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Clinical Medication Administration Fundamentals
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Clinical Medication Administration Fundamentals
Clinical Medication Administration Fundamentals
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1
Question
Which state-level legislation defines the scope of nursing practice and licensure requirements for administering medications?
Answer
State Nurse Practice Acts (NPAs)
2
Question
What are the seven essential components that must be included in a complete medication order?
Answer
Client's full name, date and time written, medication name, dosage, route, frequency of administration, and healthcare provider electronic signature.
3
Question
How does a STAT medication order differ from a 'Now' medication order regarding the timing of administration?
Answer
A STAT order is for a single dose given once and immediately (typically for condition deterioration). A 'Now' order allows the nurse up to 90 minutes to administer the medication.
4
Question
Name the seven rights of medication administration used to promote patient safety.
Answer
Right medication, right dose, right patient, right route, right time, right documentation, and right indication.
5
Question
At which three specific points must a nurse check the medication label during the administration process?
Answer
1. When removing from the dispensary/drawer. 2. When preparing (pouring or drawing up). 3. When putting away the container or disposing of packaging prior to administration.
6
Question
What protocol must be followed when a portion of a narcotic medication is not administered and needs to be wasted?
Answer
A second nurse must witness the waste of the unadministered portion.
7
Question
Which clinical presentations serve as contraindications for the oral route of medication administration?
Answer
Unconsciousness, dysphagia (difficulty swallowing), and active nausea or vomiting.
8
Question
Which specific types of oral medications are strictly prohibited from being crushed?
Answer
Extended release (ER), long-acting (LA), and enteric-coated medications.
9
Question
What instructions should a nurse provide to a patient receiving a sublingual medication?
Answer
Place the medication under the tongue to dissolve; do not swallow the medication or eat/drink until it is completely dissolved.
10
Question
Where is a buccal medication placed, and what is the rule regarding the site for subsequent doses?
Answer
It is placed between the gums and the cheek until dissolved; the nurse should alternate cheeks with each administration.
11
Question
What is the required head-of-bed (HOB) positioning for a patient receiving medications via an enteral tube?
Answer
The head of the bed should be elevated to \(30^{\circ}-45^{\circ}\) during administration and remain elevated for 60 minutes afterward.
12
Question
Which diagnostic methods are used to verify the correct placement of an enteral tube before medication is given?
Answer
Checking the pH of the aspirate or obtaining X-ray confirmation.
13
Question
Describe the relationship between the gauge number and the physical size of a needle.
Answer
The higher the gauge number, the smaller the diameter of the needle shaft.
14
Question
What are the standard needle lengths used for intramuscular (IM) versus subcutaneous (Sub-Q) injections?
Answer
IM injections typically use longer needles (\(1-1 \frac{1}{2}\) inch), while Sub-Q injections use shorter needles (\(3/8-5/8\) inch).
15
Question
Why is a filter needle required when withdrawing medication from a glass ampule?
Answer
To prevent glass shards or particles from entering the syringe when the neck of the ampule is snapped off.
16
Question
What technique should be used when snapping the neck of an ampule to ensure safety?
Answer
Wrap an alcohol pad around the neck, hold the base, and pull the top toward you so it breaks away from you.
17
Question
What preparatory step is necessary before withdrawing liquid from a vial to prevent the formation of a vacuum?
Answer
Inject a volume of air into the vial that is equal to the volume of medication to be withdrawn.
18
Question
Which nursing action is required for a vial cap before accessing the medication to ensure safety?
Answer
Ensure the cap 'spins' prior to removal to verify that no tampering has occurred.
19
Question
What is the correct sequence for administering sublingual or buccal medications in relation to oral medications?
Answer
Sublingual and buccal medications should be administered after oral medications.
20
Question
Which measurement increments are used for tuberculin syringes versus standard \(3\) mL syringes?
Answer
Tuberculin syringes are measured in \(0.01\) mL increments, whereas \(3\) mL syringes are measured in \(0.1\) mL increments.
21
Question
At what specific angle should the needle be inserted during an intradermal injection?
Answer
The needle should enter the skin at an angle of \(5-15^{\circ}\).
22
Question
Which anatomical site is typically used for performing an intradermal injection?
Answer
The underside of the forearm is the preferred site.
23
Question
How must the needle bevel be positioned when initiating an intradermal injection?
Answer
The bevel of the needle must be facing up.
24
Question
What characteristic finding must appear at the site for an intradermal test to be considered valid?
Answer
A bleb that looks like a mosquito bite should appear after the injection.
25
Question
Which common anatomical locations are recommended for subcutaneous medication administration?
Answer
The outer posterior upper arms, abdomen, and anterior aspects of the thighs are used.
26
Question
How does the needle angle for a subcutaneous injection differ for an obese client compared to an average-sized client?
Answer
An average-sized client requires a \(45^{\circ}\) angle, while an obese client requires a \(90^{\circ}\) angle.
27
Question
Why should the subcutaneous route be avoided for certain types of medications?
Answer
It should not be used for medications that are irritating or staining to tissues.
28
Question
Which common immunizations are exclusively administered via the intramuscular (IM) route?
Answer
Hepatitis B, tetanus, diphtheria, and pertussis vaccines are administered via IM injection.
29
Question
What is the standard angle used for most intramuscular injections?
Answer
Most intramuscular injections are administered at a \(90^{\circ}\) angle.
30
Question
Name the three primary anatomical sites utilized for intramuscular injections.
Answer
The three sites are the Deltoid, Vastus Lateralis, and Ventrogluteal muscles.