Lesson 10 Medication Administration

Lesson 10 - Medication Administration: HESI RN FLMIR 1904COHORT 4/8/20, 2(52 PM
Lesson 10 - Medication Administration

Due Apr 8 at 11:59pm Points 42 Questions 42
Available Mar 18 at 12am - Apr 8 at 11:59pm 22 days Time Limit None
Instructions
This is your Virtual Clinical Excursion. Each VCE is 4 hours and you will be assigned 3 VCE's per 12
hour clinical. This is to be completed on the day of clinical scheduled. This assignment will be
reviewed and graded by your clinical instructors. Do not utilize copy and paste from the internet-type
the answers in your own words utilizing available resources.
Attempt History
Attempt Time Score
LATEST Attempt 1 148 minutes 29.5 out of 42 *
* Some questions not yet graded
Score for this quiz: 29.5 out of 42 *

Submitted Apr 8 at 1:29pm
This attempt took 148 minutes.
Question 1 1 / 1 pts
Exercise 1 - Writing Activity
This exercise will take approximately 30 minutes to complete.
Exercise 1 - Question 1
The chemical name of a medication is an exact description
https://concorde.instructure.com/courses/18808/quizzes/143053?module_item_id=2323796 Page 1 of 30
of its composition and molecular structure.
Answer 1:
Correct! chemical
The trade name, brand name, or proprietary name is the
official name under which a manufacturer markets a medication.
Answer 1:
Correct! proprietary
After taking a prescribed medication, a patient reports feeling very tired.

The nurse caring for the patient consults a drug handbook and
determines that the medication is not associated with drowsiness. What
term is used to refer to this type of patient reaction?
Side effect
Correct! Adverse effect
Toxic effect
Idiosyncratic reaction
Allergic reaction
Below are abbreviations commonly associated with medication

administration. Match abbreviation term with its correct meaning.
(A) Give immediately
(B) As desired
(C) After meals
(D) Every morning
(E) Before meals
(F) Whenever there is a need
Correct! ad lib B
Correct! AC E
Correct! qAM D
Correct! STAT A
Correct! PC C
Correct! prn F
The physician has ordered laboratory studies to evaluate the peak and
trough of a medication. Which of the following statements concerning
these terms is correct? Select all that apply.
Peak refers to the time it takes for a medication to produce a response

after it is administered.
Correct!
Peak refers to the time it takes for a medication to reach its highest
effective concentration.
Trough refers to the length of time of the therapeutic response produced

by a medication.
Correct!
Trough refers to the smallest serum concentration of medication present
before the next scheduled dosage.
Trough refers to the amount of medication needed to produce a

therapeutic response.
When two medications have a(n) Synergistic effect , their combined
effect is greater than the effect of the medications given separately.
Answer 1:
Correct! synergistic effect
Indicate whether the following statement in true or false.
Medications intended for sublingual administration may not have the

desired effect if swallowed.
Correct! True
False
Which of the following statements describe activities for correctly

following the six rights of medication administration? Select all that
apply.
Correct!
Compare the MAR with the physician's written order for the name of a
medication.
Review the patient's record for allergies.
Review the supply cart for available sizes of syringes.
Correct!
Check the MAR against the physician's written order for the route of
administration.
Correct!
Compare the physician's written order for a medication with the times
selected on the MAR for scheduled administration.
Which of the following sites is preferred for administering an

intramuscular (IM) injection to an adult?
Vastus lateralis
Correct! Ventrogluteal
Deltoid
Dorsogluteal
Question 10 Not yet graded / 1 pts
What is the Z-track method? What is the benefit of using this method?
Your Answer:
The Z track method is a type of IM injection technique used to prevent

tracking (leakage) of the medication into the subcutaneous tissue
(underneath the skin). During the procedure, skin and tissue are pulled
and held firmly while a long needle is inserted into the muscle. It
prevents drug leakage into the subcutaneous tissue, helps seal the
drug in the muscle, and minimizes skin irritation.
Z-track is a means of administering medication to minimize local

skin irritation. The technique seals the medication in muscle
tissue.
Identify the characteristics of the Z-track method. Select all that apply.
Correct!
Technique for administering intramuscular (IM) injections
Correct! Minimizes local skin irritation
Allows medication to escape from the muscle tissue
Correct! Seals medication in muscle tissue
Needle remains inserted for 30 seconds to allow for even dispersal of

medication
List the six rights of medication administration.
Your Answer:
Right patient
Right Medication
Right Dose
Right Route
Right Time
Right Documentation
The right medication
The right dose
The right patient
The right route
The right time
The right documentation
Identify the four steps involved in the process for medication

reconciliation.
Your Answer:
Verify (collect medication list)
Clarify (collect a current medication list)
Reconcile (compare new medications with the list and document

changes in the orders)
Transmit (communicate the updated and verified list to the appropriate

caregivers)
Obtain, Verify, Document: Obtain a comprehensive and current

list of a patient’s medications whenever he or she experiences a
change in health care setting (e.g., during admission, transfer,
discharge). Include all current prescriptions and over-the-counter
(OTC) medications.
Consider and Compare: Review what the patient was taking at

home or preadmission and make sure that the list of
medications, dosages, and frequencies is accurate. Compare
this list to the current ordered medications and treatment plan to
ensure accuracy. Include family caregiver in this discussion
when appropriate.
Reconcile: Compare new medication orders with the current list;

investigate any discrepancies with the patient’s health care
provider and document changes.
Communicate: Ensure that all the patient’s health care providers

have the most updated list of medications. Communicate and
verify changes in medications as with the patient.
Exercise 2 - Virtual Hospital Activity

Sign in to work at Pacific View Regional Hospital on the Medical-Surgical Floor for
Period of Care 1. (Note: If you are already in the virtual hospital from a previous
exercise, click on Leave the Floor and then on Restart the Program to get to the
sign-in window.)
From the Patient List, select Piya Jordan (Room 403).
Click on Get Report.
Click on Go to Nurses' Station.
Click on Chart and select the chart for Room 403.
Click on and review the History and Physical.
Click on and review the Physician's Orders for Tuesday and Wednesday
mornings.
Click on Return to Nurse's Station and then click on Drug icon in the lower left-
hand corner of the screen.
Piya Jordan has orders for a number of medications postoperatively. Match each
medication listed below with the rationale for its administration.
(A) Reduce fever
(B) Reduce gastric acid secretion
(C) Slow the heart rate of atrial fibrillation
(D) Prevent postoperative wound infection
Correct! Digoxin 0.125 mg IV C
Correct! Famotidine 20 mg IV B
Correct! Cefotetan 2 g IV D
Correct! Acetaminophen 650 mg A

per rectum q6h
Click on Return to Nurses' Station.

Click on the Medication Room at the bottom of your screen.
Click on MAR and then on tab 403.
Review the MAR for drugs due to be given Wednesday between 0730 and 0815.
Click on Return to Medication Room.
Based on your review of the MAR, access the storage areas of the Medication
Room to obtain the needed medications for administration.
For each area you access, select the medication you plan to administer and then
click on Put Medication on Tray. When finished with a storage area, click
on Close Drawer or Close Bin.
Click on View Medication Room.
Now click on Preparation and choose the correct medication to administer.
Click on Prepare and then click on Next. Choose the correct patient to administer
this medication to.
Complete the Preparation Wizard by providing any information requested. When
the Wizard stops asking for information, click on Finish.
You can click on Review Your Medications and then on Return to the
Medication Room when ready.
0.5 mL of digoxin should have been prepared for Piya Jordan.
Answer 1:
Correct! 0.5
Which of the following medications did you prepare for this time period?
Select all that apply.
Enoxaparin 40 mg
Correct! 20 mEq potassium chloride in 250 mL normal saline
Correct!
Digoxin 0.125 mg
Morphine sulfate 2.5 mg per mL
Cefotetan 1 g
Click on Nurses' Station at the bottom of the screen.

Click on 403 at the bottom of the screen.
What should be assessed before the ordered dose of digoxin is

administered to Piya Jordan? (Hint: Refer to the Drug Guide.)
Blood pressure and IV infusion
Correct!
Apical heart and IV infusion
Potassium level and blood pressure
Patient's level of discomfort and range of motion in knees
Digoxin must be given over a(n) 5 -minute period of
time.
Answer 1:
Correct! 5
Before you administer the digoxin, what should be included in the

assessment of the IV infusion?
Your Answer:
Rate of Infusion, Patency, Integrity of the IV site
Rate of the infusion
Patency
Integrity of the IV site
Knowledge of potential signs of toxicity are important to providing

quality care. What manifestations could indicate the presence of digoxin
toxicity in Piya Jordan? Select all that apply.
Correct!
Increased nausea
Correct!
Visual changes
Correct!
Headache
Nasal stuffiness
Irritability
Perform any necessary assessments and review any pertinent

information before administering the medications that you prepared.
After you have collected the appropriate assessment data and when
you are ready for administration, click on Patient Care and then on
Medication Administration.
Verify that the correct patient and medication(s) appear in the left-
hand window.
Click the down arrow next to Select. From the drop-down menu,
select Administer and complete the Administration Wizard by
providing any information requested. When the Wizard stops asking
for information, click on Administer to Patient. Specify Yes when
asked whether this administration should be recorded in the MAR.
Click on Finish.
Indicate whether the following statement is true or false.
IV administration of digoxin creates a greater risk to the patient than IV

administration of potassium chloride.
Correct!
True
False

Sign in to work at Pacific View Regional Hospital on the Medical-
Surgical Floor for Period of Care 2. (Note: If you are already in the
virtual hospital from a previous exercise, click on Leave the Floor
and then on Restart the Program to get to the sign-in window.)

From the Patient List, select Piya Jordan (Room 403)
Click on Get Report and then on Go to Nurses' Station.
Click on Chart and then on 403.
Click on and review the History and Physical, Nurse's Notes, and
Physician's Orders.
The physician has ordered ondansetron 4 mg IV q6h prn for nausea.

Which of the following statements is true about a prn order?
It calls for a single dose of a medication to be given only once.
It is a type of order that requires the medication be given at a specific

time.
Correct! It is an order prescribed for a time when a patient requires it.
It is the only type of order canceled when a patient goes to surgery.
The physician has ordered enoxaparin 40 mg subQ. The administration
of this medication will require a(n) 25 -gauge needle.
Answer 1:
Correct! 25
When preparing to administer the enoxaparin, you may use a(n)

1 - to 3 -mL syringe.
Answer 1:
Correct! 1
Answer 2:
Correct! 3
Which of the following sites is the best location for administering

enoxaparin to Piya Jordan?
Deltoid
Correct!
Abdomen
Thigh
Buttocks
The angle range for administering a subcutaneous injection is 45 to 90

degrees. What factors will be used to determine the correct angle
placement for administering the subcutaneous injection to Piya Jordan?
Your Answer:
if you can grasp 2 inches of tissue, insert the needle at a 90 degree

angle; if you can grasp 1 inch of tissue, insert the needle at a 45 degree
angle
Body size is used to determine the correct angle for

administering a subcutaneous injection. If you can grasp 2
inches or more tissue at the desired injection site, a 90-degree
angle is used. Piya Jordan has a large abdomen. A 90-degree
angle would be the best means of administration.

Click on 403 at the bottom of the screen.
Review the Initial Observations.
Click on Patient Care and then on Nurse-Client Interactions.
Select and view the video titled 1115: Interventions—Nausea,
Blood. (Note: Check the virtual clock to see whether enough time
has elapsed. You can use the fast-forward feature to advance the
time by 2-minute intervals if the video is not yet available. Then click
again on Patient Care and on Nurse-Client Interactionsto refresh
the screen.)
After viewing the video, click on Take Vital Signs.
Click on MAR and then on tab 403.
During the video interaction, the nurse communicates plans to

administer Tylenol to Piya Jordan. Has this medication been ordered by
the physician? Are any additional actions needed before this medication
can be administered?
Your Answer:
Yes, the physician has ordered Tylenol. The physician, however,

has stipulated the medication be administered if the temperature
is greater than 102° F. The records indicate Piya Jordan's
temperature is less than 102° F. If the nurse would like to
administer the medication, she will need to consult with the
physician.
Piya Jordan has complained of nausea. Ondansetron has been
prescribed to manage the nausea.
Answer 1:
Correct! Ondansetron
Click on Return to Room 403.

Click on Medication Room at the bottom of your screen.
Click on Unit Dosage and then on the drawer for Room 403.
Select the antiemetic. Place the medication on the tray.
Click on Close Drawer and then click on Review Your Medications.
Click on View Medication Room and then on Preparation.
Ondansetron is available in a strength of 2 mg/mL.
Answer 1:
Correct! 2
The available vial of ondansetron contains 20 mL.
Answer 1:
Correct! 20
The physician has ordered a dosage of 2 mg of
ondansetron to be administered every 6 hours prn as needed for

nausea.
Answer 1:
You Answered 2
Correct Answer 14
Indicate whether the following question is true or false.
It is necessary to dilute ondansetron with D5W before administering the

medication by way of IV push.
You Answered True
Correct Answer False
Listed below are the steps describing the proper technique for
administering an IV push medication. Choose the correct order for
these steps.
Correct! Clean off injection port 4

with antiseptic swab
Correct! Recheck fluid infusion 9

rate
Correct! Perform hand hygiene and 1

apply gloves
Correct! Select injection port of IV 3

tubing closest to patient
Correct! Check patient's 2

identification by looking
at identification bracelet
and asking the patient his
or her name
Correct! Occlude IV line and check 6

for blood return
Correct! Withdraw syringe from 8

port
Correct! Connect syringe to IV line 5
Correct! Dispose of uncapped 10

needles and syringe and
perform hand hygiene
Correct! Release tubing and inject 7

medication within time
recommended
Headache, chest pain, and difficulty breathing can be side effects of
ondansetron. If Piya Jordan develops any of these, what would you do?
Your Answer:
Tell the Doctor
The onset of any adverse reactions would require contact with

the physician. If the reaction started during the actual
administration, the infusion would be halted immediately.

Sign in to work at Pacific View Regional Hospital on the Skilled
Nursing Floor for Period of Care 2. (Note: If you are already in the
virtual hospital from a previous exercise, click on Leave the Floor
and then on Restart the Program to get to the sign-in window.)
From the Patient List, select Kathryn Doyle (Room 503).
Click on Get Report; review the report and then click on Go to
Nurses' Station.
Click on Chart and then on 503.
Click on and then review the History and Physical, Nurse's Notes,
and Physician's Orders.
In what manner can Kathryn Doyle's issues with dehydration be

managed or improved during the administration of oral medications?
Your Answer:
when administering oral medications, the nurse can encourage

additional fluid intake. It may be helpful to set goals for fluid intake. An
example might be to encourage Kathryn Doyle to drink a full glass of
water or juice after taking medications
When administering oral medications, the nurse can encourage

additional fluid intake. It may be helpful to set goals for fluid
intake. An example might be to encourage Kathryn Doyle to
drink a full glass of water or juice after taking medications.
Match each of the medications ordered for Kathryn Doyle with its
appropriate purpose. (Hint: Refer to the Drug Guide as needed.)
(A) Treatment for anemia
(B) Prevention of infection
(C) Prevention of constipation
(D) Treatment for osteoporosis
(E) Improvement of appetite
(F) Relief of pain in left hip
Correct! Calcium citrate D
Correct! Ferrous sulfate
Correct! Docusate sodium C
Correct! Ibuprofen F
Question 37 0.5 / 1 pts

Click on Medication Room.
What patient data should be checked before beginning to remove

medications from the dispensing system? Select all that apply.
Fluid intake for last 8 hours
Vital signs at 0700
Correct! Medication Administration Record
You Answered Activity order
Correct!
Allergy record
Two medications prescribed for Kathryn Doyle can cause constipation.

Which drugs are they?
Ferrous sulfate and docusate sodium
Calcium citrate and ibuprofen
Ibuprofen and ferrous sulfate
Correct! Ferrous sulfate and calcium citrate
Kathryn Doyle has documented issues with dehydration. If she asks

you to crush her medications and mix them with applesauce, what
actions are indicated?
Your Answer:
the nurse must consult with the pharmacy or with the drug handbook
You must consult with the pharmacy or with the drug handbook.
Discuss actions that must be taken when preparing to crush

medications. Discuss the associated rationale.
Your Answer:
When preparing to crush medications, the crushing device must be

cleaned. Mix crushed medications in very small amounts of food or
liquid
When preparing to crush medications the crushing device must

be cleaned. Residue or fragments from previously crushed
medications will increase the concentration of the medication or
result in the patient receiving inappropriate medications.
Mix crushed medications in very small amounts of food or liquid.
Which of the following side effect is of the most concern when

administering ibuprofen?
Correct! Gastrointestinal distress
Headache
Black stools
Urinary frequency
When planning Kathryn Doyle's care, you must remember that
medications are to be administered within 30 minutes
of their ordered time.
Answer 1:
Correct! 30
Quiz Score: 29.5 out of 42

Lesson 10 Medication Administration

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Lesson 10 - Medication Administration: HESI RN FLMIR 1904COHORT 4/8/20, 2(52 PM

Lesson 10 - Medication Administration

* Some questions not yet graded

Score for this quiz: 29.5 out of 42 *

Exercise 1 - Writing Activity

This exercise will take approximately 30 minutes to complete.

The chemical name of a medication is an exact description

of its composition and molecular structure.

The trade name, brand name, or proprietary name is the

official name under which a manufacturer markets a medication.

After taking a prescribed medication, a patient reports feeling very tired.

Correct! Adverse effect

Below are abbreviations commonly associated with medication

(A) Give immediately

(C) After meals

(D) Every morning

(E) Before meals

(F) Whenever there is a need

Peak refers to the time it takes for a medication to produce a response

Trough refers to the length of time of the therapeutic response produced

Trough refers to the amount of medication needed to produce a

When two medications have a(n) Synergistic effect , their combined

effect is greater than the effect of the medications given separately.

Correct! synergistic effect

Indicate whether the following statement in true or false.

Medications intended for sublingual administration may not have the

Which of the following statements describe activities for correctly

Review the patient's record for allergies.

Review the supply cart for available sizes of syringes.

Which of the following sites is preferred for administering an

Question 10 Not yet graded / 1 pts

The Z track method is a type of IM injection technique used to prevent

Z-track is a means of administering medication to minimize local

Correct! Minimizes local skin irritation

Allows medication to escape from the muscle tissue

Correct! Seals medication in muscle tissue

Needle remains inserted for 30 seconds to allow for even dispersal of

Question 12 Not yet graded / 1 pts

List the six rights of medication administration.

The right medication

The right dose

The right patient

The right route

The right time

The right documentation

Question 13 Not yet graded / 1 pts

Identify the four steps involved in the process for medication

Verify (collect medication list)

Clarify (collect a current medication list)

Reconcile (compare new medications with the list and document

Transmit (communicate the updated and verified list to the appropriate

Obtain, Verify, Document: Obtain a comprehensive and current

Consider and Compare: Review what the patient was taking at

Reconcile: Compare new medication orders with the current list;

Communicate: Ensure that all the patient’s health care providers

Exercise 2 - Virtual Hospital Activity

This exercise will take approximately 15 minutes to complete.

(A) Reduce fever

(B) Reduce gastric acid secretion

(C) Slow the heart rate of atrial fibrillation

(D) Prevent postoperative wound infection

Correct! Digoxin 0.125 mg IV C

Correct! Acetaminophen 650 mg A