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Chapter 10: Parenteral Administration: Safe Preparation of Parenteral Medications
Test Bank
MULTIPLE CHOICE
1. Which part of the syringe contains the calibrations for drug volume measurement?
a. Plunger
b. Tip
c. Luer Lok
d. Barrel
ANS: D
The barrel contains the calibrations necessary for measurement. The plunger, the tip, and the
Luer Lok do not have the calibrations indicated on them.
DIF: Cognitive Level: Knowledge REF: p. 141 OBJ: 1

TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
2. Which needle will the nurse use to administer an intramuscular (IM) immunization on an 18
month old child?
a. 18-gauge, 1 inch needle
b. 20-gauge, 1/2 inch needle
c. 27-gauge, 1 1/2 inch needle
d. 25-gauge, 1/2 inch needle
ANS: C
The most appropriate needle gauge for pediatric IM injections is a 25- or 27-gauge, 1 1/2 inch
needle. An 18 gauge, 1 inch needle is too short and too large in diameter for pediatric
injections. A 20-gauge, 1/2 inch needle is too short and too large in diameter for pediatric
injections. A 25-gauge, 1/2 inch needle is too short for pediatric IM injections.
DIF: Cognitive Level: Application REF: p. 145 OBJ: 2

MSC: NCLEX Client Needs Category: Physiological Integrity
3. Which syringe will the nurse use to administer insulin subcutaneously to a patient?
a. A syringe calibrated in minims
b. A syringe calibrated in units
c. A syringe calibrated in tenths of mL
d. A syringe calibrated in mL
ANS: B
A syringe calibrated in units is used for insulin. A tuberculin syringe is not properly calibrated
for use with insulin. A syringe calibrated in mL or in tenths of mL would not be an accurate
way to measure insulin doses.
DIF: Cognitive Level: Comprehension REF: p. 143 OBJ: 5

4. Which action by the nurse is most accurate when drawing up medication from an ampule?
a. Consider the rim of the ampule as sterile.
b. Use a filter needle to withdraw the medication.
c. Wrap a paper towel around the neck of the ampule before breaking it.
d. Inject 0.5 mL of air into the ampule before withdrawing the medication.
ANS: B
Filtered needles are used to withdraw the medication and then changed before administration
of the injection. The rim of the ampule is considered to be contaminated because of the
possible presence of broken glass. Paper towels do not protect the nurse from broken glass.
The ampule is not airtight, so no air needs to be injected into it before removing the
medication.

5. Which action by the nurse is accurate when withdrawing medication into a syringe from a
vial?
a. Inject an amount of air equal to the medication into the vial.
b. Break the thin neck of the vial container.
c. Remove the rubber stopper on the top of the vial.
d. Discard the initial 0.5 mL of medication to ensure sterility.
ANS: A
An equal amount of air is first injected into the vial to help displace the needed medication
upon withdrawal. Vials are not meant to be broken at the neck. Removal of the rubber stopper
on a vial is unsafe and not recommended. Medication should not be discarded because it is
sterile as long as the vial is airtight and has not been contaminated.

6. An adult patient is to receive two medications IM. Which action by the nurse is most
important in order to mix the medications in one syringe?
a. Assess for the presence of adequate muscle mass.
b. Ensure that the combined medication amount is less than 2 mL.
c. Determine the compatibility of the medications.
d. Use a needle that is 25 gauge.
ANS: C
Compatibility is determined to prevent a reaction between the mixed medications. This is
important once the medication will be administered, but first it needs to be determined that the
medications can be mixed. IM injections in the adult can exceed 2 mL. A 25-gauge needle is
not appropriate for an IM injection.
DIF: Cognitive Level: Analysis REF: p. 153 OBJ: 9

7. The nurse is preparing to administer insulin. What does U 100 indicate?

a. 100 mL per unit
b. 10 units per mL
c. 100 units per mL
d. 10 units per 100 mL
ANS: C
U 100 means 100 units per mL.
DIF: Cognitive Level: Comprehension REF: p. 143 OBJ: 3 | 5

TOP: Nursing Process Step: Assessment
8. After teaching a diabetic patient about proper disposal of used syringes and needles, which
statement by the patient indicates a need for further teaching?
a. “Even needles with sleeves should be disposed of appropriately.”
b. “It is unusual that anyone could get a needle injury or disease from used needles.”
c. “It is important for me to use the designated container to dispose of my syringes
and needles.”
d. “I am going to purchase the ‘Sharps by Mail Disposal System’ once I am home.”
ANS: B
The patient needs more education because injury from needlesticks and transfer of pathogens
is a health concern. It is accurate that even needles with sleeves should be disposed of
appropriately and that a designated container to dispose of syringes and needles should be
used. The patient should be encouraged to purchase the “Sharps by Mail Disposal System.”
DIF: Cognitive Level: Application REF: p. 140 | pp. 146-147

OBJ: 1 TOP: Nursing Process Step: Evaluation
9. Which nursing action is accurate when administering parenteral medication?

a. Adjust the route of the medication, if needed.
b. Document the response to PRN medications at the end of the shift.
c. Request the pharmacist to provide education about the medication to the patient.
d. Use clinical judgment when rescheduling missed doses of a medication.
ANS: D
The nurse must exercise clinical judgment about the scheduling of new drug orders, missed
dosages, modified drug orders or substitution of therapeutically equivalent medicines by the
pharmacy, or changes in the patient’s condition that require consultation with the physician,
health care provider, or pharmacist. Adjusting the route is not within the role of the nurse.
Documenting the response to PRN medications at the end of the shift is not an acceptable
timeframe. Educating the patient about the medication is within the nurse’s role.
DIF: Cognitive Level: Application REF: p. 140 OBJ: N/A

10. What is an advantage of administering a drug parenterally?

a. The duration of action is longer.
b. Medications given by this route are inexpensive.
c. The onset of action is more rapid.
d. The dose is usually larger than an oral dose.
ANS: C
The onset of drug action is generally more rapid but of shorter duration. Duration of action is
not affected by administering a drug parenterally. Parenteral administration can be expensive.
The dose of parenteral medications is typically smaller than an oral dose.
DIF: Cognitive Level: Comprehension REF: p. 140 OBJ: 1

11. Which information provided by the nurse is most important to include when teaching a patient
about the use of an EpiPen?
a. “Hold the syringe at a 45-degree angle against the skin.”
b. “Monitor the expiration date of this medication.”
c. “After using the EpiPen, lie down for 1 hour.”
d. “Place the syringe in a cartridge prior to using.”
ANS: B
It is important to monitor the expiration date of this medication on a regular basis. The syringe
is held perpendicular to the skin. The patient should go to the emergency department after use
of an EpiPen. Placing the syringe into a cartridge is not accurate for use of an EpiPen.

12. Which type of parenteral medication container is made of glass, is scored, and needs to be
broken open before withdrawing the medication?
a. Ampule
b. Carpuject
c. Mix-O-Vial
d. Vial
ANS: A
Ampules are glass containers that need to be broken open before withdrawing medication.
Carpujects are prefilled syringes. Mix-O-Vial containers have two compartments for mixing
medications and are not scored. Vials are glass or plastic containers that are not broken open.
DIF: Cognitive Level: Knowledge REF: p. 149 OBJ: 8

13. The operating room (OR) nurse is preparing medications for use in a sterile field during a
surgical procedure. While preparing these medications, the nurse will:
a. save unused portions of medication for use in another procedure.
b. differentiate between sterile and nonsterile medications to be used in the OR.
c. ensure the scrub (sterile) nurse retrieves the medication from storage.
d. read the label aloud for verification against the order from the surgeon.
ANS: D
It is best to read the label aloud to ensure that both individuals are verifying the contents
against the verbal order from the surgeon. Unused portions of medication should not be saved
for use in another procedure. All medication during an operative procedure must remain
sterile. The circulating (nonsterile) nurse retrieves the medication from storage.

MSC: NCLEX Client Needs Category: Safe, Effective Care Environment; Physiological Integrity
14. The mother of a 6-year-old child informs the school nurse that the child is allergic to insect
stings and requires an EpiPen. If the child is stung by an insect while in school, the nurse
must:
a. hold the EpiPen perpendicularly against the thigh and activate.
b. provide additional care in the nurse’s office prior to sending the child back to class.
c. call the physician prior to administration.
d. provide a second dose within 2 minutes following initial dose.
ANS: A
When held perpendicularly against the thigh and activated, the needle of the EpiPen penetrates
the skin and a single dose of epinephrine is injected into the muscle. Once the epinephrine is
administered, the person should go to a hospital emergency department because additional
treatment may be necessary. The physician does not have to be notified prior to
administration. A second dose should not be provided at this time.

MULTIPLE RESPONSE
15. Which principle(s) is/are correct for mixing insulin? (Select all that apply.)
a. Insulin orders and calculations must be checked with another nurse.
b. Air is injected into the vial of the shorter acting insulin first.
c. The longer acting insulin is drawn up first.
d. The nurse must verify the compatibility of the insulin types.
e. Withdraw the shorter acting insulin first.
ANS: A, D, E
Two nurses should verify orders and prepared insulin amounts to prevent inaccuracy in
administration. When two medications are mixed in the same syringe, compatibility must be
determined. The shorter acting insulin is withdrawn first and air is injected into the longer
acting insulin first.

16. Which risk factor(s) should be considered when administering medications by injection?
(Select all that apply.)
a. Trauma at the site of the needle puncture
b. Possibility of infection
c. Irretrievability of the medication once administered
d. Delayed absorption
e. Delayed onset of action
f. Chance of allergic reaction
ANS: A, B, C, F
Injecting medications involves risk for trauma, infection, and allergic reaction and increases
the difficulty of treating adverse reactions or errors because of the inability to retrieve the
medication. Delayed absorption and onset of action are not risks of injecting medications.
DIF: Cognitive Level: Comprehension REF: p. 140 OBJ: N/A

17. When preparing parenteral medications, the nurse should perform which intervention(s)?
(Select all that apply.)
a. Check the expiration date.
b. Use sterile technique throughout the entire procedure.
c. Check the drug dose form ordered against the source available.
d. Prepare the drug in a clean well lighted area.
e. Check calculations.
ANS: A, C, D, E
The standard procedure for preparing all parenteral medications includes checking the
expiration date on the medication container, checking the drug dose form ordered against the
source available, preparing the drug in a clean well lighted area, and checking calculations for
accuracy. Aseptic technique is used at times during preparation. The primary rule is “sterile to
sterile” and “unsterile to unsterile.”

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have vastly increased the product,—would have improved and
beautified the whole face of the country; and the Moral and
Intellectual advantages thence accruing would alone have been
inestimable. A season of suspension of labor in a community is
usually one of aggravated dissipation, drunkenness, and crime.
But let me more clearly illustrate the effect of foreign competition
in raising prices to the consumer. To do this, I will take my own
calling for an example, because I understand that best; though any of
you can apply the principle to that with which he may be better
acquainted. I am a publisher of newspapers, and suppose I afford
them at a cheap rate. But the ability to maintain that cheapness is
based on the fact that I can certainly sell a large edition daily, so that
no part of that edition shall remain a dead loss on my hands. Now, if
there were an active and formidable Foreign competition in
newspapers,—if the edition which I printed during the night were
frequently rendered unsalable by the arrival of a foreign ship
freighted with newspapers early in the morning,—the present rates
could not be continued: the price must be increased or the quality
would decline. I presume this holds equally good of the production of
calicoes, glass, and penknives as of newspapers, though it may be
somewhat modified by the nature of the article to which it is applied.
That it does hold true of sheetings, nails, and thousands of articles, is
abundantly notorious.
I have not burdened you with statistics,—you know they are the
reliance, the stronghold, of the cause of Protection, and that we can
produce them by acres. My aim has been to exhibit not mere
collections of facts, however pertinent and forcible, but the laws on
which those facts are based,—not the immediate manifestation, but
the ever-living necessity from which it springs. The contemplation of
these laws assures me that those articles which are supplied to us by
Home Production alone are relatively cheaper than those which are
rivalled and competed with from abroad. And I am equally confident
that the shutting out of Foreign competition from our markets for
other articles of general necessity and liberal consumption which can
be made here with as little labor as anywhere would be followed by a
corresponding result,—a reduction of the price to the consumer at
the same time with increased employment and reward to our
Producing Classes.
But, Mr. President, were this only on one side true,—were it
certain that the price of the Home product would be permanently
higher than that of the Foreign, I should still insist on efficient
Protection, and for reasons I have sufficiently shown. Grant that a
British cloth costs but $3 per yard, and a corresponding American
fabric $4, I still hold that the latter would be decidedly the cheaper
for us. The Fuel, Timber, Fruits, Vegetables, &c., which make up so
large a share of the cost of the Home product, would be rendered
comparatively valueless by having our workshops in Europe. I look
not so much to the nominal price as to the comparative facility of
payment. And, where cheapness is only to be attained by a
depression of the wages of Labor to the neighborhood of the
European standard, I prefer that it should be dispensed with. One
thing must answer to another; and I hold that the farmers of this
country can better afford, as a matter of pecuniary advantage, to pay
a good price for manufactured articles than to obtain them lower
through the depression and inadequacy of the wages of the artisan
and laborer.
You will understand me, then, to be utterly hostile to that idol of
Free Trade worship, known as Free or unlimited Competition. The
sands of my hour are running low, and I cannot ask time to examine
this topic more closely; yet I am confident I could show that this Free
Competition is a most delusive and dangerous element of Political
Economy. Bear with a brief illustration: At this moment, common
shirts are made in London at the incredibly low price of three cents
per pair. Should we admit these articles free of duty and buy them
because they are so cheap? Free trade says Yes; but I say No! Sound
Policy as well as Humanity forbids it. By admitting them, we simply
reduce a large and worthy and suffering class of our population from
the ability they now possess of procuring a bare subsistence by their
labor to unavoidable destitution and pauperism. They must now
subsist upon the charity of relatives or of the community,—unless we
are ready to adopt the demoniac doctrine of the Free Trade
philosopher Malthus, that the dependent Poor ought to be rigorously
starved to death. Then what have we gained by getting these articles
so exorbitantly cheap? or, rather, what have we not lost? The labor
which formerly produced them is mainly struck out of existence; the
poor widows and seamstresses among us must still have a
subsistence; and the imported garments must be paid for: where are
the profits of our speculation?
But even this is not the worst feature of the case. The labor which
we have here thrown out of employment by the cheap importation of
this article is now ready to be employed again at any price,—if not
one that will afford bread and straw, then it must accept one that will
produce potatoes and rubbish; and with the product some Free-
Trader proceeds to break down the price and destroy the reward of
similar labor in some other portion of the earth. And thus each
depression of wages produces another, and that a third, and so on,
making the circuit of the globe,—the aggravated necessities of the
Poor acting and reacting upon each other, increasing the
omnipotence of Capital and deepening the dependence of Labor,
swelling and pampering a bloated and factitious Commerce, grinding
down and grinding down the destitute, until Malthus’s remedy for
Poverty shall become a grateful specific, and, amid the splendors and
luxuries of an all-devouring Commercial Feudalism, the squalid and
famished Millions, its dependants and victims, shall welcome death
as a deliverer from their sufferings and despair.
I wish time permitted me to give a hasty glance over the doctrines
and teachings of the Free Trade sophists, who esteem themselves the
Political Economists, christen their own views liberal and
enlightened, and complacently put ours aside as benighted and
barbarous. I should delight to show you how they mingle subtle
fallacy with obvious truth, how they reason acutely from assumed
premises, which, being mistaken or incomplete, lead to false and
often absurd conclusions,—how they contradict and confound each
other, and often, from Adam Smith, their patriarch, down to
McCulloch and Ricardo, either make admissions which undermine
their whole fabric, or confess themselves ignorant or in the dark on
points the most vital to a correct understanding of the great subject
they profess to have reduced to a Science. Yet even Adam Smith
himself expressly approves and justifies the British Navigation Act,
the most aggressively Protective measure ever enacted,—a measure
which, not being understood and seasonably counteracted by other
nations, changed for centuries the destinies of the World,—which
silently sapped and overthrew the Commercial and Political
greatness of Holland,—which silenced the thunder of Van Tromp,
and swept the broom from his mast-head. But I must not detain you
longer. I do not ask you to judge of this matter by authority, but from
facts which come home to your reason and your daily experience.
There is not an observing and strong-minded mechanic in our city
who could not set any one of these Doctors of the Law right on
essential points. I beg you to consider how few great practical
Statesmen they have ever been able to win to their standard,—I
might almost say none; for Huskisson was but a nominal disciple,
and expressly contravened their whole system upon an attempt to
apply it to the Corn Laws; and Calhoun is but a Free-Trader by
location, and has never yet answered his own powerful arguments in
behalf of Protection. On the other hand, we point you to the long
array of mighty names which have illustrated the annals of
Statesmanship of modern times,—to Chatham, William Pitt, and the
Great Frederick of Prussia; to the whole array of memorable French
Statesmen, including Napoleon the first of them all; to our own
Washington, Hamilton, Jefferson, and Madison; to our two
Clintons, Tompkins, to say nothing of the eagle-eyed and genial-
hearted LIVING master-spirit [Henry Clay] of our time. The opinions
and the arguments of all these are on record; it is by hearkening to
and heeding their counsels that we shall be prepared to walk in the
light of experience and look forward to a glorious National destiny.
My friends! I dare not detain you longer. I commit to you the cause
of the Nation’s Independence, of her Stability and her Prosperity.
Guard it wisely and shield it well; for it involves your own happiness
and the enduring welfare of your countrymen!
Henry A. Wise
Against Know-Nothingism, Sept. 18, 1852.
The laws of the United States—federal and state laws—declare and
defend the liberties of our people. They are free in every sense—free
in the sense of Magna Charta and beyond Magna Charta; free by the
surpassing franchise of American charters, which makes them
sovereign and their wills the sources of constitutions and laws.
In this country, at this time, does any man think anything? Would
he think aloud? Would he speak anything? Would he write anything?
His mind is free; his person is safe; his property is secure; his house
is his castle; the spirit of the laws is his body-guard and his house-
guard; the fate of one is the fate of all measured by the same common
rule of right; his voice is heard and felt in the general suffrage of
freemen; his trial is in open court, confronted by witnesses and
accusers; his prison house has no secrets, and he has the judgment of
his peers; and there is nought to make him afraid, so long as he
respects the rights of his equals in the eye of the law. Would he
propagate truth? Truth is free to combat error. Would he propagate
error? Error itself may stalk abroad and do her mischief, and make
night itself grow darker, provided truth is left free to follow, however
slowly, with her torches to light up the wreck! Why, then, should any
portion of the people desire to retire in secret, and by secret means to
propagate a political thought, or word, or deed, by stealth? Why band
together, exclusive of others, to do something which all may not
know of, towards some political end? If it be good, why not make the
good known? Why not think it, speak it, write it, act it out openly and
aloud? Or, is it evil, which loveth darkness rather than light? When
there is no necessity to justify a secret association for political ends,
what else can justify it? A caucus may sit in secret to consult on the
general policy of a great public party. That may be necessary or
convenient; but that even is reprehensible, if carried too far. But here
is proposed a great primary, national organization, in its inception—
What? Nobody knows. To do what? Nobody knows. How organized?
Nobody knows. Governed by whom? Nobody knows. How bound? By
what rites? By what test oaths? With what limitations and restraints?
Nobody, nobody knows! All we know is that persons of foreign birth
and of Catholic faith are proscribed; and so are all others who don’t
proscribe them at the polls. This is certainly against the spirit of
Magna Charta.
A Prussian born subject came to this country. He complied with

our naturalization laws in all respects of notice of intention,
residence, oath of allegiance, and proof of good moral character. He
remained continuously in the United States the full period of five
years. When he had fully filled the measure of his probation and was
consummately a naturalized citizen of the United States, he then,
and not until then, returned to Prussia to visit an aged father. He was
immediately, on his return, seized and forced into the Landwehr, or
militia system of Prussia, under the maxim: “Once a citizen, always a
citizen!” There he is forced to do service to the king of Prussia at this
very hour. He applies for protection to the United States. Would the
Know-Nothings interpose in his behalf or not? Look at the principles
involved. We, by our laws, encouraged him to come to our country,
and here he was allowed to become naturalized, and to that end
required to renounce and abjure all allegiance and fidelity to the king
of Prussia, and to swear allegiance and fidelity to the United States.
The king of Prussia now claims no legal forfeiture from him—he
punishes him for no crime—he claims of him no legal debt—he
claims alone that very allegiance and fidelity which we required the
man to abjure and renounce. Not only so, but he hinders the man
from returning to the United States, and from discharging the
allegiance and fidelity we required him to swear to the United States.
The king of Prussia says he should do him service for seven years, for
this was what he was born to perform; his obligations were due to
him first, and his laws were first binding him. The United States say
—true, he was born under your laws, but he had a right to expatriate
himself; he owed allegiance first to you, but he had a right to
forswear it and to swear allegiance to us; your laws first applied, but
this is a case of political obligation, not of legal obligation; it is not
for any crime or debt you claim to bind him, but it is for allegiance;
and the claim you set up to his services on the ground of his political
obligation, his allegiance to you, which we allow him to abjure and
renounce, is inconsistent with his political obligation, his allegiance,
which we required him to swear to the United States; he has sworn
fidelity to us, and we have, by our laws, pledged protection to him.
Such is the issue. Now, with which will the Know-Nothings take
sides? With the king of Prussia against our naturalized citizen and
against America, or with America and our naturalized citizen? Mark,
now, Know-Nothingism is opposed to all foreign influence—against
American institutions. The king of Prussia is a pretty potent foreign
influence—he was one of the holy alliance of crowned heads. Will
they take part with him, and not protect the citizen? Then they will
aid a foreign influence against our laws! Will they take sides with our
naturalized citizen? If so, then upon what grounds? Now, they must
have a good cause of interposition to justify us against all the
received dogmas of European despotism.
Don’t they see, can’t they perceive, that they have no other grounds
than those I have urged? He is our citizen, nationalized, owing us
allegiance and we owing him protection. And if we owe him
protection abroad, because of his sworn allegiance to us as a
naturalized citizen, what then can deprive him of his privileges at
home among us when he returns? If he be a citizen at all, he must be
allowed the privileges of citizenship, or he will not be the equal of his
fellow-citizens. And must not Know-Nothingism strike at the very
equality of citizenship, or allow him to enjoy all its lawful privileges?
If Catholics and naturalized citizens are to be citizens and yet to be
proscribed from office, they must be rated as an inferior class—an
excluded class of citizens. Will it be said that the law will not make
this distinction? Then are we to understand that Know-Nothings
would not make them equal by law? If not by law, how can they
pretend to make them unequal, by their secret order, without law
and against law? For them, by secret combination, to make them
unequal, to impose a burthen or restriction upon their privileges
which the law does not, is to set themselves up above the law, and to
supersede by private and secret authority, intangible and
irresponsible, the rule of public, political right. Indeed, is this not the
very essence of the “Higher Law” doctrine? It cannot be said to be
legitimate public sentiment and the action of its authority. Public
sentiment, proper, is a concurrence of the common mind in some
conclusion, conviction, opinion, taste, or action in respect to persons
or things subject to its public notice. It will, and it must control the
minds and actions of men, by public and conventional opinion.
Count Molé said that in France it was stronger than statutes. It is so
here. That it is which should decide at the polls of a republic. But,
here is a secret sentiment, which may be so organized as to
contradict the public sentiment. Candidate A. may be a native and a
Protestant, and may concur with the community, if it be a Know-
Nothing community, on every other subject except that of
proscribing Catholics and naturalized citizens: and candidate B. may
concur with the community on the subject of this proscription alone,
and upon no other subject; and yet the Know-Nothings might elect B.
by their secret sentiment against the public sentiment. Thus it
attacks not only American doctrines of expatriation, allegiance, and
protection, but the equality of citizenship, and the authority of public
sentiment. In the affair of Koszta, how did our blood rush to his
rescue? Did the Know-Nothing side with him and Mr. Marcy, or with
Hulseman and Austria? If with Koszta, why? Let them ask
themselves for the rationale, and see if it can in reason abide with
their orders. There is no middle ground in respect to naturalization.
We must either have naturalization laws and let foreigners become
citizens, on equal terms of capacities and privileges, or we must
exclude them altogether. If we abolish naturalization laws, we return
to the European dogma: “Once a citizen, always a citizen.” If we let
foreigners be naturalized and don’t extend to them equality of
privileges, we set up classes and distinctions of persons wholly
opposed to republicanism. We will, as Rome did, have citizens who
may be scourged. The three alternatives are presented—Our present
policy, liberal, and just, and tolerant, and equal: or the European
policy of holding the noses of native born slaves to the grind-stone of
tyranny all their lives; or, odious distinctions of citizenship tending
to social and political aristocracy. I am for the present laws of
naturalization.
As to religion, the Constitution of the United States, art. 6, sec. 3,
especially provides that no religious test shall ever be required as a
qualification to any office or public trust under the United States.
The state of Virginia has, from her earliest history, passed the most
liberal laws, not only towards naturalization, but towards foreigners.
But I have said enough to show the spirit of American laws and the
true sense of American maxims.
3d. Know-Nothingism is against the spirit of Reformation and of
Protestantism.
What was there to reform?
Let the most bigoted Protestant enumerate what he defines to have
been the abominations of the church of Rome. What would he say
were the worst? The secrets of Jesuitism, of the Auto da fe, of the
Monasteries and of the Nunneries. The private penalties of the
Inquisition’s Scavenger’s Daughter. Proscription, persecution,
bigotry, intolerance, shutting up of the book of the word. And do
Protestants now mean to out-Jesuit the Jesuits? Do they mean to
strike and not be seen? To be felt and not to be heard? To put a
shudder upon humanity by the masks of mutes? Will they wear the
monkish cowls? Will they inflict penalties at the polls without
reasoning together with their fellows at the hustings? Will they
proscribe? Persecute? Will they bloat up themselves into that bigotry
which would burn nonconformists? Will they not tolerate freedom of
conscience, but doom dissenters, in secret conclave, to a forfeiture of
civil privileges for a religious difference? Will they not translate the
scripture of their faith? Will they visit us with dark lanterns and
execute us by signs, and test oaths, and in secrecy? Protestantism!
forbid it!
If anything was ever open, fair, and free—if anything was ever
blatant even—it was the Reformation. To quote from a mighty British
pen: “It gave a mighty impulse and increased activity to thought and
inquiry, agitated the inert mass of accumulated prejudices
throughout Europe. The effect of the concussion was general, but the
shock was greatest in this country” (England). It toppled down the
full grown intolerable abuses of centuries at a blow; heaved the
ground from under the feet of bigoted faith and slavish obedience;
and the roar and dashing of opinions, loosened from their
accustomed hold, might be heard like the noise of an angry sea, and
has never yet subsided. Germany first broke the spell of misbegotten
fear, and gave the watchword; but England joined the shout, and
echoed it back, with her island voice, from her thousand cliffs and
craggy shores, in a longer and louder strain. With that cry the genius
of Great Britain rose, and threw down the gauntlet to the nations.
There was a mighty fermentation: the waters were out; public
opinion was in a state of projection; liberty was held out to all to
think and speak the truth; men’s brains were busy; their spirits
stirring; their hearts full; and their hands not idle. Their eyes were
opened to expect the greatest things, and their ears burned with
curiosity and zeal to know the truth, that the truth might make them
free. The death-blow which had been struck at scarlet vice and
bloated hypocrisy, loosened tongues, and made the talismans and
love tokens of popish superstitions with which she had beguiled her
followers and committed abominations with the people, fall harmless
from their necks.
The translation of the Bible was the chief engine in the great work.
It threw open, by a secret spring, the rich treasures of religion and
morality, which had then been locked up as in a shrine. It revealed
the visions of the Prophets, and conveyed the lessons of inspired
teachers to the meanest of the people. It gave them a common
interest in a common cause. Their hearts burnt within them as they
read. It gave a mind to the people, by giving them common subjects
of thought and feeling. It cemented their Union of character and
sentiment; it created endless diversity and collision of opinion. They
found objects to employ their faculties, and a motive in the
magnitude of the consequences attached to them, to exert the utmost
eagerness in the pursuit of truth, and the most daring intrepidity in
maintaining it. Religious controversy sharpens the understanding by
the subtlety and remoteness of the topics it discusses, and braces the
will by their infinite importance. We perceive in the history of this
period a nervous, masculine intellect. No levity, no feebleness, no
indifference; or, if there were, it is a relaxation from the intense
activity which gives a tone to its general character. But there is a
gravity approaching to piety, a seriousness of impression, a
conscientious severity of argument, an habitual fervor of enthusiasm
in their method of handling almost every subject. The debates of the
schoolmen were sharp and subtle enough: but they wanted interest
and grandeur, and were besides confined to a few. They did not affect
the general mass of the community. But the Bible was thrown open
to all ranks and conditions “to own and read,” with its wonderful
table of contents, from Genesis to the Revelation. Every village in
England would present the scene so well described in Burns’s
“Cotter’s Saturday Night.” How unlike this agitation, this shock, this
angry sea, this fermentation, this shout and its echoes, this impulse
and activity, this concussion, this general effect, this blow, this
earthquake, this roar and dashing, this longer and louder strain, this
public opinion, this liberty to all to think and speak the truth, this
stirring of spirits, this opening of eyes, this zeal to know—not
nothing—but the truth, that the truth might make them free. How
unlike to this is Know-Nothingism, sitting and brooding in secret to
proscribe Catholics and naturalized citizens! Protestantism protested
against secrecy, it protested against shutting out the light of truth, it
protested against proscription, bigotry, and intolerance. It loosened
all tongues, and fought the owls and bats of night with the light of
meridian day. The argument of Know-Nothings is the argument of
silence. The order ignores all knowledge. And its proscription can’t
arrest itself within the limit of excluding Catholics and naturalized
citizens. It must proscribe natives and Protestants both, who will not
consent to unite in proscribing Catholics and naturalized citizens.
Nor is that all; it must not only apply to birth and religion, it must
necessarily extend itself to the business of life as well as to political
preferments.
Kenneth Raynor, of North Carolina, on
Fusion of Fremont and Fillmore Forces.
Extracts from his Speech at Philadelphia, November 1, 1856.

My brother Americans, do you intend to let these mischief-makers
put you and me together by the ears? [Many voices; “no, no.”] Then
let us beat James Buchanan for the Presidency. [“We will—we will,”
and great applause.] He is the representative of slavery agitation; he
is the representative of discord between sections; he is the man
whom Northern and Southern agitators have agreed to present as
their candidate. If he be elected now, and the difficulties in Kansas be
healed, at the end of four years they will spring upon you another
question of slavery agitation. It will be the taking of Cuba from Spain,
or cutting off another slice from Mexico for the purpose of
embroiling the North against the South; and then, if I shall resist that
agitation, I shall be called an Abolitionist, again.
My countrymen, God forbid that I should attempt to dictate to you

or even advise you. I am not competent to do so. I know that
divisions exist among you, while I feel also confident that the same
purpose animates all your hearts. Do not suppose for one moment
that I am the representative of any clique or faction.
Unfortunately, I find that our friends here are in the same
condition in which the Jews were, when besieged by the Roman
general, Titus. Whilst the battering-rams of the Romans were beating
down their walls, and the firebrand of the heathen was consuming
their temple, the historian tells us that that great people were
engaged in intestine commotions, some advocating the claims of one,
and some of another, to the high priesthood of that nation; and
instead of the Romans devouring them, they devoured each other.
God forbid that my brother Americans should devour each other, at a
time when every heart and every hand should be enlisted in the same
cause, of overthrowing the common enemy of us all.
Who is that common enemy? [Voices, “The Democratic party.”]
Yes, that party have reviled us, abused us, persecuted us, and all only
because we are determined to adhere to the Constitution of our
country. Give Buchanan a lease of power for four years, and we must
toil through persecution, submit to degradation, or cause the streets
of our cities to run blood. But we will submit to degradation provided
we can see the end of our troubles. We are willing to go through a
pilgrimage, not only of four years, but of ten, or twenty, or forty
years, provided we can have an assurance that at last we shall reach
the top of Pisgah, and see the promised land which our children are
to inherit. God has not given to us poor frail mortals the power, at all
times, of controlling events. When we cannot control events, should
we not, where no sacrifice of honor is involved, pursue the policy of
Lysander, and where the lion’s skin is too short, eke it out with the
fox’s [applause]—not where principle is involved—not where a
surrender of our devotion to our country is at stake. No; never,
never!
I know nothing of your straight-out ticket; I know nothing of your
Union ticket; I know nothing of Fremont. I do know something of
Fillmore; but I would not give my Americanism, and the hopes which
I cherish of seeing Americanism installed as the policy of this nation,
for all the Fillmores, or Fremonts, or Buchanans, that ever lived on
the face of the earth.
St. Paul says, “if it offends my brother, I will eat no meat;” and if it
offends my brother here, I will not open my mouth. Nobody can
suspect me. [Voices: “certainly not.”] Then I say, can’t you combine
the vote of this state, and beat Buchanan? [This question was
responded to in the affirmative, with the greatest enthusiasm.]
Repeated cheers were proposed for the straight ticket, but the
responding voices were by no means numerous, and were mingled
with hisses. Such was the universal excitement, that for some
minutes the speaker was obliged to pause. He finally raised his voice
above the subsiding storm, and said:—
Come, my friends, we are all brothers; we are all seeking the same
end. Our object is the same. We are all struggling to reach the same
haven of safety. The only difference of opinion is as to the proper
means by which to accomplish our common end. Will not Americans
learn prudence from the past? Misfortune should have taught us
charity for each other. We have passed through the ordeal of
persecution together; we have been subjected to the same difficulties,
and the same oppression; we have been baptized (I may say) in the
same stream of calumny. Then, in the name of God—in the name of
our common country—in the name of Americanism—in the name of
American nationality—in the name of religious freedom—in the
name of the Union, I beseech you to learn charity for the difference
of opinion which prevails among you. Let brethren forbear with
brethren. Let us recollect that it is not by vituperation, by the censure
of our brethren, that we can ever accomplish this great end of
conquering a common enemy. My friends, how long are we to suffer?
How long will it be before we shall learn that it is only by a union of
counsels, a concentration of energy, a combination of purpose, that
we can destroy the common enemy of every conservative man. [Great
applause.]
I shall not attempt to advise you, for I am not competent to do it.
You have information which I do not possess. You know all the
undercurrents of opinion which prevail here in your community,
with which I am unacquainted; but will you allow an humble man to
express his opinion to brethren whom he loves? May I do it? I am a
Fillmore man—nothing but a Fillmore man, and if I resided here, I
would vote no ticket which had not the name of Millard Fillmore at
its head, and I would advise no Fillmore man to vote a ticket with
Fremont’s name on it; but I would vote for that ticket which would
make my voice tell at the polls.
Now let us look at this thing practically. In reading history I have
always admired the character of Oliver Cromwell. What was the great
motive by which he was actuated in overthrowing the house of
Stuart? It was unfailing devotion to principle. His motto was, “Put
your trust in God, and keep your powder dry.” I admire the devotion
to principle in every man who says that he does not intend to vote
any but the straight ticket, for it shows that Americanism has such a
lodgment in his heart, that he cannot bear even seemingly to
compromise it. That is “putting your trust in God;” but, my friends, is
it “keeping your powder dry?” The enemy may steal into the camp
while you are asleep, and may pour water upon your cartridges, so
that when the day of battle shall come, you may shoot, but you will
kill nobody. I want the vote of every American, on Tuesday next, to
tell. Would to God that you could give the twenty-seven electoral
votes of Pennsylvania to Fillmore. Then vote the straight ticket, if
that will give him the twenty-seven votes. But suppose it will not
(and I am afraid it will not), then the question is, had you better give
Buchanan the twenty-seven votes, or give Fillmore eight, ten, twelve,
or twenty, as the case may be. I go for beating Buchanan.
Gentlemen, you do not know what we Americans suffer at the
South. I am abused and reviled for standing up in defence of you.
When I hear the whole North denounced as a set of Abolitionists,
whose purpose it is to interfere with the peculiar institutions of the
South, I brand such charges as slanders on the Northern people. I tell
them that the great mass of the Northern people are sound on this
question; that they are opposed to slavery, as I should be if I were a
Northern man; but that I do not believe that the great mass of the
Northern people have any idea of interfering with the constitutional
rights of the people of the South. I know that such men as Garrison
and Forney have. I know that Garrison believes the Constitution to
be a “league with hell,” and would therefore destroy it if he could;
and I know that Forney loves office so well, that even at the risk of
snapping the Union, he will keep alive slavery agitation. But Garrison
does not represent New England, and Forney does not represent you.
As much as I have been reviled for standing by you, I am so
anxious to have Buchanan beaten, that were I residing here, if I could
not give Fillmore the whole twenty-seven votes, I would give him all I
could, by giving him the number to which he might be entitled by the
numerical proportion of the votes at the ballot-box. Yet, if there is a
brother American here who feels in his “heart of hearts,” that by
voting that Union ticket, he would compromise his Americanism, I
say to such an one, “do not vote that ticket.” At the same time,
candor compels me to say, that I differ in opinion with him. If I
believed that that ticket was a fusion, or that it called upon any
Fillmore man to vote for Fremont, I would advise no one to vote it. I
would not vote a ticket that had on it the name of Fremont; but I
would vote a ticket with Fillmore’s name upon it, and which would
give him (if not the twenty-seven electoral votes) seven, or ten, or
twenty, just as the numerical proportion of the votes might decide.
I appeal to every conservative, Union-loving man in this nation,
who is disposed to give to the South all the constitutional privileges
to which she is entitled, and who wishes to rebuke the Democratic
party for the repeal of the Missouri compromise, and for keeping up
the eternal agitation of slavery. I appeal to you as a southern man—as
a slaveholder. I do not ask you to be pro-slavery men, to be the
advocates of slavery, when I say to you that we, your brethren of the
South, expect you to preserve our constitutional rights—and, God
knows, we ask nothing more—against fanatics, either north or south.
Will you do it?
My friends, the election is fast approaching. There is but little time
for deliberation left. Is there no way by which the votes of the anti-
Buchanan party can be concentrated on the same ticket? I would
shed tears of blood—God knows I would—if I could be instrumental
in prevailing on all true Americans to combine. I cannot tell you how
to combine; but is it yet too late? If it is too late to do it throughout
the state, cannot you in Philadelphia do it? The Presidential election
may depend upon the state of Pennsylvania, and the state of
Pennsylvania may depend upon the city of Philadelphia. On the vote
of the city of Philadelphia may depend not only our own rights, but
the rights of our children and our children’s children. I appeal to my
brother Americans, for I have no right to appeal to anybody else; I
cannot address the Fremont party, for I have no affiliation with
them; I cannot address the Buchanan party, for my object is to
destroy them if possible. To my American brethren, then, I appeal,
for God’s sake, do not let the sun rise upon that wrath, which I see
divides you. Your object is the same—to rescue your common
country.
Let me advise you who know nothing of your divisions—who
belong neither to one clique or the other. I say with the deepest
sincerity that I think all parties ought to have concentrated upon the
Fillmore ticket. Mr. Fillmore is a northern man. Your southern
brethren were willing to support him. He had guided the ship of state
safely through the storm, and it was but reasonable to suppose that
in time of difficulty he would again be found the same good pilot. But
if we cannot get all others to unite on Mr. Fillmore, each of us must
inquire, “What is my duty? If the mountain will not come to
Mahomet, shall not Mahomet go to the mountain; and if he will not
go to the mountain, in heaven’s name, shall he not go half way?”
I am fighting for the victory which we may obtain in this contest.
And what an issue is now pending! We read in the Iliad how, for ten
long years, a great people of antiquity were engaged in the siege of
Troy. What was the stake for which they contended? It was nothing
more than a beautiful woman, who had been ravished by a sprig of
the royal line of Troy. What is the stake for which we contend? It is
constitutional liberty—the right of the American people to govern
their own country—the right of every citizen to worship God
according to the dictates of his conscience. The great issue is,
whether the American flag shall still wave in glory when we shall
have gone to our graves, or whether it shall be trailed in dishonor—
whether the “blackness of darkness” which would follow the
dissolution of this Union, shall cover the land.
I do not tell you how to combine: but I urge you to resort to that
mode (if there is such a mode possible), by which you can get
together—by which your votes can be made effectual at the polls—by
which Millard Fillmore can go before the House of Representatives
with the strong moral power which a large electoral vote will give
him.
That is the way in which we must view the question as practical
men. Yet so different are the conditions of our nature, so different
the sentiments which actuate us, that I will not be guilty of such
presumption, as to tell any man what particular course he should
take. You know my opinions; if they are worth anything, receive
them into your hearts, simply as the sentiments of a brother
American; if they are worth nothing, let them pass as the idle wind.
In conclusion I will only say that whether we be defeated or
whether we be victorious, the only reward I ask for in the labor in
which I am engaged is, that you may recollect me as one who had at
heart only the welfare of his country, and who endeavored to
promote it by appealing to the associations of the past, and all the
hopes of the future.
Religious Test.
Debate in the Convention on that article in the Constitution in

regard to it.
Mr. Pinkney moved that no religious test shall ever be required as
a qualification to any office or public trust under the United States.
Mr. Sherman thought it unnecessary, the prevailing liberality
being a sufficient security against all such tests.
Rev. Mr. Backus of Mass. I beg leave to offer a few thoughts upon
the Constitution proposed to us; and I shall begin with the exclusion
of any religious test. Many appear to be much concerned about it;
but nothing is more evident, both in reason and the Holy Scriptures,
than that religion is ever a matter between God and individuals; and
that, therefore, no man or set of men can impose any religious test
without invading the essential prerogatives of our Lord Jesus Christ.
Ministers first assumed this power under the Christian name, and
then Constantine approved of the practice when he adopted the
profession of Christianity as an engine of state policy. And let the
history of all nations be searched, from that day to this, and it will
appear that the imposing of religious tests hath been the greatest
engine of tyranny in the world.
Oliver Wolcott of Conn. For myself I should be content either
with or without that clause in the Constitution which excludes test
laws. Knowledge and liberty are so prevalent in this country, that I
do not believe that the United States would ever be disposed to
establish one religious sect and lay all others under legal disabilities.
But as we know not what may take place hereafter, and any such test
would be destructive of the rights of free citizens, I cannot think it
superfluous to have added a clause which secures us from the
possibility of such oppression.
Mr. Madison of Va. I confess to you, sir, that were uniformity of
religion to be introduced by this system, it would, in my opinion, be
ineligible; but I have no reason to conclude that uniformity of
government will produce that of religion. This subject is, for the
honor of America, left perfectly free and unshackled. The
government has no jurisdiction over it—the least reflection will
convince us there is no danger on this ground. Happily for the states,
they enjoy the utmost freedom of religion. This freedom arises from
that multiplicity of sects which pervades America, and which is the
best and only security for religious liberty in any society. For, where
there is such a variety of sects, there cannot be a majority of any one
sect to oppress and persecute the rest.
Mr. Iredell of N. C. used this language: “Every person in the least
conversant with the history of mankind, knows what dreadful
mischiefs have been committed by religious persecution. Under the
color of religious tests, the utmost cruelties have been exercised.
Those in power have generally considered all wisdom centred in
themselves, that they alone had the right to dictate to the rest of
mankind, and that all opposition to their tenets was profane and
impious. The consequence of this intolerant spirit has been that each
church has in turn set itself up against every other, and persecutions
and wars of the most implacable and bloody nature have taken place
in every part of the world. America has set an example to mankind to
think more rationally—that a man may be of religious sentiments
differing from our own, without being a bad member of society. The
principles of toleration, to the honor of this age, are doing away those
errors and prejudices which have so long prevailed even in the most
intolerant countries. In Roman Catholic lands, principles of
moderation are adopted, which would have been spurned a century
or two ago. It will be fatal, indeed, to find, at the time when examples
of toleration are set even by arbitrary governments, that this country,
so impressed with the highest sense of liberty, should adopt
principles on this subject that were narrow, despotic, and illiberal.”

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DIF: Cognitive Level: Knowledge REF: p. 141 OBJ: 1

DIF: Cognitive Level: Application REF: p. 145 OBJ: 2

DIF: Cognitive Level: Comprehension REF: p. 143 OBJ: 5

DIF: Cognitive Level: Application REF: p. 150 OBJ: 8

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7. The nurse is preparing to administer insulin. What does U 100 indicate?

DIF: Cognitive Level: Comprehension REF: p. 143 OBJ: 3 | 5

DIF: Cognitive Level: Application REF: p. 140 | pp. 146-147

9. Which nursing action is accurate when administering parenteral medication?

DIF: Cognitive Level: Application REF: p. 140 OBJ: N/A

10. What is an advantage of administering a drug parenterally?

DIF: Cognitive Level: Comprehension REF: p. 140 OBJ: 1

DIF: Cognitive Level: Application REF: p. 144 OBJ: 6

DIF: Cognitive Level: Knowledge REF: p. 149 OBJ: 8

DIF: Cognitive Level: Application REF: p. 155 OBJ: 8

DIF: Cognitive Level: Application REF: p. 144 OBJ: 6

DIF: Cognitive Level: Application REF: p. 153 OBJ: 9

DIF: Cognitive Level: Comprehension REF: p. 140 OBJ: N/A

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A Prussian born subject came to this country. He complied with

Extracts from his Speech at Philadelphia, November 1, 1856.

My countrymen, God forbid that I should attempt to dictate to you

Debate in the Convention on that article in the Constitution in

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