SUMMIT COLLEGE NCLEX REVIEW1 PDF

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SUMMIT COLLEGE
NCLEX REVIEW1...

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outer aspect of upper arm, the abdomen (from below costal margin to iliac crest), anterior aspect of thighs, upper back, upper ventral or dorsogluteal area List 5 sites for subcutaneous injections = abdomen Injections in the _______ are absorbed most rapidly, ones in the arms less rapidly, in the thighs are even less rapid, those in the upper ventral or dorsogluteal areas are the slowest. 25-30 A ______-______ gauge, 3/8" - 1" needle can be used for subcutaneous injections. 1 Usually no more than _______ mL of solution is given subcutaneously. 45-90 Subcutaneous injections are administered at a ______-_______ degree angle. umbilicus Heparin is administered sub Q, the abdomen is the most common site. Avoid the area 2" around the ______ and belt line. ventrogluteal The _______ site involves the gluteus medius and gluteus minimus muscle in the hip area. greater trochanter To locate the ventrogluteal site, place the palm of your hand over the _______, with your fingers facing the patient's head. Place the index finger on the anterosuperior iliac spine and extend the middle finger dorsally, palpating the iliac crest. A triangle is formed, and the injection is given in the center of the triangle. anterosuperior iliac spine To locate the ventrogluteal site, place the palm of your hand over the greater trochanter, with your fingers facing the patient's head. Place the index finger on the _____ _____ _____ and extend the middle finger dorsally, palpating the iliac crest. A triangle is formed, and the injection is given in the center of the triangle. vastus lateralis The _______ involves the quadriceps femoris muscle and is located along the anterolateral aspect of the thigh. vastus lateralis To locate the _______ site for injection, divide the thigh into thirds horizontally and vertically and administer the injection in the outer middle third. vastus lateralis The ________ is particularly desirable for infants and children, whose gluteal muscles are developed poorly. ventrogluteal, vastus lateralis, deltoid, List the 3 sites used for intramuscular injections = deltoid The _______ muscle is located in the lateral aspect of the upper arm; it is the recommended site for vaccines for adults and may be used for children between 1-18 years old for vaccination; is not developed enough in infants for injections. deltoid Damage to the radial nerve and artery is at risk with use of the _______ site.

acromion Locate the deltoid injection site by palpating the lower edge of the _______ process. A triangle is formed at the midpoint in line with the axilla on the lateral aspect of the upper arm, with the base of the triangle at the acromion process. 20-25, 18-25 Intramuscular medications should be given with a ______-______ gauge needle, if it is aqueous solution. If it is in oil-based solution, ______-______ gauge needle is preferred. 1-4 Generally, ____-____ mL is the accepted range, with no more than 1 mL at the deltoid site for IM injections. 1-2 In less developed muscles of children and elderly, IM injections should be limited to ______ mL. 72-90 Give an IM injection perpendicular to the body to ensure an angle of injection between ______-______. z-track technique The _______ is recommended for all IM injections to ensure medication does not leak back along the needle track and into the subcutaneous tissue. z track technique In the _______, attach a clean needle to the syringe after the syringe is filled with medication to prevent the injection of any residual medication on the needle into superficial tissues. Pull the skin down, or to one side, about 1" & hold in this position with non-dominant hand. Insert the needle and inject the medication slowly. Withdraw the needle steadily and release the displaced tissue. Apply gentle pressure with a dry sponge. 1 In the z track technique, attach a clean needle to the syringe after the syringe is filled with medication to prevent the injection of any residual medication on the needle into superficial tissues. Pull the skin down, or to one side, about _______" & hold in this position with non-dominant hand. Insert the needle and inject the medication slowly. Withdraw the needle steadily and release the displaced tissue. Apply gentle pressure with a dry sponge. upper arm 5 sites for subcutaneous injections: outer aspect of ______, the abdomen (from below costal margin to iliac crest), anterior aspect of thighs, upper back, upper ventral or dorsogluteal area. costal margin 5 sites for subcutaneous injections: outer aspect of upper arm, the abdomen (from below _______ to iliac crest), anterior aspect of thighs, upper back, upper ventral or dorsogluteal area. iliac crest 5 sites for subcutaneous injections: outer aspect of upper arm, the abdomen (from below costal margin to _______), anterior aspect of thighs, upper back, upper ventral or dorsogluteal area.

thighs 5 sites for subcutaneous injections: outer aspect of upper arm, the abdomen (from below costal margin to iliac crest), anterior aspect of ________, upper back, upper ventral or dorsogluteal area. back 5 sites for subcutaneous injections: outer aspect of upper arm, the abdomen (from below costal margin to iliac crest), anterior aspect of thighs, upper _______, upper ventral or dorsogluteal area. ventral 5 sites for subcutaneous injections: outer aspect of upper arm, the abdomen (from below costal margin to iliac crest), anterior aspect of thighs, upper back, upper _______ or dorsogluteal area. dorsogluteal 5 sites for subcutaneous injections: outer aspect of upper arm, the abdomen (from below costal margin to iliac crest), anterior aspect of thighs, upper back, upper ventral or _______ area. intradermal ______ medications are administered into the dermis, just below the epidermis. It has the longest absorption time of all the parental routes. inner surface of forearm, upper back, under the scapular List 3 common sites for intradermal injections: 1/4, 1/2 A ______-______", 26 or 27 gauge needle is used when giving an intradermal injection. 26, 27 A 1/4-1/2", _______ or _______ gauge needle is used when giving an intradermal injection. 0.5 The amount given intradermally is usually less than ______ mL. 5-15 The angle of administration for an intradermal injection is ______-______ degrees. 5/8-1" Vastus lateralis needles size 5/8-1 1/4" Deltoid needle size for children 5/8-1 1/2" Deltoid needle size for adults 1 1/2" Ventrogluteal needle size 1, 3 The volume of a subcutaneous injection is usually up to ______ mL. An intramuscular injection is the administration of up to _______ mL of medication into one muscle or muscle group. Intradermal injections are commonly used for diagnostic purposes in small volumes, usually 0.1 to 0.5 mL. B Which one of the following medications would most likely be administered via a transdermal patch?

a) Epinephrine b) Hormonal medications c) Antidepressants d) Antibiotics B A nurse is using an 18-gauge needle to administer a medication to a client. The nurse knows that when compared to a 27-gauge needle, an 18-gauge needle has which of the following features? a) Greater length b) Larger diameter c) Shorter length d) Smaller diameter a, c, d Multiple Choice Question - Select all answer choices that apply. A nurse is caring for a client who refuses to take the prescribed medication, stating that she is allergic to it. What should the nurse do when the client refuses to take the medication? Select all that apply. a) Circle the scheduled time on the MAR b) Inform the nurse manager about the situation c) Report the situation to the prescriber d) Identify the reason for not administering e) Discuss the reason for refusal with the client a A nurse is caring for a client undergoing IV therapy. The nurse knows that intravenous administration of medication is appropriate in which of the following situations? a) When the client has disorders that affect the absorption of medications b) When the drug needs to act on the client very slowly c) When the drug needs to be administered only once d) When the client wants to avoid the discomfort of an intradermal injection inunction _______ is medication incorporated into an agent that is administered by rubbing it into the skin. b The nurse transcribes an order that reads: Colace 100 mg PO daily. This is an example of which type of order? a) As needed order b) Standing order c) Single order d) Stat order c

You are preparing to administer a sublingual medication. Which of the following instructions to the patient is correct? a) "Take a big drink of water and swallow the pill." b) "Swallow frequently to get the best benefit." c) "Try not to swallow while the pill dissolves." d) "Chew the pill so it will dissolve faster." therapeutic _______ range is the concentration of drug in the blood serum that produces the desired effect without causing toxicity. peak _______ level is the highest plasma concentration. trough ______ level is the point when the drug is at the lowest concentration. half ______ life is the amount of time it takes for 50% of the blood concentration of a drug to be eliminated from the body. c What is involved in the absorption, distribution, metabolism, and excretion of medication? a) Pharmacology b) Pharmacotherapeutics c) Pharmacokinetics d) Pharmacodynamics d A physician at a health care facility suggests the use of a metered-dose inhaler for an asthmatic client. Which of the following describes the mechanism of a metered-dose inhaler? a) A device that forces liquid drug through a narrow channel using pressurized air b) A propeller-driven device that spins and suspends a finely powdered medication c) A device that forces medication through a narrow channel with the help of inert gas d) A canister containing medication that is released when the container is compressed aerosol A(n) _______ inhaler results after a liquid drug is forced through a narrow channel using pressurized air or an inert gas. turbo A(n) _______ inhaler is a propeller-driven device that spins and suspends a finely powdered medication b If the dosage is inappropriate for a client, who is responsible? a) Medical technician b) Nurse

c) Physician d) Pharmacist a A nurse is administering a prescribed dose of medication to a client through a medication lock. How often should the nurse flush the medication lock to maintain patency? a) Every 8 to 12 hours b) Every one or two hours c) Every 72 to 96 hours d) Every 36 to 48 hours parenteral The ______ route includes such methods as intravenous administration and injections. Pills are given by an oral route and a nebulizer is administered by the pulmonary route. An ointment is a topical medication. b Which of the following clients receives a drug that requires parenteral route? a) A man who has an antifungal ointment applied to his skin rash daily b) A woman who has been ordered intravenous antibiotics c) A man with emphysema who uses nebulized bronchodilators d) A woman who takes a diuretic pill each morning b A nurse is administering medications through an enteral tube to a client with swallowing difficulties due to a cerebrovascular accident (CVA). Which of the following actions should the nurse perform to prevent gastric reflux? a) Administer the medication over several minutes. b) Help the client into a Fowler's position. c) Check for drug allergies in the client's history. d) Add diluted medication to the syringe. c The nurse is preparing to administer a medication via a nasogastric tube. What guideline is appropriate for the nurse to follow when administering a drug via this route? a) If connected to suction, do not reconnect to suction for five minutes after drug administration. b) Position the client supine prior to administering the drug. c) Flush the tube with water between each drug administered. d) Administer the medication at a cold temperature. b A nurse is caring for a client with difficulty breathing due to nasal congestion. What care should the nurse take to prevent the client from inhaling large droplets of the medication when the nasal spray is being administered? a) Help the client to a sitting position with her head tilted backward.

b) Instruct the client to breathe through her mouth. c) Place a rolled towel or pillow behind the client's neck. d) Place the tip of the container just inside the nostril. d A nurse needs to use a moisturizer for an older adult client with dry skin. Why is the onset of the medication action atypical in an older adult client? a) Diminished physical mobility b) Decreased appetite c) Decreased body temperature d) Diminished subcutaneous fat 1, 2, 4, 6, 5, 3 You need to prepare an insulin pen for injection of a prescribed dose of insulin. Arrange the following steps in the correct order. 1. Clean the tip of the pen with alcohol. 2. Screw the correct needle onto the tip of the pen. 3. Verify the dose selector returned to "0." 4. Dial the dose selector to 2 units. 5. Watch for a drop of insulin at the needle tip. 6. Hold the pen upright and press the plunger firmly. a A nurse is using a volume control set to administer a dose of prescribed medication to a client. The nurse opens the lower clamp until the tubing is filled with fluid and then reclamps it. Which of the following statements explains the nurse's action? a) Purges air from the tubing b) Removes colonizing microorganisms c) Mixes the drug throughout the fluid d) Provides diluent for the medication c Regarding medication administration, what must occur at the change of shifts? a) The medications for the division are counted b) The client's medications must be drawn up c) The narcotics for the division are counted d) The LPNs only on the division count medications d To which of the following patients would the nurse be most likely to administer a PRN medication? a) A patient who is experiencing severe and unprecedented chest pain b) A patient who requires daily medication to control hypertension c) A patient whose asthma is treated with inhaled corticosteroids d) A patient who is complaining of pain near her surgical site b

When educating an elderly client about the administration of medication during discharge teaching, the nurse notes that the client is having difficulty comprehending the instruction. What intervention should the nurse follow in this case to ensure the client's safety? a) Ask a second nurse to repeat the instruction. b) Involve a second responsible person in the instruction. c) Ask the client's physician to provide instruction. d) Write discharge instructions on the medication containers. a A nurse at the health care facility needs to administer an otic application for a client with an earache. What should the nurse do after instilling the prescribed eardrops in the client's ear? a) Ask the client to maintain the position for some time b) Instill the medication in the opposite ear if prescribed c) Briefly postpone the application in the second ear d) Place a cotton ball in the ear to absorb excess medication b A nurse is using an IV port when administering medication to a client. Which of the following IV administrations has the greatest potential to cause life-threatening changes? a) Continuous administration b) Bolus administration c) Electronic infusion device d) Secondary administration c A client with dry skin has been prescribed inunction. Which of the following should the nurse do to promote absorption of the ointment? a) Shaking the contents of the ointment b) Warming the inunction before application c) Rubbing the ointment into the skin d) Applying inunction with a cotton ball b What is the name of the process by which a drug moves through the body and is eventually eliminated? a) Pharmacotherapeutics b) Pharmacokinetics c) Pharmacodynamics d) Pharmacology b The nurse is caring for a client who has problems coordinating his breathing with the inhaler use. Therefore, the client is unable to receive the full dose. Which of the

following would help maximize drug absorption in this client? a) Nasal drops b) Spacer c) Turbo-inhaler d) Metered-dose inhaler spacer A _______ provides a reservoir for the aerosol medication. As the client takes additional breaths, he continues to inhale the medication held in the reservoir. This tends to maximize the drug's absorption because it prevents drug loss. allergic reaction Urticaria, hives, wheezing, and dyspnea are the symptoms of severe _______, which is due to an anaphylactic reaction. d A client has been prescribed nasal medication. What care should the nurse take to avoid potential complications due to the administration of this medication? a) Administer medication within 30 to 60 minutes of the scheduled time b) Allow sufficient time to prepare the medication with minimal distraction c) Read and compare labels on the medication with the medical record d) Review the client's medication, allergy, and medical history d Which of the following medication-administration systems protects the client by identifying the rights of medication administration? a) Self-administered medication system b) Automated medication-dispensing system c) Unit dose system d) Barcode Medication Administration enteric ______ coated tablets are covered with a hard surface that impedes absorption until the tablet has left the stomach; thus, the medication is released in the small intestine. Used when the active ingredient of the drug is irritating to the stomach mucosa. 15-30 Medications should be crushed to a fine powder and mixed with _____-_____ mL of water before delivery through the enteral feeding tube. parenteral The word ______ means outside the intestines or alimentary canal. i.e. - injections bolus A _______ is a relatively large amount of medication given all at once; this administration sometimes is described as a drug given by IV push, or rapid intravenous administration. continuous A ________ infusion, also called continuous drip, is instillation of a parenteral drug over several hours. It involves adding medication to a large volume of IV solution. After the

medication is added, the solution is administered by gravity infusion or, more commonly, with an electronic infusion device such as a controller or pump. b A nurse needs to administer a prescribed medication to a client using IV push. In which of the following ways is the medication being administered to the client? a) Continuous drip b) Bolus administration c) Electronic infusion device d) Gravity infusion d A nurse needs to administer a subcutaneous injection to a client. Which of the following distances should the nurse maintain when rotating within an injection site? a) About two fingers' width apart b) About three fingers' width apart c) About four fingers' width apart d) About a finger's width apart albumin _______ is a plasma protein contained within the plasma. It is used to restore intravascular volume and to maintain cardiac output in clients with hypoproteinemia. d A client suffers from infectious diarrhea. Based on her loss of fluid, her protein level is below normal. What blood product will the physician order to restore intravascular volume? a) Whole blood b) Platelets c) Packed red cells d) Albumin distribution The process by which the medication is delivered to the target cells and tissues is called _______. absorption _______ is the process by which a medication enters the bloodstream. synergism _______ is a drug interaction that increases the drug effect. metabolism The process of chemically changing the drug in the body is called _______; it takes place mainly in the liver. c A client with an infection is receiving intravenous antibiotic therapy. The client has an intermittent infusion device in place. The nurse flushes the device with normal saline solution before administering the antibiotic based on which rationale? a) To facilitate cannulation of the central vein

b) To minimize the danger of fluid overload c) To prevent blood clot formation d) To allow increased mobility for the client c A nurse is administering enoxaparin, (blood thinner) to a patient with DVT, via the subcutaneous route. Which of the following is a recommended guideline when administering a subcutaneous injection? a) Pinching is advised for obese patients to lift the adipose tissue away from underlying muscle and tissue. b) Sites commonly used for a subcutaneous injection are the inner sur...