NCLEX : Drug Administration and Distribution

Study concepts, example questions & explanations for NCLEX

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Example Questions

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Example Question #1 : Drug Administration And Distribution

Ethel is an 80-year-old woman who was admitted for dehydration. The nurse reports that she is not making  of urine and the physician orders a bolus of 250ml to be infused within 30 minutes. What is the correct drip rate for Ethel's infusion?

Possible Answers:

Correct answer:

Explanation:

The minimum urine requirement per hour for most adults is . Based on a low finding, the physician may decide Ethel needs fluid replacement. 

Calculate drip rate in minutes using the following formula: 

Ethel's equation looks as follows:

Example Question #23 : Nclex

Which of the following is the preferred location of intramuscular (IM) injection in infants?

Possible Answers:

Dorsogluteal region

Vastus lateralis

Deltoid

Biceps brachii

Rectus femoris

Correct answer:

Vastus lateralis

Explanation:

The vastus lateralis is the preferred site of injection in infants. Rectus femoris injections may be preformed as a second choice. The dorsogluteal site should not be used in infants as the muscle is not developed and there is risk associated with the location of the sciatic nerve. Deltoid injections may be given to older children when the muscle becomes larger. 

Example Question #24 : Nclex

The nurse is preparing to administer an intramuscular (IM) injection to a 4.8 pound infant. The nurse should position the needle at which angle? 

Possible Answers:

90 degrees

30 degrees

45 degrees

60 degrees

15 degrees

Correct answer:

45 degrees

Explanation:

The preferred angle for intramuscular (IM) injections is 90 degrees. However, very small infants may require that the injection be given at a 45 degree angle. Based on patient condition, it is the nurse's responsibility to assess the needs of the patient and adjust care as appropriate.

Example Question #25 : General Concepts

The new pediatric nurse has just given a suppository to a 5-year-old boy. He has a bowel movement 7 minutes post administration. Which action should the nurse take next? 

Possible Answers:

Give an additional half of the prescribed dose

Examine the stool for the suppository

Inform the physician that the child has had a bowel movement

Give another full dose of the suppository

Consult pharmacy

Correct answer:

Examine the stool for the suppository

Explanation:

First, examine the stool for the suppository. Based on the findings, inform the physician. If the suppository was fully present in the stool, the physician may want to prescribe another dose. If not, he may choose to re-order half of the prescribed dose or none at all.  

Example Question #4 : Drug Administration And Distribution

The geriatric nurse is administering nightly medications to a 65-year-old woman with dysphagia. The patient is able to swallow crushed medications with thickened liquids. Which of the following medications should the nurse not crush? 

Possible Answers:

Potassium chloride

Sertraline HCl

Multivitamins

Pantoprazole ER

Acetaminophen

Correct answer:

Pantoprazole ER

Explanation:

Pantoprazole ER should not be crushed. "ER" is an abbreviation for extended release. Extended release medications dissolve over a delayed period of time. Crushing the medication results in a faster rate of absorption by body tissues due to disruption of the coating that allows it's extended release.

Example Question #5 : Drug Administration And Distribution

The pediatric nurse is summoned to a room by the parents of a 2-year-old child. The peripheral IV line has been removed by the patient. When starting a new line, the nurse carefully chooses placement. The nurse should attempt to start the IV __________.

Possible Answers:

as lateral as possible

as proximal as possible

as distal as possible

as medial as possible

as ipsilateral as possible

Correct answer:

as distal as possible

Explanation:

Most peripheral IV's are started in the right or left arm. Distal to the arm would mean closest to the fingertips. When starting an IV, always start looking for potential sites closest to the fingertips and work upwards. If a vein is punctured and becomes unusable, it is possible to move above the previous attempt and start a successful IV. 

Example Question #32 : Nclex

Jane is a 49-year-old woman who has recently had a peripherally inserted central catheter (PICC) placed. The nurse is teaching Jane how to flush her PICC. She knows that the teaching was effective when Jane states which of the following?

Possible Answers:

"I will use a 10mL syringe or larger to flush my PICC line."

"I will use a 3mL syringe or larger to flush my PICC line."

"I will use a 1mL syringe or larger to flush my PICC line."

"I will use a 20mL syringe or larger to flush my PICC line."

"I will use a 30mL syringe or larger to flush my PICC line."

Correct answer:

"I will use a 10mL syringe or larger to flush my PICC line."

Explanation:

One should always use a 10mL syringe or larger to flush a PICC line. Smaller syringes place greater pressure on the line which could result in damage. For example, a 3mL syringe places greater pressure on a PICC line than a 5mL syringe.

Example Question #1 : Drug Administration And Distribution

The pediatric nurse must convince a 4-year-old boy to take his medication. Which phrase is the most acceptable? 

Possible Answers:

"If you take your medicine, I will give you a soda pop!"

"If you don't take your medicine now, you will need to take a time-out."

"Will you please take your medication for us?"

"Your mother and I need you to take your medicine now."

"It is time to take your medicine. It tastes just like candy!"

Correct answer:

"Your mother and I need you to take your medicine now."

Explanation:

When convincing a child to take medicine, be straightforward and clear. Try not to offer the child a choice, as they likely won't take it. Stay away from using bribery, punishment, or comparing medicine to candy. Be honest about the taste of the medicine or risk losing the trust of the child.

Example Question #34 : General Concepts

When performing a blood transfusion, which of the following procedures should not be adhered to in order to ensure safe delivery of blood product to the patient?

Possible Answers:

The blood should be administered with isotonic solutions such as lactated Ringers

The preferred gauge of the needle should be between 18 to 20 gauge to allow for improved flow

Blood must be used within the first 30 minutes of arrival to the unit.

The tubing should be of a "Y type" to allow for fluid and blood product simultaneous infusion.

Positively identify the patient identification. 

Correct answer:

The blood should be administered with isotonic solutions such as lactated Ringers

Explanation:

All are true except for the use of lactated Ringer's this may cause a hemolytic reaction, only normal saline 0.9% is utilized. 

Example Question #35 : General Concepts

A nurse is teaching a mother how to administer nystatin to her 2-month-old child in the treatment of oral candidiasis. Which of the following is an appropriate instruction given by the nurse to the mother?

Possible Answers:

Place the medication in the child's bottle

Rinse the mouth post-administration

Apply to the mouth using a cotton-tipped applicator

Give the medication before meals

Use a syringe to squirt the medication to the back of the mouth

Correct answer:

Apply to the mouth using a cotton-tipped applicator

Explanation:

Apply medication to the mouth using a cotton-tipped applicator. Give the medication after meals and avoid rinsing the mouth. The medication should have contact with the mucosa without being washed away. Do not place the medication in a child's bottle, they may refuse to eat due to the bitter taste of the medication. Do not use a syringe to squirt the liquid to the back of the mouth since the child will likely spit it out.

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