N212-Safe Medication Administration and
Dosage Test questions With 100% Verified Solutions
A client admitted with unstable angina is started on intravenous heparin and
nitroglycerin. The client's chest pain resolves, and the client is weaned from the
nitroglycerin. Noting that the client had a synthetic valve replacement for aortic stenosis
2 years ago, a physician writes an order to restart the oral warfarin (Coumadin®) 5 mg
at 1900 hours. Which is the nurse's best action?
a. Administer the warfarin as prescribed.
b. Call the physician to question the warfarin order.
c. Discontinue the heparin drip and then administer the warfarin.
d. Hold the dose of warfarin until the heparin has been discontinued. - ANSWERS
ANSWER: A
Both heparin and warfarin are anticoagulants, but their actions are different. Oral
warfarin requires 3 to 5 days to reach effective levels. It is usually begun while the client
is still on heparin. Calling the physician is unnecessary. The nurse's scope of practice
does not permit altering medication orders. The nurse should neither discontinue the
heparin nor hold the warfarin without a written order.
➧ Test-taking Tip: Use the process of elimination to eliminate options 3 and 4, which
alter medication orders, because these are not within the nurse's scope of practice. Of
the two remaining options, focus on the action of heparin and warfarin. Recall that
warfarin takes 3 to 5 days to reach therapeutic effectiveness, during which time the
client will continue to require anticoagulation.
A nurse administers a usual morning dose of 4 units of regular insulin and 8 units of
NPH insulin at 0730 to a client with a blood glucose level of 110 mg/dL. Which
statements regarding the client's insulin are correct?
a. The onset of the regular insulin will be at 0745 and the peak at 1300.
b. The onset of the regular insulin will be at 0800 and the peak at 1000.
c. The onset of the NPH insulin will be at 0800 and the peak at 1000.
d. The onset of the NPH insulin will be at 1230 and the peak at 2330. - ANSWERS
ANSWER: B
The onset of regular insulin (short-acting) is one-half to 1 hour, and the peak is 2 to 4
hours. The onset of NPH insulin (intermediate acting) is 1 to 2 hours, and the peak is 6
to 10 hours. All other options have incorrect medication onset and peak times.
,➧ Test-taking Tip: Apply knowledge of insulin onset and peak times.
Which instructions should the nurse provide to a client regarding diabetes management
during stress or illness? SELECT ALL THAT APPLY.
a. Notify the health-care provider if unable to keep fluids or foods down.
b. Test finger stick glucose levels and urine ketones daily and keep a record.
c. Continue to take oral hyperglycemic medication and/or insulin as prescribed.
d. Supplement food intake with carbohydrate containing fluids, such as juices or soups.
e. When on an oral agent, administer insulin in addition to the oral agent during the
illness.
f. A minor illness, such as the flu, usually does not affect the blood glucose and insulin
needs. - ANSWERS ANSWER: A, C
An acute or minor illness can evoke a counterregulatory hormone response resulting in
hyperglycemia, thus the client should continue medications as prescribed. If the client is
unable to eat due to nausea and vomiting, dehydration can occur from hyperglycemia
and the lack of fluid intake. Blood glucose should be checked every 4 hours when ill and
the ketones tested every 3 to 4 hours if the glucose is greater than 240 mg/dL. The
client should supplement the diet with carbohydrate-containing fluids only if eating less
than normal due to the illness. Insulin may or may not be necessary; it is based on the
client's blood glucose level.
➧ Test-taking Tip: Focus on the counterregulatory hormone response during an illness
that causes hyperglycemia.
A health-care provider (HCP) adds a second medication for blood pressure control for a
client whose blood pressure has not been well-controlled with one antihypertensive
medication. If the HCP orders the following medication combinations, which
combination should the nurse question?
a. Atenolol (Tenormin®) and metoprolol (Lopressor®)
b. Metolazone (Zaroxolyn®) and valsartan (Diovan®)
c. Captopril (Capoten®) and furosemide (Lasix®)
d. Bumetanide (BUmex®) and diltiazem (Cardizem®) - ANSWERS ANSWER: A
When two medications are used to treat hypertension, each medication should be from
different drug classifications. Atenolol and metroprolol are both beta-adrenergic blockers
and would essentially have the same mechanism of action. Metolazone is a thiazide-like
diuretic, and valsartan is an angiotensin II receptor blocker (ARB). Captopril is an
angiotensinconverting enzyme (ACE) inhibitor, and furosemide is a loop diuretic.
Bumetanide is a loop diuretic, and diltiazem is a calcium channel blocker.
,➧ Test-taking Tip: Recall that beta blockers end in "lol." Use this as a cue to identify the
two medications that are within the same drug classification and would be
inappropriately prescribed.
A nurse is assessing a client who is taking atorvastatin (Lipitor®). For which
manifestations should the nurse specifically assess?
a. Constipation and hemorrhoids
b. Muscle pain and weakness
c. Fatigue and dysrhythmias
d. Flushing and postural hypotension - ANSWERS ANSWER: B
Atorvastatin is a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor
(statin) used to lower lipid levels. Statins can cause muscle tissue injury manifested by
muscle ache or weakness. Muscle injury can progress to myositis (muscle
inflammation) or rhabdomyolysis (muscle disintegration). Additional SE of statins is
confusion and decreased UO. Bile acid sequestrants may cause constipation and
hemorrhoids because they are not absorbed from the small intestine. Diarrhea, not
constipation, is a side effect of statin medications. Side effects of niacin, a lipid-lowering
agent, include flushing, dysrhythmias, and postural hypotension.
➧ Test-taking Tip:The key words are "specifically assess." The nurse should be
monitoring for side effects. Select the option that includes the side effect for the
HMGCoA reductase inhibitors (statins).
A nurse is caring for a group of clients all in need of pain medication. The nurse has
determined the most appropriate pain medication for each client based on the client's
level of pain. Prioritize the order in which the nurse should plan to administer the pain
medication beginning with the analgesic for the client with the most severe pain. a.
___ Ketorolac (Toradol) 10 mg oral
b. ___Fentanyl (Sublimaze®) intravenously per patient-controlled analgesia with a bolus
dose
c. ___Hydromorphone (Dilaudid®) 5mg oral
d. ___Morphine sulfate 4 mg IV - ANSWERS a. _4__ Ketorolac (Toradol) 10 mg oral
b. _1__Fentanyl (Sublimaze®) intravenously per patient-controlled analgesia with a
bolus dose
c. _3__Hydromorphone (Dilaudid®) 5mg oral
d. _2__Morphine sulfate 4 mg IV
The most potent of the medications is fentanyl (Sublimaze®), an opioid narcotic
analgesic that binds to opiate receptors in the central nervous system (CNS), altering
the response to and perception of pain. A dose of 0.1 to 0.2 mg is equivalent to 10 mg
of morphine sulfate. Morphine sulfate is also an opioid analgesic. Hydromorphone,
, another opioid analgesic, would be third in priority. The oral dosing of this medication
would indicate that the client's pain is less severe than the client receiving fentanyl or
morphine sulfate. Hydromorphone 7.5 mg oral is an equianalgesic dose to 30 mg of oral
morphine or 10 mg parenteral morphine. Ketorolac is a NSAID and nonopioid analgesic
that inhibits prostaglandin synthesis, producing peripherally mediated analgesia.
Propoxyphene is last in priority. It also binds to opiate receptors in the CNS but is used
in treating mild to moderate pain. It has analgesic effects similar to acetaminophen.
➧ Test-taking Tip: Focus on ordering the medications starting with the most potent
opioid analgesics and ending with the nonopioid analgesic.
A nurse applies a fentanyl (Sublimaze®) transdermal patch to a client for the first time.
Shortly after application, the client is experiencing pain. Which nursing action is most
appropriate?
a. Remove the transdermal patch and apply a new one.
b. Administer a short-acting opioid analgesic.
c. Rub the transdermal patch to enhance absorption of the medication.
d. Call the physician to request a fentanyl transdermal patch with a higher dosage. -
ANSWERS ANSWER: B
When the first fentanyl transdermal patch is applied, effective analgesia may take 12 to
24 (6) hours to develop because absorption is slow. Removing the patch is
unnecessary. Transdermal patches should not be rubbed to enhance absorption
because it can cause the delivery of the medication to fluctuate. It is premature to
request a higher dose of fentanyl.
➧ Test-taking Tip: Focus on that fact that absorption from a fentanyl transdermal patch
is slow.
A nurse is to administer vancomycin to a client diagnosed with sepsis. The client is to
have a peak and trough level completed on this dose of the medication. Which action
should the nurse initiate first?
a. Determine if the trough level has been drawn on the client.
b. Determine medication compatibilities before infusing into an existing intravenous line.
c. Check the client's culture and sensitivity report.
d. Check the amount of time over which the medication dose should infuse. -
ANSWERS ANSWER: A
The trough level is the lowest concentration so it needs to be collected just before the
next administration. The peak level is the highest concentration - draw this 1-2hrs after
completion of IV vanco. Determining medication compatibilities and checking C&S
reports and the infusion duration are important actions before administering
vancomycin. However, these actions can be done while the laboratory is obtaining the
trough level or after knowing that the level has been drawn.
Dosage Test questions With 100% Verified Solutions
A client admitted with unstable angina is started on intravenous heparin and
nitroglycerin. The client's chest pain resolves, and the client is weaned from the
nitroglycerin. Noting that the client had a synthetic valve replacement for aortic stenosis
2 years ago, a physician writes an order to restart the oral warfarin (Coumadin®) 5 mg
at 1900 hours. Which is the nurse's best action?
a. Administer the warfarin as prescribed.
b. Call the physician to question the warfarin order.
c. Discontinue the heparin drip and then administer the warfarin.
d. Hold the dose of warfarin until the heparin has been discontinued. - ANSWERS
ANSWER: A
Both heparin and warfarin are anticoagulants, but their actions are different. Oral
warfarin requires 3 to 5 days to reach effective levels. It is usually begun while the client
is still on heparin. Calling the physician is unnecessary. The nurse's scope of practice
does not permit altering medication orders. The nurse should neither discontinue the
heparin nor hold the warfarin without a written order.
➧ Test-taking Tip: Use the process of elimination to eliminate options 3 and 4, which
alter medication orders, because these are not within the nurse's scope of practice. Of
the two remaining options, focus on the action of heparin and warfarin. Recall that
warfarin takes 3 to 5 days to reach therapeutic effectiveness, during which time the
client will continue to require anticoagulation.
A nurse administers a usual morning dose of 4 units of regular insulin and 8 units of
NPH insulin at 0730 to a client with a blood glucose level of 110 mg/dL. Which
statements regarding the client's insulin are correct?
a. The onset of the regular insulin will be at 0745 and the peak at 1300.
b. The onset of the regular insulin will be at 0800 and the peak at 1000.
c. The onset of the NPH insulin will be at 0800 and the peak at 1000.
d. The onset of the NPH insulin will be at 1230 and the peak at 2330. - ANSWERS
ANSWER: B
The onset of regular insulin (short-acting) is one-half to 1 hour, and the peak is 2 to 4
hours. The onset of NPH insulin (intermediate acting) is 1 to 2 hours, and the peak is 6
to 10 hours. All other options have incorrect medication onset and peak times.
,➧ Test-taking Tip: Apply knowledge of insulin onset and peak times.
Which instructions should the nurse provide to a client regarding diabetes management
during stress or illness? SELECT ALL THAT APPLY.
a. Notify the health-care provider if unable to keep fluids or foods down.
b. Test finger stick glucose levels and urine ketones daily and keep a record.
c. Continue to take oral hyperglycemic medication and/or insulin as prescribed.
d. Supplement food intake with carbohydrate containing fluids, such as juices or soups.
e. When on an oral agent, administer insulin in addition to the oral agent during the
illness.
f. A minor illness, such as the flu, usually does not affect the blood glucose and insulin
needs. - ANSWERS ANSWER: A, C
An acute or minor illness can evoke a counterregulatory hormone response resulting in
hyperglycemia, thus the client should continue medications as prescribed. If the client is
unable to eat due to nausea and vomiting, dehydration can occur from hyperglycemia
and the lack of fluid intake. Blood glucose should be checked every 4 hours when ill and
the ketones tested every 3 to 4 hours if the glucose is greater than 240 mg/dL. The
client should supplement the diet with carbohydrate-containing fluids only if eating less
than normal due to the illness. Insulin may or may not be necessary; it is based on the
client's blood glucose level.
➧ Test-taking Tip: Focus on the counterregulatory hormone response during an illness
that causes hyperglycemia.
A health-care provider (HCP) adds a second medication for blood pressure control for a
client whose blood pressure has not been well-controlled with one antihypertensive
medication. If the HCP orders the following medication combinations, which
combination should the nurse question?
a. Atenolol (Tenormin®) and metoprolol (Lopressor®)
b. Metolazone (Zaroxolyn®) and valsartan (Diovan®)
c. Captopril (Capoten®) and furosemide (Lasix®)
d. Bumetanide (BUmex®) and diltiazem (Cardizem®) - ANSWERS ANSWER: A
When two medications are used to treat hypertension, each medication should be from
different drug classifications. Atenolol and metroprolol are both beta-adrenergic blockers
and would essentially have the same mechanism of action. Metolazone is a thiazide-like
diuretic, and valsartan is an angiotensin II receptor blocker (ARB). Captopril is an
angiotensinconverting enzyme (ACE) inhibitor, and furosemide is a loop diuretic.
Bumetanide is a loop diuretic, and diltiazem is a calcium channel blocker.
,➧ Test-taking Tip: Recall that beta blockers end in "lol." Use this as a cue to identify the
two medications that are within the same drug classification and would be
inappropriately prescribed.
A nurse is assessing a client who is taking atorvastatin (Lipitor®). For which
manifestations should the nurse specifically assess?
a. Constipation and hemorrhoids
b. Muscle pain and weakness
c. Fatigue and dysrhythmias
d. Flushing and postural hypotension - ANSWERS ANSWER: B
Atorvastatin is a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor
(statin) used to lower lipid levels. Statins can cause muscle tissue injury manifested by
muscle ache or weakness. Muscle injury can progress to myositis (muscle
inflammation) or rhabdomyolysis (muscle disintegration). Additional SE of statins is
confusion and decreased UO. Bile acid sequestrants may cause constipation and
hemorrhoids because they are not absorbed from the small intestine. Diarrhea, not
constipation, is a side effect of statin medications. Side effects of niacin, a lipid-lowering
agent, include flushing, dysrhythmias, and postural hypotension.
➧ Test-taking Tip:The key words are "specifically assess." The nurse should be
monitoring for side effects. Select the option that includes the side effect for the
HMGCoA reductase inhibitors (statins).
A nurse is caring for a group of clients all in need of pain medication. The nurse has
determined the most appropriate pain medication for each client based on the client's
level of pain. Prioritize the order in which the nurse should plan to administer the pain
medication beginning with the analgesic for the client with the most severe pain. a.
___ Ketorolac (Toradol) 10 mg oral
b. ___Fentanyl (Sublimaze®) intravenously per patient-controlled analgesia with a bolus
dose
c. ___Hydromorphone (Dilaudid®) 5mg oral
d. ___Morphine sulfate 4 mg IV - ANSWERS a. _4__ Ketorolac (Toradol) 10 mg oral
b. _1__Fentanyl (Sublimaze®) intravenously per patient-controlled analgesia with a
bolus dose
c. _3__Hydromorphone (Dilaudid®) 5mg oral
d. _2__Morphine sulfate 4 mg IV
The most potent of the medications is fentanyl (Sublimaze®), an opioid narcotic
analgesic that binds to opiate receptors in the central nervous system (CNS), altering
the response to and perception of pain. A dose of 0.1 to 0.2 mg is equivalent to 10 mg
of morphine sulfate. Morphine sulfate is also an opioid analgesic. Hydromorphone,
, another opioid analgesic, would be third in priority. The oral dosing of this medication
would indicate that the client's pain is less severe than the client receiving fentanyl or
morphine sulfate. Hydromorphone 7.5 mg oral is an equianalgesic dose to 30 mg of oral
morphine or 10 mg parenteral morphine. Ketorolac is a NSAID and nonopioid analgesic
that inhibits prostaglandin synthesis, producing peripherally mediated analgesia.
Propoxyphene is last in priority. It also binds to opiate receptors in the CNS but is used
in treating mild to moderate pain. It has analgesic effects similar to acetaminophen.
➧ Test-taking Tip: Focus on ordering the medications starting with the most potent
opioid analgesics and ending with the nonopioid analgesic.
A nurse applies a fentanyl (Sublimaze®) transdermal patch to a client for the first time.
Shortly after application, the client is experiencing pain. Which nursing action is most
appropriate?
a. Remove the transdermal patch and apply a new one.
b. Administer a short-acting opioid analgesic.
c. Rub the transdermal patch to enhance absorption of the medication.
d. Call the physician to request a fentanyl transdermal patch with a higher dosage. -
ANSWERS ANSWER: B
When the first fentanyl transdermal patch is applied, effective analgesia may take 12 to
24 (6) hours to develop because absorption is slow. Removing the patch is
unnecessary. Transdermal patches should not be rubbed to enhance absorption
because it can cause the delivery of the medication to fluctuate. It is premature to
request a higher dose of fentanyl.
➧ Test-taking Tip: Focus on that fact that absorption from a fentanyl transdermal patch
is slow.
A nurse is to administer vancomycin to a client diagnosed with sepsis. The client is to
have a peak and trough level completed on this dose of the medication. Which action
should the nurse initiate first?
a. Determine if the trough level has been drawn on the client.
b. Determine medication compatibilities before infusing into an existing intravenous line.
c. Check the client's culture and sensitivity report.
d. Check the amount of time over which the medication dose should infuse. -
ANSWERS ANSWER: A
The trough level is the lowest concentration so it needs to be collected just before the
next administration. The peak level is the highest concentration - draw this 1-2hrs after
completion of IV vanco. Determining medication compatibilities and checking C&S
reports and the infusion duration are important actions before administering
vancomycin. However, these actions can be done while the laboratory is obtaining the
trough level or after knowing that the level has been drawn.
