NCLEX-RN Pharmacology
Gastrointestinal System Practice
Questions
20 ATI & NGN-Style MCQs with Detailed
Rationales, Medication Safety, Clinical
Judgment & Exam Prep
Question 16
Clinical Scenario
A 68-year-old man is admitted with nausea and vomiting
following abdominal surgery. The provider prescribes
promethazine 25 mg intravenously every 6 hours as needed.
The nurse reviews the medication administration guidelines
before giving the first dose.
Question Stem
Which nursing action is most appropriate when administering
intravenous promethazine?
A. Administer the medication rapidly through a small hand vein.
, B. Dilute the medication appropriately, administer through a
patent large vein when possible, and closely monitor the IV site.
C. Mix the medication with total parenteral nutrition (TPN) to
reduce venous irritation.
D. Administer the medication subcutaneously if the patient
reports burning.
Correct Answer
Correct Answer: B. Dilute the medication appropriately,
administer through a patent large vein when possible, and
closely monitor the IV site.
Detailed Rationale
Promethazine is a phenothiazine antiemetic with antihistaminic
and antidopaminergic properties. Intravenous promethazine is
a vesicant capable of causing severe tissue injury, including
burning, thrombophlebitis, tissue necrosis, and, in rare cases,
limb amputation if extravasation occurs. When IV
administration is necessary, the medication should be
appropriately diluted, infused slowly through a well-functioning
large vein (or central venous access when available), and the IV
site should be monitored continuously for pain, swelling, or
erythema.
Option A is incorrect because rapid administration into a small
peripheral vein increases the risk of vascular injury.
Gastrointestinal System Practice
Questions
20 ATI & NGN-Style MCQs with Detailed
Rationales, Medication Safety, Clinical
Judgment & Exam Prep
Question 16
Clinical Scenario
A 68-year-old man is admitted with nausea and vomiting
following abdominal surgery. The provider prescribes
promethazine 25 mg intravenously every 6 hours as needed.
The nurse reviews the medication administration guidelines
before giving the first dose.
Question Stem
Which nursing action is most appropriate when administering
intravenous promethazine?
A. Administer the medication rapidly through a small hand vein.
, B. Dilute the medication appropriately, administer through a
patent large vein when possible, and closely monitor the IV site.
C. Mix the medication with total parenteral nutrition (TPN) to
reduce venous irritation.
D. Administer the medication subcutaneously if the patient
reports burning.
Correct Answer
Correct Answer: B. Dilute the medication appropriately,
administer through a patent large vein when possible, and
closely monitor the IV site.
Detailed Rationale
Promethazine is a phenothiazine antiemetic with antihistaminic
and antidopaminergic properties. Intravenous promethazine is
a vesicant capable of causing severe tissue injury, including
burning, thrombophlebitis, tissue necrosis, and, in rare cases,
limb amputation if extravasation occurs. When IV
administration is necessary, the medication should be
appropriately diluted, infused slowly through a well-functioning
large vein (or central venous access when available), and the IV
site should be monitored continuously for pain, swelling, or
erythema.
Option A is incorrect because rapid administration into a small
peripheral vein increases the risk of vascular injury.
