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Pharmacological and Parenteral Therapies – Part 2

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Pharmacological and Parenteral Therapies – Part 2

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Question 1 of 30

1. Question

1. Mr. W has orders for a physical therapy consult. The nurse contacts the appropriate department but 12 hours later, no one has come to see the client. Which is the most appropriate action of the nurse?

A. Call the supervisor and file a complaint against the physical therapy department.
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B. Contact the physician to notify him that the orders were not carried out.
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C. Assess the client's activity level by assisting with ambulation using a gait belt.
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D. Contact the physical therapy department again and repeat the order.
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Hint

Hint: Your responsibility includes verifying that ordered services are carried out—start by promptly following up with the department to ensure the consult is scheduled before escalating to supervisors or providers.
Question 2 of 30

2. Question

2. A drug form in which medication particles are instilled into a liquid and combined through agitation of the solution is called:

A. Suspension.
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B. Elixir.
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C. Syrup.
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D. Tincture.
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Hint

Hint: Think of a preparation where solid particles are dispersed but not dissolved in a liquid—requiring shaking before use because the particles will settle out if left standing.
Question 3 of 30

3. Question

3. Following a dose of medication, a client develops inflamed mucous membranes and nasal discharge. What type of minor reaction is this client experiencing?

A. Urticaria.
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B. Pruritis.
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C. Hives.
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D. Rhinitis.
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Hint

Hint: Think about inflammation of the nasal mucosa and symptoms like runny nose or nasal congestion—these describe an inflammation of the nasal passages rather than skin reactions such as itching or hives.
Question 4 of 30

4. Question

4. Mr. Y is receiving medication through a catheter that has been placed into the subarachnoid space of his spinal column. What route of medication administration is this called?

A. Intrapleural.
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B. Intraosseous.
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C. Intrathecal.
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D. Intraperitoneal.
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Hint

Hint: This route delivers medication directly into the cerebrospinal fluid around the spinal cord—think spinal canal and subarachnoid space rather than into bone, chest, or abdomen.
Question 5 of 30

5. Question

5. A client is having difficulties swallowing a large tablet of medication. Which of the following interventions from the nurse may best assist this client?

A. Help the client to lie down while taking the medication.
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B. Obtain an order to give the medication intravenously instead.
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C. Dissolve the tablet in a glass of pineapple juice.
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D. Assist the client to drink a full glass of water when taking the tablet.
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Hint

Hint: Facilitate safe swallowing by using gravity and an adequate amount of fluid to help the tablet pass, and keep the client upright to reduce aspiration risk.
Question 6 of 30

6. Question

6. A nurse is attempting to find the ventrogluteal muscle to administer an intramuscular medication. In which method does the nurse find this site?

A. The nurse places her palm on the client's hip at the level of the greater trochanter, pointing the thumb toward the client's groin and administering the injection between the first and second fingers.
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B. The nurse measures two finger-widths below the acromion process and administers the injection at this point.
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C. The nurse estimates the upper and outer quadrant of the buttock and gives the injection 3 inches below the iliac crest.
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D. The nurse grasps the muscle of the upper thigh and administers the injection 6 inches above the knee.
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Hint

Hint: Use the greater trochanter and anterior superior iliac spine as landmarks—place your palm on the trochanter with fingers toward the ASIS to form a “V” and inject in the center of that triangle.
Question 7 of 30

7. Question

7. A nurse is administering total parenteral nutrition for a client. The solution contains 12% dextrose and 5% amino acids. Which of the following sites is most appropriate to administer this solution?

A. Left radial arterial line.
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B. Right subclavian catheter.
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C. Left peripheral intravenous catheter.
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D. Both a and c.
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Hint

Hint: High-concentration dextrose solutions are hyperosmolar and should be infused into a high-flow central vein (central venous access) to prevent phlebitis and vascular damage.
Question 8 of 30

8. Question

8. Mr. S is complaining of pain following a surgical procedure. The nurse checks his orders and finds that he has an order for meperidine 25 mg prn q 4 hrs for shivering. What is the next action of the nurse?

A. Give 25mg of the medication and use it for pain.
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B. Contact the pharmacy to clarify the purpose of the medication.
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C. Check the medication record for other prn pain medications.
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D. Administer 12.5 mg of the medication and document that the client was shivering.
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Hint

Hint: Before administering, verify whether the standing PRN order matches the symptom—check the medication administration record for an appropriate PRN analgesic rather than assuming a shivering-specific order can be used for pain.
Question 9 of 30

9. Question

9. Which of the following medications is an example of an adjuvant drug?

A. Ibuprofen.
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B. Fentanyl.
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C. Hydromorphone.
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D. Hydroxyzine.
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Hint

Hint: Adjuvant drugs in pain management are non-opioid medications (such as antihistamines, antidepressants, or anticonvulsants) used to enhance analgesia or treat associated symptoms like anxiety or itching, unlike primary opioids.
Question 10 of 30

10. Question

10. Which of the following is a potential complication of administering a dorsogluteal intramuscular injection?

A. Striking the bone of the humerus with the needle.
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B. Inserting the needle into the sciatic nerve.
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C. Causing extravasation of medication into the subcutaneous tissues.
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D. Causing an air embolus in the superior iliac artery.
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Hint

Hint: Consider anatomical landmarks and the risk of damaging large peripheral nerves when choosing gluteal injection sites—this site lies close to the sciatic nerve, increasing the chance of nerve injury if placement is incorrect.
Question 11 of 30

11. Question

11. A nurse is preparing to administer a rectal suppository to a client. After applying gloves, checking the client’s identification band, and closing the door, what is the next step of the nurse?

A. Assist the client to lie in the Trendelenburg position.
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B. Unwrap the suppository and lubricate the end.
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C. Remove gloves and wash hands.
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D. Record the date, time, and amount of suppository to give.
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Hint

Hint: Before insertion, make the suppository ready for placement by ensuring it’s accessible and the insertion end is lubricated to facilitate a gentle, atraumatic insertion.
Question 12 of 30

12. Question

12. Which of the following questions must the nurse ask when formulating a nursing diagnosis?

A. What diagnosis did the physician make for this client?
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B. What is the issue that I can solve for this client?
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C. What physician orders will resolve this issue?
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D. What underlying disease does this client have?
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Hint

Hint: Focus on identifying the patient problem that falls within the nurse’s scope of practice—nursing diagnoses address issues nurses can treat or manage, not physician medical diagnoses or orders.
Question 13 of 30

13. Question

13. Which of the following is a disadvantage of taking medication through an oral route?

A. The drug may be absorbed too rapidly.
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B. The drug may have a bad taste.
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C. The drug is more expensive to use.
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D. Both a and b.
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Hint

Hint: Think about common patient complaints with oral medications—palatability is a frequent disadvantage, whereas systemic absorption via the GI tract is typically slower rather than too rapid.
Question 14 of 30

14. Question

14. One tablespoon of medication is equal to how many milliliters of fluid?

A. 5 ml.
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B. 15 ml.
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C. 30 ml.
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D. 60 ml.
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Hint

Hint: Remember common kitchen conversions: 1 teaspoon is about 5 mL and there are 3 teaspoons in 1 tablespoon, so multiply accordingly.
Question 15 of 30

15. Question

15. Which of the following must the nurse consider before administering medications through a nasogastric tube?

A. The nurse must determine whether a tablet can be crushed.
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B. The nurse must use 5 cc of cold water to instill the medication.
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C. The nurse must aspirate from the tube after giving the medication.
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D. The nurse must immediately reconnect low-intermittent suction after the medication.
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Hint

Hint: Consider the medication’s formulation—whether it’s extended‑release, enteric‑coated, or otherwise unsuitable for alteration—before deciding how to prepare it for NG tube administration.
Question 16 of 30

16. Question

16. What gauge of needle is most appropriate when giving an adult a subcutaneous injection?

A. 16 gauge.
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B. 18 gauge.
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C. 24 gauge.
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D. 30 gauge.
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Hint

Hint: Remember that subcutaneous injections use a smaller-diameter needle (higher gauge); choose a mid-20s gauge rather than the large-bore 16–18 needles used for IV/IM or the ultra-fine 30 gauge reserved for very small-volume injections like some insulin preparations.
Question 17 of 30

17. Question

17. Which is the most appropriate muscle site for an intramuscular injection for a 9-month old child?

A. Deltoid.
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B. Ventrogluteal.
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C. Dorsogluteal.
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D. Vastus lateralis.
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Hint

Hint: For infants under one year, choose the muscle with the greatest developed mass and lowest risk of injuring major nerves or vessels—gluteal sites are typically avoided in this age group.
Question 18 of 30

18. Question

18. A nurse is caring for a client who is breastfeeding her baby. Which of the following medications can the nurse administer to this client?

A. Aspirin.
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B. Lipitor.
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C. Prednisone.
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D. Amiodarone.
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Hint

Hint: Consider which class of drugs is often compatible with breastfeeding in short-to-moderate courses because its benefits outweigh minimal transfer into breastmilk, unlike anticoagulants, lipid-lowering agents, or drugs with long tissue half-lives and thyroid toxicity.
Question 19 of 30

19. Question

19. A nurse is administering a blood transfusion when the client begins to complain of a headache and difficulty breathing. His blood pressure is 170/110 mmHg. What is the next action of the nurse?

A. Administer a sedative and analgesic as directed.
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B. Assist the client to sit upright and slow the transfusion.
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C. Check the client's urinary output.
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D. Assist the client to lie supine in the Trendelenburg position.
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Hint

Hint: These symptoms during a transfusion suggest circulatory overload—manage by addressing pulmonary congestion and reducing the transfusion rate while positioning the client to ease breathing.
Question 20 of 30

20. Question

20. A nurse is caring for a client who has a triple-lumen, peripherally inserted central catheter (PICC) in the right arm. Which of the following is a consideration when working with this type of central line?

A. The client should be restricted to showers only, no baths.
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B. The nurse should flush one of the ports with saline solution every 8 hours.
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C. The nurse should avoid taking a blood pressure in the right arm.
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D. The client should avoid exercise until the PICC has been removed.
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Hint

Hint: Think about how external compression from a blood pressure cuff can mechanically compress the catheter, increasing risk of occlusion or damage to the line in the limb where the PICC is inserted.
Question 21 of 30

21. Question

21. A nurse is caring for a client who has low blood pressure. The physician has ordered dopamine 2 mcg/kg/min on a continuous infusion. The nurse notes that the client weights 186 pounds. What is the appropriate rate for this infusion?

A. 168 mcg/min.
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B. 372 mcg/min.
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C. 168 mg/min.
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D. 372 mg/min.
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Hint

Hint: Convert the client’s weight from pounds to kilograms, multiply by the ordered mcg/kg/min dose to get mcg/min, and be careful to distinguish micrograms (mcg) from milligrams (mg).
Question 22 of 30

22. Question

22. A nurse needs to administer 15 units of regular insulin and 20 units of NPH subcutaneously to a client with diabetes. In what order does the nurse draw these medications?

A. Draw 20 units of NPH, then 15 units of regular, in the same syringe.
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B. Draw 15 units of regular, then 20 units of NPH, in the same syringe.
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C. Draw 15 units of regular, then 20 units of NPH, in different syringes.
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D. Draw 5 units of regular, then 20 units of NPH, then 10 more units of regular, in different syringes.
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Hint

Hint: Remember the “clear before cloudy” rule when mixing insulins—withdraw the short-acting (clear) insulin before the intermediate-acting (cloudy) to prevent contaminating the clear vial.
Question 23 of 30

23. Question

23. A client is seen in the emergency room as a victim of suspected domestic violence. The nurse’s aide brings the client to a center curtained area, gives her a gown to change into, and asks her to wait for the nurse. What is the most appropriate action of the nurse upon arrival?

A. Ask the client to undress to visualize any injuries.
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B. Take the client into a private room.
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C. Notify the police to file an initial report.
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D. Notify the house supervisor to keep security on alert.
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Hint

Hint: Prioritize the client’s safety, confidentiality, and ability to speak freely by moving them to a private, secure setting before discussing injuries or next steps.
Question 24 of 30

24. Question

24. Which of the following abbreviations is acceptable to use as part of medication documentation?

A. Q.O.D.
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B. MS.
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C. IU.
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D. prn.
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Hint

Hint: Pick the abbreviation that is short, unambiguous, and accepted by medication-safety guidelines; avoid those with periods or characters that are commonly misread or listed on “do not use” lists.
Question 25 of 30

25. Question

25. How many milliliters are equal to one quart of fluid?

A. 250 ml.
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B. 500 ml.
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C. 1000 ml.
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D. 2000 ml.
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Hint

Hint: Convert quarts to liters first (1 quart ≈ 0.95 L), then convert liters to milliliters (1 L = 1000 mL) and pick the option closest to that value.
Question 26 of 30

26. Question

26. A nurse receives an order for Iansoprazole (Prevacid) 15 mg daily. The medication is available in syrup form of 5 mg/ml. How many milliliters must this nurse give?

A. 5 ml.
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B. 1 ml.
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C. 3 ml.
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D. 15 ml.
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Hint

Hint: Convert required milligrams to volume by dividing the ordered dose by the concentration (mg per mL) to determine how many milliliters to administer.
Question 27 of 30

27. Question

27. A nurse asks her coworker to administer Mr. J’s 12pm medication because she is running behind. Which of the following information must the nurse verify with Mr. J before giving him his medication?

A. His name and address.
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B. His name and hospital identification number.
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C. His name and room number.
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D. His name and diagnosis.
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Hint

Hint: Use the two–patient identifier rule for safe medication administration—confirm the patient’s name plus a second unique identifier (not room, address, or diagnosis) before giving meds.
Question 28 of 30

28. Question

28. Which of the following is more likely to occur with aging as a complication of medication administration?

A. Increased renal function.
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B. Increased gastrointestinal absorption.
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C. Increased visual acuity.
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D. Increased ratio of fat compared to lean body mass.
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Hint

Hint: Consider how age-related changes in body composition—specifically a greater proportion of adipose tissue relative to lean muscle and total body water—affect the distribution and half-life of lipophilic medications.
Question 29 of 30

29. Question

29. Which of the following interventions should the nurse consider when giving an oral medication to a child?

A. Mix the medication with milk to mask the taste.
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B. Dilute the medication in a glass of water.
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C. Refeed the medication if the child pushes it out with his tongue.
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D. Mix the medication in a food the child enjoys.
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Hint

Hint: Prioritize safe dosing and aspiration prevention—if a child expels part of an oral dose, do not simply re-administer the medication without reassessing how much was swallowed and notifying the prescriber or following facility policy.
Question 30 of 30

30. Question

30. Which of the following methods best describes administration of an intradermal injection?

A. Pull the skin taut and insert the needle bevel-up just slightly under the skin; inject medication to create a wheal.
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B. Pull the skin taut and insert the needle bevel-down just slightly under the skin; inject medication to create a wheal.
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C. Pinch the skin and insert the needle bevel-down into the skin fold to create a wheal.
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D. Pinch the skin and insert the needle bevel-up at a 45-degree angle into the skin.
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Hint

Hint: For intradermal injections, remember to place the needle almost parallel to the skin with the bevel facing upward and inject very shallowly to form a small wheal rather than using a deep or angled technique.

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