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The nurse is administering an IV push medication through an IV lock. After injecting the medication, which action will be taken next?
- A. Flushing the lock
- B. Regulating the IV flow
- C. Clamping the tubing for 10 minutes
- D. Holding the patient's arm up to improve blood flow
Correct Answer: A
Rationale: Flushing the IV lock with saline or heparin (per facility policy) after administering an IV push medication ensures the medication is cleared from the lock and prevents clotting. The other actions are not appropriate.
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A patient with asthma is to begin medication therapy using a metered-dose inhaler. What is an important reminder to include during teaching sessions with the patient?
- A. Repeat subsequent puffs, if ordered, after 5 minutes.
- B. Inhale slowly while pressing down to release the medication.
- C. Inhale quickly while pressing down to release the medication.
- D. Administer the inhaler while holding it 3 to 4 inches away from the mouth.
Correct Answer: B
Rationale: Inhaling slowly while pressing the inhaler ensures proper medication delivery to the lungs. The inhaler should be 1-2 inches from the mouth or use a spacer, and subsequent puffs should be 1-2 minutes apart, not 5 minutes.
A patient is receiving eyedrops that contain a beta-blocker medication. The nurse will use what method to reduce systemic effects after administering the eyedrops?
- A. Wiping off excess liquid immediately after instilling the drops
- B. Having the patient close the eye tightly after the drops are instilled
- C. Having the patient try to keep the eye open for 30 seconds after the drops are instilled
- D. Applying gentle pressure to the patient's nasolacrimal duct for 30 to 60 seconds after instilling the drops
Correct Answer: D
Rationale: Applying gentle pressure to the nasolacrimal duct for 30-60 seconds reduces systemic absorption of eyedrops by preventing drainage into the nasal cavity. The other methods do not effectively reduce systemic effects.
The nurse is giving an intradermal (ID) injection and will choose which syringe for this injection?
- A. interderm_1.PNG
- B. interderm_2.PNG
- C. interderm_3.PNG
- D. interderm_4.PNG
Correct Answer: B
Rationale: The proper size syringe for ID injection is a 1-mL tuberculin. The other syringes pictured are incorrect. Insulin syringes (marked in units) are not used for intradermal injections.
While the nurse is assisting a patient in taking his medications, the medication cup falls to the floor, spilling the tablets. What is the nurse's best action at this time?
- A. Discarding the medications and repeating preparation
- B. Asking the patient if he will take the medications
- C. Waiting until the next dose time, and then giving the medications
- D. Retrieving the medications and administering them to avoid waste
Correct Answer: A
Rationale: Medications that fall to the floor are contaminated and must be discarded. The nurse should prepare a new dose to ensure safety. The other actions risk administering contaminated medication or delaying treatment.
After administering an intradermal (ID) injection for a skin test, the nurse notices a small bleb at the injection site. Which of these is the best action for the nurse to take at this time?
- A. Apply heat.
- B. Massage the area.
- C. Do nothing.
- D. Report the bleb to the physician.
Correct Answer: C
Rationale: A small bleb is an expected outcome after an intradermal injection for skin testing, indicating proper administration. No further action is needed.