What actions are appropriate when administering an intramusc...

What actions are appropriate when administering an intramuscular injection? Select all that apply.

A. Always wear gloves
B. Cleanse skin at injection site
C. Place pressure on the area after removing the needle
D. Recap the needle before disposal
E. Aspirate after inserting the needle

Correct Answer: A,B,C,E

Rationale: When administering an intramuscular injection, the nurse should always wear gloves, cleanse the skin at the injection site prior to administration, aspirate for 5 to 10 seconds after inserting the needle, apply pressure to the area after removing the needle, and never recap the needle.

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What is the most appropriate response when a patient says, 'This doesn't look like my usual pill'?

A. This is the same pill your doctor has been ordering.'
B. It must be from a different manufacturer.'
C. It looks different? Are you sure?'
D. Let me double check with your doctor and the order.'

Correct Answer: D

Rationale: If the patient makes any statement about the drug, the nurse needs to hold the drug and investigate the patient's statement, double checking the chart and the order and obtaining clarification and/or confirmation from the prescriber. It may be that the dosage or manufacturer has changed and that is what makes the pill look different. It is always important to err on the side of caution. Telling the patient that the pill is the same or that it is from a different manufacturer may be true, but the nurse needs to confirm that before giving it to the patient. Repeating the patient's statement and then asking him if he is sure is inappropriate because it implies that the patient is incorrect.

Where should a buccal medication be placed?

A. Under the tongue
B. Against the cheek mucous membrane
C. Inside the rectum
D. At the back of the tongue

Correct Answer: B

Rationale: Buccal drugs are placed in the mouth against the mucous membranes of the cheek in either the upper or lower jaw. Sublingual medications are placed under the tongue. Rectal suppositories are inserted into the rectum. Oral medications are placed at the back of the tongue.

What action is most appropriate when a nurse cannot read a healthcare provider's handwriting on a medication order?

A. The nurse should question the order with the primary health care provider
B. The nurse should try to interpret the handwriting
C. The nurse should confirm the order with a nearby health care provider
D. The nurse should obtain a verbal order

Correct Answer: A

Rationale: Any order that is unclear, particularly due to illegible handwriting, should be questioned. The nurse should not try to interpret the handwriting as it may lead to a misinterpretation. The nurse should also not confirm the order with any other physician who is nearby. Administering drugs based on verbal orders is permissible only during emergencies.

What is most important for the nurse to do when preparing to administer a prescribed oral drug? Select all that apply.

A. Making sure the client is in an upright position prior to administration
B. Ensuring that a full glass of water is readily available
C. Leaving PRN drugs at the bedside for ready access if needed
D. Instructing the client to tilt his or her head back to swallow a capsule
E. Having the client refrain from sipping on the water before placing the tablet in the mouth

Correct Answer: A,B

Rationale: Clients should always be in an upright position when receiving oral drugs and a glass of water should be readily available. They should be encouraged to take a few sips of water before placing the tablet or capsule in the mouth. Drugs should never be left at the client's bedside. Instruct clients to tilt their head back to swallow a tablet and slightly forward to swallow a capsule.

What sites are appropriate for subcutaneous injection? Select all that apply.

A. Upper arm
B. Inner forearm
C. Upper abdomen
D. Gluteus maximus
E. Upper thigh

Correct Answer: A,C,E

Rationale: The sites for subcutaneous injection are the upper arms, the upper abdomen, and the upper thighs.