Question

A client is attempting to put pills in his mouth from a medicine cup and drops one pill on the bed sheet. The nurse should:

Answer 1

Correct Answers:

discard the pill and get another from the dose pack.

Rationale :

🟢 Once a pill has been dropped onto a non-sterile surface such as bed linens, it is considered contaminated and should not be administered to the client.

🟢 The nurse must safely discard the contaminated pill according to facility policy and replace it with a new one from the client’s prescribed dose pack or pharmacy supply.

🟢 Administering a dropped or contaminated medication poses a risk for infection or compromised safety and violates safe medication administration practices.

🟢 This is not considered a medication error as long as the dose is replaced properly and not administered incorrectly.

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Answer 2

Correct Answers:

remove excess ointment from the lid with a cotton ball.
remove gloves and perform hand hygiene.
ask the client to roll the eye around and from side to side.

Rationale :

🟢 B. Remove excess ointment from the lid with a cotton ball

🧼 After applying the ointment, a small amount may spread onto the eyelid.

🧻 Use a clean cotton ball or sterile gauze to gently wipe away the excess—this maintains hygiene and comfort.

🚫 Do not rub or press the eye, and avoid touching the eye directly to prevent irritation or contamination.

🟢 C. Remove gloves and perform hand hygiene

🧤 After the procedure, the nurse should remove gloves correctly to avoid contamination.

🧴 Then perform hand hygiene immediately to follow standard precautions.

🔄 This action helps prevent cross-contamination between clients or surfaces and ensures safe practice.

🟢 D. Ask the client to roll the eye around and from side to side

👁️ Instruct the client to gently roll the eyes to help spread the ointment evenly over the ocular surface.

🔄 This promotes uniform medication absorption and improves effectiveness.

😌 It also helps prevent the ointment from collecting in one area and makes the application more comfortable.

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Answer 3

Correct Answers:

Measure liquid medication by bringing liquid medication cup to eye level.

Rationale :

🟢 When administering liquid medications, the nurse must bring the medication cup to eye level to accurately read the meniscus (the curve formed at the surface of the liquid).

🟢 This technique prevents dosing errors caused by parallax error—an incorrect measurement from looking at the cup from above or below.

🟢 Proper technique ensures the client receives the prescribed dose, especially for medications where accuracy is critical, such as anticoagulants or antiepileptics.

🟢 It also demonstrates adherence to safe medication administration practices taught in nursing fundamentals.

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Answer 4

Correct Answers:

should not be swallowed because it alters the absorption potential.

Rationale :

🟡 Sublingual medications, like nitroglycerin, are specifically formulated to be absorbed through the mucous membranes under the tongue, providing rapid onset of action—crucial in treating chest pain or angina.

🟡 Swallowing the tablet bypasses this mucosal absorption and sends the drug to the gastrointestinal tract, where it is metabolized by the liver (first-pass effect), significantly reducing its effectiveness.

🟡 Educating the client on correct sublingual technique ensures therapeutic effectiveness and prevents treatment failure during acute episodes.

🟡 The nurse should also consider suggesting ways to minimize taste discomfort, such as sipping water before and after (without swallowing the pill) or discussing alternatives with the provider.

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Answer 5

Correct Answers:

Downward and back.

Rationale :

🟢 In infants and children under 3 years, the ear canal is shorter and more horizontal than in older children and adults.

🟢 To straighten the ear canal and allow proper delivery of eardrops, the auricle (pinna) should be gently pulled downward and back.

🟢 This positioning aligns the external auditory canal, ensuring the medication reaches the tympanic membrane and middle ear effectively.

🟢 Using the correct technique reduces the risk of trauma and improves absorption of the medication.

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Answer 6

Correct Answers:

have the client tilt the head forward.

Rationale :

🟢 When administering nasal medication via an atomizer spray, the client should tilt the head slightly forward, not backward. This prevents the medication from running down the throat and ensures it stays in the nasal passages where it's intended to act.

🟢 This position helps target the nasal mucosa and enhances local absorption.

🟢 The nurse should also instruct the client to breathe in gently during administration, while the nurse or the client activates the spray.

🟢 Proper positioning ensures comfort, accuracy, and therapeutic effectiveness.

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Answer 7

Correct Answers:

rotate sites to avoid skin irritation.

Rationale :

🟢 Rotating transdermal patch sites is essential to prevent skin irritation, breakdown, and sensitization from prolonged exposure to the adhesive and medication.

🟢 Nitroglycerin patches deliver medication systemically through the skin, and rotating locations maintains skin integrity and ensures consistent absorption.

🟢 Patches should be applied to clean, dry, hairless areas such as the chest, upper arm, or back—not over hairy or broken skin.

🟢 Documentation (e.g., initials and time) is helpful, but rotating the site is most critical to ensure safe and effective therapy.

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Answer 8

Correct Answers:

The client touches the conjunctival sac with the eyedropper to make sure she is in the correct location.

Rationale :

🔴 Touching the conjunctival sac or any part of the eye with the eyedropper tip contaminates the dropper, increasing the risk of eye infections.

🔴 Proper technique involves holding the dropper close to—but not touching—the eye, while instilling the drop into the lower conjunctival sac.

🔴 This incorrect action indicates the client needs further teaching on maintaining aseptic technique during eye drop administration.

🔴 All other actions listed are appropriate, including cleaning the eye properly and administering another drop if the first one missed the target.

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Answer 9

Correct Answers:

6 weeks from the start of using the inhaler

Rationale :

🟢 The client is prescribed 2 puffs twice daily, which equals 4 puffs per day.

🟢 The inhaler contains 200 puffs, so:

200puffs÷4puffs/day=50daysofuse200 puffs ÷ 4 puffs/day = 50 days of use200puffs÷4puffs/day=50daysofuse

🟢 Since 50 days is approximately 7 weeks, the nurse should advise the client to refill around 6 weeks to ensure there is no interruption in medication availability.

🟢 This proactive approach allows time to secure a refill before the medication runs out, promoting adherence and symptom control.

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Answer 10

Correct Answers:

"I should wait 20 to 30 seconds between puffs and 2 to 5 minutes between inhalations of different medications. I should administer the inhaled steroids first followed by the bronchodilator."

Rationale :

🔴 This statement reflects incorrect medication sequencing. The bronchodilator (e.g., albuterol) should be administered first, not the steroid.

🔴 Administering the bronchodilator first opens the airways, allowing better absorption of the corticosteroid when given afterward.

🔴 The waiting time between puffs of the same medication (typically 30 seconds to 1 minute) is correct, and waiting 2 to 5 minutes between different medications is also reasonable.

🔴 However, the reversal of the medication order indicates that the client needs further teaching on correct MDI use.

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QLexNursing

1 :
A client is attempting to put pills in his mouth from a medicine cup and drops one pill on the bed sheet. The nurse should:

2 :
When applying ophthalmic ointments, the nurse should: (Select all that apply.)

3 :
A nurse is administering oral medications to patients. Which action will the nurse take?

4 :
A client complains about the taste of the sublingual nitro-glycerine and admits that he swallows it rather than holding it under his tongue. The nurse explains that sublingual medications:

5 :
The ear canal should be straightened when instilling eardrops to provide direct access to deeper ear structures. In what direction should the auricle be pulled in an infant to straighten the ear canal?

6 :
The nurse administering a nasal medication via an atomizer bottle should:

7 :
A client has an order for a nitroglycerin transdermal patch. The best way to ensure proper administration of this medication is to:

8 :
A client has been prescribed eye drops for the treatment of glaucoma. The nurse is observing the client self-administer the eye drops. Which action by the client requires further teaching?

9 :
A client who is being discharged today is going home with an inhaler. The client is to administer 2 puffs of the inhaler twice daily. The inhaler contains 200 puffs. When should the nurse appropriately advise the client to refill the medication?

10 :
The nurse is teaching the client how to use an MDI with a spacer device. Which statement, if made by the client, indicates further teaching is required?

QLexNursing

1 : A client is attempting to put pills in his mouth from a medicine cup and drops one pill on the bed sheet. The nurse should:

2 : When applying ophthalmic ointments, the nurse should: (Select all that apply.)

3 : A nurse is administering oral medications to patients. Which action will the nurse take?

4 : A client complains about the taste of the sublingual nitro-glycerine and admits that he swallows it rather than holding it under his tongue. The nurse explains that sublingual medications:

5 : The ear canal should be straightened when instilling eardrops to provide direct access to deeper ear structures. In what direction should the auricle be pulled in an infant to straighten the ear canal?

6 : The nurse administering a nasal medication via an atomizer bottle should:

7 : A client has an order for a nitroglycerin transdermal patch. The best way to ensure proper administration of this medication is to:

8 : A client has been prescribed eye drops for the treatment of glaucoma. The nurse is observing the client self-administer the eye drops. Which action by the client requires further teaching?

9 : A client who is being discharged today is going home with an inhaler. The client is to administer 2 puffs of the inhaler twice daily. The inhaler contains 200 puffs. When should the nurse appropriately advise the client to refill the medication?

10 : The nurse is teaching the client how to use an MDI with a spacer device. Which statement, if made by the client, indicates further teaching is required?

1 :
A client is attempting to put pills in his mouth from a medicine cup and drops one pill on the bed sheet. The nurse should:

2 :
When applying ophthalmic ointments, the nurse should: (Select all that apply.)

3 :
A nurse is administering oral medications to patients. Which action will the nurse take?

4 :
A client complains about the taste of the sublingual nitro-glycerine and admits that he swallows it rather than holding it under his tongue. The nurse explains that sublingual medications:

5 :
The ear canal should be straightened when instilling eardrops to provide direct access to deeper ear structures. In what direction should the auricle be pulled in an infant to straighten the ear canal?

6 :
The nurse administering a nasal medication via an atomizer bottle should:

7 :
A client has an order for a nitroglycerin transdermal patch. The best way to ensure proper administration of this medication is to:

8 :
A client has been prescribed eye drops for the treatment of glaucoma. The nurse is observing the client self-administer the eye drops. Which action by the client requires further teaching?

9 :
A client who is being discharged today is going home with an inhaler. The client is to administer 2 puffs of the inhaler twice daily. The inhaler contains 200 puffs. When should the nurse appropriately advise the client to refill the medication?

10 :
The nurse is teaching the client how to use an MDI with a spacer device. Which statement, if made by the client, indicates further teaching is required?