NCAS Pharmacology and Medication Administration 2 — Questions and Answers
Question 1: A nurse is preparing to administer a subcutaneous insulin injection to an adult patient with average body weight. Which needle length is most appropriate?
- 1.5 inches
- 1 inch
- 5/8 inch or shorter (Correct answer)
- 2 inches
Correct answer: 5/8 inch or shorter
Short needles (5/8 inch or shorter) are used for subcutaneous insulin injections to deposit medication into the subcutaneous fat layer without reaching muscle.
Question 2: A patient started on an ACE inhibitor two weeks ago calls the clinic complaining of a bothersome symptom. Which adverse effect is most characteristic of this drug class?
- Peripheral edema
- Excessive urination
- Persistent dry cough (Correct answer)
- Muscle cramps
Correct answer: Persistent dry cough
ACE inhibitors cause accumulation of bradykinin in the lungs, resulting in a persistent dry cough that often requires switching to an ARB.
Question 3: A patient receiving IV morphine develops a respiratory rate of 8 breaths per minute and is difficult to arouse. Which medication should the nurse prepare to administer?
- Flumazenil
- Naloxone (Correct answer)
- Protamine sulfate
- Vitamin K
Correct answer: Naloxone
Naloxone is an opioid receptor antagonist that rapidly reverses opioid-induced respiratory depression and sedation.
Question 4: What is the primary nursing safety action that must be completed immediately before administering any medication to a patient?
- Verifying the patient's allergy history in the chart
- Confirming the order with the prescribing physician
- Using two patient identifiers to confirm patient identity (Correct answer)
- Documenting medication administration in the MAR
Correct answer: Using two patient identifiers to confirm patient identity
Verifying patient identity using two identifiers (name and date of birth or medical record number) before every medication administration prevents medication errors.
Question 5: A patient is prescribed a transdermal nitroglycerin patch. Which nursing instruction regarding application is most accurate?
- Apply it directly over the precordial area for maximum cardiac effect
- Apply to a clean, dry, hairless skin area and rotate sites with each dose (Correct answer)
- Apply only to the inner forearm and do not rotate
- Apply over a bony prominence to ensure firm adhesion
Correct answer: Apply to a clean, dry, hairless skin area and rotate sites with each dose
Transdermal patches should be applied to clean, dry, hairless skin on non-bony areas, with site rotation to prevent skin irritation and ensure consistent absorption.
Question 6: A nurse is assessing a patient receiving digoxin and notes a new complaint of seeing yellow-green halos around lights along with a heart rate of 48 bpm. What does the nurse suspect?
- Therapeutic drug response indicating adequate dosing
- Digoxin toxicity (Correct answer)
- Hypertensive urgency requiring immediate intervention
- Allergic reaction to the medication
Correct answer: Digoxin toxicity
Xanthopsia (yellow-green visual disturbances) combined with bradycardia are classic signs of digoxin toxicity requiring immediate provider notification.
Question 7: When administering an intramuscular injection requiring a large volume of medication to an adult patient, which injection site is currently recommended by evidence-based practice?
- Deltoid
- Dorsogluteal
- Ventrogluteal (Correct answer)
- Vastus lateralis
Correct answer: Ventrogluteal
The ventrogluteal site is preferred for adult IM injections because it contains no major blood vessels or nerves and can safely accommodate larger medication volumes.
NCAS Pharmacology and Medication Administration 2
A nurse is preparing to administer a subcutaneous insulin injection to an adult patient with average body weight.
Which needle length is most appropriate?