NCLEX Medication Administration Practice Exam
What is the primary purpose of a medication order?
a) To ensure patient safety
b) To confirm medication availability
c) To record the medication prescribed
d) To request medication refill
A nurse is administering a medication via a nasogastric tube. Which action should the nurse take first?
a) Check the patient’s identification
b) Flush the tube with water
c) Crush the medication
d) Verify the placement of the tube
Which of the following should be monitored when a patient is taking warfarin (Coumadin)?
a) Hemoglobin levels
b) International normalized ratio (INR)
c) Platelet count
d) Potassium levels
When administering a subcutaneous injection, what is the correct needle angle?
a) 15 degrees
b) 30 degrees
c) 45 degrees
d) 90 degrees
Which of the following medications is considered a high-alert medication?
a) Acetaminophen
b) Insulin
c) Lorazepam
d) Omeprazole
What should a nurse do if a patient refuses to take a prescribed medication?
a) Administer the medication regardless of refusal
b) Document the refusal and inform the healthcare provider
c) Try to convince the patient to take the medication
d) Notify the patient’s family about the refusal
Which medication is used as a first-line treatment for hypertension?
a) Furosemide (Lasix)
b) Lisinopril (Zestril)
c) Atorvastatin (Lipitor)
d) Digoxin (Lanoxin)
What is the most common side effect of opioid analgesics?
a) Nausea
b) Constipation
c) Drowsiness
d) Diarrhea
Which of the following is a contraindication for administering acetaminophen (Tylenol)?
a) Liver disease
b) Kidney disease
c) Asthma
d) Hypertension
What should the nurse do before administering a dose of medication via IV route?
a) Verify the patient’s identity and allergies
b) Check the patient’s blood pressure
c) Assess the intravenous site for redness
d) Check the expiration date of the medication
A patient is receiving chemotherapy. Which of the following is an important consideration when administering chemotherapy drugs?
a) The patient should have a full stomach
b) The nurse must wear personal protective equipment (PPE)
c) Chemotherapy drugs are given only in the morning
d) The patient should be encouraged to exercise
What is the first action the nurse should take when an error in medication administration is identified?
a) Notify the healthcare provider
b) Document the error in the patient’s chart
c) Assess the patient for any adverse effects
d) Discontinue the medication immediately
Which of the following is an example of a medication that should not be crushed?
a) Aspirin
b) Enalapril
c) Enteric-coated tablets
d) Acetaminophen
What is the correct method of administering an intramuscular (IM) injection in an adult?
a) 45-degree angle
b) 60-degree angle
c) 90-degree angle
d) 15-degree angle
Which medication is contraindicated for a patient with a history of anaphylaxis to penicillin?
a) Amoxicillin
b) Clindamycin
c) Erythromycin
d) Doxycycline
What is the correct action for the nurse when administering a liquid medication to a child?
a) Measure the dose using a tablespoon
b) Use a calibrated dropper or oral syringe
c) Ask the child to drink the medication directly from the bottle
d) Mix the medication with water before administration
A nurse is preparing to administer a medication intravenously. What is the first step the nurse should take?
a) Verify the patient’s ID
b) Inspect the IV site
c) Verify the physician’s order
d) Prepare the medication
Which of the following best describes the “right time” when administering medications?
a) Administering medications within 30 minutes before or after the scheduled time
b) Administering medications as early as possible
c) Administering medications after checking the patient’s temperature
d) Administering medications after the physician’s office visit
What is the most important factor when administering a medication via a patient-controlled analgesia (PCA) pump?
a) Verifying the drug dosage with the patient
b) Ensuring the patient is educated on PCA use
c) Monitoring the patient’s blood pressure continuously
d) Ensuring the patient has a high fluid intake
Which of the following is a common side effect of antihistamines?
a) Drowsiness
b) Insomnia
c) Diarrhea
d) Tachycardia
What is the nurse’s responsibility before administering a medication?
a) Ask the patient if they are allergic to any medications
b) Observe the patient for any side effects from previous medications
c) Verify the medication order, patient identity, and drug
d) Inform the family about the medication schedule
Which medication would be most appropriate for treating a patient with a bacterial infection?
a) Acetaminophen
b) Amoxicillin
c) Lorazepam
d) Diphenhydramine
A patient is prescribed a medication that is a teratogen. Which of the following should be done before administration?
a) Ensure the patient is not pregnant
b) Increase the dose for non-pregnant patients
c) Administer with a contraceptive
d) Only administer the medication in the morning
Which of the following is an example of a medication given by the intradermal route?
a) Influenza vaccine
b) Insulin
c) Tuberculosis test
d) Vitamin B12 injection
A nurse is administering a medication to a pediatric patient. Which is the correct method for calculating the correct pediatric dosage?
a) Using the patient’s age and weight
b) Using the patient’s height and gender
c) Using the adult dose as a baseline
d) Using the average weight for children of the same age
Which of the following is an appropriate action when a patient is being administered a drug that may cause sedation?
a) Instruct the patient to rest and avoid activities that require concentration
b) Encourage the patient to drink caffeine
c) Instruct the patient to perform light exercises
d) Withhold the medication if the patient complains of drowsiness
Which of the following is the best method to verify that a medication is correctly administered to the right patient?
a) Ask the patient their name
b) Check the patient’s wristband
c) Ask the family member for confirmation
d) Compare the medication with the patient’s chart
Which of the following is an example of a non-parenteral route of medication administration?
a) Intravenous
b) Subcutaneous
c) Oral
d) Intramuscular
When administering a controlled substance, which is the nurse’s responsibility?
a) Document the patient’s vital signs
b) Double-check the drug with a second nurse
c) Administer the medication at the prescribed time
d) Ensure the patient is comfortable and relaxed
What is the most common route of administration for insulin?
a) Oral
b) Subcutaneous
c) Intramuscular
d) Intravenous
Which of the following is a potential side effect of administering morphine for pain management?
a) Hypertension
b) Tachypnea
c) Respiratory depression
d) Diarrhea
A nurse is administering a blood pressure medication to a patient. The patient has a systolic blood pressure of 90 mmHg. What should the nurse do?
a) Administer the medication as prescribed
b) Withhold the medication and notify the healthcare provider
c) Increase the dosage of the medication
d) Administer a double dose of the medication
Which medication is commonly used to treat type 2 diabetes mellitus by increasing insulin sensitivity?
a) Metformin (Glucophage)
b) Insulin
c) Glipizide (Glucotrol)
d) Lisinopril
When administering a medication via a patch, what is the first action a nurse should take?
a) Apply the patch directly to the patient’s skin
b) Remove the old patch before applying the new one
c) Place the patch over the patient’s wound
d) Warm the patch before application
Which of the following is a potential complication of administering corticosteroids long-term?
a) Hyperkalemia
b) Osteoporosis
c) Hypoglycemia
d) Hyperthyroidism
When preparing to administer oral medication to a patient with dysphagia, the nurse should:
a) Crush the medication and mix it with a liquid
b) Administer the medication with a large glass of water
c) Contact the physician for a liquid formulation
d) Have the patient swallow the pill whole
A nurse is administering insulin to a diabetic patient. The patient’s blood glucose level is 180 mg/dL. What should the nurse do?
a) Administer the prescribed dose of insulin
b) Skip the insulin dose and notify the healthcare provider
c) Increase the insulin dose by 10 units
d) Administer a snack with the insulin dose
Which of the following medications should be avoided in patients with a history of peptic ulcers?
a) Ibuprofen
b) Paracetamol
c) Diphenhydramine
d) Hydrocodone
A patient is prescribed a medication that can cause photosensitivity. The nurse should:
a) Instruct the patient to wear sunscreen and protective clothing
b) Advise the patient to stay indoors at all times
c) Tell the patient to reduce fluid intake while on the medication
d) Instruct the patient to avoid contact with other people
What is the primary action of antiplatelet medications such as aspirin?
a) Increase red blood cell production
b) Prevent the formation of blood clots
c) Relieve pain and inflammation
d) Decrease heart rate
Which is the correct technique for administering an intradermal injection?
a) Insert the needle at a 90-degree angle
b) Insert the needle at a 15-degree angle
c) Insert the needle at a 45-degree angle
d) Insert the needle at a 30-degree angle
Which of the following is a priority assessment for a patient receiving digoxin (Lanoxin)?
a) Blood glucose levels
b) Potassium levels
c) White blood cell count
d) Hemoglobin levels
Which medication should be used cautiously in patients with asthma?
a) Salbutamol (Ventolin)
b) Ibuprofen
c) Prednisone
d) Albuterol
When administering a medication via an enteral feeding tube, the nurse should:
a) Crush all medications together and administer with water
b) Administer medications one at a time and flush the tube between each medication
c) Skip the flushing step if the medication is liquid
d) Mix the medication with the patient’s food
Which of the following is a nursing consideration when administering acetaminophen (Tylenol)?
a) Monitor liver function tests
b) Check for signs of hypokalemia
c) Administer with a large amount of water
d) Avoid giving to patients with diabetes
When preparing a medication for injection, what is the nurse’s primary concern?
a) Sterility of the medication
b) Expiration date of the medication
c) Correct patient identification
d) Proper technique for injection
Which medication should be given to a patient in an acute asthma attack?
a) Furosemide (Lasix)
b) Albuterol (Ventolin)
c) Metformin (Glucophage)
d) Prednisone
Which of the following should be done when administering a medication through an intravenous (IV) line?
a) Inject the medication quickly to avoid complications
b) Ensure the IV site is free of signs of infection
c) Use an expired medication if there is no alternative
d) Administer the medication without checking the label
Which of the following is a common side effect of antihypertensive medications?
a) Dry mouth
b) Insomnia
c) Weight gain
d) Blurred vision
What should a nurse do if a patient experiences dizziness and lightheadedness after taking a blood pressure medication?
a) Reassure the patient that this is normal
b) Help the patient lie down and monitor blood pressure
c) Administer a painkiller for the dizziness
d) Increase the dose of the medication
Which of the following is the best method for administering a drug via a nebulizer?
a) Ask the patient to breathe in deeply and hold their breath for 5 seconds
b) Administer the drug as a single inhalation
c) Have the patient inhale the medication slowly and deeply
d) Ask the patient to inhale through the mouthpiece for 10 seconds
Which of the following medications may cause hyperglycemia as a side effect?
a) Insulin
b) Beta-blockers
c) Corticosteroids
d) Antihistamines
What is the correct action for a nurse administering a narcotic pain medication to a patient who is also taking a benzodiazepine?
a) Administer the narcotic without concern
b) Monitor the patient for respiratory depression
c) Increase the narcotic dose to account for tolerance
d) Avoid administering the medication together
Which of the following is important when a patient is receiving chemotherapy medications?
a) Strict isolation precautions
b) Encouraging physical activity
c) Monitoring for infection
d) Decreasing fluid intake
Which medication is commonly used for preventing blood clots after surgery?
a) Warfarin (Coumadin)
b) Ibuprofen (Advil)
c) Acetaminophen (Tylenol)
d) Morphine
What is the best method for ensuring safe administration of high-alert medications such as insulin or heparin?
a) Double-check the drug order with a colleague
b) Administer the drug in the evening
c) Skip the patient identification step if in a hurry
d) Use the patient’s self-report for drug accuracy
Which of the following would be appropriate for a nurse to do before administering a scheduled dose of an antibiotic?
a) Delay administration until the patient’s temperature rises
b) Check for a history of allergies to antibiotics
c) Administer the medication with any available food
d) Ask the patient to wait until their condition worsens
What is an important consideration when administering an oral suspension medication to a child?
a) Shake the bottle well before administering
b) Crush the tablet for easier administration
c) Administer the medication in a single large dose
d) Ask the child to chew the liquid for better absorption
What is a potential side effect of diuretics?
a) Hypokalemia
b) Hypertension
c) Hyperkalemia
d) Dehydration
Which of the following medications is contraindicated in patients with glaucoma?
a) Beta-blockers
b) Anticholinergic medications
c) Antihistamines
d) Steroid medications
Which of the following medications is used to treat high blood pressure?
a) Lorazepam (Ativan)
b) Lisinopril (Zestril)
c) Metformin (Glucophage)
d) Simvastatin (Zocor)
What is the most important action for a nurse administering a blood thinner like warfarin (Coumadin)?
a) Monitor for signs of bleeding
b) Administer the drug at the same time every day
c) Withhold the drug if the patient develops a fever
d) Ensure the patient has an adequate intake of vitamin C
A nurse is administering a medication to a patient with a history of seizures. Which of the following medications should be administered with caution?
a) Lorazepam (Ativan)
b) Phenytoin (Dilantin)
c) Diazepam (Valium)
d) Carbamazepine (Tegretol)
Which of the following is a common side effect of beta-blockers?
a) Increased heart rate
b) Constipation
c) Bradycardia
d) Hypertension
Which action is appropriate when administering an intravenous (IV) medication?
a) Administer the medication slowly over the recommended time
b) Push the medication quickly to avoid patient discomfort
c) Mix the IV medication with other fluids if necessary
d) Skip checking the IV site for patency
What is the correct route for administering insulin to a diabetic patient?
a) Oral
b) Intramuscular
c) Subcutaneous
d) Intravenous
A nurse is administering an antibiotic to a patient. The patient reports a history of a rash with penicillin. What should the nurse do?
a) Administer the medication as prescribed
b) Withhold the medication and contact the healthcare provider
c) Administer the medication with antihistamines
d) Change the route of administration
Which of the following medications may cause sedation as a side effect?
a) Furosemide (Lasix)
b) Diphenhydramine (Benadryl)
c) Atorvastatin (Lipitor)
d) Lisinopril (Zestril)
When administering a liquid medication, which of the following is the correct technique?
a) Pour the medication into the cap and administer from there
b) Measure the medication at eye level to ensure accuracy
c) Administer the medication while the patient is standing
d) Add water to dilute the medication if it’s too strong
Which of the following is the most important consideration when administering a patient’s first dose of a new antibiotic?
a) Monitor for signs of an allergic reaction
b) Administer with food to prevent stomach upset
c) Provide the patient with an antihistamine
d) Ensure the patient takes the full course of the antibiotic
A nurse is administering a blood pressure medication that causes dizziness. Which of the following is most important to teach the patient?
a) Lie down if you feel lightheaded or dizzy
b) Increase your salt intake to prevent dizziness
c) Take the medication with a large meal to minimize dizziness
d) Drink a cup of coffee after taking the medication
Which medication should a nurse withhold and report if a patient’s platelet count is low?
a) Warfarin (Coumadin)
b) Aspirin
c) Diphenhydramine (Benadryl)
d) Metformin (Glucophage)
Which of the following medications is used to treat an acute asthma attack?
a) Fluticasone (Flonase)
b) Salmeterol (Serevent)
c) Albuterol (Proventil)
d) Montelukast (Singulair)
A nurse is administering a medication to a patient with renal failure. Which of the following should the nurse monitor closely?
a) Liver enzymes
b) Potassium levels
c) Blood glucose levels
d) Hemoglobin levels
What is a primary consideration when administering digoxin to a patient with heart failure?
a) Monitor for signs of hypoglycemia
b) Check the apical pulse before administering
c) Ensure the patient is on a low-fat diet
d) Assess the patient’s renal function
When administering a medication through a nasogastric (NG) tube, what should the nurse do first?
a) Flush the tube with water before and after the medication
b) Crush all medications and administer them together
c) Administer all medications at once for convenience
d) Skip the flush if the medication is liquid
Which medication requires regular blood tests to monitor therapeutic levels?
a) Warfarin (Coumadin)
b) Albuterol (Proventil)
c) Omeprazole (Prilosec)
d) Acetaminophen (Tylenol)
Which of the following actions is most appropriate when administering a nebulizer treatment?
a) Ask the patient to take slow, deep breaths during treatment
b) Instruct the patient to hold their breath for 10 seconds
c) Administer the treatment while the patient is talking
d) Use a spacer device to speed up medication delivery
A patient is receiving a blood transfusion. Which of the following should the nurse monitor closely?
a) Vital signs
b) Weight gain
c) Respiratory rate
d) Urine output
Which of the following should be monitored closely in a patient receiving a loop diuretic like furosemide (Lasix)?
a) Fluid intake
b) Blood pressure
c) Blood glucose levels
d) Potassium levels
Which medication is commonly used to treat anaphylaxis?
a) Diphenhydramine (Benadryl)
b) Epinephrine (Adrenaline)
c) Prednisone
d) Albuterol (Ventolin)
What should the nurse assess before administering a sedative medication like lorazepam (Ativan)?
a) Liver function
b) Renal function
c) Respiratory rate
d) Blood glucose levels
Which of the following is an appropriate action when administering an opioid medication?
a) Ensure the patient has a functioning IV line
b) Administer the medication quickly to avoid discomfort
c) Monitor for signs of respiratory depression
d) Offer the patient a snack before administration
Which of the following medications is used to manage high cholesterol?
a) Lisinopril (Zestril)
b) Atorvastatin (Lipitor)
c) Metformin (Glucophage)
d) Albuterol (Ventolin)
A nurse is preparing to administer a subcutaneous injection of insulin. Which of the following is the correct technique?
a) Insert the needle at a 45-degree angle
b) Inject the insulin slowly
c) Use the upper arm for injection
d) Inject the insulin into a vein
What is the primary concern when administering a medication to a pregnant patient?
a) Risk of teratogenic effects
b) Impact on blood pressure
c) Potential for weight gain
d) Effects on blood glucose
Which of the following medications can cause ototoxicity as a side effect?
a) Gentamicin (Garamycin)
b) Diphenhydramine (Benadryl)
c) Warfarin (Coumadin)
d) Simvastatin (Zocor)
Which of the following is an important consideration when administering a potassium-sparing diuretic like spironolactone (Aldactone)?
a) Monitor for signs of hyperkalemia
b) Administer the medication with a high-sodium diet
c) Restrict fluid intake during therapy
d) Increase dietary intake of potassium
Which of the following medications is used to treat peptic ulcer disease?
a) Omeprazole (Prilosec)
b) Atorvastatin (Lipitor)
c) Digoxin (Lanoxin)
d) Metformin (Glucophage)
Which of the following should a nurse do when administering a blood pressure medication to an older adult?
a) Start with a low dose to minimize the risk of hypotension
b) Administer a double dose to ensure effectiveness
c) Give the medication on an empty stomach
d) Administer the medication at bedtime
What is the best way to administer oral liquid medication to a pediatric patient?
a) Use a teaspoon to administer the medication
b) Use a dropper and allow the child to swallow it
c) Give the medication with a full glass of water
d) Give the medication in a large spoon
Which of the following medications is most likely to cause a drug interaction with grapefruit juice?
a) Digoxin (Lanoxin)
b) Simvastatin (Zocor)
c) Heparin
d) Metformin (Glucophage)
A nurse is administering oral medication to a patient. What is the most important action before administering the medication?
a) Check the patient’s identification bracelet
b) Inform the patient about possible side effects
c) Ask the patient about their allergies
d) Ensure the patient is sitting upright
A patient is receiving morphine for pain relief. Which of the following is most important to monitor?
a) Blood pressure
b) Respiratory rate
c) Urine output
d) Bowel sounds
Which of the following is the correct technique for administering an intramuscular (IM) injection?
a) Insert the needle at a 15-degree angle
b) Use a 1-inch needle for most IM injections
c) Inject the medication rapidly to minimize discomfort
d) Administer the injection in the upper arm only
Which of the following medications is used to treat hypothyroidism?
a) Levothyroxine (Synthroid)
b) Metformin (Glucophage)
c) Atorvastatin (Lipitor)
d) Lisinopril (Zestril)
What is the primary purpose of administering an antacid to a patient?
a) Reduce inflammation
b) Neutralize stomach acid
c) Relieve pain
d) Increase digestion
Which of the following is a common side effect of opioid pain medications?
a) Diarrhea
b) Drowsiness
c) Increased appetite
d) Hyperactivity
A nurse is preparing to administer an antihypertensive medication. Which of the following should the nurse monitor most closely?
a) Respiratory rate
b) Blood pressure
c) Blood glucose levels
d) Bowel movements
Which of the following is an important consideration when administering a medication to a patient with liver disease?
a) Ensure the medication is taken with food
b) Monitor for signs of drug toxicity
c) Provide an increased dose to compensate for liver dysfunction
d) Limit the amount of water the patient drinks
What is the nurse’s first action when administering a medication that requires frequent blood level monitoring?
a) Administer the medication slowly
b) Ensure the patient understands the need for the monitoring
c) Collect a blood sample before administration
d) Ask the patient to report any adverse effects
Which medication is used as a treatment for type 2 diabetes?
a) Insulin
b) Metformin (Glucophage)
c) Glucagon
d) Prednisone
When administering a medication via nasogastric (NG) tube, which of the following should the nurse do?
a) Crush the medication and mix it with a large volume of water
b) Use the same tube for each medication administration
c) Flush the tube before and after administration with at least 30 mL of water
d) Administer all medications simultaneously
Which of the following medications should be taken on an empty stomach for optimal absorption?
a) Ibuprofen (Advil)
b) Levothyroxine (Synthroid)
c) Omeprazole (Prilosec)
d) Metformin (Glucophage)
Which medication is used to reverse the effects of opioid overdose?
a) Naloxone (Narcan)
b) Flumazenil
c) Protamine sulfate
d) Atropine
A nurse is administering an antibiotic to a patient with a history of renal failure. What should the nurse monitor most closely?
a) Liver function tests
b) Serum creatinine levels
c) White blood cell count
d) Electrolyte balance
Which of the following is a side effect of ACE inhibitors like enalapril (Vasotec)?
a) Dry cough
b) Tachycardia
c) Weight loss
d) Constipation
Which of the following should be monitored when administering anticoagulants such as heparin?
a) Heart rate
b) White blood cell count
c) Prothrombin time (PT)
d) Platelet count
Which of the following medications is commonly used to treat anxiety?
a) Sertraline (Zoloft)
b) Diphenhydramine (Benadryl)
c) Lorazepam (Ativan)
d) Lisinopril (Zestril)
When administering a medication to a patient with asthma, what is the most important consideration?
a) Monitor for shortness of breath
b) Ensure the patient is hydrated
c) Ask the patient to avoid any physical activity
d) Administer with food to reduce irritation
Which of the following medications is contraindicated in patients with a history of peptic ulcers?
a) Omeprazole (Prilosec)
b) Ibuprofen (Advil)
c) Metformin (Glucophage)
d) Hydrochlorothiazide
A nurse is administering a medication to a patient with a history of hepatic impairment. What is the most important action?
a) Administer a lower dose of the medication
b) Monitor the patient’s respiratory rate
c) Provide the patient with vitamin supplements
d) Administer the medication with food
What is a priority assessment when administering a medication for the first time to a patient with a known allergy?
a) Assess for signs of an allergic reaction
b) Check the patient’s vital signs
c) Provide the patient with a snack after administration
d) Ensure the patient drinks plenty of water
Which of the following medications is commonly used to treat heart failure?
a) Furosemide (Lasix)
b) Doxycycline (Vibramycin)
c) Gabapentin (Neurontin)
d) Aspirin
Which of the following drugs is used to treat atrial fibrillation?
a) Digoxin (Lanoxin)
b) Simvastatin (Zocor)
c) Metformin (Glucophage)
d) Lisinopril (Zestril)
Which of the following is a primary concern when administering diuretics to a patient?
a) Risk of fluid overload
b) Risk of dehydration and electrolyte imbalance
c) Risk of hypoglycemia
d) Risk of hypertension
Which medication can cause a patient to experience a “disulfiram-like reaction” when alcohol is consumed?
a) Metronidazole (Flagyl)
b) Ciprofloxacin (Cipro)
c) Amoxicillin (Amoxil)
d) Fluoxetine (Prozac)
Which of the following actions should a nurse take when administering a medication through an intravenous (IV) line?
a) Flush the line with saline before and after medication administration
b) Administer the medication quickly to avoid discomfort
c) Skip checking for IV patency if the line is already in place
d) Use the IV line for medication administration only
Which of the following medications is used to treat chronic obstructive pulmonary disease (COPD)?
a) Albuterol (Proventil)
b) Salmeterol (Serevent)
c) Diphenhydramine (Benadryl)
d) Diphenhydramine (Benadryl)
What is the primary nursing consideration when administering a medication that causes hypotension?
a) Monitor the patient’s blood pressure before and after administration
b) Instruct the patient to lie down for 15 minutes after taking the medication
c) Administer the medication on an empty stomach
d) Offer fluids to prevent dehydration
Which of the following medications should a nurse administer for an acute asthma exacerbation?
a) Albuterol (Ventolin)
b) Salmeterol (Serevent)
c) Montelukast (Singulair)
d) Theophylline (Theo-Dur)
When administering an insulin injection, which of the following sites is preferred for subcutaneous injection?
a) Abdomen
b) Upper arm
c) Gluteal region
d) Deltoid muscle
What should a nurse instruct a patient to do after taking a bisphosphonate such as alendronate (Fosamax)?
a) Lie down for 30 minutes after administration
b) Take the medication with a large glass of water
c) Take the medication at bedtime
d) Take the medication with food to prevent gastric irritation
What is the most important nursing action after administering an opioid analgesic?
a) Monitor for signs of nausea
b) Assess pain relief and level of sedation
c) Ensure the patient is well-hydrated
d) Provide a snack for the patient
Which medication is commonly prescribed to treat GERD (gastroesophageal reflux disease)?
a) Omeprazole (Prilosec)
b) Diphenhydramine (Benadryl)
c) Aspirin
d) Metronidazole (Flagyl)
Which of the following should a nurse instruct a patient to avoid while taking a tetracycline antibiotic such as doxycycline?
a) Dairy products
b) Salt substitutes
c) Caffeine
d) Vitamin C supplements
A patient is receiving warfarin (Coumadin). Which laboratory value is the most important to monitor?
a) Prothrombin time (PT)
b) White blood cell count
c) Serum potassium levels
d) Creatinine clearance
When administering a beta-blocker like metoprolol (Lopressor), the nurse should monitor for which of the following?
a) Decreased blood pressure and heart rate
b) Increased blood glucose levels
c) Increased respiratory rate
d) Hyperkalemia
Which of the following medications can cause photosensitivity, leading to increased risk of sunburn?
a) Doxycycline (Vibramycin)
b) Clonidine (Catapres)
c) Prednisone
d) Sertraline (Zoloft)
Which of the following medications is used to treat anaphylaxis?
a) Epinephrine (Adrenalin)
b) Diphenhydramine (Benadryl)
c) Prednisone
d) Furosemide (Lasix)
When administering an oral medication to a pediatric patient, which of the following is the most appropriate action?
a) Crush the medication and mix it with food
b) Use a syringe to administer the medication directly into the mouth
c) Encourage the child to chew the medication
d) Dissolve the medication in a large glass of juice
Which of the following is a common side effect of taking corticosteroids like prednisone?
a) Weight loss
b) Increased appetite
c) Constipation
d) Insomnia
What should the nurse monitor for when administering furosemide (Lasix) to a patient?
a) Respiratory rate
b) Electrolyte levels
c) Blood pressure
d) Weight gain
What is the action of a proton pump inhibitor like omeprazole (Prilosec)?
a) Increase acid production in the stomach
b) Neutralize stomach acid
c) Block acid production in the stomach
d) Protect the stomach lining
When administering a diuretic such as spironolactone (Aldactone), which of the following should the nurse monitor most closely?
a) Serum potassium levels
b) Blood glucose levels
c) Serum calcium levels
d) Hemoglobin levels
A patient is prescribed digoxin (Lanoxin). Which of the following findings should the nurse report immediately?
a) A heart rate of 56 bpm
b) A blood pressure of 130/80 mmHg
c) A blood glucose level of 100 mg/dL
d) A potassium level of 4.0 mEq/L
Which of the following medications can be given to treat hyperkalemia?
a) Potassium chloride (KCl)
b) Sodium bicarbonate
c) Sodium polystyrene sulfonate (Kayexalate)
d) Magnesium sulfate
When administering an inhaled corticosteroid like fluticasone (Flovent), the nurse should advise the patient to:
a) Rinse the mouth after use to prevent oral thrush
b) Hold their breath for 10 seconds after inhaling
c) Use a spacer for better drug delivery
d) Avoid using a bronchodilator before the corticosteroid
Which of the following is a key nursing consideration when administering acetaminophen (Tylenol)?
a) Monitor for signs of bleeding
b) Monitor liver function tests
c) Monitor for signs of constipation
d) Monitor renal function tests
Which medication is commonly used to treat seizures in patients with epilepsy?
a) Valproic acid (Depakote)
b) Metformin (Glucophage)
c) Atenolol (Tenormin)
d) Diphenhydramine (Benadryl)
Which of the following is the most important action when administering a sedative to a patient before a surgical procedure?
a) Ensure the patient is well-hydrated
b) Monitor the patient’s oxygen saturation levels
c) Encourage the patient to eat before the procedure
d) Administer the sedative with food
A nurse is administering a medication to a pregnant patient. Which of the following should be assessed first?
a) Fetal heart rate
b) Blood pressure
c) Allergies
d) Gestational age
Which medication is most commonly used to treat hypertension?
a) Lisinopril (Zestril)
b) Metoprolol (Lopressor)
c) Losartan (Cozaar)
d) All of the above
When administering heparin, which lab value is most important to monitor?
a) Platelet count
b) Partial thromboplastin time (PTT)
c) Prothrombin time (PT)
d) Hemoglobin level
Which of the following should the nurse instruct a patient to avoid when taking an MAOI (monoamine oxidase inhibitor) such as phenelzine (Nardil)?
a) Aged cheese
b) Fresh fruits and vegetables
c) Lean meats
d) Low-fat milk
Which of the following is a common side effect of antihistamines like diphenhydramine (Benadryl)?
a) Diarrhea
b) Sedation
c) Tachycardia
d) Insomnia
What should a nurse monitor for in a patient receiving a blood transfusion?
a) Oxygen saturation levels
b) Signs of an allergic reaction or transfusion reaction
c) Blood glucose levels
d) Kidney function tests
Which of the following medications is used for the treatment of rheumatoid arthritis?
a) Methotrexate (Rheumatrex)
b) Hydrochlorothiazide (HCTZ)
c) Furosemide (Lasix)
d) Lisinopril (Zestril)
What is the nurse’s priority action when administering a medication with a high risk for toxicity, such as lithium?
a) Administer the medication with food
b) Monitor serum drug levels regularly
c) Encourage fluid intake
d) Provide the patient with a laxative
Which of the following should the nurse teach a patient taking anticoagulants like warfarin (Coumadin)?
a) Avoid foods high in vitamin K
b) Take the medication with meals
c) Avoid drinking fluids
d) Limit exercise
Medication Administration NCLEX Questions and Answers for Study Guide
Discuss the nursing responsibilities in the safe administration of medications. Include the five rights of medication administration and how they contribute to patient safety.
Answer:
Nurses have a critical role in ensuring the safe and effective administration of medications. The five rights of medication administration are: the right patient, the right drug, the right dose, the right route, and the right time. These rights serve as the foundation for safe medication administration and help prevent errors.
- Right Patient: The nurse must confirm the patient’s identity, typically by asking the patient to state their full name and checking their identification wristband or records. This is crucial in preventing medication errors where patients may receive the wrong drug.
- Right Drug: Nurses should verify that the correct medication is being administered by checking the prescription order, drug label, and MAR (Medication Administration Record) against the medication. Ensuring the drug is appropriate for the patient’s condition is essential for avoiding therapeutic errors.
- Right Dose: Ensuring the right dose requires checking the dosage on the label against the physician’s order. Calculations should be double-checked when administering medications that require precise dosing, such as in pediatric or geriatric patients.
- Right Route: The nurse must ensure that the medication is administered using the correct route (oral, intravenous, intramuscular, etc.) as prescribed. The wrong route could affect the drug’s effectiveness or cause adverse effects.
- Right Time: Administering the medication at the correct time ensures that the drug works effectively within the prescribed therapeutic window. Nurses should also observe the timing of medications in relation to meals or other medications to ensure the best outcome.
Nurses must also educate patients about their medications, monitor for side effects, and document all actions taken. These steps are vital in promoting patient safety and ensuring proper therapeutic outcomes.
Explain the role of the nurse in preventing medication errors during medication administration. What strategies can nurses use to reduce the risk of errors?
Answer:
Medication errors can have serious consequences, and nurses play a vital role in preventing these errors through vigilance, education, and adherence to best practices. The primary strategies for reducing medication errors include the following:
- Double-Check Procedures: Nurses should double-check medication orders, labels, and dosages. This includes comparing the medication against the MAR, verifying the patient’s identity, and ensuring that the right dose, drug, and route are selected. When necessary, a second nurse should verify calculations or unfamiliar medications.
- Utilizing Technology: The use of barcode scanning systems and electronic medication administration records (eMAR) can significantly reduce the risk of errors. Barcode scanning helps verify that the correct drug is being given to the correct patient, which can help avoid mismatches. Electronic records ensure that prescriptions are legible and facilitate error-free documentation.
- Clear Communication: Effective communication among healthcare providers is essential for preventing medication errors. Nurses must communicate any discrepancies or concerns with the prescribing physician or pharmacist. Clear communication with patients about their medications, including instructions for use, potential side effects, and what to do in case of a missed dose, is also vital.
- Proper Education: Nurses should educate patients and families about their medications, especially if they are prescribed new or complex regimens. This education can help patients take their medications as prescribed and recognize early signs of adverse effects.
- Environmental Control: Nurses should ensure that the medication preparation area is quiet and free from distractions. A cluttered or noisy environment increases the likelihood of mistakes during medication administration. Nurses should also be well-rested and avoid multitasking to maintain focus during medication administration.
- Reporting Errors and Near Misses: A culture of safety includes the reporting of any medication errors or near misses. This allows for system-wide improvements and helps identify patterns that may lead to further errors. Reporting and investigating these incidents can result in the development of more effective practices and policies.
By using these strategies, nurses can significantly reduce the occurrence of medication errors and ensure that patients receive the safest care possible.
Describe the steps a nurse should take when preparing and administering a medication via the intravenous (IV) route. Discuss the importance of aseptic technique and patient monitoring.
Answer:
Administering medication via the intravenous (IV) route requires careful preparation and precise technique to ensure the medication is delivered safely and effectively. The following steps outline the process a nurse should follow when administering IV medications:
- Verify the Medication Order: Before preparing the medication, the nurse must verify the physician’s order for the IV medication. The drug, dose, route, and frequency should be confirmed to ensure there are no discrepancies.
- Prepare the Medication: Once the order is verified, the nurse should prepare the medication in a clean, designated area. If the medication is in a vial or ampule, the nurse should check the expiration date and ensure the drug is clear and free from particulate matter. The dose should be measured accurately, especially when dealing with potent or high-risk medications. If the medication is to be diluted, the nurse must follow proper dilution instructions.
- Select the IV Access Site: The nurse must select an appropriate IV access site, such as a peripheral vein or central line, based on the type of medication and the patient’s condition. The IV site should be inspected for any signs of infection, inflammation, or phlebitis before insertion.
- Aseptic Technique: Aseptic technique is essential when preparing and administering IV medications to prevent infections. The nurse should wash their hands thoroughly before handling any sterile equipment. The vial, ampule, and IV tubing should be handled in a sterile manner, and the IV site should be cleaned with an alcohol swab before insertion. Gloves should be worn throughout the procedure.
- Administer the Medication: The medication should be administered slowly and in accordance with the prescribed rate, as some medications can cause irritation or adverse reactions if infused too rapidly. The nurse should ensure that the IV line is patent and that there are no signs of infiltration or extravasation.
- Monitor the Patient: After administering the medication, the nurse should closely monitor the patient for any adverse effects, including signs of allergic reactions or complications such as phlebitis, infiltration, or anaphylaxis. Monitoring the IV site for redness, swelling, or tenderness is essential to prevent further complications.
- Document the Administration: Accurate documentation is critical to ensure continuity of care. The nurse should document the medication, dose, time, route, and any patient responses or side effects in the medical record. This ensures that all members of the healthcare team are informed of the medication administration.
By adhering to these steps and maintaining aseptic technique, nurses can ensure the safe and effective administration of IV medications, reducing the risk of complications and promoting patient safety.
Explain the concept of “high-alert” medications and the additional safety precautions that must be taken when administering these drugs.
Answer:
“High-alert” medications are those that have a heightened risk of causing significant patient harm if they are used incorrectly. These medications require additional safety precautions due to their narrow therapeutic index and potential for serious adverse effects. Examples of high-alert medications include anticoagulants (e.g., warfarin), insulins, opioids, and certain chemotherapy agents.
The following safety precautions should be taken when administering high-alert medications:
- Double-Check the Medication: Nurses should perform a thorough verification of the medication, including reviewing the physician’s order, confirming the drug and dose, and checking the patient’s identity. In high-alert situations, it is recommended that two healthcare providers independently verify the medication before administration.
- Use of Specialized Equipment: High-alert medications may require specialized administration equipment, such as infusion pumps or calibrated syringes. This ensures that the medication is administered at the correct rate and dose.
- Frequent Monitoring: Patients receiving high-alert medications need to be monitored closely for adverse effects. This includes monitoring vital signs, laboratory values, and specific drug-related parameters (e.g., INR for warfarin, blood glucose levels for insulin). Nurses should be vigilant for signs of toxicity, such as bleeding with anticoagulants or respiratory depression with opioids.
- Patient Education: Educating patients about their high-alert medications is vital. The nurse should inform patients about the purpose of the medication, possible side effects, signs of overdose, and when to seek medical attention. This empowers patients to be active participants in their care.
- Adherence to Policies and Protocols: Hospitals and healthcare organizations typically have strict protocols for the administration of high-alert medications. Nurses should adhere to these protocols and report any discrepancies or concerns immediately to prevent errors.
- Clear Documentation: Accurate and thorough documentation is especially important when administering high-alert medications. The nurse should document the medication name, dose, time, route, patient response, and any adverse reactions. This ensures continuity of care and provides a legal record of the administration.
By taking these precautions, nurses can help minimize the risks associated with high-alert medications and ensure patient safety.
Explain the importance of proper drug storage and the impact it can have on medication efficacy and patient safety.
Answer:
Proper drug storage is essential for ensuring the safety, efficacy, and stability of medications. Incorrect storage of medications can lead to drug degradation, reduced potency, and potential harm to patients. The following factors highlight the importance of correct drug storage:
- Temperature Control: Many medications require specific temperature ranges to maintain their potency. For example, some drugs need to be stored in a refrigerator, while others must be kept at room temperature. Failure to adhere to these guidelines can result in reduced effectiveness or the formation of harmful compounds. For instance, insulin must be kept refrigerated, but not frozen, to prevent loss of its therapeutic properties.
- Light Protection: Some medications, particularly those in liquid form, are sensitive to light. Exposure to light can cause chemical changes, leading to degradation of the drug. Medications that are light-sensitive should be stored in opaque containers or in a dark environment to preserve their effectiveness.
- Moisture Control: Moisture can cause solid medications like tablets or powders to degrade, while liquids may become contaminated. Medications should be stored in airtight containers to prevent exposure to humidity, which could alter their chemical composition.
- Security and Safety: Medications, especially controlled substances like narcotics, need to be securely stored to prevent misuse or theft. Access should be restricted to authorized personnel only. This reduces the risk of medication errors, diversion, or potential abuse.
- Separation of Medications: It is essential to store medications in a manner that prevents cross-contamination or confusion. Medications should be clearly labeled, with similar-looking drugs separated to avoid mix-ups. For example, medications with similar names or packaging should be stored separately to prevent administration errors.
- Expiration Dates: Medications should be used within their expiration date to ensure safety and efficacy. Expired medications may be ineffective and can cause harm. Nurses must regularly check expiration dates and remove outdated medications from the storage area.
Inadequate storage of medications can lead to compromised treatment outcomes, adverse reactions, or therapeutic failure. Nurses must ensure that all medications are stored according to the manufacturer’s guidelines and institutional policies, thereby promoting patient safety and optimal therapeutic effectiveness.
Describe the role of a nurse in managing a medication administration error. What steps should the nurse take if an error occurs?
Answer:
Medication administration errors are serious occurrences in healthcare settings, and nurses play a key role in managing these errors to minimize harm to the patient. If a medication error occurs, nurses must respond promptly and systematically to ensure patient safety and to prevent future errors.
- Assess the Patient’s Condition: The first step is to assess the patient for any immediate adverse effects. This includes monitoring vital signs, assessing the patient for signs of an allergic reaction, overdose, or other symptoms that may arise from the error. The nurse should take action to manage any symptoms or complications.
- Notify the Healthcare Team: Once the nurse has assessed the patient, the next step is to notify the appropriate healthcare providers, including the attending physician and pharmacist. This allows the team to evaluate the situation, provide further treatment if needed, and adjust the care plan to address any complications from the error.
- Document the Error: The nurse must accurately document the medication error, including details such as the medication name, dose, time, route, and any patient reactions. Documentation should be factual and objective, detailing the events surrounding the error without assigning blame. This provides a record for clinical review and helps prevent future errors.
- Report the Error: Nurses should follow institutional protocols for reporting medication errors, including notifying the pharmacy and using incident reporting systems. Reporting errors allows for root cause analysis to determine how the error occurred and what can be done to prevent it from happening again.
- Follow Up: Nurses should continue to monitor the patient closely for any delayed effects of the medication error. This includes reassessing vital signs, laboratory results, and any new symptoms that may arise from the mistake. If additional treatment or interventions are needed, the nurse should act promptly.
- Participate in Root Cause Analysis: After an error occurs, healthcare institutions often conduct a root cause analysis to understand the factors that contributed to the mistake. Nurses should be involved in this process to identify areas for improvement, such as communication, drug labeling, or other system issues that may have contributed to the error.
- Educational Follow-up: Nurses should be educated on the root causes of the error to prevent recurrence. Continuous professional development and training help nurses improve their medication administration practices and reduce the likelihood of future errors.
By following these steps, nurses can manage medication administration errors effectively, minimize harm, and contribute to a culture of safety within the healthcare environment.
Discuss the role of patient education in medication administration, including the key aspects of educating patients about their prescribed medications.
Answer:
Patient education plays a crucial role in the safe and effective administration of medications. Educated patients are more likely to adhere to their prescribed regimens, understand potential side effects, and take an active role in their health management. Nurses are responsible for providing clear, accurate, and comprehensive education regarding medication use.
- Purpose of the Medication: Nurses should explain to patients why they are taking the prescribed medication. Understanding the purpose of the medication can help patients recognize the importance of adhering to the prescribed schedule. For example, a patient on antibiotics should be told the importance of completing the full course to prevent resistance.
- Dosage and Timing: It is important for patients to understand how much medication they need to take, when to take it, and whether it should be taken with food, at a specific time, or on an empty stomach. Nurses should also inform patients about any special instructions regarding their medication, such as whether to split or crush tablets.
- Side Effects and Adverse Reactions: Patients need to be informed about the potential side effects and adverse reactions of their medications. The nurse should explain common side effects and what actions the patient should take if these occur, such as reporting them or adjusting the medication dose. For example, a patient on antihypertensive medication should be informed about possible dizziness and advised to avoid sudden position changes.
- Drug Interactions: Patients should be educated on possible drug interactions, including how their medication may interact with over-the-counter drugs, herbal supplements, or foods. For instance, patients on blood thinners (like warfarin) should be advised to avoid foods high in vitamin K, which may interfere with the medication’s effectiveness.
- Proper Storage: Nurses should inform patients about how to store their medications properly. This includes providing instructions on keeping medications away from heat, moisture, and light, as well as ensuring they are safely stored away from children.
- Missed Doses: The nurse should advise the patient on what to do if they miss a dose. For example, patients on antibiotics should be instructed to take the missed dose as soon as they remember, unless it’s almost time for the next dose, in which case they should skip it and resume the regular schedule.
- Compliance and Refills: Nurses should stress the importance of adhering to the prescribed dosage and schedule. Patients should be encouraged to notify their healthcare provider if they experience difficulties in taking their medications, such as financial constraints or side effects. Additionally, the nurse should remind the patient to refill prescriptions on time and to communicate any issues with the prescribing physician.
By providing thorough education, nurses empower patients to manage their own medications safely and effectively, improving treatment outcomes and reducing the risk of medication errors or complications.
Explain the differences between enteral and parenteral routes of medication administration and the implications for nursing practice.
Answer:
Medications can be administered via various routes, each of which has different implications for nursing practice. The two main categories of routes are enteral and parenteral, each with its own set of considerations.
- Enteral Route: The enteral route refers to the administration of medications through the gastrointestinal (GI) tract. This includes oral, sublingual, and rectal routes. The most common form of medication administration, the oral route, involves swallowing pills, capsules, or liquids. Sublingual administration involves placing the medication under the tongue for absorption, while rectal administration involves inserting suppositories into the rectum.
- Advantages: The enteral route is non-invasive, convenient, and easy to administer. It is often the preferred method for medications that are well-absorbed in the GI tract.
- Disadvantages: Enteral medications may be affected by the patient’s ability to swallow, gastrointestinal motility, or food interactions. In patients with GI conditions such as nausea, vomiting, or malabsorption disorders, enteral administration may be ineffective or unsafe.
Nursing Implications: Nurses should assess the patient’s ability to swallow and consider any conditions that might impair absorption. For oral medications, the nurse must ensure that the patient takes the medication with or without food as instructed. Nurses should also educate patients about the proper use of enteral medications to enhance compliance.
- Parenteral Route: The parenteral route involves the administration of medications outside of the GI tract, including intravenous (IV), intramuscular (IM), and subcutaneous (SC) injections. The IV route provides the fastest delivery of medications, as the drug is directly injected into the bloodstream. IM and SC injections are absorbed more slowly and are often used for vaccines or other types of drugs that cannot be taken orally.
- Advantages: Parenteral medications are typically absorbed more quickly than enteral medications, making them ideal for emergency situations. They are also used when the patient cannot take oral medications, such as in the case of unconsciousness or severe nausea.
- Disadvantages: Parenteral administration requires sterile technique and skilled technique to avoid complications such as infection, tissue damage, or allergic reactions. IV medications also carry a risk of fluid overload, especially in patients with heart conditions.
Nursing Implications: Nurses must carefully select the appropriate parenteral route based on the patient’s condition and medication requirements. When administering injections, nurses must adhere to aseptic techniques to prevent infection and ensure proper injection sites. Monitoring for adverse effects, such as irritation or infiltration, is essential when using the parenteral route.
In conclusion, both enteral and parenteral routes have specific benefits and challenges. Nurses must assess each patient’s condition and medication needs, providing the safest and most effective method of administration based on these factors.