1
NCLEX PN Exam Bank Administering Medications
via Enteral and Parenteral Routes
Table of Contents
Subtopic 1: Principles and Safety of Medication Administration via Enteral and Parenteral
Routes ......................................................................................................................... 2
Subtopic 2: Legal, Ethical, and Documentation Considerations in Medication
Administration ............................................................................................................ 10
Subtopic 3: Pharmacokinetics and Bioavailability of Enteral vs. Parenteral Medications ... 18
Subtopic 4: Safe Dosage Calculations and Conversion Between Enteral and Parenteral
Medications................................................................................................................ 26
Subtopic 5: Intramuscular (IM) Injections – Sites, Techniques, and Complications ........... 34
Subtopic 6: Blood and Blood Product Administration Safety and Nursing Responsibilities 42
Subtopic 7: Parenteral Medications – Pediatric and Geriatric Considerations .................. 50
Subtopic 8: Preventing and Managing Medication Complications in Enteral and Parenteral
Administration ............................................................................................................ 57
Subtopic 9: Intramuscular (IM) Injection Technique, Safety, and Site Considerations ....... 65
Subtopic 10: Emergency Medication Administration and High-Risk Situations (Q181–Q200)
.................................................................................................................................. 72
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Subtopic 1: Principles and Safety of Medication
Administration via Enteral and Parenteral Routes
(Questions 1–20)
1. A nurse is preparing to administer a crushed medication through a nasogastric (NG)
tube. Which of the following actions should the nurse take first?
A. Flush the tube with 30 mL of water
B. Verify the tube placement
C. Mix the medication with enteral feeding formula
D. Elevate the head of the bed to 15 degrees
Correct Answer: B. Verify the tube placement
Rationale: Verifying NG tube placement is essential to ensure the medication is delivered
to the stomach and not the lungs, preventing aspiration or pneumonia.
2. A nurse is administering an intramuscular injection into the ventrogluteal site. What is
the most appropriate angle for insertion?
A. 15 degrees
B. 30 degrees
C. 90 degrees
D. 45 degrees
Correct Answer: C. 90 degrees
Rationale: Intramuscular injections are administered at a 90-degree angle to reach the
muscle layer effectively for proper absorption.
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3. Before administering a medication via a percutaneous endoscopic gastrostomy (PEG)
tube, which step is most important?
A. Assess bowel sounds
B. Ask the client to cough
C. Check for residual volume
D. Rinse the medication cup
Correct Answer: C. Check for residual volume
Rationale: Checking residual volume ensures the stomach is empty enough to receive the
medication and prevents complications such as aspiration or delayed gastric emptying.
4. A nurse is administering insulin subcutaneously to a patient. What site would provide the
most consistent absorption?
A. Thigh
B. Buttock
C. Abdomen
D. Upper arm
Correct Answer: C. Abdomen
Rationale: The abdomen provides the most consistent and predictable absorption of
insulin due to better blood flow.
5. When administering an enteral medication, which of the following practices is
contraindicated?
A. Flushing the tube before and after medication
B. Administering medications one at a time
C. Mixing multiple medications in one syringe
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D. Using liquid forms of medications when possible
Correct Answer: C. Mixing multiple medications in one syringe
Rationale: Mixing medications can cause drug interactions or clog the tube. Medications
should be administered separately.
6. The nurse is preparing to administer heparin via subcutaneous injection. What is the
preferred site for administration?
A. Deltoid
B. Abdomen, at least 2 inches from the umbilicus
C. Ventrogluteal
D. Anterior thigh
Correct Answer: B. Abdomen, at least 2 inches from the umbilicus
Rationale: This site is preferred due to its consistent absorption and lower risk of bruising
or vascular injury.
7. A nurse is giving a medication through a jejunostomy tube. What special consideration is
necessary?
A. Use extended-release tablets
B. Administer medications in liquid form
C. Clamp the tube for 2 hours post-administration
D. Position patient in supine position
Correct Answer: B. Administer medications in liquid form
Rationale: Liquid medications are preferred in jejunal administration to prevent tube
obstruction and promote absorption.
NCLEX PN Exam Bank Administering Medications
via Enteral and Parenteral Routes
Table of Contents
Subtopic 1: Principles and Safety of Medication Administration via Enteral and Parenteral
Routes ......................................................................................................................... 2
Subtopic 2: Legal, Ethical, and Documentation Considerations in Medication
Administration ............................................................................................................ 10
Subtopic 3: Pharmacokinetics and Bioavailability of Enteral vs. Parenteral Medications ... 18
Subtopic 4: Safe Dosage Calculations and Conversion Between Enteral and Parenteral
Medications................................................................................................................ 26
Subtopic 5: Intramuscular (IM) Injections – Sites, Techniques, and Complications ........... 34
Subtopic 6: Blood and Blood Product Administration Safety and Nursing Responsibilities 42
Subtopic 7: Parenteral Medications – Pediatric and Geriatric Considerations .................. 50
Subtopic 8: Preventing and Managing Medication Complications in Enteral and Parenteral
Administration ............................................................................................................ 57
Subtopic 9: Intramuscular (IM) Injection Technique, Safety, and Site Considerations ....... 65
Subtopic 10: Emergency Medication Administration and High-Risk Situations (Q181–Q200)
.................................................................................................................................. 72
, 2
Subtopic 1: Principles and Safety of Medication
Administration via Enteral and Parenteral Routes
(Questions 1–20)
1. A nurse is preparing to administer a crushed medication through a nasogastric (NG)
tube. Which of the following actions should the nurse take first?
A. Flush the tube with 30 mL of water
B. Verify the tube placement
C. Mix the medication with enteral feeding formula
D. Elevate the head of the bed to 15 degrees
Correct Answer: B. Verify the tube placement
Rationale: Verifying NG tube placement is essential to ensure the medication is delivered
to the stomach and not the lungs, preventing aspiration or pneumonia.
2. A nurse is administering an intramuscular injection into the ventrogluteal site. What is
the most appropriate angle for insertion?
A. 15 degrees
B. 30 degrees
C. 90 degrees
D. 45 degrees
Correct Answer: C. 90 degrees
Rationale: Intramuscular injections are administered at a 90-degree angle to reach the
muscle layer effectively for proper absorption.
, 3
3. Before administering a medication via a percutaneous endoscopic gastrostomy (PEG)
tube, which step is most important?
A. Assess bowel sounds
B. Ask the client to cough
C. Check for residual volume
D. Rinse the medication cup
Correct Answer: C. Check for residual volume
Rationale: Checking residual volume ensures the stomach is empty enough to receive the
medication and prevents complications such as aspiration or delayed gastric emptying.
4. A nurse is administering insulin subcutaneously to a patient. What site would provide the
most consistent absorption?
A. Thigh
B. Buttock
C. Abdomen
D. Upper arm
Correct Answer: C. Abdomen
Rationale: The abdomen provides the most consistent and predictable absorption of
insulin due to better blood flow.
5. When administering an enteral medication, which of the following practices is
contraindicated?
A. Flushing the tube before and after medication
B. Administering medications one at a time
C. Mixing multiple medications in one syringe
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D. Using liquid forms of medications when possible
Correct Answer: C. Mixing multiple medications in one syringe
Rationale: Mixing medications can cause drug interactions or clog the tube. Medications
should be administered separately.
6. The nurse is preparing to administer heparin via subcutaneous injection. What is the
preferred site for administration?
A. Deltoid
B. Abdomen, at least 2 inches from the umbilicus
C. Ventrogluteal
D. Anterior thigh
Correct Answer: B. Abdomen, at least 2 inches from the umbilicus
Rationale: This site is preferred due to its consistent absorption and lower risk of bruising
or vascular injury.
7. A nurse is giving a medication through a jejunostomy tube. What special consideration is
necessary?
A. Use extended-release tablets
B. Administer medications in liquid form
C. Clamp the tube for 2 hours post-administration
D. Position patient in supine position
Correct Answer: B. Administer medications in liquid form
Rationale: Liquid medications are preferred in jejunal administration to prevent tube
obstruction and promote absorption.
