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If an enteric-coated tablet was crushed and administered through a PEG tube, what would be the result?
- A. The patient would get too much medication at one time, causing an overdose.
- B. The patient would not get the desired effect from the medication because of contact with stomach acid.
- C. The patient would experience gastric irritation because the tablets are not designed to dissolve until they reach the intestines.
- D. The patient would still get the desired effects from the medication with no increase in ill effects.
Correct Answer: B,C
Rationale: Enteric-coated tablets are designed to dissolve in the intestines, not the stomach. Crushing them exposes the medication to stomach acid, which may inactivate it (B) and cause gastric irritation (C).
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Why is it necessary to flush a feeding tube with 30 to 60 mL of water before and 20 to 30 mL after administration of medications?
- A. To prevent interactions of medications with the formula in the tube
- B. To give the patient some much-needed fluid intake
- C. To prevent adherence of the drug to the tube
- D. To ensure fluid and electrolyte balance is maintained
- E. To prevent clogging of the tube
Correct Answer: A,C,E
Rationale: Flushing prevents medication interactions with formula (A), adherence to the tube (C), and clogging (E). Fluid intake (B) and electrolyte balance (D) are not primary reasons.
You are teaching a male patient to apply a nitroglycerin transdermal patch. You know the patient needs more teaching when he states
- A. I will be sure I remove the previous patch prior to putting on a new one.
- B. I will put the patch on a place without much body hair.
- C. I will not cut the patch to make it fit a smaller area.
- D. I will place the new patch in the same place as the previous one.
Correct Answer: D
Rationale: Patches should be rotated to different sites to prevent skin irritation. The other statements are correct.
You are pouring a liquid medication. Which actions will you take?
- A. Set the medication cup on top of the medication case and stoop to eye level to pour
- B. Hold the bottle so the label is in the palm of your hand to avoid spills on the label.
- C. For elderly patients, use a calibrated dropper or syringe to measure the medication.
- D. Measure the amount of liquid in a medication cup at the lowest level of the meniscus.
Correct Answer: B,D
Rationale: Holding the bottle with the label in the palm prevents spills from obscuring the label (B). Measuring at the meniscus ensures accuracy (D). Option A is incorrect because stooping to eye level is impractical, and C is not universally required.
A patient has an order for silver sulfadiazine (Silvadene) cream to be applied liberally to a burn on the forearm. How will you administer this medication?
- A. Use a tongue depressor to apply a thick coat of medication to the arm.
- B. Use a cotton-tipped applicator to apply a thin covering of medication to the arm.
- C. Place the tip of the medication tube against the burn and squeeze the tube until the burn is covered with the medication.
- D. Apply a thin coat of medication onto a gauze 4x4 and place it over the burn.
Correct Answer: A
Rationale: Silver sulfadiazine is applied liberally in a thick layer using a sterile tool like a tongue depressor to promote healing and prevent infection.
What is the preferred way of disposing of oral narcotics that must be wasted?
- A. Crush the extra medication and rinse it down the sink in front of a witness.
- B. Flush the extra medication down the toilet in front of a witness.
- C. Dispose of the extra medication in a chemical waste container in front of a witness.
- D. Place the unused portion of the narcotic back in the narcotic drawer in front of a witness.
Correct Answer: C
Rationale: Disposing of narcotics in a chemical waste container ensures safe and secure disposal, preventing diversion or environmental contamination.