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Chapter 06: Principles of Medication Administration and Medication Safety
MULTIPLE CHOICE
1. Where would the procedures and treatments directed by the health care provider be
found? a. Summary sheet
b. Physician’s order form
c. Physician’s progress notes
d. History and physical examination form
ANS: B
The physician’s order form contains all procedures and treatments ordered by the health care
provider. A summary sheet provides a brief overview of the hospital course at discharge.
Physician’s progress notes provide regular observations on the patient’s course of treatment
and response. A history and physical examination form provides information about baseline
information from the patient.
DIF: Cognitive Level: Knowledge REF: Page 61 OBJ: 2
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment NOT:
CONCEPT(S): Clinical Judgment
2. Which action will the nurse take when it is determined that the narcotic count is incorrect
while obtaining a medication from the narcotic area?
a. Determine the cause of the discrepancy at the end of the shift.
b. Notify the health care provider stat.
c. Call the nurse from the previous shift to determine if there was a discrepancy earlier.
d. Report the discrepancy to the charge nurse immediately.
ANS: D
Reporting the discrepancy to the charge nurse immediately enables the supervisory staff to
narrow the time frame during which a medication was taken and not documented. The
discrepancy needs to be addressed immediately, and therefore determining the cause of the
discrepancy at the end of the shift is not the most appropriate action for the nurse to take. It
is not appropriate to contact the health care provider for an incorrect narcotic count. The
count would have been verified at shift change; calling the nurse from the previous shift is
not an appropriate action for the nurse to take.
DIF: Cognitive Level: Analysis REF: Page 70 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment NOT:
CONCEPT(S): Clinical Judgment; Safety
3. Which action will the nurse take if a dosage is unclear on a health care provider’s order?
a. Ask the patient what dosage was given in the past.
b. Ask another physician to determine the correct dosage.
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c. Tell the patient that the medication will not be given.
d. Contact the health care provider to verify the correct dosage.
ANS: D
Any questionable orders should be verified by the health care provider who wrote the orders.
The patient is not a reliable source of verification. The physician who wrote the order should
verify it. It would be a medication error to withhold the dose instead of verifying it.
DIF: Cognitive Level: Application REF: Page 76 | Page 77
OBJ: 5 TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity NOT:
CONCEPT(S): Clinical Judgment; Safety
4. What is the most reliable method to calculate a pediatric patient’s medication dosage?
a. Age
b. Height
c. Body surface area (BSA)
d. Placement on a growth scale
ANS: C
The most reliable method is by proportional amount of BSA or body weight. Because of the
differences in weight among children, age is not a reliable method. Because of the
differences in height among children, this is not a reliable method. Placement on a growth
scale identifies how the child corresponds to other children on a percentile. Although it is
determined by a specific measurement, the percentile identified would not be a specific
measurement; therefore, this is not a reliable method.
DIF: Cognitive Level: ComprehensionREF: Page 77 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Development
5. Which medication route provides the most rapid onset of a medication but also poses the
greatest risk of adverse effects?
a. Intradermal
b. Subcutaneous (subcut)
c. Intramuscular (IM)
d. Intravenous (IV)
ANS: D
IV medications are delivered directly into the bloodstream and avoid the “first pass” effect of
the liver. Intradermal, subcut, and IM administration have a slower absorption rate.
DIF: Cognitive Level: Knowledge REF: Page 78 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity NOT:
CONCEPT(S): Clinical Judgment; Safety
6. Which is known as the “fifth vital sign”?
a. Temperature
b. Respirations
c. Pain
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Chapter 06: Principles of Medication Administration and Medication Safety
MULTIPLE CHOICE
1. Where would the procedures and treatments directed by the health care provider be
found? a. Summary sheet
b. Physician’s order form
c. Physician’s progress notes
d. History and physical examination form
ANS: B
The physician’s order form contains all procedures and treatments ordered by the health care
provider. A summary sheet provides a brief overview of the hospital course at discharge.
Physician’s progress notes provide regular observations on the patient’s course of treatment
and response. A history and physical examination form provides information about baseline
information from the patient.
DIF: Cognitive Level: Knowledge REF: Page 61 OBJ: 2
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment NOT:
CONCEPT(S): Clinical Judgment
2. Which action will the nurse take when it is determined that the narcotic count is incorrect
while obtaining a medication from the narcotic area?
a. Determine the cause of the discrepancy at the end of the shift.
b. Notify the health care provider stat.
c. Call the nurse from the previous shift to determine if there was a discrepancy earlier.
d. Report the discrepancy to the charge nurse immediately.
ANS: D
Reporting the discrepancy to the charge nurse immediately enables the supervisory staff to
narrow the time frame during which a medication was taken and not documented. The
discrepancy needs to be addressed immediately, and therefore determining the cause of the
discrepancy at the end of the shift is not the most appropriate action for the nurse to take. It
is not appropriate to contact the health care provider for an incorrect narcotic count. The
count would have been verified at shift change; calling the nurse from the previous shift is
not an appropriate action for the nurse to take.
DIF: Cognitive Level: Analysis REF: Page 70 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment NOT:
CONCEPT(S): Clinical Judgment; Safety
3. Which action will the nurse take if a dosage is unclear on a health care provider’s order?
a. Ask the patient what dosage was given in the past.
b. Ask another physician to determine the correct dosage.
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c. Tell the patient that the medication will not be given.
d. Contact the health care provider to verify the correct dosage.
ANS: D
Any questionable orders should be verified by the health care provider who wrote the orders.
The patient is not a reliable source of verification. The physician who wrote the order should
verify it. It would be a medication error to withhold the dose instead of verifying it.
DIF: Cognitive Level: Application REF: Page 76 | Page 77
OBJ: 5 TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity NOT:
CONCEPT(S): Clinical Judgment; Safety
4. What is the most reliable method to calculate a pediatric patient’s medication dosage?
a. Age
b. Height
c. Body surface area (BSA)
d. Placement on a growth scale
ANS: C
The most reliable method is by proportional amount of BSA or body weight. Because of the
differences in weight among children, age is not a reliable method. Because of the
differences in height among children, this is not a reliable method. Placement on a growth
scale identifies how the child corresponds to other children on a percentile. Although it is
determined by a specific measurement, the percentile identified would not be a specific
measurement; therefore, this is not a reliable method.
DIF: Cognitive Level: ComprehensionREF: Page 77 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Development
5. Which medication route provides the most rapid onset of a medication but also poses the
greatest risk of adverse effects?
a. Intradermal
b. Subcutaneous (subcut)
c. Intramuscular (IM)
d. Intravenous (IV)
ANS: D
IV medications are delivered directly into the bloodstream and avoid the “first pass” effect of
the liver. Intradermal, subcut, and IM administration have a slower absorption rate.
DIF: Cognitive Level: Knowledge REF: Page 78 OBJ: 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity NOT:
CONCEPT(S): Clinical Judgment; Safety
6. Which is known as the “fifth vital sign”?
a. Temperature
b. Respirations
c. Pain
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