Oral And Enteral Medication Administration - NCLEX Pn

1. What is the correct method to measure liquid oral medication accurately?

   Use a calibrated oral syringe or medication cup at eye level. Calibrated tools at eye level allow precise reading of the meniscus, ensuring accurate dosing and reducing measurement errors.

2. Which assessment is essential before giving an oral medication to reduce aspiration risk?

   Assess swallowing ability and level of consciousness. These assessments identify risks of aspiration or choking, ensuring the patient can safely ingest and process the medication.

3. Identify the correct action if a patient refuses an oral medication.

   Do not force; document refusal and notify the nurse/prescriber. Respecting patient autonomy prevents coercion, while documentation and notification ensure care continuity and legal protection.

4. What is the correct action if a patient is NPO and an oral medication is scheduled?

   Hold and clarify the order before administering. NPO status prohibits oral intake to prevent complications, requiring order clarification for alternative routes or adjustments.

5. What is the minimum number of label checks required before giving an oral medication?

   Three label checks. Checking the label at retrieval, preparation, and bedside confirms medication accuracy multiple times, reducing the chance of administration errors.

6. What is the correct action before giving medications through an enteral feeding tube?

   Stop feeding (if running) and flush tube per policy. Pausing feedings prevents drug-nutrient interactions, and flushing maintains tube patency for effective medication delivery.

7. What is the preferred ongoing bedside method to verify feeding tube placement before meds?

   Measure pH of aspirate per policy and assess tube marking/length. pH measurement distinguishes gastric from respiratory placement, while markings confirm stability, providing reliable bedside verification.

8. Which instruction is correct for administering sublingual medication?

   Place under tongue; do not chew or swallow. This method facilitates rapid absorption through the sublingual mucosa, avoiding gastrointestinal degradation for quicker therapeutic effects.

9. Which step confirms initial placement of a newly inserted enteral feeding tube before first use?

   Radiographic confirmation per facility policy. X-ray imaging definitively visualizes tube position in the gastrointestinal tract, ensuring safe initial use per safety standards.

10. What is the preferred position for administering oral medications to reduce aspiration risk?

    High Fowler position (upright). An upright position leverages gravity to aid swallowing and directs contents toward the stomach, minimizing the chance of pulmonary aspiration.

11. What is the primary safety purpose of the medication rights in oral/enteral administration?

    To prevent medication errors and patient harm. The medication rights provide a systematic framework to ensure accurate administration, thereby minimizing risks of errors that could lead to adverse patient outcomes.

12. Identify the correct action if resistance is met when flushing an enteral feeding tube.

    Stop; do not force; troubleshoot and notify the nurse/provider. Avoiding force prevents tube damage or patient injury, with troubleshooting and escalation ensuring prompt resolution of potential clogs.

13. What is the correct fluid to use to flush an enteral feeding tube for medication delivery?

    Sterile water for immunocompromised; otherwise water per policy. Tailoring flush fluid to patient risk reduces infection potential, aligning with infection control policies for vulnerable populations.

14. Identify the correct action if an oral medication label is illegible or missing.

    Do not administer; obtain a clarified, labeled dose. Unclear or absent labels pose a high risk of errors, requiring replacement to maintain safety and compliance with administration protocols.

15. Which medication right verifies the medication label matches the provider prescription?

    Right medication. This right ensures the drug dispensed matches the prescribed one by directly comparing the label to the order, preventing substitution errors.

16. What is the correct patient identifier method before giving an oral or enteral medication?

    Use two identifiers (not room number). Two unique identifiers, such as name and date of birth, accurately confirm identity, avoiding errors from non-specific details like room assignments.

17. Which oral dosage forms must not be crushed for administration?

    Enteric-coated and extended-release forms. Crushing these forms disrupts their protective coatings or controlled-release mechanisms, potentially causing rapid absorption or gastrointestinal harm.

18. Which medication should be given with food to reduce gastric irritation when ordered?

    Medications known to irritate GI mucosa (per order/guide). Food acts as a buffer to protect the gastric lining from irritants, improving tolerance as specified in prescribing guidelines.

19. Which route should be used when a patient cannot swallow safely but has a feeding tube?

    Enteral (via feeding tube) route. This route delivers medication directly into the gastrointestinal tract, bypassing the need for oral swallowing in patients with dysphagia.

20. What is the correct action if a patient questions the appearance of an oral medication?

    Hold dose and verify with pharmacy/prescriber. Patient concerns may indicate discrepancies like generic variations or errors, necessitating verification to ensure safety before proceeding.

21. What is the correct technique for administering tablets or capsules to a patient with dysphagia?

    Use approved liquid/crushable form per order and policy. Adapting forms to liquid or crushed per guidelines allows safe delivery without requiring intact swallowing, adhering to patient-specific needs.

22. Which order of steps is correct for enteral medication administration via tube?

    Verify placement, stop feed, flush, give med, flush, restart as ordered. This sequence prioritizes safety by confirming position, clearing the tube, delivering medication, and restoring nutrition without interruptions.

23. Which medication administration practice prevents tube clogging with multiple enteral meds?

    Give each medication separately with flushes between. Administering individually with intervening flushes dilutes residues and prevents incompatibilities that could lead to occlusions.

24. Which instruction is correct for administering buccal medication?

    Place between gum and cheek; allow to dissolve. Buccal placement enables direct mucosal absorption, bypassing first-pass liver metabolism for efficient drug delivery.

25. What documentation is required after oral or enteral medication administration?

    Drug, dose, route, time, patient response, and any held/refused dose. Detailed records facilitate monitoring of efficacy, adverse effects, and compliance, supporting legal and clinical continuity in patient care.

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