Drug Administration and Distribution - NCLEX-PN

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Question

Which of the following is the preferred location of intramuscular (IM) injection in infants?

Answer

The vastus lateralis is the preferred site of injection in infants. Rectus femoris injections may be preformed as a second choice. The dorsogluteal site should not be used in infants as the muscle is not developed and there is risk associated with the location of the sciatic nerve. Deltoid injections may be given to older children when the muscle becomes larger.

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Question

The nurse is preparing to administer an intramuscular (IM) injection to a 4.8 pound infant. The nurse should position the needle at which angle?

Answer

The preferred angle for intramuscular (IM) injections is 90 degrees. However, very small infants may require that the injection be given at a 45 degree angle. Based on patient condition, it is the nurse's responsibility to assess the needs of the patient and adjust care as appropriate.

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Question

The new pediatric nurse has just given a suppository to a 5-year-old boy. He has a bowel movement 7 minutes post administration. Which action should the nurse take next?

Answer

First, examine the stool for the suppository. Based on the findings, inform the physician. If the suppository was fully present in the stool, the physician may want to prescribe another dose. If not, he may choose to re-order half of the prescribed dose or none at all.

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Question

The pediatric nurse must convince a 4-year-old boy to take his medication. Which phrase is the most acceptable?

Answer

When convincing a child to take medicine, be straightforward and clear. Try not to offer the child a choice, as they likely won't take it. Stay away from using bribery, punishment, or comparing medicine to candy. Be honest about the taste of the medicine or risk losing the trust of the child.

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Question

The pediatric nurse is summoned to a room by the parents of a 2-year-old child. The peripheral IV line has been removed by the patient. When starting a new line, the nurse carefully chooses placement. The nurse should attempt to start the IV __________.

Answer

Most peripheral IV's are started in the right or left arm. Distal to the arm would mean closest to the fingertips. When starting an IV, always start looking for potential sites closest to the fingertips and work upwards. If a vein is punctured and becomes unusable, it is possible to move above the previous attempt and start a successful IV.

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Question

Jane is a 49-year-old woman who has recently had a peripherally inserted central catheter (PICC) placed. The nurse is teaching Jane how to flush her PICC. She knows that the teaching was effective when Jane states which of the following?

Answer

One should always use a 10mL syringe or larger to flush a PICC line. Smaller syringes place greater pressure on the line which could result in damage. For example, a 3mL syringe places greater pressure on a PICC line than a 5mL syringe.

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Question

Which of the following is an appropriate reason to delay antibiotic administration in a stable patient?

Answer

Obtaining a set of blood cultures before treating a bacterial infection helps to individualize care and reduce antibiotic resistance (using a narrow-spectrum antibiotic doesn't work against so many types of bacteria). By identifying specific bacteria in the blood, a narrow-spectrum antibiotic may be chosen. A physician may prescribe a broad-spectrum antibiotic initially and change treatment later based on the results of the blood cultures.

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Question

A nurse is teaching a mother how to administer nystatin to her 2-month-old child in the treatment of oral candidiasis. Which of the following is an appropriate instruction given by the nurse to the mother?

Answer

Apply medication to the mouth using a cotton-tipped applicator. Give the medication after meals and avoid rinsing the mouth. The medication should have contact with the mucosa without being washed away. Do not place the medication in a child's bottle, they may refuse to eat due to the bitter taste of the medication. Do not use a syringe to squirt the liquid to the back of the mouth since the child will likely spit it out.

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Question

When performing a blood transfusion, which of the following procedures should not be adhered to in order to ensure safe delivery of blood product to the patient?

Answer

All are true except for the use of lactated Ringer's this may cause a hemolytic reaction, only normal saline 0.9% is utilized.

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Question

The nurse is teaching a patient who has just been prescribed antibiotics. The nurse knows that teaching has been effective when the patient states which of the following?

Answer

Antibiotics may interfere with the function of oral contraceptives. A woman who is on oral contraceptives must use a back-up method of birth control to prevent pregnancy. Antibiotics should only be taken as prescribed. They should be taken continuously until all pills are gone. It is dangerous to take leftover antibiotics. Antibiotics will not prevent illness and do not work against viruses such as influenza. Misuse of antibiotics may contribute to antibiotic resistance and the rise of antibiotic resistant bacteria.

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Question

Ethel is an 80-year-old woman who was admitted for dehydration. The nurse reports that she is not making of urine and the physician orders a bolus of 250ml to be infused within 30 minutes. What is the correct drip rate for Ethel's infusion?

Answer

The minimum urine requirement per hour for most adults is . Based on a low finding, the physician may decide Ethel needs fluid replacement.

Calculate drip rate in minutes using the following formula:

Ethel's equation looks as follows:

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Question

The geriatric nurse is administering nightly medications to a 65-year-old woman with dysphagia. The patient is able to swallow crushed medications with thickened liquids. Which of the following medications should the nurse not crush?

Answer

Pantoprazole ER should not be crushed. "ER" is an abbreviation for extended release. Extended release medications dissolve over a delayed period of time. Crushing the medication results in a faster rate of absorption by body tissues due to disruption of the coating that allows it's extended release.

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Question

Which of the following is the preferred location of intramuscular (IM) injection in infants?

Answer

The vastus lateralis is the preferred site of injection in infants. Rectus femoris injections may be preformed as a second choice. The dorsogluteal site should not be used in infants as the muscle is not developed and there is risk associated with the location of the sciatic nerve. Deltoid injections may be given to older children when the muscle becomes larger.

Compare your answer with the correct one above

Question

The nurse is preparing to administer an intramuscular (IM) injection to a 4.8 pound infant. The nurse should position the needle at which angle?

Answer

The preferred angle for intramuscular (IM) injections is 90 degrees. However, very small infants may require that the injection be given at a 45 degree angle. Based on patient condition, it is the nurse's responsibility to assess the needs of the patient and adjust care as appropriate.

Compare your answer with the correct one above

Question

The new pediatric nurse has just given a suppository to a 5-year-old boy. He has a bowel movement 7 minutes post administration. Which action should the nurse take next?

Answer

First, examine the stool for the suppository. Based on the findings, inform the physician. If the suppository was fully present in the stool, the physician may want to prescribe another dose. If not, he may choose to re-order half of the prescribed dose or none at all.

Compare your answer with the correct one above

Question

The pediatric nurse must convince a 4-year-old boy to take his medication. Which phrase is the most acceptable?

Answer

When convincing a child to take medicine, be straightforward and clear. Try not to offer the child a choice, as they likely won't take it. Stay away from using bribery, punishment, or comparing medicine to candy. Be honest about the taste of the medicine or risk losing the trust of the child.

Compare your answer with the correct one above

Question

The pediatric nurse is summoned to a room by the parents of a 2-year-old child. The peripheral IV line has been removed by the patient. When starting a new line, the nurse carefully chooses placement. The nurse should attempt to start the IV __________.

Answer

Most peripheral IV's are started in the right or left arm. Distal to the arm would mean closest to the fingertips. When starting an IV, always start looking for potential sites closest to the fingertips and work upwards. If a vein is punctured and becomes unusable, it is possible to move above the previous attempt and start a successful IV.

Compare your answer with the correct one above

Question

Jane is a 49-year-old woman who has recently had a peripherally inserted central catheter (PICC) placed. The nurse is teaching Jane how to flush her PICC. She knows that the teaching was effective when Jane states which of the following?

Answer

One should always use a 10mL syringe or larger to flush a PICC line. Smaller syringes place greater pressure on the line which could result in damage. For example, a 3mL syringe places greater pressure on a PICC line than a 5mL syringe.

Compare your answer with the correct one above

Question

Which of the following is an appropriate reason to delay antibiotic administration in a stable patient?

Answer

Obtaining a set of blood cultures before treating a bacterial infection helps to individualize care and reduce antibiotic resistance (using a narrow-spectrum antibiotic doesn't work against so many types of bacteria). By identifying specific bacteria in the blood, a narrow-spectrum antibiotic may be chosen. A physician may prescribe a broad-spectrum antibiotic initially and change treatment later based on the results of the blood cultures.

Compare your answer with the correct one above

Question

A nurse is teaching a mother how to administer nystatin to her 2-month-old child in the treatment of oral candidiasis. Which of the following is an appropriate instruction given by the nurse to the mother?

Answer

Apply medication to the mouth using a cotton-tipped applicator. Give the medication after meals and avoid rinsing the mouth. The medication should have contact with the mucosa without being washed away. Do not place the medication in a child's bottle, they may refuse to eat due to the bitter taste of the medication. Do not use a syringe to squirt the liquid to the back of the mouth since the child will likely spit it out.

Compare your answer with the correct one above

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