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Chapter 36. Administration of Oral, Topical, and Mucosal Medications
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Chapter 36. Administration of Oral, Topical, and Mucosal Medications
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Chapter 36. Administration of Oral, Topical, and Mucosal MedicationsMultiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is providing care to a patient with colorectal cancer who typically takes sustained-release
(MS Contin), furosemide (Lasix), and metoprolol (Lopressor). The patient’s wife reports that because the
morphine
patient has bad mouth sores and has a hard time swallowing pills, she has crushed the pills and given him his
medications in ice cream. The nurse correctly tells the patient’s wife:
1. “Mixing the medication with ice cream is a bad idea, because dairy products reduce the
absorption of blood pressure medications.”
2. “I’m sure it has been hard for him to swallow. Has he lost any weight?”
3. “The morphine tablets shouldn’t be crushed because that releases all of the medication
at once.”
4. “We usually tell people with mouth sores to suck on ice or popsicles before they try to
swallow pills.”
2. The nurse is providing acetaminophen (Tylenol) suspension to a patient via percutaneous gastrostomy tube.
First, the nurse should
1. Measure the appropriate dose of medication using a medicine cup.
2. Draw up the medication into a catheter-tipped syringe.
3. Uncap the bottle while wearing clean gloves.
4. Shake the bottle of medication gently.
3. While preparing a dose of liquid medication for administration through a gastrostomy tube, the nurse
measures 15 mL into a plastic medicine cup. Which of the following indicates the appropriate dose
of medication?
1. When the cup is held at eye level, the lowest level of the medication meniscus rests on the
15-mL calibration line.
2. When the cup is held up to the light, the middle of the medication meniscus rests on the
15-mL calibration line.
3. When the cup is sitting on a level table, the top of the medication meniscus rests on the
15- mL calibration line.
4. When the cup is placed on a countertop, any part of the medication meniscus rests on the
15-mL calibration line.
4. The nurse is providing meperidine (Demerol) to a patient who reports postsurgical pain 8/10. The order is for
50 mg to be orally administered to the patient in tablet form every 4 hours, but each tablet contains 100
mg. The best action by the nurse is to
1. Call the doctor to request that the order be changed to 100 mg every 8 hours.
2. Administer half of the tablet to the patient and then discard the other half by flushing
it down the toilet.
3. Administer half the tablet to the patient and dispose of the other half in a chemical waste
container with another licensed nurse as a witness, recording the narcotic drug wastage on
the narcotic record and having the witness cosign.
4. Administer half the tablet to the patient and save the other half for the next dose.
5. The nurse is providing medications to a patient who is currently receiving continuous tube feeding via
gastrostomy tube. The patient has a dose of phenytoin (Dilantin) due. The nurse’s best course of action is
to
1. Determine whether the patient is experiencing any pain.
2. Flush the gastrostomy tube with 30 mL of water before administration.
, 3. Hold the medication for the day.
4. Stop the tube feeding for at least 1 hour before administration.
6. A nurse correctly administers digoxin (Lanoxin) and propranolol (Inderal) via a feeding tube by
1. Flushing with water, administering the digoxin, administering the propranolol, and
flushing with water.
2. Checking the residual, flushing with water, administering the digoxin, flushing with water,
administering the propranolol, and flushing with water.
3. Flushing with water, administering the digoxin, flushing with water, administering
the propranolol, and flushing with water.
4. Checking the residual, flushing with water, administering the digoxin, administering the
propranolol, and flushing with water.
7. While helping a student nurse apply a nitroglycerine patch to the patient’s skin, the nursing instructor
would appropriately intervene if
1. The student nurse removed a patch that was applied yesterday before applying the
new patch.
2. The student nurse removed her gloves before placing the patch.
3. The student nurse wrote the date, time, and her initials on the patch before applying it
to the patient’s skin.
4. The student nurse placed the new patch on the patient’s right shoulder because the
last patch was on the left shoulder.
8. Under the supervision of a registered nurse (RN), an LVN/LPN is providing parents with instructions for
administering eye drops to their young child, who has been diagnosed with pink eye. The nurse correctly
tells the parents:
1. “Have your child tip his head back and look down.”
2. “Brace your hand against the child’s chin as you steady the dropper.”
3. “Gently raise the upper lid to expose the eyeball before putting in the eye drops.”
4. “Place the drop in the middle part of the space created when you pull down the lower lid.”
9. If a patient is using two types of inhalers—a bronchodilator and a steroid—the nurse correctly instructs the
patient to
1. First use the bronchodilator, then wait 5 minutes, then use the steroid.
2. First rinse out his mouth, then use the steroid, then wait 5 minutes, then use the
bronchodilator.
3. First use the bronchodilator, then wait 5 minutes, then use the steroid, then rinse out
his mouth.
4. First use the steroid, then wait 5 minutes, then use the bronchodilator, then rinse out
his mouth.
10. As a nurse, it is preferable to use electronic medication administration records (eMARs) whenever possible
because
1. eMAR systems help prevent medication errors due to built-in safeguards.
2. Using eMAR systems reduces bookkeeping costs and thus helps reduce the cost of care for
patients.
3. Paper MAR systems are frowned on by regulators.
4. eMAR systems increase security by preventing theft of narcotics and other drugs.
11. A patient who is alert and oriented refuses to take her blood pressure medication this morning. The nurse
appropriately tells the patient:
1. “You really should take your medicine so you can get well.”
, 2. “That is fine. I’ll just throw the pill away, and we’ll keep an eye on your blood pressure.”
3. “Is there a reason why you don’t want to take your blood pressure medicine today?”
4. “We can try again later and see if you feel like taking it with lunch.”
12. The nurse is preparing to administer a medication by the sublingual route. The highest priority is to
1. Determine whether the patient can swallow safely.
2. Identify what time the patient typically takes the medication at home.
3. Crush the medication and mix it with applesauce.
4. Assess the patient’s mouth for lesions.
13. When discussing discharge instructions provided to the parents of a 2-year-old with an ear infection, the nurse
would know that more teaching is required if the mother states:
1. “I will pull her pinna down and back to straighten the ear canal before I put in the
eardrops.”
2. “I will pull her pinna up and back to straighten the ear canal before I put in the eardrops.”
3. “I will position the dropper so that the drop rolls down the wall of the canal, to prevent it
from landing on her eardrum.”
4. “I will be careful not to let the dropper touch her skin to prevent contamination of the
medicine.”
14. A patient tells the nurse, “I have been using a decongestant nasal spray for 3 months, but I still have terrible
nasal congestion.” The nurse could appropriately respond:
1. “You probably need an antibiotic to clear up the congestion.”
2. “Are you sure you are administering the nasal spray correctly?”
3. “Nasal decongestant sprays can cause rebound congestion with long-term use.”
4. “Who told you to use that kind of nasal spray for 3 months?”
15. A nurse would most appropriately administer medication via the rectal route to
1. A 56-year-old who has had surgery for rectal cancer.
2. A 45-year-old with severe nausea and vomiting, who is unable to keep anything down.
3. A 58-year-old with a recent myocardial infarction and ventricular dysrhythmias.
4. A 2-year-old with a newly diagnosed seizure disorder.
16. A nurse correctly notifies the prescribing physician that a prescription for an elixir is inappropriate if the
patient
1. Does not like the taste of most medicine.
2. Cannot swallow solid food.
3. Has sores in the mouth.
4. Is a recovering alcoholic.
17. A nurse correctly recognizes that a liquid medication with undissolved particles is
1. An elixir and should not be shaken before use.
2. A solution and should be shaken before use.
3. A suspension and should be shaken before use.
4. A syrup and should not be shaken before use.
18. A nurse appropriately remains with a patient until after the patient has swallowed narcotic medication because
1. The patient may rarely “cheek” the medication in an attempt to save it up and take
an overdose later.
2. Narcotic medications pose extra safety risks because they depress respiration and
lower blood pressure.
3. The patient may be afraid to take narcotic medication because of the risk for addiction.
4. All of the above.
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