QMAP Medication Administration Routes 2 — Questions and Answers
Question 1: Which route delivers medication through the skin into the bloodstream via a patch?
- Topical
- Transdermal (Correct answer)
- Sublingual
- Intramuscular
Correct answer: Transdermal
Transdermal patches deliver medication through the skin into the bloodstream for systemic effect.
Unlike topical medications which act locally, transdermal systems deliver medication systemically. Common examples include fentanyl patches for pain and nicotine patches. QMAPs must rotate application sites and remove old patches before applying new ones.
Question 2: When administering eye drops, where should the drops be placed?
- Directly on the cornea
- In the lower conjunctival sac (Correct answer)
- On the upper eyelid
- At the outer corner of the closed eye
Correct answer: In the lower conjunctival sac
Drops go in the lower conjunctival sac, formed by gently pulling down the lower eyelid.
Gently pull down the lower eyelid to expose the conjunctival sac. Hold the dropper close but not touching the eye. Placing drops on the cornea causes reflexive blinking that wastes the medication.
Question 3: A resident has a rectal medication ordered. Which form would this most likely be?
- Capsule
- Transdermal patch
- Suppository (Correct answer)
- Lozenge
Correct answer: Suppository
Rectal medications are typically suppositories that dissolve or melt at body temperature.
Rectal administration is used when oral route is unavailable, the medication would be destroyed by stomach acid, or local effect is desired. Insert gently past the internal sphincter and have the resident remain lying down for 15-20 minutes.
Question 4: What is the primary difference between topical and systemic medication routes?
- There is no difference
- Topical acts locally at the application site; systemic delivers throughout the body via bloodstream (Correct answer)
- Topical is always safer
- Systemic is only given by injection
Correct answer: Topical acts locally at the application site; systemic delivers throughout the body via bloodstream
Topical medications act at the application site, while systemic medications enter the bloodstream and affect the entire body.
Topical routes include creams, ointments, and localized drops. Systemic routes include oral, sublingual, transdermal patches, and injections. The line can blur as topical medications may have some systemic absorption.
Question 5: When administering a nasal spray, in which direction should the nozzle be pointed?
- Straight up toward the top of the head
- Toward the septum
- Toward the outer wall of the nostril, away from the septum (Correct answer)
- Downward toward the floor of the nose
Correct answer: Toward the outer wall of the nostril, away from the septum
Aim toward the outer wall, away from the septum, to maximize absorption and minimize irritation.
Pointing toward the septum can cause irritation, nosebleeds, and potential septal perforation. Insert the nozzle just inside the nostril, aim toward the outer wall, and spray while the resident inhales gently through the nose.
Question 6: A medication order says "apply to affected area BID." What does this tell the QMAP about the route?
- It is an oral medication
- It is a topical medication applied to a specific area twice daily (Correct answer)
- It is sublingual
- It is a rectal medication
Correct answer: It is a topical medication applied to a specific area twice daily
"Apply to affected area" indicates topical, and BID means twice daily.
Order language provides route clues: "take by mouth" or "PO" = oral, "place under tongue" or "SL" = sublingual, "apply to" = topical, "instill" = eye/ear drops, "inhale" = respiratory.
QMAP Medication Administration Routes 2
Which route delivers medication through the skin into the bloodstream via a patch?