Parenteral Medications Test Questions/Blueprint
Question
Course Objective
1. The nurse is evaluating the integrity of the ventrogluteal
Step in the
Nursing
Process
implement
Cognitive Level
(Blooms)
Difficulty
Level
Item
Discrim.
Apply
1.000
0.0
implement
Apply
0.959
0.1
injection site. The nurse finds the site by locating the:
a.
Middle third of the lateral thigh
b.
Greater trochanter, anterior iliac spine, and
iliac crest
c.
Anterior aspect of the upper thigh
d.
Acromion process and axilla
2. The client is to receive a Mantoux test for tuberculosis.
This test is administered via an intradermal injection.
The nurse recognizes that the angle of injection that
is used for an intradermal injection is:
a.
15 degrees
b.
30 degrees
c.
45 degrees
d.
90 degrees
©2011 Keith Rischer/www.KeithRN.com
Response
3. The primary care provider prescribed 2 mL of a medication
implement
Apply
0.959
0.1
implement
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1.000
0.0
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0.946
0.0
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apply
0.797
0.3
to be given IM for a 40 year old female who is 5’7” tall
and weighs 255 pounds. Which of the following is
the most appropriate site to administer?
a.
deltoid
b.
vastus lateralis
c.
ventro gluteal
d.
abdomen
4, The subcutaneous injection angles vary from
a.
5 to 15 degrees.
b.
15 to 35 degrees.
c.
35 to 40 degrees.
d.
45 to 90 degrees
5. The maximum volume of medication that may be
administered subcutaneously to an adult is:
a.
0.5 ml
b.
1.0 ml
c.
1.5 ml
d.
3.0 ml
6. The insulin that is commonly used as sliding scale
coverage because it has the most rapid onset is:
a.
Ultra Lente
b.
Lispro (Humalog)
©2011 Keith Rischer/www.KeithRN.com
c.
NPH
d.
Lantus (Glargine)
7. The nurse is to administer 30 units of Regular Insulin
subcutaneously in the upper arm to a 50 year old,
300 pound client. The nurse can grasp approximately
2 inches of the client’s tissue at the upper arm. Which
of the following is the most appropriate for the nurse
to use?
Assess
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0.824
0.2
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1.000
0.0
assess
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apply
0.676
-0.2
a.
A tuberculin syringe, #29 gauge, ½ inch
needle.
b.
3 mL syringe, #28 gauge, 1 inch needle.
c.
1 mL insulin syringe, #29 gauge, 1/2 inch
needle.
d.
0.5 mL insulin syringe, #29 gauge, 1/2 inch
needle.
8. After withdrawing the first dose of medication from a
multidose vial, the vial:
a.
is discarded in the garbage.
b.
is initialed, dated, and timed.
c.
is placed in the refrigerator.
d.
is discarded in the sharps container.
9. The preferred site for administration of an IM injection for
immunizations in an adult is the:
a.
ventrogluteal
b.
dorsogluteal.
©2011 Keith Rischer/www.KeithRN.com
c.
deltoid
d.
vastus lateralis.
10. Which gauge needle is most appropriate for drawing up a
implement
Apply
0.959
0.0
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0.973
0.1
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apply
0.905
0.2
thick, viscous solution from a vial?
a.
24 g.
b.
22 g.
c.
18 g.
d.
28 g.
11. Mr. Brown is receiving heparin subcutaneously. Which of
the following demonstrates correct technique for
this procedure?
a.
Administer in the abdomen, massage the site
after the injection.
b.
Administer in the upper arm, do not aspirate
before or massage after the injection.
c.
Administer in the central abdomen proximal to
the umbilicus, do not aspirate before or
massage after the injection.
d.
Administer in the lateral aspect of the
abdomen, do not aspirate before or massage
after the injection.
12. The nurse is teaching the client how to prepare 10 units
of regular insulin and 5 units of NPH insulin for
injection. The nurse instructs the client to:
a.
Inject air into the regular insulin and then into
the NPH insulin
©2011 Keith Rischer/www.KeithRN.com
b.
Withdraw the regular insulin first
c.
Inject air into and withdraw the NPH insulin
immediately
d.
Inject air into both vials and withdraw the
regular insulin first.
13. The nurse is caring for a client who is experiencing
severe pain and is insistent about “getting some relief
quickly.” Which of the following prescriptions is most
likely to produce the quickest pain relief?
a.
Percocet oral tablets
b.
Lidocaine patch topical patch
c.
Morphine intramuscular injection
d.
Morphine oral tablets
14. What is a comfort measure intervention that the nurse
Assess
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Understand
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0.986
0.0
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0.986
0.1
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Understand
apply
0.689
0.3
can utilize when administering an injection IM?
a.
Massage the injection site after administering.
b.
Apply an antibiotic ointment to site of
injection.
c.
Insert a sharp needle slowly.
d.
Relax the muscle.
15. The nurse administers the intramuscular medication by
the Z-track method. The medication was
administered by this method to:
a.
Provide faster absorption of the medication
b.
Reduce discomfort from the needle
©2011 Keith Rischer/www.KeithRN.com
c.
Provide more even absorption of the drug
d.
Prevent the drug from irritating sensitive
tissues
KEY:
Cognitive Level:
Remembering
Understanding
Applying
Analyzing
Evaluating
Creating
Item Discrimination = how well an item distinguishes between high and low scoring students.
 0 is OK if it’s info that everyone absolutely needs to know, i.e. key content.
 .2 to .3 is desirable for most
 .4 or higher is OK for just a few questions. If all were .4, most of our students would fail the test.
 Negative discrimination means a problem, like a poorly written question, mis-speaking in lecture, not fully clarifying a
topic, or an error on the answer key.
©2011 Keith Rischer/www.KeithRN.com
FINAL EXAM
Question
Course
Objective
. PARENTERAL MEDICATION ADMINISTRATION
81.
Step in the
Nursing
Process
implement
Cognitive Level
(Blooms)
Difficulty
Level
Item
Discrim.
apply
1.000
0.0
Assess
implement
apply
0.958
0.1
Assess
implement
Apply
0.986
0.1
Assess
Apply
0.958
0.1
When withdrawing medication from an ampule the
nurse:
a.
cleanses the ampule neck with alcohol.
b.
uses a filter needle.
c.
injects air into the ampule.
d.
initials, dates, and times the ampule.
20. You are to administer Heparin 5000 units to a 45 yr old
male who weighs 190 lbs. You will:
a.
Use a 28g. ½” needle 100 unit insulin syringe
and administer in lateral abdomen
b.
Use a 28g. ½” needle 1 mL tuberculin syringe
and administer in outer aspect of upper arm
c.
Use a 28g. ½” needle 1 mL tuberculin syringe
and administer in lateral abdomen
d.
Use a 22g. 1” needle 1 mL tuberculin syringe
and administer in lateral abdomen
21. You are to administer Morphine 8 mg (1.5 mL) IM to a 228
lb
75 yr old female. The BEST location would be:
a.
Deltoid
b.
Vastus lateralis
c.
Abdomen
d.
Ventro gluteal
22. To administer Morphine 8 mg (1.5 mL) IM to this same
©2011 Keith Rischer/www.KeithRN.com
Response
patient who weighs 228 lbs, the correct needle and
syringe would be:
a.
28 g. ½” needle with 3 mL syringe
b.
22 g. 1” needle with 3 mL syringe
c.
22 g. 1 ½ ” needle with 3 mL syringe
d,
22 g. 1 ½ ” needle with 5 mL syringe
23. The nurse is administering an injection at the ventrogluteal
site. On aspiration, the nurse notices that there is blood
in the syringe. The nurse should:
a.
Inject the medication
b.
Pull the needle back slightly and inject the
medication
c.
Move the skin to the side and inject the
medication slowly
d.
Discontinue the injection and prepare the
medication again
©2011 Keith Rischer/www.KeithRN.com
implement
Implement
evaluate
apply
0.958
0.1