NURSING COMPETENCIES -
MEDICATION ADMINISTRATION
PRACTICAL EXAM QUESTIONS AND
ANSWERS
Steps of preparing medication of mixed insulins to be given in same syringe - Answer-1)
Rotates NPH insulin vial between hands to adequately mix solution
2) Prepares both vials by checking expiration date/date vial was opened and cleaning
with alcohol prep
3) Injects volume of air into NPH vial equal to ordered amount, while ensuring needle
does not contact the NPH Insulin
4) Injects volume of air into Regular Insulin vial equal to ordered amount
5) Withdraws correct dose of Regular insulin
6) Withdraws correct amount of NPH insulin
7) Ensures that the total dose is correct
8) Carefully recaps needle
9) Verifies medication and order according to institution's policy
Steps for preparing patient for injection - Answer-1) Properly identifies patient and
explains procedure
2) Washes hands and dons clean gloves
3) Positions patient comfortably and provides privacy
4) Identifies proper placement of injection ensuring site is free from bruises, redness, or
lesions
5) Preps injection site with alcohol swab pad
6) Checks syringe making sure volume of medication correct and no air bubbles present
Steps for administering parenteral injection - Intradermal (ID) - Answer-1) Inserts needle
bevel-up @ 10-15 degrees with dominant hand while using non-dominant hand to hold
skin taut
2) Slowly injects medication while observing for formation-"wheal"
3) Withdraws needle and pats site dry with gauze pad
4) Disposes syringe properly
Steps for administering parenteral injection - Subcutaneous (SC) (SQ) - Answer-1)
Chooses a correct site for subcutaneous injection
2) Holds syringe with dominant hand, pinches subcutaneous tissue(if needed) with non-
dominant hand
3) Quickly inserts needle at 45 to 90 degree angle, depending on thickness of
subcutaneous tissue at site (45 degree angle if 1 inch can be "pinched", 90 degree
angle if 2 inch can be "pinched")
4) Does not aspirate for blood return
, 5) Injects medication slowly
6) Withdraws needle quickly and disposes syringe
Steps for administering parenteral injection - Intramuscular (IM) - Answer-1) Correctly
landmarks site chosen by instructor
2) Holds syringe with dominant hand, spreads skin taut with non-dominant hand
3) Quickly inserts needle at 90 degree angle
4) Aspirates (5-10 sec) for blood return
5) If no blood return, injects medication slowly
6) Withdraws needle quickly and disposes syringe properly
7) Describes Z-track technique (upon instructor request)
Steps for completing procedure of medication administration - Answer-1) Assures
patient comfort
2) Disposes of used equipment properly
3) Removes gloves and washes hands
4) Documents the procedure.
How to check for "right medication" - Answer-Most hospitals have one kind or another of
Medication Administration Record ("MAR"). Compare the medication name on the
container to the medication name on the MAR.
How to check for "right dose" - Answer-For "right medication and right dose", do the
"Three Checks" (comparing the label on the medication package against the order three
times):
1) When first taking the medicine container off the shelf (if not unit dose) or from the
patient's medication drawer
2) Just before opening the unit dose package (or getting the dose out of the container, if
not unit dose)
3) Just before giving the unit dose to the patient (or just before placing the container
back on the shelf, if not unit dose)
It is common practice to have a second nurse "double check you" on rapid-acting
powerful medications; particularly insulin and heparin.
Steps for identifying the right patient - Answer-Always use TWO methods to identify
patients.
Check wristband for
1). Patient's name
2). Another method, for example date of birth or medical record number and compare to
the information on the Medicine Administration record.
Characteristics of subcutaneous (SC) (SQ) injection (gauge, length, what it is, injection
sites, technique to administer, angle) - Answer--Use a 25 gauge or smaller needle that
is 3/8 to 5/8 inches long.
MEDICATION ADMINISTRATION
PRACTICAL EXAM QUESTIONS AND
ANSWERS
Steps of preparing medication of mixed insulins to be given in same syringe - Answer-1)
Rotates NPH insulin vial between hands to adequately mix solution
2) Prepares both vials by checking expiration date/date vial was opened and cleaning
with alcohol prep
3) Injects volume of air into NPH vial equal to ordered amount, while ensuring needle
does not contact the NPH Insulin
4) Injects volume of air into Regular Insulin vial equal to ordered amount
5) Withdraws correct dose of Regular insulin
6) Withdraws correct amount of NPH insulin
7) Ensures that the total dose is correct
8) Carefully recaps needle
9) Verifies medication and order according to institution's policy
Steps for preparing patient for injection - Answer-1) Properly identifies patient and
explains procedure
2) Washes hands and dons clean gloves
3) Positions patient comfortably and provides privacy
4) Identifies proper placement of injection ensuring site is free from bruises, redness, or
lesions
5) Preps injection site with alcohol swab pad
6) Checks syringe making sure volume of medication correct and no air bubbles present
Steps for administering parenteral injection - Intradermal (ID) - Answer-1) Inserts needle
bevel-up @ 10-15 degrees with dominant hand while using non-dominant hand to hold
skin taut
2) Slowly injects medication while observing for formation-"wheal"
3) Withdraws needle and pats site dry with gauze pad
4) Disposes syringe properly
Steps for administering parenteral injection - Subcutaneous (SC) (SQ) - Answer-1)
Chooses a correct site for subcutaneous injection
2) Holds syringe with dominant hand, pinches subcutaneous tissue(if needed) with non-
dominant hand
3) Quickly inserts needle at 45 to 90 degree angle, depending on thickness of
subcutaneous tissue at site (45 degree angle if 1 inch can be "pinched", 90 degree
angle if 2 inch can be "pinched")
4) Does not aspirate for blood return
, 5) Injects medication slowly
6) Withdraws needle quickly and disposes syringe
Steps for administering parenteral injection - Intramuscular (IM) - Answer-1) Correctly
landmarks site chosen by instructor
2) Holds syringe with dominant hand, spreads skin taut with non-dominant hand
3) Quickly inserts needle at 90 degree angle
4) Aspirates (5-10 sec) for blood return
5) If no blood return, injects medication slowly
6) Withdraws needle quickly and disposes syringe properly
7) Describes Z-track technique (upon instructor request)
Steps for completing procedure of medication administration - Answer-1) Assures
patient comfort
2) Disposes of used equipment properly
3) Removes gloves and washes hands
4) Documents the procedure.
How to check for "right medication" - Answer-Most hospitals have one kind or another of
Medication Administration Record ("MAR"). Compare the medication name on the
container to the medication name on the MAR.
How to check for "right dose" - Answer-For "right medication and right dose", do the
"Three Checks" (comparing the label on the medication package against the order three
times):
1) When first taking the medicine container off the shelf (if not unit dose) or from the
patient's medication drawer
2) Just before opening the unit dose package (or getting the dose out of the container, if
not unit dose)
3) Just before giving the unit dose to the patient (or just before placing the container
back on the shelf, if not unit dose)
It is common practice to have a second nurse "double check you" on rapid-acting
powerful medications; particularly insulin and heparin.
Steps for identifying the right patient - Answer-Always use TWO methods to identify
patients.
Check wristband for
1). Patient's name
2). Another method, for example date of birth or medical record number and compare to
the information on the Medicine Administration record.
Characteristics of subcutaneous (SC) (SQ) injection (gauge, length, what it is, injection
sites, technique to administer, angle) - Answer--Use a 25 gauge or smaller needle that
is 3/8 to 5/8 inches long.
