pharmacology practice questions medication safety
Workman LaCharity drug classifications nursing
pharmacology clinical pharmacology study guide
nursing exam prep safe medication administration
Section 1: Principles of Safe Medication Administration (Questions 1-25)
1. The nurse is preparing to administer a medication to a patient. Which of the
following is the most critical step to ensure patient safety?
A. Checking the medication label three times.
B. Verifying the patient's identity using two identifiers.
C. Administering the medication within 30 minutes of the scheduled time.
D. Documenting the medication administration immediately after giving it.
Correct Answer: B
B. Verifying the patient's identity using two identifiers.
Rationale:
Verifying the patient's identity using two identifiers is the single most
critical step to prevent medication errors. While checking the label and timely
administration are important, verifying the right patient is the cornerstone of the
"Rights" of medication administration. Using two identifiers (e.g., name and date
of birth) is the standard of practice to prevent giving a medication to the wrong
patient. A is incorrect because while important, it is a process check, not the final
patient safety check. C is incorrect because timeliness is a goal, but patient
identity is the absolute priority. D is incorrect because documentation should
occur immediately after administration, but it does not prevent an error from
happening in the first place.
2. A nurse is reviewing a new medication order. The order reads: "Give 5 mg of
Drug X PO now." The pharmacy sends a bottle labeled "Drug X 10 mg/mL." How
many mL will the nurse administer?
A. 0.5 mL
B. 1 mL
,C. 2 mL
D. 5 mL
Correct Answer: A
A. 0.5 mL
Rationale:
Use the formula: Desired/Have × Volume = Amount to administer. Desired
= 5 mg, Have = 10 mg, Volume = 1 mL. (5 mg / 10 mg) × 1 mL = 0.5 mL. B, C, and D
are incorrect calculations.
3. Which of the following are considered the "Rights" of medication
administration? (Select all that apply.)
A. Right Patient
B. Right Drug
C. Right Dose
D. Right Route
E. Right Time
F. Right Diagnosis
Correct Answer: A, B, C, D, E
A, B, C, D, E.
Rationale:
The classic "Five Rights" are Right Patient, Right Drug, Right Dose, Right
Route, and Right Time. Many institutions have expanded these to include Right
Documentation, Right Reason, and Right to Refuse. F is incorrect. "Right
Diagnosis" is not a standard "Right." The "Right Reason" is the closest concept,
which refers to ensuring the medication is appropriate for the patient's condition.
4. The nurse is administering a medication via a nasogastric (NG) tube. Which
action is most appropriate?
A. Administer the medication with a large amount of water to flush the tube.
B. Crush all medications, including enteric-coated and sustained-release tablets,
into a fine powder.
C. Verify tube placement by injecting air and auscultating the epigastric area.
D. Mix all crushed medications together in water before administration.
,Correct Answer: A
A. Administer the medication with a large amount of water to flush the
tube.
Rationale:
Flushing the NG tube with water before, between, and after medication
administration is essential to prevent clogging and ensure the full dose is
delivered. B is incorrect because crushing enteric-coated or sustained-release
medications can cause rapid absorption, potential toxicity, or inactivation by
stomach acid. C is incorrect because auscultating for air is no longer considered a
reliable method for verifying NG tube placement. Checking pH of aspirated gastric
contents is the preferred method. D is incorrect because mixing medications
together can cause chemical interactions and make it impossible to identify which
medication caused a reaction. They should be administered separately.
5. A patient has an order for a medication to be given "subcutaneously." The
nurse knows this means the medication will be injected into which layer of
tissue?
A. The epidermis.
B. The dermis.
C. The subcutaneous fat layer.
D. The muscle.
Correct Answer: C
C. The subcutaneous fat layer.
Rationale:
Subcutaneous (SC or SubQ) injections are administered into the fatty
tissue layer just below the dermis. This route provides a slower, more sustained
absorption rate than IM or IV routes. A and B are incorrect as these are layers of
the skin itself, used for intradermal injections. D is incorrect. This describes an
intramuscular (IM) injection.
6. The nurse is preparing to administer an oral medication to a patient who has
difficulty swallowing pills. Which action is most appropriate?
A. Crush the medication and mix it with applesauce.
B. Place the pill in the patient's mouth and encourage them to swallow with
water.
, C. Check with the pharmacist to see if a liquid form is available.
D. Dissolve the medication in a hot beverage.
Correct Answer: C
C. Check with the pharmacist to see if a liquid form is available.
Rationale:
Before crushing any medication, the nurse must verify that it is safe to
crush. Many medications are extended-release, sustained-release, or enteric-
coated and should not be crushed. Checking with the pharmacist for a liquid
alternative is the safest first step. A is incorrect because not all medications can
be safely crushed. B is incorrect because this may cause choking and does not
address the underlying difficulty. D is incorrect because hot liquids can alter the
medication's effectiveness or cause burns.
7. Which of the following is the correct technique for administering eye drops?
A. Instill the drops directly onto the center of the cornea.
B. Have the patient look up, pull down the lower lid, and instill the drops into the
conjunctival sac.
C. Touch the dropper tip to the eye to ensure proper placement.
D. Instill the drops into the inner canthus of the eye.
Correct Answer: B
B. Have the patient look up, pull down the lower lid, and instill the drops
into the conjunctival sac.
Rationale:
The correct technique involves pulling down the lower eyelid to create a
pouch (conjunctival sac) and instilling the drops there. This prevents injury to the
cornea and ensures proper absorption. A is incorrect because instilling directly
onto the cornea can cause injury and discomfort. C is incorrect because touching
the dropper tip to the eye can contaminate the medication bottle. D is incorrect
because this is not the correct location for absorption.
8. A nurse is preparing to administer ear drops to an adult patient. Which action
is correct?
A. Pull the pinna up and back.
B. Pull the pinna down and back.
Workman LaCharity drug classifications nursing
pharmacology clinical pharmacology study guide
nursing exam prep safe medication administration
Section 1: Principles of Safe Medication Administration (Questions 1-25)
1. The nurse is preparing to administer a medication to a patient. Which of the
following is the most critical step to ensure patient safety?
A. Checking the medication label three times.
B. Verifying the patient's identity using two identifiers.
C. Administering the medication within 30 minutes of the scheduled time.
D. Documenting the medication administration immediately after giving it.
Correct Answer: B
B. Verifying the patient's identity using two identifiers.
Rationale:
Verifying the patient's identity using two identifiers is the single most
critical step to prevent medication errors. While checking the label and timely
administration are important, verifying the right patient is the cornerstone of the
"Rights" of medication administration. Using two identifiers (e.g., name and date
of birth) is the standard of practice to prevent giving a medication to the wrong
patient. A is incorrect because while important, it is a process check, not the final
patient safety check. C is incorrect because timeliness is a goal, but patient
identity is the absolute priority. D is incorrect because documentation should
occur immediately after administration, but it does not prevent an error from
happening in the first place.
2. A nurse is reviewing a new medication order. The order reads: "Give 5 mg of
Drug X PO now." The pharmacy sends a bottle labeled "Drug X 10 mg/mL." How
many mL will the nurse administer?
A. 0.5 mL
B. 1 mL
,C. 2 mL
D. 5 mL
Correct Answer: A
A. 0.5 mL
Rationale:
Use the formula: Desired/Have × Volume = Amount to administer. Desired
= 5 mg, Have = 10 mg, Volume = 1 mL. (5 mg / 10 mg) × 1 mL = 0.5 mL. B, C, and D
are incorrect calculations.
3. Which of the following are considered the "Rights" of medication
administration? (Select all that apply.)
A. Right Patient
B. Right Drug
C. Right Dose
D. Right Route
E. Right Time
F. Right Diagnosis
Correct Answer: A, B, C, D, E
A, B, C, D, E.
Rationale:
The classic "Five Rights" are Right Patient, Right Drug, Right Dose, Right
Route, and Right Time. Many institutions have expanded these to include Right
Documentation, Right Reason, and Right to Refuse. F is incorrect. "Right
Diagnosis" is not a standard "Right." The "Right Reason" is the closest concept,
which refers to ensuring the medication is appropriate for the patient's condition.
4. The nurse is administering a medication via a nasogastric (NG) tube. Which
action is most appropriate?
A. Administer the medication with a large amount of water to flush the tube.
B. Crush all medications, including enteric-coated and sustained-release tablets,
into a fine powder.
C. Verify tube placement by injecting air and auscultating the epigastric area.
D. Mix all crushed medications together in water before administration.
,Correct Answer: A
A. Administer the medication with a large amount of water to flush the
tube.
Rationale:
Flushing the NG tube with water before, between, and after medication
administration is essential to prevent clogging and ensure the full dose is
delivered. B is incorrect because crushing enteric-coated or sustained-release
medications can cause rapid absorption, potential toxicity, or inactivation by
stomach acid. C is incorrect because auscultating for air is no longer considered a
reliable method for verifying NG tube placement. Checking pH of aspirated gastric
contents is the preferred method. D is incorrect because mixing medications
together can cause chemical interactions and make it impossible to identify which
medication caused a reaction. They should be administered separately.
5. A patient has an order for a medication to be given "subcutaneously." The
nurse knows this means the medication will be injected into which layer of
tissue?
A. The epidermis.
B. The dermis.
C. The subcutaneous fat layer.
D. The muscle.
Correct Answer: C
C. The subcutaneous fat layer.
Rationale:
Subcutaneous (SC or SubQ) injections are administered into the fatty
tissue layer just below the dermis. This route provides a slower, more sustained
absorption rate than IM or IV routes. A and B are incorrect as these are layers of
the skin itself, used for intradermal injections. D is incorrect. This describes an
intramuscular (IM) injection.
6. The nurse is preparing to administer an oral medication to a patient who has
difficulty swallowing pills. Which action is most appropriate?
A. Crush the medication and mix it with applesauce.
B. Place the pill in the patient's mouth and encourage them to swallow with
water.
, C. Check with the pharmacist to see if a liquid form is available.
D. Dissolve the medication in a hot beverage.
Correct Answer: C
C. Check with the pharmacist to see if a liquid form is available.
Rationale:
Before crushing any medication, the nurse must verify that it is safe to
crush. Many medications are extended-release, sustained-release, or enteric-
coated and should not be crushed. Checking with the pharmacist for a liquid
alternative is the safest first step. A is incorrect because not all medications can
be safely crushed. B is incorrect because this may cause choking and does not
address the underlying difficulty. D is incorrect because hot liquids can alter the
medication's effectiveness or cause burns.
7. Which of the following is the correct technique for administering eye drops?
A. Instill the drops directly onto the center of the cornea.
B. Have the patient look up, pull down the lower lid, and instill the drops into the
conjunctival sac.
C. Touch the dropper tip to the eye to ensure proper placement.
D. Instill the drops into the inner canthus of the eye.
Correct Answer: B
B. Have the patient look up, pull down the lower lid, and instill the drops
into the conjunctival sac.
Rationale:
The correct technique involves pulling down the lower eyelid to create a
pouch (conjunctival sac) and instilling the drops there. This prevents injury to the
cornea and ensures proper absorption. A is incorrect because instilling directly
onto the cornea can cause injury and discomfort. C is incorrect because touching
the dropper tip to the eye can contaminate the medication bottle. D is incorrect
because this is not the correct location for absorption.
8. A nurse is preparing to administer ear drops to an adult patient. Which action
is correct?
A. Pull the pinna up and back.
B. Pull the pinna down and back.
