Med admin Exam UPDATED QUESTIONS
AND CORRECT ANSWERS
A client with terminal cancer is prescribed fentanyl patches for pain management while
receiving hospice care at home. Which instructions related to this medication should the
nurse provide? Select all that apply
1. Apply a heating pad over the patch to aid drug absorption
2. Cut the patch in half before application if less medication is needed
3. Fold the used patch in half so that the edges adhere and immediately discard
4. Place the patch 1 inch from the source of pain for maximal effectiveness
5. Remove the old patch when applying a new patch every 72 hours - CORRECT
ANSWER 3, 5
When given via transdermal patch, fentanyl is absorbed systemically through the skin to
provide continuous analgesia. Patches are replaced EVERY 72 HOURS, and the used patch
must be removed before applying a new one
Used patches must be folded and discarded immediately, as some medication remains in a
used patch. Opioid medications must be stored and disposed of securely (flushed down the
toilet, discarded in a sharps container) as accidental exposure is potentially fatal for children,
pets, and caregivers
Option 1:
Heat (heating pad) should not be placed over a patch as this accelerates absorption
Option 4:
Transdermal patches should be applied to an area of flat, intact skin (upper back, chest) to
prevent accidental removal. The site should be clean, with little hair. Unlike transdermal
patches, topical analgesic patches (lidocaine, capsicum) deliver drug locally and are placed
near the site of pain
, The nurse plans to administer 0900 medications via the NG route to a client with an NG tube.
The nurse contacts the primary HCP to clarify which prescriptions that are contraindicated
using this route? Select all that apply
1. Enteric-coated ibuprofen
2. Extra-strength acetaminophen
3. Metoprolol extended-release
4. Sulfamethoxazole double-strength
5. Tamsulosin slow-release capsule - CORRECT ANSWER 1, 3, 5
Enteric-coated drugs have a barrier coating that dissolves at a slower rate (usually in the
small intestine) to protect the stomach from irritant effects. Crushing enteric-coated
medications disrupts the barrier coating and may cause stomach irritation. In addition, the
particles from the coating may clog the NG tube
Slow, extended, or sustained release drug formulations are designed to dissolve very slowly
within a specific time frame. Crushing these medications alter this property and introduces
the risk of adverse effects from toxic blood levels due to more rapid drug absorption
The nurse is preparing to administer an IM immunization to a 6 month old infant. Which
needle length and injection site would be the most appropriate to minimize a local reaction to
the vaccine components?
1. 3/8 inch (9 mm) needle in the anterolateral thigh
2. 5/8 inch (16 mm) needle in the ventrogluteal muscle
3. 1 inch (25 mm) needle in the anterolateral thigh
4. 1 1/2 inch (38 mm) needle in the ventrogluteal muscle - CORRECT ANSWER 3
The vastus lateralis muscle in the anterolateral middle portion of the thigh is the preferred IM
injection site for newborns (age <1 month) and infants (age 1-12 months)
AND CORRECT ANSWERS
A client with terminal cancer is prescribed fentanyl patches for pain management while
receiving hospice care at home. Which instructions related to this medication should the
nurse provide? Select all that apply
1. Apply a heating pad over the patch to aid drug absorption
2. Cut the patch in half before application if less medication is needed
3. Fold the used patch in half so that the edges adhere and immediately discard
4. Place the patch 1 inch from the source of pain for maximal effectiveness
5. Remove the old patch when applying a new patch every 72 hours - CORRECT
ANSWER 3, 5
When given via transdermal patch, fentanyl is absorbed systemically through the skin to
provide continuous analgesia. Patches are replaced EVERY 72 HOURS, and the used patch
must be removed before applying a new one
Used patches must be folded and discarded immediately, as some medication remains in a
used patch. Opioid medications must be stored and disposed of securely (flushed down the
toilet, discarded in a sharps container) as accidental exposure is potentially fatal for children,
pets, and caregivers
Option 1:
Heat (heating pad) should not be placed over a patch as this accelerates absorption
Option 4:
Transdermal patches should be applied to an area of flat, intact skin (upper back, chest) to
prevent accidental removal. The site should be clean, with little hair. Unlike transdermal
patches, topical analgesic patches (lidocaine, capsicum) deliver drug locally and are placed
near the site of pain
, The nurse plans to administer 0900 medications via the NG route to a client with an NG tube.
The nurse contacts the primary HCP to clarify which prescriptions that are contraindicated
using this route? Select all that apply
1. Enteric-coated ibuprofen
2. Extra-strength acetaminophen
3. Metoprolol extended-release
4. Sulfamethoxazole double-strength
5. Tamsulosin slow-release capsule - CORRECT ANSWER 1, 3, 5
Enteric-coated drugs have a barrier coating that dissolves at a slower rate (usually in the
small intestine) to protect the stomach from irritant effects. Crushing enteric-coated
medications disrupts the barrier coating and may cause stomach irritation. In addition, the
particles from the coating may clog the NG tube
Slow, extended, or sustained release drug formulations are designed to dissolve very slowly
within a specific time frame. Crushing these medications alter this property and introduces
the risk of adverse effects from toxic blood levels due to more rapid drug absorption
The nurse is preparing to administer an IM immunization to a 6 month old infant. Which
needle length and injection site would be the most appropriate to minimize a local reaction to
the vaccine components?
1. 3/8 inch (9 mm) needle in the anterolateral thigh
2. 5/8 inch (16 mm) needle in the ventrogluteal muscle
3. 1 inch (25 mm) needle in the anterolateral thigh
4. 1 1/2 inch (38 mm) needle in the ventrogluteal muscle - CORRECT ANSWER 3
The vastus lateralis muscle in the anterolateral middle portion of the thigh is the preferred IM
injection site for newborns (age <1 month) and infants (age 1-12 months)
