HESI PN MED SURG EXAM FOR 2023 -Administering Oral, Topical, And Mucosal Medications

Administering Oral, Topical, And Mucosal Medications The nurse is reviewing a medication order for a patient. The health-care provider prescribed the medication to be given by mouth (PO). In which manner will the nurse give the medication to the patient if it arrives in tablet form? 1. Give the patient a fluid to help swallow the medication. 2. Place the medication carefully between the patient's cheek and gum. 3. Dissolve the medication in a glass of water and have the patient drink the fluid. 4. Check to see if the medication is securely under the patient's tongue. - 1 Rationales Option 1: When medications are ordered PO, which means "by mouth" (per os in Latin). The nurse can confirm the order with the health-care provider to make sure that sublingual or buccal routes were not intended. Option 2: Oral medications can be placed between the patient's cheek and gum to be absorbed by the oral membranes. The health-care provider would need to order the medication to be administered buccal. Option 3: There is not enough information in the question to determine if the medication can be dissolved or not. In addition, dissolving the medication in a glass of water is risky because the patient may not be able to drink the entire amount. Option 4: Oral medications can be placed under the patient's tongue to be absorbed by the oral membranes. The health-care provider would have ordered the medication to be administered sublingual. The nurse is providing care for a patient who is unconscious and receiving enteral feeding. The nurse is reviewing the classifications and characteristics of medications ordered for the patient. Which type of drug does the nurse identify as being safe to crush for administration? 1. An antihypertensive drug in tablet form 2. An enteric-coated anti-inflammatory pill 3. A sustained-release anti-allergy capsule 4. A liquid-filled vitamin gel capsule - 1 Rationales Option 1: Drugs that are not enteric coated or sustained release can be crushed and administered through an enteric feeding tube. Option 2: Anti-inflammatory drugs are enteric coated because they cause gastric irritation. These medications should not be crushed. Option 3: Sustained released medications are frequently dispensed in capsule form. Opening the capsule and crushing the medication can result in a rapid absorption of the medications. Option 4: Liquid-filled gel capsules are not crushed or emptied. The gel is used to protect the medication inside from certain digestion processes. Vitamins need to be absorbed from the duodenum or small intestine. The nurse works in a clinic and is preparing to instill ear drops for a variety of diagnoses. For which patient should the nurse hold the prescribed medication? 1. The patient with an ear infection who has purulent drainage. 2. The patient who has an insect trapped in the ear canal. 3. The patient who has an accumulation of sticky wax in the ear canal. 4. The patient who has hardened wax wedged in the ear canal. - 1 Rationales Option 1: The patient with an ear infection who has purulent drainage is likely to have a ruptured ear drum. Medication should not be administered if the ear drum is not intact. Option 2: The nurse can put ear drops into the ear canal of a patient who has a foreign object in the ear, such as a bug. The type of ear drop used may serve to "smother" the bug and prevent movement. Option 3: When a patient has an accumulation of sticky wax in the ear canal, ear drops may be instilled that will aid in cleaning the ear. Option 4: When a patient has hardened wax wedged in the ear canal, drops can be instilled that will soften the substance and aid in cleaning the ear. The nurse is interviewing a patient who reports prolonged use of nasal spray for nasal congestion. Which patient teaching does the nurse provide? 1. Frequent use of a decongestant spray can cause nasal cavity cancer. 2. Prolonged use of a decongestant spray can cause nosebleeds. 3. Recommended time for use of a decongestant spray is two weeks. 4. Side effects of a decongestant spray will eventually resolve with use. - 2 Rationales Option 1: There is no specific information provided that indicates that frequent use of a decongestant spray can cause nasal cavity cancer. Option 2: Prolonged use of a decongestant spray will result in shrinking and scarring of the nasal passage, causing lesions and nosebleeds. Option 3: The recommended time for the use of a decongestant spray is three days, not two weeks. Option 4: The side effects of a decongestant spray (rebound congestion) will not resolve with continued use. The nurse is reinforcing teaching to a patient who is newly diagnosed with chronic respiratory disease about how to use a metered-dose inhaler. Which information should the nurse reinforce? 1. Hold the inhaler 1 to 2 in. in front of an open mouth. 2. Hold the inhaled medication in the lungs for 15 to 30 sec. 3. Place the inhaler in a cold location between medication administrations. 4. Firmly purse the lips around the inhaler mouthpiece for a good seal. - 1 Rationales Option 1: The patient should hold the mouthpiece of the inhaler 1 to 2 in. in front of the open mouth. When the inhaler is depressed, the patient should deeply inhale the dispensed medication. Option 2: The inhaled medication only needs to be held for 10 sec and then the patient should exhale slowly through pursed lips. Option 3: The inhaler does not need to be in a cold location between uses. However, the inhaler should not be left in a hot location, such as a closed car, to prevent the canister from exploding. Option 4: The recommended method of using a metered-dose inhaler no longer requires the mouthpiece be placed in the patient's mouth. The new method prevents droplets of medication from landing on the tongue and increasing the severity of the side effects.