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school, study guide
1. Principles of Pharmacology & Medication Administration
1. A nurse is preparing to administer a medication via the intramuscular (IM)
route. Which site is generally contraindicated for IM injections in infants and
young children due to the risk of sciatic nerve damage?
A. Vastus lateralis
B. Ventrogluteal
C. Dorsogluteal
D. Deltoid
Correct Answer: C. Dorsogluteal
Rationale: The dorsogluteal site is not recommended for infants and
young children under 3 years old because the gluteal muscles are not well-
developed, and there is a risk of injury to the sciatic nerve. The vastus lateralis is
the preferred site for infants. The ventrogluteal site is safe for all ages but
requires landmarks that can be harder to find in infants. The deltoid is not used
for infants.
2. A client is prescribed a medication that is highly protein-bound. The nurse
understands that a decrease in serum albumin levels could lead to which of the
following?
A. Decreased drug efficacy
B. Increased risk of drug toxicity
C. Rapid excretion of the drug
D. No change in drug action
Correct Answer: B. Increased risk of drug toxicity
Rationale: When a drug is highly protein-bound, it attaches to proteins like
albumin in the blood. Only the unbound (free) portion of the drug is active. If
albumin levels decrease (e.g., in malnutrition or liver disease), there are fewer
,binding sites, leading to more free drug in the bloodstream. This increases the
drug's effect and the risk of toxicity.
3. Which of the following are appropriate nursing actions to prevent medication
errors? (Select all that apply.)
A. Use only abbreviations approved by the facility.
B. Clarify illegible or unclear medication orders with the prescriber.
C. Administer medications prepared by another nurse without verification.
D. Follow the "eight rights" of medication administration.
E. Document medication administration immediately after giving the drug.
Correct Answers: A, B, D, E
Rationale: Using approved abbreviations (A) reduces confusion. Clarifying
unclear orders (B) is a key safety step. Following the "eight rights" (D) is the
cornerstone of safe medication administration. Documenting immediately (E)
ensures an accurate record and prevents duplicate doses. A nurse should never
administer a medication prepared by another nurse without verifying it
themselves (C is incorrect).
4. A nurse is reviewing a client's medication history. The client states, "I take a
'water pill' for my blood pressure." The nurse should recognize this as a
potential for which type of medication error?
A. Omission error
B. Wrong dose error
C. Communication error
D. Unauthorized drug error
Correct Answer: C. Communication error
Rationale: The client using a non-specific term like "water pill" creates a
communication barrier. The nurse must clarify the exact name, dose, and
frequency of the medication to prevent errors. This is a classic communication
error.
,5. A client is ordered to receive a medication via a nasogastric (NG) tube. Which
action should the nurse take first?
A. Flush the tube with 30 mL of water.
B. Verify tube placement.
C. Crush the medication into a fine powder.
D. Mix the medication with a small amount of applesauce.
Correct Answer: B. Verify tube placement.
Rationale: The first and most critical step before administering any
medication through an NG tube is to verify its placement to ensure it is in the
stomach and not in the lungs. All other steps follow this verification.
6. A nurse is calculating a pediatric dose for a child who weighs 22 lb. The safe
dose range for the medication is 10-20 mg/kg/day. What is the safe dose range
for this child in mg/day? (Round to the nearest whole number).
A. 100-200 mg/day
B. 220-440 mg/day
C. 50-100 mg/day
D. 10-20 mg/day
Correct Answer: A. 100-200 mg/day
Rationale: First, convert the weight from pounds to kilograms: 22 lb / 2.2
kg/lb = 10 kg. Then, multiply the weight by the dose range: 10 kg × 10 mg/kg/day
= 100 mg/day. 10 kg × 20 mg/kg/day = 200 mg/day. The safe dose range is 100-
200 mg/day.
7. A nurse is preparing to administer a sublingual nitroglycerin tablet. Which
instruction is most important for the nurse to provide?
A. "Swallow the tablet with a full glass of water."
B. "Place the tablet under your tongue and let it dissolve."
, C. "Chew the tablet for faster absorption."
D. "Take this medication with food to prevent stomach upset."
Correct Answer: B. "Place the tablet under your tongue and let it
dissolve."
Rationale: Sublingual medications are designed to be placed under the
tongue to dissolve and be absorbed directly into the bloodstream, bypassing the
digestive system for a faster onset of action. Swallowing, chewing, or taking with
food would alter the absorption.
8. A client has an order for a medication to be given "QID." The nurse should
plan to administer this medication at which times?
A. Once a day
B. Twice a day
C. Three times a day
D. Four times a day
Correct Answer: D. Four times a day
Rationale: "QID" is a standard abbreviation for quater in die, which means
four times a day. Common administration times are 0900, 1300, 1700, and 2100.
9. A nurse is caring for a client with renal impairment. The nurse should
anticipate that the dose of a renally-excreted drug will be:
A. Increased.
B. Decreased.
C. Unchanged.
D. Administered more frequently.
Correct Answer: B. Decreased.
Rationale: Clients with renal impairment have a decreased ability to
excrete drugs, leading to an accumulation of the drug in the body. To prevent
toxicity, the dose is often decreased, or the dosing interval is lengthened.
school, study guide
1. Principles of Pharmacology & Medication Administration
1. A nurse is preparing to administer a medication via the intramuscular (IM)
route. Which site is generally contraindicated for IM injections in infants and
young children due to the risk of sciatic nerve damage?
A. Vastus lateralis
B. Ventrogluteal
C. Dorsogluteal
D. Deltoid
Correct Answer: C. Dorsogluteal
Rationale: The dorsogluteal site is not recommended for infants and
young children under 3 years old because the gluteal muscles are not well-
developed, and there is a risk of injury to the sciatic nerve. The vastus lateralis is
the preferred site for infants. The ventrogluteal site is safe for all ages but
requires landmarks that can be harder to find in infants. The deltoid is not used
for infants.
2. A client is prescribed a medication that is highly protein-bound. The nurse
understands that a decrease in serum albumin levels could lead to which of the
following?
A. Decreased drug efficacy
B. Increased risk of drug toxicity
C. Rapid excretion of the drug
D. No change in drug action
Correct Answer: B. Increased risk of drug toxicity
Rationale: When a drug is highly protein-bound, it attaches to proteins like
albumin in the blood. Only the unbound (free) portion of the drug is active. If
albumin levels decrease (e.g., in malnutrition or liver disease), there are fewer
,binding sites, leading to more free drug in the bloodstream. This increases the
drug's effect and the risk of toxicity.
3. Which of the following are appropriate nursing actions to prevent medication
errors? (Select all that apply.)
A. Use only abbreviations approved by the facility.
B. Clarify illegible or unclear medication orders with the prescriber.
C. Administer medications prepared by another nurse without verification.
D. Follow the "eight rights" of medication administration.
E. Document medication administration immediately after giving the drug.
Correct Answers: A, B, D, E
Rationale: Using approved abbreviations (A) reduces confusion. Clarifying
unclear orders (B) is a key safety step. Following the "eight rights" (D) is the
cornerstone of safe medication administration. Documenting immediately (E)
ensures an accurate record and prevents duplicate doses. A nurse should never
administer a medication prepared by another nurse without verifying it
themselves (C is incorrect).
4. A nurse is reviewing a client's medication history. The client states, "I take a
'water pill' for my blood pressure." The nurse should recognize this as a
potential for which type of medication error?
A. Omission error
B. Wrong dose error
C. Communication error
D. Unauthorized drug error
Correct Answer: C. Communication error
Rationale: The client using a non-specific term like "water pill" creates a
communication barrier. The nurse must clarify the exact name, dose, and
frequency of the medication to prevent errors. This is a classic communication
error.
,5. A client is ordered to receive a medication via a nasogastric (NG) tube. Which
action should the nurse take first?
A. Flush the tube with 30 mL of water.
B. Verify tube placement.
C. Crush the medication into a fine powder.
D. Mix the medication with a small amount of applesauce.
Correct Answer: B. Verify tube placement.
Rationale: The first and most critical step before administering any
medication through an NG tube is to verify its placement to ensure it is in the
stomach and not in the lungs. All other steps follow this verification.
6. A nurse is calculating a pediatric dose for a child who weighs 22 lb. The safe
dose range for the medication is 10-20 mg/kg/day. What is the safe dose range
for this child in mg/day? (Round to the nearest whole number).
A. 100-200 mg/day
B. 220-440 mg/day
C. 50-100 mg/day
D. 10-20 mg/day
Correct Answer: A. 100-200 mg/day
Rationale: First, convert the weight from pounds to kilograms: 22 lb / 2.2
kg/lb = 10 kg. Then, multiply the weight by the dose range: 10 kg × 10 mg/kg/day
= 100 mg/day. 10 kg × 20 mg/kg/day = 200 mg/day. The safe dose range is 100-
200 mg/day.
7. A nurse is preparing to administer a sublingual nitroglycerin tablet. Which
instruction is most important for the nurse to provide?
A. "Swallow the tablet with a full glass of water."
B. "Place the tablet under your tongue and let it dissolve."
, C. "Chew the tablet for faster absorption."
D. "Take this medication with food to prevent stomach upset."
Correct Answer: B. "Place the tablet under your tongue and let it
dissolve."
Rationale: Sublingual medications are designed to be placed under the
tongue to dissolve and be absorbed directly into the bloodstream, bypassing the
digestive system for a faster onset of action. Swallowing, chewing, or taking with
food would alter the absorption.
8. A client has an order for a medication to be given "QID." The nurse should
plan to administer this medication at which times?
A. Once a day
B. Twice a day
C. Three times a day
D. Four times a day
Correct Answer: D. Four times a day
Rationale: "QID" is a standard abbreviation for quater in die, which means
four times a day. Common administration times are 0900, 1300, 1700, and 2100.
9. A nurse is caring for a client with renal impairment. The nurse should
anticipate that the dose of a renally-excreted drug will be:
A. Increased.
B. Decreased.
C. Unchanged.
D. Administered more frequently.
Correct Answer: B. Decreased.
Rationale: Clients with renal impairment have a decreased ability to
excrete drugs, leading to an accumulation of the drug in the body. To prevent
toxicity, the dose is often decreased, or the dosing interval is lengthened.
