Drug Administration Routes, Preparation, and Administration

Every question here, with the answer

1. A client is prescribed an opioid analgesic. Which nursing action is the priority related to safe administration?

   1. Open the unit-dose medication in the medication room before entering the client’s room.
   2. Assess the respiratory rate and oxygen saturation before and after administration.
   3. Assess only the client’s blood pressure before administration.
   4. Leave the medication at the bedside so the client can take it when pain increases.

   Answer: Assess the respiratory rate and oxygen saturation before and after administration.

   Opioids may cause respiratory depression, so respiratory status must be assessed before and after giving the drug. The other actions either assess the wrong parameter, create a medication safety risk, or conflict with bedside administration guidance.

2. The nurse is preparing to administer oral tablets to a client. Which actions follow the section’s procedure? Select all that apply.

   1. Assess swallowing ability and gag reflex by offering a sip of water.
   2. Position the client upright or on the side as the condition allows.
   3. Ask whether the client prefers all medications at once or one or two at a time.
   4. Crush all tablets together if the client says swallowing is difficult.
   5. Give the medication with approximately 8 ounces of water unless the client has a fluid restriction.

   Answer: Assess swallowing ability and gag reflex by offering a sip of water., Position the client upright or on the side as the condition allows., Ask whether the client prefers all medications at once or one or two at a time., Give the medication with approximately 8 ounces of water unless the client has a fluid restriction.

   The section directs the nurse to position the client safely, assess swallowing and gag reflex, ask about preferred pacing, and provide water unless restricted. Crushing all tablets together is unsafe because some tablets should not be crushed and crushed tablets should be kept separate.

3. A client has difficulty swallowing and asks the nurse to crush a timed-release tablet into applesauce. What is the best response by the nurse?

   1. Tell the client to chew the tablet slowly to improve swallowing.
   2. Do not crush or chew the tablet; consult a pharmacist for an appropriate administration technique.
   3. Split the tablet even if it is not scored so the pieces are smaller.
   4. Crush the tablet and mix it with food because the client cannot swallow it whole.

   Answer: Do not crush or chew the tablet; consult a pharmacist for an appropriate administration technique.

   Timed-release tablets should not be crushed or chewed because doing so can change absorption and may cause toxicity. When a client has difficulty swallowing a tablet or capsule, the nurse should consult a pharmacist for guidance.

4. The nurse is teaching a client how to take a sublingual or buccal medication. Which instructions are appropriate? Select all that apply.

   1. Chew the medication and drink water immediately to help it work faster.
   2. Moisten the oral cavity with sips of water before placing the medication.
   3. Do not swallow or chew the pill, and avoid food, drinking, or smoking until it dissolves.
   4. Allow the medication to dissolve completely.
   5. Place a sublingual medication under the tongue or a buccal medication between the cheek and gum.

   Answer: Moisten the oral cavity with sips of water before placing the medication., Do not swallow or chew the pill, and avoid food, drinking, or smoking until it dissolves., Allow the medication to dissolve completely., Place a sublingual medication under the tongue or a buccal medication between the cheek and gum.

   Sublingual and buccal medications are placed in the mouth to dissolve and be absorbed through vascular oral tissue. Swallowing, chewing, eating, drinking, or smoking before the medication dissolves conflicts with the administration instructions.

5. Immediately after receiving a nasal spray, a client sneezes and asks the nurse for another spray. What should the nurse do?

   1. Do not readminister the nasal spray.
   2. Have the client blow the nose immediately and then repeat the dose.
   3. Repeat the dose in the same nostril immediately.
   4. Repeat the dose only if the client reports no burning or stinging.

   Answer: Do not readminister the nasal spray.

   The nurse should not give another dose after sneezing because the amount already absorbed cannot be determined. Repeating the spray could result in giving more medication than intended, and the client should avoid blowing the nose immediately after administration.

6. A nurse is teaching a client about routine subcutaneous injections. Which instructions are consistent with the section? Select all that apply.

   1. Use a site that feels hard when palpated if it is easy to reach.
   2. Check the drug’s package insert or labeling for the specific injection sites.
   3. Gentle pressure may be applied after the drug has been administered.
   4. Rotate routine injections regularly among different sites.
   5. Do not rub the injection site after administration.

   Answer: Check the drug’s package insert or labeling for the specific injection sites., Gentle pressure may be applied after the drug has been administered., Rotate routine injections regularly among different sites., Do not rub the injection site after administration.

   The section states that specific sites are usually found in the package insert or labeling, routine injections should be rotated, and hard sites should be avoided. The site should not be rubbed after injection, although gentle pressure may be used.