NSG 100 Final Exam Prep
1. The nurse is administering oral medications to the client. Which steps should be taken by
the nurse to safely administer oral medications? Prioritizethe nurse's action by placing each
step in the correct order
A. Document on the client's MAR administering the medication
B. Check the label after preparing the medication
C. Check the client's name band and another agency approved identifier
D. Review the medication prescribed on the medication administration record(MAR)
E. Check the label on the medication against the MAR
F. Give the medication to the client with a glass of water
G. Check the medication at the bedside: D, E, B, C, G, F, A
Key: Use visualization to focus on the information in the question and then visualizethe steps of
the procedure. A medication should be checked 3 times before it is administered to the client.
Review the medication prescribed on the MAR Check the label on the medication against the
MARCheck the label after preparing the medication
Check the client's name band and another agency approved identifierCheck the medication at
the bedside
Give the medication with a glass of water
Document on the client's MAR administering the medication
2. The nurse observes a nursing student prepare and administer medications to adult clients.
Which action by the nursing student warrants intervention bythe nurse?
A. Injects air into a vial before withdrawing 20 mg furosemide from a viallabeled 20 mg/mL
B. Selects a 1 mL syringe and 5/8 -inch needle for giving 0.5 mL of Heparinsubcutaneously
C. Instructs the client to place a medication to be taken buccal under theclient's tongue
D. Pours the prescribed "Robitussin 2 tsp now" to the 10-mL mark on amedication cup: C
Key: Look for a student nurse's incorrect action. Use the process of elimination toeliminate the
correct answers A, B, D
Buccal medications should be held in the cheek rather than under the tongue. Rateof
absorption may be affected.
,3. The nurse is to administer chlordiazepoxide HCL 25 mg intramuscularly (IM) to the
client.The medication package contains 100 mg of sterile, powderedchlordiazepoxide HCL that
must be reconstituted with 2 mL of diluent. After reconstitution, how many mL of medication
should the nurse withdraw into asyringe.
A. 0.5 mL
B. 1 mL
C. 2 mL
D. 2.5 mL: A
Key: Carefully read what the question is asking. Be sure that you choose the optionthat
corresponds Reconstitution: 100 mg = 2 ml; the desired dose is 25 mg
4. A client is being discharged from the hospital with a nebulizer for self- administration of
inhalation medication. Which statement made by the clientindicates to the nurse that the client
education has been successful?
A. "Inhaled medications should only be taken in the morning."
B. "Doses for inhaled medications are larger than those taken orally"
C. "Medicines taken by inhalation produce a very rapid response."
D. "Inhaled drugs are often rendered inactive by hepatic metabolism reac- tions": C.
medicines taken by inhalation produce a very rapid response" Rationale: Inhaled drugs produce
an immediate therapeutic response. Options 1,2,4are incorrect. Inhaled medications can be used
at any time during the day. Drugs for inhaled drugs are small compared to orally ingested
medications, and because
these drugs go directly to the lung surface area and are readily absorbed, very little of the
substance is lost due to metabolism
5. The nurse is teaching the client about newly prescribed medication. Which statement made
by the client would indicated the need for further medicationeducation?
A. "the liquid form of the drug will be absorbed faster than the tablets."
B. "If I take more, I'll have a better response"
C. "taking this drug with food will decrease how much gets into my system."
D. "I can consult my health care provider if I experience unexpected adverseeffects": B. "If I
take more, I'll have a better response.
Rationale: Although taking a larger dose of a medication usually results in a greater therapeutic
response, the response also depends on the drugs plasma concentra- tion and could reach a
toxic level. Answers 1, 3, and 4 are all true statements
6. The nurse is caring for several clients.Which client will the nurse anticipateis most likely to
experience an alteration in drug metabolism?
, A. A 3- day old premature infant
B. a 22- year old pregnant female
C. a 32- year old man with kidney stones
D. a 50 -year old executive with hypertension: A: A 3 day old premature infantRa-tionale:
Infants do not develop a mature microsomal enzyme system until they area year old and
therefore do not metabolize drugs very efficiently. Pregnancy does not significantly affect
drug metabolism, the concern with pregnancy is primarily focused on alterations in
distributions due to the fetal-placental barrier. The presenceof kidney stones would not influence
drug metabolism. Hypertension is not a factorthat directly results in abnormal metabolism
7. The client is receiving multiple medications, including one drug specifical- ly used to
stimulate gastric peristalsis. The nurse knows that this drug could have which influence on
additional oral medications?
A. Increased absorption
B. Reduced excretion
C. Decreased absorption
D. enhanced distribution: C. Decreased absorption
Rationale: Peristalsis is the wavelike muscular contraction that pushes food into thestomach
and helps to mix the stomach contents. An increase in this activity would decrease the time
that drugs would remain in the GI system and decrease absorp-tion. Excretion of the drugs
occur mostly in the kidneys, lungs, and glands. Peristalsiswould not reduce excretions. A delay
in peristalsis would prolong absorption time, and peristalsis is not involved in the distribution
of drugs to their target sites
8. The rehabilitation nurse wishes to make the following entry into a client'splan of care:
"Client will reestablish a pattern of daily bowel movements without straining within two
months." The nurse would write this statement under which section of the plan of care?
A. Nursing diagnosis/problem list
B. Nursing orders
C. Short-term goals
D. Long-term goals: D.
Rationale: Long-term goals describe changes in client behavior expected over a timeframe
greater than one week. They are usually designed to restore normal functioning in a problem
area and are helpful to other healthcare workers who carefor the client, often in a variety of
settings.
9. Which of the following items of subjective client data would be document-ed in the
medical record by the nurse?
A. Client's face is pale
1. The nurse is administering oral medications to the client. Which steps should be taken by
the nurse to safely administer oral medications? Prioritizethe nurse's action by placing each
step in the correct order
A. Document on the client's MAR administering the medication
B. Check the label after preparing the medication
C. Check the client's name band and another agency approved identifier
D. Review the medication prescribed on the medication administration record(MAR)
E. Check the label on the medication against the MAR
F. Give the medication to the client with a glass of water
G. Check the medication at the bedside: D, E, B, C, G, F, A
Key: Use visualization to focus on the information in the question and then visualizethe steps of
the procedure. A medication should be checked 3 times before it is administered to the client.
Review the medication prescribed on the MAR Check the label on the medication against the
MARCheck the label after preparing the medication
Check the client's name band and another agency approved identifierCheck the medication at
the bedside
Give the medication with a glass of water
Document on the client's MAR administering the medication
2. The nurse observes a nursing student prepare and administer medications to adult clients.
Which action by the nursing student warrants intervention bythe nurse?
A. Injects air into a vial before withdrawing 20 mg furosemide from a viallabeled 20 mg/mL
B. Selects a 1 mL syringe and 5/8 -inch needle for giving 0.5 mL of Heparinsubcutaneously
C. Instructs the client to place a medication to be taken buccal under theclient's tongue
D. Pours the prescribed "Robitussin 2 tsp now" to the 10-mL mark on amedication cup: C
Key: Look for a student nurse's incorrect action. Use the process of elimination toeliminate the
correct answers A, B, D
Buccal medications should be held in the cheek rather than under the tongue. Rateof
absorption may be affected.
,3. The nurse is to administer chlordiazepoxide HCL 25 mg intramuscularly (IM) to the
client.The medication package contains 100 mg of sterile, powderedchlordiazepoxide HCL that
must be reconstituted with 2 mL of diluent. After reconstitution, how many mL of medication
should the nurse withdraw into asyringe.
A. 0.5 mL
B. 1 mL
C. 2 mL
D. 2.5 mL: A
Key: Carefully read what the question is asking. Be sure that you choose the optionthat
corresponds Reconstitution: 100 mg = 2 ml; the desired dose is 25 mg
4. A client is being discharged from the hospital with a nebulizer for self- administration of
inhalation medication. Which statement made by the clientindicates to the nurse that the client
education has been successful?
A. "Inhaled medications should only be taken in the morning."
B. "Doses for inhaled medications are larger than those taken orally"
C. "Medicines taken by inhalation produce a very rapid response."
D. "Inhaled drugs are often rendered inactive by hepatic metabolism reac- tions": C.
medicines taken by inhalation produce a very rapid response" Rationale: Inhaled drugs produce
an immediate therapeutic response. Options 1,2,4are incorrect. Inhaled medications can be used
at any time during the day. Drugs for inhaled drugs are small compared to orally ingested
medications, and because
these drugs go directly to the lung surface area and are readily absorbed, very little of the
substance is lost due to metabolism
5. The nurse is teaching the client about newly prescribed medication. Which statement made
by the client would indicated the need for further medicationeducation?
A. "the liquid form of the drug will be absorbed faster than the tablets."
B. "If I take more, I'll have a better response"
C. "taking this drug with food will decrease how much gets into my system."
D. "I can consult my health care provider if I experience unexpected adverseeffects": B. "If I
take more, I'll have a better response.
Rationale: Although taking a larger dose of a medication usually results in a greater therapeutic
response, the response also depends on the drugs plasma concentra- tion and could reach a
toxic level. Answers 1, 3, and 4 are all true statements
6. The nurse is caring for several clients.Which client will the nurse anticipateis most likely to
experience an alteration in drug metabolism?
, A. A 3- day old premature infant
B. a 22- year old pregnant female
C. a 32- year old man with kidney stones
D. a 50 -year old executive with hypertension: A: A 3 day old premature infantRa-tionale:
Infants do not develop a mature microsomal enzyme system until they area year old and
therefore do not metabolize drugs very efficiently. Pregnancy does not significantly affect
drug metabolism, the concern with pregnancy is primarily focused on alterations in
distributions due to the fetal-placental barrier. The presenceof kidney stones would not influence
drug metabolism. Hypertension is not a factorthat directly results in abnormal metabolism
7. The client is receiving multiple medications, including one drug specifical- ly used to
stimulate gastric peristalsis. The nurse knows that this drug could have which influence on
additional oral medications?
A. Increased absorption
B. Reduced excretion
C. Decreased absorption
D. enhanced distribution: C. Decreased absorption
Rationale: Peristalsis is the wavelike muscular contraction that pushes food into thestomach
and helps to mix the stomach contents. An increase in this activity would decrease the time
that drugs would remain in the GI system and decrease absorp-tion. Excretion of the drugs
occur mostly in the kidneys, lungs, and glands. Peristalsiswould not reduce excretions. A delay
in peristalsis would prolong absorption time, and peristalsis is not involved in the distribution
of drugs to their target sites
8. The rehabilitation nurse wishes to make the following entry into a client'splan of care:
"Client will reestablish a pattern of daily bowel movements without straining within two
months." The nurse would write this statement under which section of the plan of care?
A. Nursing diagnosis/problem list
B. Nursing orders
C. Short-term goals
D. Long-term goals: D.
Rationale: Long-term goals describe changes in client behavior expected over a timeframe
greater than one week. They are usually designed to restore normal functioning in a problem
area and are helpful to other healthcare workers who carefor the client, often in a variety of
settings.
9. Which of the following items of subjective client data would be document-ed in the
medical record by the nurse?
A. Client's face is pale
