Focus on Pharmacology: Essentials for Health Professionals, 3e (Moini) Chapter 7 Administration of Medications

1) In the ambulatory care setting, most medicines are ordered:

A) in tablet form

B) in liquid form

C) stat

D) asap

Answer: C

Explanation: C) In the ambulatory care setting, most medicines are ordered stat. This is so they are available as quickly as possible because of an emergency or because an emergency situation may be imminent. The other choices are incorrect because there is no single clear-cut form of medication (tablet or liquid) that is predominantly used. The final choice "asap" is not as critical as a "stat" order.

2) The most common medication error involves:

A) the dosage of the drug

B) the correct route of administration

C) the monitoring of side effects

D) not noticing drug information or warnings

Answer: A

Explanation: A) Dosage of the drug is the most common medication error because correct dosage amounts are so prone to calculation errors, among other types. Route of administration, side effect monitoring, and not noticing drug information or warnings all contribute to medication errors but are nowhere near as prevalent as errors involving drug dosages.

3) Drug errors most often involve:

A) antitussives and analgesics

B) anti-inflammatories and antibiotics

C) antibiotics and analgesics

D) antipyretics and anti-inflammatories

Answer: C

Explanation: C) Drug errors most often involve antibiotics and analgesics. Many prescriptions are issued concerning the fighting of infections (antibiotics) and the relief of pain (analgesics), and this large amount helps to contribute to increased errors. The other choices involve antiinflammatories, antipyretics, and antitussives, which are prescribed on a lesser scale.

4) Which of the following routes is the most common route by which medications are given?

A) Intravenous

B) Subcutaneous

C) Topical

D) Oral

Answer: D

Explanation: D) The oral route is the most common route of administration. Combining prescribed medications and OTC medications–by far the most popular method of administering drugs–is by oral tablets, capsules, liquids, powders, and so on. Intravenous, subcutaneous, and topical medications are all used widely but are nowhere as popular as those given orally. In the case of injectable drugs, this is partly because of the pain and discomfort that they involve compared with the ease of oral administration. Topicals are intended primarily for localized effects, not systemic, and treat more specialized conditions.

5) Most needles are made of stainless steel and are:

A) reusable

B) disposable

C) dull until sharpened

D) tuberculin

Answer: B

Explanation: B) Most needles are made of stainless steel and are disposable, although some needles are made to be reused several times. The reusable types are far less abundant than the disposable needles. Needles are packaged already sharpened and ready for use, not dull.

Tuberculin needles are just one type of needle available and are not the most popular type.

6) Ampules are usually marked with ink and:

A) sealed with a rubber cap

B) opaque

C) prescored

D) must be filled with medication

Answer: C

Explanation: C) Ampules are usually marked with ink at the point at which they are to be broken open; this point of the neck of the ampule is "prescored" for easy opening. They are not sealed with a rubber cap (as vials are); are clear, not opaque; and usually contain a single dose of medication before use.

7) The most common method of administering an intramuscular injection involves a:

A) 15-degree angle

B) 45-degree angle

C) 90-degree angle

D) 180-degree angle

Answer: C

Explanation: C) A 90-degree angle is the most commonly used method of administering an intramuscular injection. The needle pierces through the dermal and subcutaneous layers of skin and proceeds into the desired muscle. The Z-track method of injection is also used but is not as popular for IM injections. The other choices of angles are incorrect in that they do not offer an optimal penetration of the skin tissues required to reach the muscle.

8) How many times must the medication label be checked during its preparation to confirm the right drug, dose, and strength?

A) One

B) Two

C) Three

D) Four

Answer: C

Explanation: C) It must be checked three times. It cannot be stressed enough that careful, repetitive standards of practice, such as rechecking this type of information, is one of the best methods of ensuring accuracy. Nothing less than three checks of the information are allowed, so the first two choices are incorrect. The last choice, although not wrong, is beyond the minimum expected amount of information checks to be carried out.

9) After administering a medication, you must ensure that the patient:

A) is not allergic to the medication

B) does not have a reaction to the medication

C) lies still for at least 15 minutes without moving

D) does not drive a car for at least 15 minutes

Answer: B

Explanation: B) After administering a medication, you must make sure the patient does not have a reaction to it. A patient should never be allowed to leave without this occurring. Determining a potential allergy to the medication must always be checked before administering the medication. Having the patient lie still is not a realistic scenario for most medications, and only certain medications create the scenario that requires a patient to not drive a car immediately after their administration.

10) Medication errors must be documented in the medical record with:

A) the initials of the physician in charge

B) a pen containing indelible ink

C) the signature of the individual who made the error

D) the initials of the medical office administrator

Answer: C

Explanation: C) Medication errors must be documented in the medical record with the signature of the individual who made the error. It is not required for the physician or medical office administrator to initial the notation; what is important is that the person responsible signs the record to indicate his or her taking responsibility for the mistake. The type of ink used is not a concern.

11) Intradermal injections are usually given into the inner forearm or ________.

A) outer forearm

B) upper back

C) lower back

D) thigh

Answer: B

Explanation: B) Intradermal injections are usually given into the inner forearm or the upper back areas that usually have little hair growth. The outer forearm and thigh (especially of men) usually have thicker hair growth, and the lower back is sometimes more abundant with hair in men.

12) Because suppositories are designed to melt at body temperature, they are usually kept:

A) warm

B) at room temperature

C) in the refrigerator

D) in ice

Answer: C

Explanation: C) Suppositories are usually kept in a refrigerator because of their ability to melt at body temperature. As such, keeping them warm would not contain their solidity. Storing them in ice would make them too cold for proper use. Room temperature is not cold enough for the secure storage of suppositories.

13) The first time you should check a medication's label is when:

A) the medication is removed from its container

B) the medication is returned to the storage area

C) you are about to administer the medication

D) the medication is taken from the storage area

Answer: D

Explanation: D) The first time to check a medication's label is when it is removed from the storage area. The second time to check it is just before it is removed from its container. The third time to check it is when it is returned to the storage area or just before administration.

14) Which of the following significantly reduces medication errors?

A) history of allergies

B) unit-dose systems

C) checking the patient's chart

D) wasting of expired medications

Answer: B

Explanation: B) Unit-dose systems significantly reduce medication errors because the medications they contain are already in the correct dose. When using other types of medications that are not packaged as unit-dose systems, it is important to perform appropriate dosage calculations to determine the accurate dose.

15) The route that may be more dangerous than others because of the possibility of injecting a drug incorrectly into a vein is which of the following routes?

A) Intradermal route

B) Intramuscular route

C) Intravenous route

D) Anti-tick drugs

Answer: C

Explanation: C) The intravenous route may be more dangerous than the others because of the possibility of injecting a drug incorrectly into a vein, causing serious harm or even death. Intravenous medications are absorbed more quickly than oral medications and are irretrievable after being injected. The intradermal and intramuscular routes are not as dangerous because injecting between skin layers or muscles does not involve the same speed of absorption as does intravenous injection. The intrathecal route is not discussed in this capacity in this chapter.

16) Aseptic technique is used when administering parenteral drugs because these drugs require which type of procedure?

A) Invasive

B) Infective

C) Isotonic

D) Iodized

Answer: A

Explanation: A) The aseptic technique is used for parenteral administration because it is an invasive procedure. The body is "invaded" when the needle punctures through the skin, and the wound becomes a pathway for infection. The other choices are incorrect because infective means "causing infection," isotonic means "purified for use with the body or its openings," and iodized means "treated with iodine."

17) The easiest way to make sure the drug is being given to the patient it was ordered for is to:

A) look at the patient's chart

B) ask the patient his or her name

C) ask a family member the patient's name

D) check the physician's order

Answer: B

Explanation: B) The easiest way to make sure the drug is being given to the patient ordered is to ask the patient his or her name. You may also call the patient before administering the medication. Never assume that the patient is the correct person without verifying his or her name. None of the other choices are enough to ensure the patient is the correct one.

18) Which of the following is NOT a site of administration for subcutaneous injections?

A) abdomen

B) back

C) arms

D) chest

Answer: D

Explanation: D) The chest is not a site of administration for subcutaneous injections, which are usually given into the subcutaneous tissue below the dermis in the upper arms, upper back, or upper abdomen.

19) Drugs that are absorbed through the gastrointestinal tract are known as:

A) intrathecal

B) enteral

C) percutaneous

D) parenteral

Answer: B

Explanation: B) Drugs that are absorbed through the gastrointestinal tract are known as "enteral." Intrathecal refers to drugs injected between tendon spaces, parenteral refers to all injected drugs, and percutaneous means "placed in direct contact with the skin or mucous membranes."

20) Which of the following is often used as a diluent in parenteral medications?

A) Cocoa butter

B) Alcohol

C) Powder

D) Sterile normal saline

Answer: D

Explanation: D) Sterile normal saline is often used as a diluent in parenteral medications. Powder or cocoa butter cannot be used as diluents because they are either solid or semisolid. Alcohol is not used as a diluent because it has its own strong effects on the body, and a diluent essentially must be a stable, pure liquid.

21) The intramuscular route is commonly used for drugs that are irritating to:

A) subcutaneous tissue

B) muscles

C) the esophagus

D) the ears

Answer: A

Explanation: A) Sometimes, certain drugs irritate subcutaneous tissue, and they are injected intramuscularly to avoid irritating the subcutaneous tissue. Intramuscular injections are not used to avoid irritation to the muscles, esophagus, or ears.

22) Piggyback infusions are sometimes used as part of which type of injections?

A) Subcutaneous injections

B) Intravenous injections

C) Intramuscular injections

D) Intradermal injections

Answer: B

Explanation: B) Piggyback infusions are sometimes used as part of intravenous injections. In piggyback infusions, drugs are mixed with compatible fluids and administered over 30 to 60 minutes; this is along with another intravenous drug that is already being administered. Piggyback infusions are not used with the three other choices.

23) The legal document recording the medication's order and its administration is known as the:

A) wall chart

B) want book

C) PDR

D) medical record

Answer: D

Explanation: D) The medical record is the legal document recording the medication's order and its administration. A wall chart is a reference tool for medical information, a want book is used in pharmacy stocking, and the PDR is a drug-reference publication.

24) Dull or damaged needles should:

A) be repaired

B) be sharpened

C) never be used

D) be used only once and then discarded

Answer: C

Explanation: C) Dull or damaged needles should never be used. They should not be repaired or sharpened. They should especially not be used once and then discarded. Dull or damaged needles can cause serious harm to the patient and/or the health-care worker.

25) Commonly used needle shafts may range from:

A) 1 to 5 inches

B) 1/10 to 1 inch

C) 1/2 to 1 inch

D) 1/2 to 2 inches

Answer: D

Explanation: D) Commonly used needle shafts range from 1/2 to 2 inches. All the other choices are either nonexistent or extremely uncommon available sizes of needle shafts.

26) "Wasting the medication" concerns the disposal of:

A) normal saline

B) OTC medications

C) controlled substances

D) only oral medications

Answer: C

Explanation: C) "Wasting the medication" refers to the disposal of controlled substances, involving someone who witnesses the event and the documentation of the disposal. This term only applies to controlled substances, not normal saline or OTC medications. Controlled substances may be in many different forms, not just oral medications.

27) Which type of tube is placed directly into the patient's stomach and used to feed the patient?

A) Gastrostomy

B) Nasopharynx

C) Nasogastric

D) Catheter

Answer: A

Explanation: A) A gastrostomy tube is placed directly into a patient's stomach and used to feed the patient. Nasogastric and nasopharynx refer to "through the nose," and a catheter may be inserted into various body orifices–often used for draining, not for feeding.

28) Two common socioeconomic problems for elderly adults are the lack of finances to purchase medications and:

A) proper housing

B) proper nutrition

C) the lack of transportation to obtain them

D) the lack of access to technology

Answer: C

Explanation: C) Elderly people often experience the downside of socioeconomic factors, such as the lack of finances for medications and the lack of transportation to obtain them. Proper housing and nutrition as well as access to technology are factors that may affect some of the elderly population, but these are not as common and thus are not discussed in this chapter.

29) The three most commonly used types of syringes are hypodermic, tuberculin, and:

A) IV

B) insulin

C) saline

D) butterfly

Answer: B

Explanation: B) Hypodermic, tuberculin, and insulin syringes are the three most common types. IV administration uses needles inserted by using short angles to the skin, directly into a vein, and taped down to the skin. This method allows longer term, continuous infusion of IV medications. There are no specific syringes referred to as "saline" syringes. The term butterfly refers to a clamp used in IV administration.

30) The most common nasal instillations are:

A) nasal decongestants

B) nasal blocks

C) for infections

D) cough suppressants

Answer: A

Explanation: A) The most common nasal instillations are nasal decongestants. This is accomplished by the shrinking of swollen mucous membranes and the loosening and drainage of secretions. Nasal instillations are used for nasal infections but not as commonly. Cough suppressants are administered orally.