ATI Medication Administration Complete Success Study Guide 2026 |
Comprehensive Nursing Review Material with Essential
Pharmacology Concepts, Medication Safety Guidelines, Clinical
Application Strategies, Skills Review & Exam Readiness Preparation
SECTION 1: MEDICATION ADMINISTRATION – GENERAL PRINCIPLES
Question 1
A nurse is preparing to administer an oral medication to a client who has difficulty
swallowing tablets. Which of the following actions should the nurse take?
A. Crush the tablet without checking the formulation
B. Crush the tablet only if it is not an enteric-coated or extended-release
formulation
C. Dissolve the tablet in a large volume of fluid
D. Ask the provider to change the medication to an injectable form
Answer: B
Rationale: Enteric-coated tablets are designed to dissolve in the small intestine
(not the stomach) to prevent gastric irritation or drug destruction by stomach
acid. Extended-release formulations should never be crushed as this alters the
release mechanism and can cause toxicity. The nurse should check the
formulation before crushing and consider alternative forms if crushing is not
appropriate.
Question 2
A nurse is teaching a client about using a metered-dose inhaler (MDI) without a
spacer. Which of the following instructions should the nurse include?
A. "Inhale quickly and forcefully."
B. "Hold your breath for 5 seconds after inhalation."
C. "Activate the inhaler just after starting to inhale."
D. "Exhale completely before placing the inhaler in your mouth."
Answer: C
Rationale: The inhaler should be activated just after the client begins a slow, deep
inhalation to ensure the medication is drawn deep into the lungs. The breath
,should be held for 5–10 seconds. Rapid forceful inhalation causes medication to
impact the back of the throat rather than reaching the lungs.
Question 3
A nurse is preparing to administer a medication via a nasogastric (NG) tube.
Which of the following actions should the nurse take?
A. Crush enteric-coated tablets before administration
B. Mix all medications together in one syringe
C. Flush the tube with 15–30 mL of water between each medication
D. Administer medications at room temperature only
Answer: C
Rationale: The tube should be flushed with water between each medication to
prevent interactions and ensure each medication is delivered fully into the
stomach. Enteric-coated tablets should never be crushed. Medications should
generally not be mixed together due to potential incompatibilities.
Question 4
A nurse is preparing to administer an enteric-coated tablet to a client. The client
requests that the tablet be crushed to make it easier to swallow. Which of the
following responses should the nurse give?
A. "I will crush the tablet and mix it with pudding."
B. "I need to check with your provider to see if this medication is available in a
liquid form."
C. "Crushing this tablet will cause it to be released too quickly."
D. "I can crush it as long as you take it with food."
Answer: B
Rationale: Enteric-coated tablets should never be crushed because the coating
protects the drug from stomach acid or prevents gastric irritation. The nurse
should check with the provider for an alternative formulation such as a liquid, or
consult the pharmacist.
,Question 5
A nurse is administering a transdermal patch to a client. Which of the following
actions is correct?
A. Apply the patch to a hairy area for better adhesion
B. Wear gloves when applying the patch
C. Cut the patch in half for a lower dose
D. Apply the patch to the same site each time
Answer: B
Rationale: Gloves should be worn when applying transdermal patches to prevent
absorption of the medication through the nurse's skin. Patches should be applied
to clean, dry, hairless areas and rotated to different sites to prevent skin irritation.
Patches should never be cut, as this alters the dose delivery.
Question 6
A nurse is preparing to administer eye drops. Which of the following actions
should the nurse take?
A. Have the client look up and to the side
B. Instill the drop directly onto the cornea
C. Apply pressure to the outer canthus after instillation
D. Have the client close their eyes and move them side to side
Answer: A
Rationale: The client should look up and to the side to move the cornea away
from the drop site. The drop should be instilled into the conjunctival sac, not
directly on the cornea. Pressure should be applied to the inner canthus
(nasolacrimal duct) to prevent systemic absorption, not the outer canthus.
Question 7
A nurse is preparing to administer a subcutaneous injection of heparin. Which of
the following actions is correct?
A. Aspirate before injection
B. Massage the site after injection
, C. Administer at a 45- to 90-degree angle
D. Use a 1-inch needle
Answer: C
Rationale: Subcutaneous injections are administered at a 45- to 90-degree angle
depending on the amount of subcutaneous tissue. Aspiration is not
recommended for subcutaneous heparin as it can cause tissue damage.
Massaging the site can cause hematoma formation.
Question 8
A nurse is preparing to administer an IM injection. Which of the following sites is
preferred for administering a 3 mL injection to an adult?
A. Deltoid
B. Dorsogluteal
C. Ventrogluteal
D. Vastus lateralis
Answer: C
Rationale: The ventrogluteal site is the preferred site for large-volume IM
injections (up to 5 mL) in adults. The deltoid is used for small volumes (≤1 mL).
The dorsogluteal site is no longer recommended due to risk of sciatic nerve injury.
Question 9
A nurse is preparing to administer a medication via IV push. Which of the
following actions should the nurse take?
A. Administer the medication over 1–2 seconds
B. Verify the compatibility of the medication with the IV solution
C. Use a 22-gauge needle for administration
D. Administer the medication through a port closest to the patient
Answer: B
Rationale: The nurse must verify compatibility of the IV medication with the
existing IV solution and any other medications. IV push medications should be
administered at the prescribed rate (often over 1–5 minutes). The port closest to
the patient is used for IV push to ensure the full dose reaches the patient.
Comprehensive Nursing Review Material with Essential
Pharmacology Concepts, Medication Safety Guidelines, Clinical
Application Strategies, Skills Review & Exam Readiness Preparation
SECTION 1: MEDICATION ADMINISTRATION – GENERAL PRINCIPLES
Question 1
A nurse is preparing to administer an oral medication to a client who has difficulty
swallowing tablets. Which of the following actions should the nurse take?
A. Crush the tablet without checking the formulation
B. Crush the tablet only if it is not an enteric-coated or extended-release
formulation
C. Dissolve the tablet in a large volume of fluid
D. Ask the provider to change the medication to an injectable form
Answer: B
Rationale: Enteric-coated tablets are designed to dissolve in the small intestine
(not the stomach) to prevent gastric irritation or drug destruction by stomach
acid. Extended-release formulations should never be crushed as this alters the
release mechanism and can cause toxicity. The nurse should check the
formulation before crushing and consider alternative forms if crushing is not
appropriate.
Question 2
A nurse is teaching a client about using a metered-dose inhaler (MDI) without a
spacer. Which of the following instructions should the nurse include?
A. "Inhale quickly and forcefully."
B. "Hold your breath for 5 seconds after inhalation."
C. "Activate the inhaler just after starting to inhale."
D. "Exhale completely before placing the inhaler in your mouth."
Answer: C
Rationale: The inhaler should be activated just after the client begins a slow, deep
inhalation to ensure the medication is drawn deep into the lungs. The breath
,should be held for 5–10 seconds. Rapid forceful inhalation causes medication to
impact the back of the throat rather than reaching the lungs.
Question 3
A nurse is preparing to administer a medication via a nasogastric (NG) tube.
Which of the following actions should the nurse take?
A. Crush enteric-coated tablets before administration
B. Mix all medications together in one syringe
C. Flush the tube with 15–30 mL of water between each medication
D. Administer medications at room temperature only
Answer: C
Rationale: The tube should be flushed with water between each medication to
prevent interactions and ensure each medication is delivered fully into the
stomach. Enteric-coated tablets should never be crushed. Medications should
generally not be mixed together due to potential incompatibilities.
Question 4
A nurse is preparing to administer an enteric-coated tablet to a client. The client
requests that the tablet be crushed to make it easier to swallow. Which of the
following responses should the nurse give?
A. "I will crush the tablet and mix it with pudding."
B. "I need to check with your provider to see if this medication is available in a
liquid form."
C. "Crushing this tablet will cause it to be released too quickly."
D. "I can crush it as long as you take it with food."
Answer: B
Rationale: Enteric-coated tablets should never be crushed because the coating
protects the drug from stomach acid or prevents gastric irritation. The nurse
should check with the provider for an alternative formulation such as a liquid, or
consult the pharmacist.
,Question 5
A nurse is administering a transdermal patch to a client. Which of the following
actions is correct?
A. Apply the patch to a hairy area for better adhesion
B. Wear gloves when applying the patch
C. Cut the patch in half for a lower dose
D. Apply the patch to the same site each time
Answer: B
Rationale: Gloves should be worn when applying transdermal patches to prevent
absorption of the medication through the nurse's skin. Patches should be applied
to clean, dry, hairless areas and rotated to different sites to prevent skin irritation.
Patches should never be cut, as this alters the dose delivery.
Question 6
A nurse is preparing to administer eye drops. Which of the following actions
should the nurse take?
A. Have the client look up and to the side
B. Instill the drop directly onto the cornea
C. Apply pressure to the outer canthus after instillation
D. Have the client close their eyes and move them side to side
Answer: A
Rationale: The client should look up and to the side to move the cornea away
from the drop site. The drop should be instilled into the conjunctival sac, not
directly on the cornea. Pressure should be applied to the inner canthus
(nasolacrimal duct) to prevent systemic absorption, not the outer canthus.
Question 7
A nurse is preparing to administer a subcutaneous injection of heparin. Which of
the following actions is correct?
A. Aspirate before injection
B. Massage the site after injection
, C. Administer at a 45- to 90-degree angle
D. Use a 1-inch needle
Answer: C
Rationale: Subcutaneous injections are administered at a 45- to 90-degree angle
depending on the amount of subcutaneous tissue. Aspiration is not
recommended for subcutaneous heparin as it can cause tissue damage.
Massaging the site can cause hematoma formation.
Question 8
A nurse is preparing to administer an IM injection. Which of the following sites is
preferred for administering a 3 mL injection to an adult?
A. Deltoid
B. Dorsogluteal
C. Ventrogluteal
D. Vastus lateralis
Answer: C
Rationale: The ventrogluteal site is the preferred site for large-volume IM
injections (up to 5 mL) in adults. The deltoid is used for small volumes (≤1 mL).
The dorsogluteal site is no longer recommended due to risk of sciatic nerve injury.
Question 9
A nurse is preparing to administer a medication via IV push. Which of the
following actions should the nurse take?
A. Administer the medication over 1–2 seconds
B. Verify the compatibility of the medication with the IV solution
C. Use a 22-gauge needle for administration
D. Administer the medication through a port closest to the patient
Answer: B
Rationale: The nurse must verify compatibility of the IV medication with the
existing IV solution and any other medications. IV push medications should be
administered at the prescribed rate (often over 1–5 minutes). The port closest to
the patient is used for IV push to ensure the full dose reaches the patient.
