Nonparenteral Medications

Multiple Choice

1. The health care provider prescribes a sublingual medication, and the pharmacy sends an oral form. Which action does the nurse take?

a. Administer the identical drug orally.

b. Call the pharmacy for the correct formulation.

c. Withhold the drug and notify the provider.

d. Calculate the oral equivalent dose for the patient.

ANS: B

The nurse can administer the sublingual medication in sublingual form only; changing the route of administration is practicing medicine and is outside the scope of practice for the nurse. The nurse cannot administer the oral medication, even if it is the identical drug, because it is the wrong route and violates a patient medication right. Withholding the medication until the provider is notified is risky and unnecessary because the nurse can ask the pharmacy to send the correct form of the medication. If the pharmacy does not carry the prescribed form, the nurse should contact the provider. Many medications come in several forms; thus, determining an equivalent dose of a medication in another form is possible; however, the nurse needs a prescription for both forms of the medication to administer the oral form.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Evaluates the patient’s ability to take the medications unassisted. b. Leaves the medications on the breakfast tray for the patient to take later. c. Asks the patient if holding the medications in the hand is preferred. d. Holds the medicine cup to the patient’s lips and tips it into the mouth.

2. An alert and oriented patient is to receive oral medication. Which does the nurse implement to administer the prescribed medication?

ANS: C

Patients can participate in medication administration by holding the medication in the cup or hand before placing it in the mouth. The nurse already knows that this patient is alert. If the provider allows the patient to self-medicate in the hospital, the nurse supervises the activity and ensures patient self-administration of the medications on time. The nurse never leaves medication on the breakfast tray for many reasons. He or she needs to verify that the patient has taken the medication so that correct documentation may occur. Holding the cup for the patient is unnecessary and potentially insulting to the patient.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Question the entire group by calling for the specific patient. b. Request that the other patients identify the patient. c. Ask the patients who is scheduled to receive medications now. d. Follow agency policy and professional standards to ensure accurate identification.

3. The nurse approaches a group of patients, one of whom is to receive a dose of medication. Which is the best method for the nurse to identify the patient needing the medication?

ANS: D

To identify the patient needing the medication, the nurse checks the patient identification bracelet and asks the patient to state his or her name. The nurse then compares the spelling of the name and the medical record number on the bracelet to the MAR. The nurse does not rely on other individuals to identify the patient for the medication administration to avoid the risk of misidentification. The use of at least two identifiers is the only approved method of identifying a correct patient.

DIF: Cognitive Level: Remembering OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Document the medication immediately before administration. b. Record the time administered and the nurse’s name immediately after administration. c. Record medication administration time, route, and dose at the end of the shift. d. Delegate recording administration time and the nurse’s name in the record.

4. The nurse needs to document a medication that has just been administered. Which technique does the nurse use to document medication administration when in a hurry?

ANS: B

The nurse records his or her name and administration time immediately after medication administration to maintain an up-to-date, accurate patient medical record. Documentation is not done before administration because the activity has not yet happened. It is risky to document at the end of the shift because the chance of a documentation omission or error increases with the amount of time that passes. Correct documentation is one of the six rights of medication administration. Documentation of medication administration may never be delegated. Being hurried is not a reason to skip the safety checks and proper documentation.

DIF: Cognitive Level: Remembering OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Choose a site with moderate exposure to the sun. b. Remove the old patch before applying a new patch. c. Put the new patch at the same site to promote even absorption. d. Apply a warm compress to the site before application.

5. The nurse instructs the patient about applying a transdermal patch. Which does the nurse include in patient teaching?

ANS: B

To prevent overdoses and tolerance to patches, the nurse instructs the patient to remove the old patch, cleanse the site, and apply the next patch to a different place. Sun exposure can promote medication degradation and increase the absorption rate. The nurse avoids instructing the patient to apply a warm compress to prevent rapid medication absorption that potentially can lead to overdose.

DIF: Cognitive Level: Understanding OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Dispense the eyedrops to the inner corner of each eye. b. Wash the eyes with a warm, wet washcloth. c. Check the patient identifiers before administration. d. Determine the patient’s history of taking this medication.

6. The nurse prepares to administer artificial tears to the patient’s eyes twice daily. Which will the nurse implement when administering the patient’s eyedrops as the priority?

ANS: C

The nurse verifies patient identifiers before administering medication, regardless of the route. He or she avoids dispensing eyedrops to the inner corner of the eye to avoid irritating the cornea. Eyedrops are instilled into the conjunctival sac. The nurse would wash the patient’s eyes if they were matted or were draining, but that would not be the priority over proper patient identification. The nurse can assess for the patient’s history of using this medicati on, but that also does not take priority over identifying the patient.

DIF: Cognitive Level: Remembering OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Planning a. Withhold the patient’s ophthalmic drops. b. Warm the eyedrops for subsequent doses. c. Notify the ophthalmologist of the findings. d. Ask the patient questions to clarify what is meant by “blurred.”

7. The patient reports blurred vision after the instillation of eyedrops. What action does the nurse implement first?

ANS: D

The nurse questions the patient for additional information before determining the scope of his or her complaint because blurred vision can be either an adverse effect of the medication or expected because of the type of medication being instilled. The nurse gathers additional information before deciding to withhold the eyedrops. The nurse avoids warming eyedrops because it can increase the absorption rate and patient discomfort. Notifying the provider is not indicated.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Assessment a. Observe caregiver administration of eardrops. b. Provide a demonstration of eardrop instillation. c. State that eardrop instillations do not injure ears. d. Agree that instillation of eardrops is challenging.

8. A patient’s family member is afraid of hurting the patient when giving eardrops per discharge instructions. Which action will the nurse take first?

ANS: B

The nurse needs to demonstrate the procedure with a clear explanation based on what the family member is stating. An opportunity for a return demonstration must be provided, with the nurse supporting the family member and coaching as needed. The risk for patient injury is low for eardrops, but it exists. Instilling eardrops is a simple skill; however, when the caregiver expresses concern about medication administration, the duty the nurse owes to the patient is to provide encouragement and teaching to prevent patient injury. Stating the eardrop administration is challenging does not provide any useful information to the family member.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Planning a. Warm the eardrops in a microwave oven on low. b. Pull the auricle upward and outward. c. Apply eardrops to a cotton ball and insert them in the affected ear. d. Instruct the child to lie with the affected ear on a warm compress.

9. The nurse is preparing to administer eardrops to a 5-year-old child. Nursing care is appropriate if which technique is used by the nurse?

ANS: B

The nurse pulls the patient’s pinna upward and outward to provide access to deeper ear structures for a patient over the age of 3 years. Eardrops are never warmed in a microwave oven because of the risk of overheating the medication; microwave heating potentially leads to patient burns or decreased effectiveness of the eardrops. If cotton balls are used with eardrops, they are nonmedicated and inserted into the ear canal gently for a brief period of time after the drops have been instilled. The eardrops would drain out of the ear quickly if the patient lies on a warm compress with the affected ear down.

DIF: Cognitive Level: Remembering OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Administer two puffs of medication in rapid succession. b. Maintain a firm seal with lips around the mouthpiece of the inhaler. c. Dispense the glucocorticoids 30 seconds after a bronchodilator. d. Instruct the patient to press the MDI after breathing in and out deeply.

10. A patient with chronic obstructive pulmonary disease uses a metered-dose inhaler (MDI). Which information does the nurse provide to ensure the patient receives the maximum benefit of the medication?

ANS: B

The nurse instructs the patient to maintain a firm seal around the mouthpiece of the MDI to facilitate dispensing medication into the lungs so the patient benefits from a full dose of the medication undiluted by room air. The nurse also instructs the patient to take a bronchodilator before any subsequent medications administered by an MDI such as glucocorticoids. An MDI delivers medication by inhalation and does not lend itself to delivering two puffs in rapid succession because a short wait is usually required for the medication to reach deeper parts of the lung. Not only is it difficult to activate the MDI quickly, but the patient may not have the ventilatory capacity to quickly inhale two puffs. When administering glucocorticoids after a bronchodilator, the nurse waits 5 minutes to give the bronchodilator time to work and then administers the second agent. To use an MDI, the nurse instructs the patient to exhale and then inhale slowly and deeply to drive the inhalation medication into the lungs.

DIF: Cognitive Level: Understanding OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Inserting the suppository into patient’s rectum b. Notifying the patient’s health care provider of the suppository results c. Documenting the administration of a suppository after insertion d. Informing the nurse of the patient’s bowel movement

11. The nurse needs to administer a rectal suppository to a patient to treat constipation. Which action may the nurse delegate to the nursing assistive personnel (NAP)?

ANS: D

The nurse instructs the NAP to report the results of the suppository, which in this case would be the expulsion of feces. Administration of medication is the nurse’s responsibility. The health care provider will learn the results of the suppository by reading the nurse’s documentation or when making rounds unless other instructions were given. Documentation of the medication administration is the nurse’s responsibility.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Planning a. Assists the patient to right lateral position and flexes the left leg. b. Performs a preadministration digital rectal examination. c. Washes hands and applies sterile gloves before the procedure. d. Inserts the suppository 10 cm (4 inches) into the patient’s rectum.

12. The nurse prepares to administer acetaminophen 650 mg rectally to an adult patient. Which does the nurse implement to administer the suppository properly?

ANS: D

The nurse inserts the suppository about 10 cm (4 inches) into the adult patient’s rectum to clear the rectal sphincters because the sphincters help to keep the medication in the patient’s rectum. The nurse assists the patient into the left lateral position to take advantage of the normal anatomy of the descending colon. This curvature in the colon helps to sequester the medication, contain it in the patient, and increase its effectiveness. The nurse avoids performing a digital examination before inserting a suppository because it is not indicated. Washing hands is always a reasonable nursing action, but sterile gloves are not indicated. Clean gloves are sufficient for this procedure because the nurse wants to avoid contamination from the rectum.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Use a tampon to hold the suppository in place. b. Place a perineal pad in her underpants when getting up. c. Expect a moderate localized burning and itching. d. Remain in the semi-Fowler’s position for 2 hours.

13. The nurse administers a vaginal suppository. What information will the nurse include in patient teaching about postadministration care?

ANS: B

The nurse instructs the patient to place a perineal pad in her underpants because there will be a small amount of vaginal drainage after insertion of a suppository as the suppository melts. The nurse instructs the patient to avoid tampon use during the use of vaginal suppositories because the tampon absorbs the liquid, which decreases the effectiveness of the suppository. Burning and itching after administration of a vaginal suppository are unexpected. The patient should remain in supine position – not semi-Fowler’s – because in this position, gravity has no effect on the absorption rate.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Open the unit-dose package and pour contents into a medicine cup. b. Use a measuring cup with both metric and dram markings for accuracy. c. Request pharmacy dispense small doses in pre-filled, one time use syringes. d. Perform hand hygiene and don gloves, if needed, and identify the patient.

14. The nurse is preparing a liquid medication. Which technique does the nurse use to ensure an accurate dose?

ANS: C

Best practice requires the pharmacy to dispense doses of oral medications in pre-filled syringes if the drug is not available in correct dose unit-dose containers. The nurse does not pour liquid medication from a unit-dose container into a medicine cup. Medicine cups should no longer contain apothecary markings, such as fluid drams. Hand hygiene, donning gloves, and identifying the patient are all required actions but do not pertain to dispensing the most accurate dose of liquid medications.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. The diet history b. Any drug tolerance c. Any allergy history d. The surgical history

15. The nurse prepares medication for a patient 1 hour after admission. What information about the patient is the nurse’s priority assessment before the initial administration of medication?

ANS: C

To prevent patient injury, the nurse interviews the patient about allergies, including food and medication, before administering any medication. If the patient admits to drug or food allergies, the nurse probes him or her for additional information about the allergy to determine the nature of the reaction. Diet history is a reasonable assessment because malnutrition increases the risk of patient injury from medications that are protein bound and can increase the risk of complications from nutritionally related problems but it is not the priority. Drug tolerance is a reasonable assessment if the patient is receiving pain medication or another agent to which he or she potentially develops tolerance but is also not the priority. Surgical history is the lowest-priority assessment for this patient; however, the nurse gathers information about the patient’s surgical history for the admission assessment to complete the patient profile.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Assessment a. Instructs the patient to hold the mouthpiece with the hands. b. Uses a mask to deliver the ordered medication. c. Places the patient in a supine position for the treatment. d. Has the patient drink some fluid before the treatment.

16. The nurse is helping a dyspneic older adult with severe arthritis to use a nebulizer for respiratory medications. Nursing care would be correct if the nurse takes which action during the medication administration?

ANS: B

Using a face mask does not require the patient to remember to hold the mouthpiece correctly and would be appropriate for this patient with arthritis. The patient may be unable to hold the mouthpiece correctly because of the weakness and arthritis of the hands. Patients receiving respiratory treatments should be upright when possible. Patients who are dyspneic need to breathe rather than take in fluids, which alters their breathing pattern. The dyspnea can also cause aspirations if fluids are taken.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Pour tablets from stock without touching them. b. Withhold the medication and notify the health care provider. c. Have another nurse witness taking two aspirin tablets from the bottle. d. Inform the patient that family needs to bring this medication in.

17. The nurse needs to administer enteric-coated aspirin to the patient. The pharmacy does not carry enteric-coated aspirin. Which is the best nursing approach for this situation?

ANS: B

The best choice for the nurse is to withhold the medication and notify the provider that enteric-coated aspirin is not available. The purpose of administering enteric-coated aspirin is to decrease gastric upset and complications; thus uncoated aspirin is an unsuitable substitute. The nurse needs another order to administer nonenteric-coated aspirin. The nurse pours tablets from any stock container without touching them to maintain infection control. Aspirin is not the same medication as enteric-coated aspirin and thus cannot be administered to the patient; therefore, the nurse would not pour these tablets from stock. Having another nurse witness the procedure does not solve the problem. The patient’s family should not have to bring the medication in unless it is a very rare medication.

N

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Hold the medication under the tongue. b. Chew the medication before swallowing. c. Swallow the medication after 30 seconds. d. Hold the medication between the cheek and gums until it dissolves.

18. The patient is to receive a buccal medication. Which information does the nurse include in patient teaching?

ANS: D

For proper administration of buccal medication, the nurse instructs the patient to hold the medication between the cheek and gums until it has dissolved. Medication administered under the tongue is delivered sublingually. The nurse instructs the patient to chew a chewable tablet.

DIF: Cognitive Level: Understanding OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Apply mild pressure on the entire eye. b. Apply the eye ointment along inner edge of lower eyelid. c. Remove any periorbital crusting with a warm face cloth. d. Wipe away any crusting from the outer to the inner canthus.

19. The nurse prepares to administer cyclosporine eyedrops to a patient with dry eyes. Which of the following actions does the nurse implement before instilling the eyedrops?

ANS: C

Before instilling any eyedrops, the nurse cleanses the periorbital area with a warm face cloth if needed to remove the debris gently. The nurse can apply pressure to the inner corner of the eye after instillation to decrease systemic absorption of the medication but should not apply pressure over the entire eye. Eyedrops, not ointment, have been ordered. The nurse wipes the eyes from inner to outer canthus.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Planning a. Moistens the finger with sterile saline. b. Places a thin ribbon of ointment along the conjunctiva. c. Rubs the medication briskly after application. d. Looks downward before application of the ointment.

20. The nurse teaches the patient how to administer eye ointment. Instruction by the nurse has been correct if the patient demonstrates which technique?

ANS: B

A thin ribbon of ointment is placed evenly along the inner edge of the lower eyelid on the conjunctiva from the inner to the outer canthus. The finger can be moistened if applying an intraocular disk, not eye ointment. The patient can rub the lid lightly after the medication is applied as long as rubbing is not contraindicated. The patient needs to look up to move the sensitive cornea away from the conjunctival sac to reduce the blink reflex during application of the ointment.

DIF: Cognitive Level: Evaluating OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Evaluation a. The scored white tablet b. The capsule c. The buccal medication d. The enteric-coated tablet

21. The patient has a scored white tablet, a capsule, buccal medication, and an enteric-coated tablet. Which medication will the nurse administer last?

ANS: C

The buccal medication must be able to dissolve between the cheek and the gums to provide the correct absorption. Any liquid must be postponed until the buccal medication has dissolved. For therapeutic effect, it makes no difference in which order the other medications are given. They will be absorbed in the areas of the body where expected.

DIF: Cognitive Level: Remembering OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. The patient self-administers the medication using the nebulizer. b. The patient correctly describes the use of a small-volume nebulizer. c. The patient recites side effects and clinical indicators to report. d. The patient’s respiratory rate falls to an acceptable level.

22. The nurse plans care for the patient who has newly diagnosed asthma and receives albuterol nebulizer therapy. The patient’s respiratory rate is 34 breaths per minute, and breath sounds reveal wheezing throughout both lung fields. Which outcome is the nurse’s priority for this patient within 24 hours?

ANS: D

Airway and breathing are usually at the top of patient priorities; thus, the nurse works to improve the patient’s respiratory status first. Expected outcomes include improved oxygen saturation and breathing patterns. Self-administration is contraindicated for the patient during an acute episode. Describing the use of a nebulizer and verbalizing information are indicated before discharge and not during an acute episode.

DIF: Cognitive Level: Evaluating OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Evaluation a. Warm the eardrops in a sink of warm water. b. Pull the pinna down and straight back. c. Place the child in a restraint to avoid injury. d. Administer the drops as soon as possible after removing them from the refrigerator.

23. The nurse is preparing to administer eardrops to a 28-month-old child. Nursing care is appropriate if which technique is used by the nurse?

ANS: B

The nurse pulls the patient’s pinna down and straight back to facilitate the medication reaching the inner ear. Eardrops should be administered at room temperature, not warmed up or cold from the refrigerator, because cold eardrops can cause vertigo. A restraint might or might not be required, but that is not an expected part of the procedure.

DIF: Cognitive Level: Understanding OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Pouring the medications slowly into the tube b. Checking the gastric residual volume before feeding c. Elevating the head of the bed at least 45 degrees d. Flushing the tube between medications and after the last one

24. A patient is to receive three medications via an enteral feeding tube. What action by the nurse best contributes to maintaining the patency of the tube?

ANS: D

Flushing the tube with water helps it to remain patent by rinsing away any of the residual medication left in it. Pouring the medications into the tube slowly does nothing for patency. Checking the gastric residual volume identifies only how the stomach is emptying. Elevating the head of the bed helps to prevent aspiration, not tube clogging.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Stop any infusion through the feeding tube. b. Assess all of the patient’s vital signs. c. Notify the health care provider. d. Reposition the patient.

25. The nurse is caring for a patient with an enteral feeding tube. During assessment, the nurse finds that the patient’s oxygen saturation level has dropped significantly and the respiratory rate and effort have increased. What action does the nurse take first?

ANS: A

The patient is exhibiting signs of aspiration, and feeding and medications through the tube must be stopped first. This is done quickly; if not done, none of the other actions will not be effective. It’s essential that the nurse goes to the source of the problem. The vital signs can be checked after the tube feeding has been stopped and the patient repositioned for better airway clearance. The health care provider can be notified after the nurse has intervened by turning off the tube feeding, repositioning the patient for optimal airway clearance, and taking vital signs.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. The patient’s lungs are clear 1 hour after administration. b. The nurse assesses the medication’s therapeutic effect. c. The patient is able to swallow medications one at a time. d. The nurse does not note any adverse reactions.

26. The nurse is administering medications to a patient who had a stroke and has some difficulty swallowing. What assessment by the nurse would indicate that goals for a priority nursing diagnosis have been met?

ANS: A

A patient who has difficulty swallowing is at high risk for aspiration. Assessing clear lungs after administering medications would demonstrate that the patient did not aspirate. Assessing the therapeutic effect of the medication and not noting any adverse reactions are also good outcomes, but not the priority. Being able to take medications 1 at a time is not related to aspiration.

DIF: Cognitive Level: Evaluating OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Evaluation

Multiple Response

1. The nurse is preparing medications for a patient who cannot swallow pills. Which of the following medications cannot be crushed? (Select all that apply.)

a. Capsule b. Scored tablet c. Enteric-coated tablet d. Buccal tablet e. Unscored tablet

ANS: A, C, D

Capsules and enteric-coated tablets are not crushed because the coating of these drugs protects the stomach from irritation or protects the drug from destruction by stomach acids. The buccal tablet needs to dissolve or remain in the mouth for proper absorption. The nurse can crush the scored or unscored tablet because the medication absorption will not be altered.

DIF: Cognitive Level: Remembering OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Planning a. Incorrect activation b. Not shaking the cannister c. Not keeping the cannister cool d. Not taking medication as directed e. Failing to clean the mouthpiece

2. The faculty member instructs students to be cautious when teaching patients how to use an inhaler because there are many problems associated with this method of administration. Which of the following are potential problems when using inhalers? (Select all that apply.)

ANS: A, B, E

Potential problems when using an inhaler include incorrect activation, not shaking the cannister first, and failing to clean the mouthpiece which can become clogged. Inhalers are kept at room temperature. Not taking medication as directed demonstrates non-adherence and the nurse needs to investigate the cause.

DIF: Cognitive Level: Remembering OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Planning a. Uses tepid water and large bore syringe to flush the tube. b. Flushes tube with water before and after each medication. c. Follows manufacturer guidelines before using pancrelipase. d. Attempts to irrigate the tube using room temperature cola. e. Checks agency policy regarding use of a declogging stylus.

3. A patient’s feeding tube has become blocked. What actions by the nursing student would require the faculty member to intervene? (Select all that apply.)

ANS: B, D

N

Correct options for attempting to unblock a feeding tube include attempting to flush with tepid water and large bore syringe, following manufacturer’s instructions if pancrelipase is u sed, and using a declogging stylus if agency policy allows. The faculty would intervene if the student attempted to unclog the tube using cola. Flushing before and after each medication is important to prevent clogs. But if the tube is already clogged, this won’t help.

DIF: Cognitive Level: Evaluating OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation a. Avoid using straws with medication administration. b. Assess the patient’s ability to swallow pills. c. Place medications on the weaker side of the mouth. d. Consult with speech therapy about thickened liquids. e. Give medications then instruct the patient to lie down and rest.

4. A new nurse has a patient who is a high risk of aspiration. The new nurse reviews methods to keep the patient safe with an experienced nurse. Which interventions do the nurses discuss as protective strategies? (Select all that apply.)

ANS: A, B, D

Appropriate actions to protect the patient from aspiration include avoiding straws, assessing the patient’s ability to swallow pills, and considering a speech therapy consultation to determine if the patient requires thickened liquids. Medications should be placed on the stronger side of the mouth. The patient should remain in an upright position after eating, drinking, or taking medications if possible.

DIF: Cognitive Level: Evaluating OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Implementation

Completion

1. The nurse is teaching a patient how to calculate how long the metered-dose inhaler (MDI) cannister can be used. If the cannister contains 200 puffs and the patient administers 2 puffs 3 times each day, how long will the cannister last? The cannister will last for _____ days.

ANS: 33

Two puffs  3 times daily = 6 puffs per day; 200 puffs/6 puffs per day = 33.3 days; therefore, the cannister will last 33 days with correct medication administration.

DIF: Cognitive Level: Applying OBJ: NCLEX: Physiological Integrity

TOP: Nursing Process: Planning