of the following is the proper technique for this injection?
a. Using the Z-track method
b. Inserting the needle at a 5- to 15-degree angle until resistance is felt
c. Pinching the skin at the injection site and injecting the needle below the tissue fold
d. Spreading the skin tightly over the injection site, inserting the needle, then
releasing the skin

ANS: C
The proper technique for SC injection for a patient who is obese is to pinch the skin at the
site and inject the needle below the skin fold at a 90-degree angle.

DIF: Cognitive Level: Comprehension REF: p. 165

7. In which of the following situations should the nurse administer an intramuscular

medication (IM) with the Z-track method?
a. When the medication is known to be irritating to tissues
b. When the patient is emaciated and has very little muscle mass
c. When the medication must be absorbed quickly into the tissues
d. When the patient is obese and has a deep fat layer below the muscle mass

Copyright © 2011 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Test Bank 10-3

ANS: A
The Z-track method should be used for medications known to irritate tissues. This method
also prevents the deposit of medication through sensitive tissues.

DIF: Cognitive Level: Application REF: p. 163

8. After administering an intradermal (ID) injection for a skin test, the nurse notices a small
bleb at the injection site. Which of the following is the proper action for the nurse to
take?
a. Apply heat
b. Massage the area
c. Report the bleb to the physician
d. Do nothing

ANS: D
The formation of a small bleb is expected after an ID injection for skin testing.

DIF: Cognitive Level: Comprehension REF: p. 164

9. What important action should the nurse take after administering an intravenous (IV) push
medication through an IV lock?
a. Flushing the lock
b. Regulating the IV flow
c. Clamping the tubing for 10 minutes
d. Holding the patient’s arm up to improve blood flow

ANS: A
IV locks are to be flushed before and after each use; either a heparin or saline flush is used,
depending on the individual institution’s policy.

Regulating the IV flow, clamping the tubing for 10 minutes, or holding the patient’s arm up
to improve blood flow are not appropriate actions.

DIF: Cognitive Level: Comprehension REF: pp. 174, 175

10. Which of the following is the proper method of mixing intravenous (IV) solutions and
medications?
a. Shaking the bag or bottle vigorously
b. Holding the bag or bottle and gently turning it end-to-end
c. Inverting the bag or bottle just once after injecting the medication
d. Allowing the IV solution to stand for 10 minutes to enhance even distribution of
medication

ANS: B

Copyright © 2011 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Test Bank 10-4

When adding medications to IV fluid containers, mix the medication and the IV solution by
holding the bag or bottle and turning it end-to-end.

DIF: Cognitive Level: Comprehension REF: p. 170

11. Which of the following statements describes the proper way for the nurse to measure 4
mL of a liquid cough elixir for a child?
a. Use a teaspoon to measure and administer.
b. Hold the medication cup at eye level and fill it to the desired level.
c. Withdraw the elixir from the container with a syringe with a needle attached.
d. Withdraw the elixir from the container with a syringe without a needle attached.

ANS: D
Liquid medication volumes of less than 5 mL should be withdrawn in a syringe without a
needle. To prevent accidental ingestion of the needle during administration of the liquid,
never use a needle to draw up oral medication.

Using a teaspoon to measure and administer liquid medication or holding the medication cup
at eye level and filling it to the desired level are not accurate methods for measuring small
volumes. Never withdraw the elixir from the container with a syringe with a needle attached.

DIF: Cognitive Level: Comprehension REF: p. 155

12. The nurse is assisting a patient to take his medications; however, the medication cup falls
to the floor, spilling the contents. What is the appropriate action for the nurse to take?
a. Discard the medications and repeat the preparation
b. Document that the client refused the medications
c. Wait until the next dosage time and then give the medications
d. Retrieve the medications and administer them to avoid waste

ANS: A
Medications that fall to the floor need to be discarded, and the procedure must be repeated
with new medications.

DIF: Cognitive Level: Application REF: p. 152

13. The patient is to receive a buccal medication. Which action is appropriate for the nurse to
take?
a. Encouraging the patient to swallow if necessary
b. Administering water after the medication has been given
c. Placing the medication between the upper molar teeth and cheek
d. Placing the tablet under the client’s tongue and allow it to dissolve completely

ANS: C
Buccal medications are properly administered between the upper molar teeth and the cheek.

Copyright © 2011 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Test Bank 10-5

Caution the patient against swallowing, and do not administer with water. Medications given
under the tongue are sublingually administered.

DIF: Cognitive Level: Comprehension REF: p. 154

14. Which technique is proper for the nurse to take when administering medications through
a nasogastric (NG) tube?
a. Administering the medications with a small medication syringe
b. Applying gentle pressure on the syringe’s piston to infuse the medication
c. Flushing the tubing with 30 mL of saline after the medication has been given
d. Using the barrel of the syringe, allow the fluid to flow via gravity into the NG tube

ANS: D
For NG tubes, medications are poured into the barrel of the syringe with the piston removed,
and fluid is allowed to flow via gravity into the tube. Never force any fluid into the tube.
Flush the tubing with 30 mL of tap water to ensure that the medication is cleared from the
tube.

DIF: Cognitive Level: Comprehension REF: p. 156

15. Which technique should the nurse use to facilitate the administration of a rectal
suppository?
a. Having the patient lie on his or her right side unless contraindicated
b. Having the patient hold his or her breath during insertion of the medication
c. Lubricating the suppository with a small amount of petroleum-based lubricant
d. Encouraging the patient to lie on his or her left side for 15 to 20 minutes after
insertion

ANS: D
For rectal suppository insertion, the patient should be positioned on his or her left side.
Lubricate the suppository with a small amount of water-soluble lubricant, have the patient
take a deep breath and exhale through the mouth during insertion, and then have the patient
remain lying on his or her left side for 15 to 20 minutes to allow absorption of the drug.

DIF: Cognitive Level: Application REF: p. 157

16. What is the best action for the nurse to take to reduce systemic effects after administering
eye drops?
a. Wiping off excess liquid immediately after instilling drops
b. Having the patient close the eye tightly after instilling drops
c. Having the patient close the eye; then move the eye around to help distribute the
medication
d. Applying gentle pressure to the patient’s nasolacrimal duct for 30 to 60 seconds
after instilling drops

ANS: D

Copyright © 2011 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Test Bank 10-6

When administering drugs that cause systemic effects, protect your finger with a clean tissue,
then apply gentle pressure to the patient’s nasolacrimal duct for 30 to 60 seconds.

DIF: Cognitive Level: Comprehension REF: p. 176

17. What is the proper technique for the nurse to perform when administering ear drops to a
2-year-old child?
a. Administer the drops without altering the ear canal direction.
b. Straighten the ear canal by pulling the lobe upward and back.
c. Straighten the ear canal by pulling the auricle down and back.
d. Straighten the ear canal by pulling the auricle upward and outward.

ANS: C
For an infant or a child younger than age 3, straighten the ear canal by pulling the auricle
down and back. For adults, pull the auricle up and outward.

DIF: Cognitive Level: Comprehension REF: p. 176

18. A patient with asthma is to begin medication therapy with a metered-dose inhaler. What
important reminder should the nurse include during teaching sessions with the patient?
a. Repeat subsequent puffs, if ordered, after 5 minutes.
b. Inhale slowly while pressing down to release the medication.
c. Inhale quickly while pressing down to release the medication.
d. Administer the inhaler while holding it 7.5 to 10 cm away from the mouth.

ANS: B
Position the inhaler to an open mouth, with the inhaler 2.5 to 5 cm away from the mouth, or
attach a spacer to the mouthpiece of the inhaler, or place the mouthpiece in the mouth. To
administer, press down on the inhaler to release the medication while inhaling slowly. Wait 1
minute between puffs.

DIF: Cognitive Level: Application REF: p. 178

19. Which of the following actions is considered a standard precaution for medication
administration?
a. Bending the syringe to prevent re-use
b. Recapping needles to prevent needlestick injury
c. Discarding all syringes and needles into the wastebasket
d. Discarding all syringes and needles in a puncture-resistant container

ANS: D
Standard precautions include wearing clean gloves when there is potential exposure to a
patient’s blood or other body fluids. Discard all disposable syringes and needles in the
appropriate puncture-resistant container.

Copyright © 2011 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Test Bank 10-7

Never bend needles or syringes, never recap needles, and never discard syringes and needles
in wastebaskets.

DIF: Cognitive Level: Application REF: p. 153

20. The patient states that he prefers to chew rather than swallow his pills. One pill has the
abbreviation “SR” after the name of the medication. Which of the following instructions
should be followed when giving this medication?
a. Break the tablet into halves or quarters.
b. Dissolve the tablet in a small amount of water before giving it.
c. The tablet should not be crushed or broken before administration.
d. Use a mortar and pestle to crush the tablet as needed to ease administration if
needed.

ANS: C
The sustained-release (SR) or enteric-coated tablets, or capsules, are forms of medications
that should not be crushed for administration in order to protect the gastrointestinal lining
and the medication itself.

DIF: Cognitive Level: Application REF: p. 153

21. When administering nasal spray, the nurse should instruct the patient as follows:
a. “You will need to blow your nose before I give this medication.”
b. “You will need to blow your nose after I give this medication.”
c. “When I give this medication, you will need to hold your breath.”
d. “You should sit up for 5 minutes after you receive the nasal spray.”

ANS: A
The patient will need to blow his or her nose before the medication is administered because
the nasal passages should be cleared before receiving nasal spray.

If the patient blows his or her nose after receiving the medication, this action will remove the
medication from the nasal passages. The patient should receive the spray while inhaling
through the open nostril. The patient should remain in a supine position for 5 minutes
afterward.

DIF: Cognitive Level: Application REF: p. 177

COMPLETION

1. The nurse is preparing to give an intramuscular (IM) injection to an average-sized adult

male. Select all of the following that apply for an intramuscular injection.
a. Choose a 6 to 13 mm (¼- to ½-inch), 26- or 27-gauge needle.
b. Choose a 13 to 16 mm (½- to 5/8-inch), 25-gauge needle.
c. Choose a 38 mm (1½-inch), 21- to 25-gauge needle.
d. Select a site at least 5 cm away from the umbilicus.

Copyright © 2011 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Test Bank for Pharmacology for Canadian Health Care Practice, 2nd Edition: Lilley

Test Bank 10-8

e. The dorsogluteal site is the preferred site for IM injections.

f. The ventrogluteal site is the preferred site for IM injections.
g. Insert the needle at a 45-degree angle.
h. Insert the needle at a 90-degree angle.
i. Insert the needle at a 5- to 1.5-degree angle.
j. The Z-track method is recommended for most IM injections.
k. The Z-track method is used with subcutaneous (SC) injections.
l. Before injecting the medication, withdraw the plunger to check for blood return.
m. Do not check for blood return before injecting the medication.

Your answer should appear as lowercase letters separated by a comma and a space as
follows: a, b, c, d

ANS: c, f, h, j, k

DIF: Cognitive Level: Analysis REF: pp. 162, 163

Copyright © 2011 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

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