Medication Administration Test Questions/Blueprint
Question
1. If a client makes a comment implying that a particular
medication seems unusual in any way, the nurse’s
responsibility is to
a. convince the patient to take it because the nurse was
careful to obtain the correct medication.
b. hold the medication until the nurse has double checked
the order, the medication, the patient, and is positive all
are correct.
c. have another nurse give the medication to reassure the
patient that the medication is correct.
d. skip this dose and assess the patient for confusion.
2. The nurse is to give a patient medication for pain. The order
reads, “Morphine Sulfate 20 mg. intravenously (IV) q 2 hr prn
pain.” The drug book states the normal dose is 2-10 mg. The
nurse should
a. administer the ordered amount of the drug.
b. administer the usual dose of the drug.
c. contact the physician concerning the written order.
d. check with the head nurse to see if it is safe to give the
ordered amount.
3. Your patient on Atenolol, a medication given for high blood
pressure causes fatigue and impotence. This is a predictable
but unavoidable response to this drug. This is defined as:
a. therapeutic effect
b. A cumulative effect
c. A side effect
d. An allergic reaction.
4. When a nurse provides a medication to a client, who has the
ultimate responsibility for the medication that is being
administered?
a. The nurse administering the medication
b. The client taking the medication
c. The pharmacist dispensing the medication
d. The physician prescribing the medication
5. Disease or impairment of which body organ places your
©2011 Keith Rischer/www.KeithRN.com
Course
Objective
Step in
the Nursing
Process
Assess
implement
Cognitive
Level
(Blooms)
Understand
apply
Difficult
y Level
1.000
Item
Discrim
.
0.0
assess
Understand
Apply
analyze
0.987
0.1
assess
Remember
0.987
0.1
assess
Understand
apply
0.883
0.1
assess
Understand
0.844
0.3
Response
6.
7.
8.
9.
patient at the highest risk for developing toxic effects of
medications given related to excretion:
a. large intestines
b. lungs
c. liver
d. kidneys
Before administering Furosemide (Lasix), a loop diuretic, it is
essential that the nurse will assess the following before
administering as ordered:
a. heart rate
b. blood pressure
c. last serum potassium level
d. both B & C
The patient is ordered a medication to be given by the
sublingual route. The nurse will
a. place the medication between the cheek and gums..
b. instruct the patient to place the medication under his
tongue.
c. tell the patient to take a full glass of water after
swallowing the medication.
d. straighten the ear canal before giving the medication.
Which of the following statements best describes how the
physiologic changes of aging influence the administration of
medications to elderly persons?
a. There is an increase in renal blood flow, resulting in
rapid uptake of medication by the kidney.
b. There is less complete and slower absorption from the
gastrointestinal tract, because of decreased gastric
motility and blood flow to the G.I. tract.
c. There is an increased proportion of lean body mass,
which increases the potential for toxicity of fat-soluble
drugs.
d. There is faster biotransformation of drugs in the liver,
and therefore higher potency of medication.
The client is in the bathroom. When the nurse enters the room
to give her medications, the client asks her to leave the pills on
the bedside table. What should the nurse do?
a. Leave the medication on the bedside table.
b. Wait in the room until the client comes out of the
bathroom.
c. Go into the bathroom and give the client her pills.
d. Tell the client she will return shortly to administer the
©2011 Keith Rischer/www.KeithRN.com
apply
assess
Understand
Apply
Analyze
Evaluate
0.831
0.2
implement
Understand
apply
1.000
0.0
assess
Understand
apply
0.766
0.1
assess
implement
Understand
apply
0.844
0.2
B or D accepted, students don’t have
experience yet to judge that they
don’t have time to wait for patient,
and that wasn’t stated in lecture
medications.
10. The nurse is preparing to administer 8 mg of a 10 mg dose of
an intravenous narcotic. Which of the following statements
made by the nurse best reflects an understanding of the
appropriate manner to handle this situation?
a. “I will sign out the narcotic before the end-of-shift count
is completed.”
b. “I need to get another RN to witness the waste and
sign the narcotic sheet.”
c. “Narcotics are expensive, so it makes sense to save
the unused portion for the next time they need the
drug.”
d. “I always make sure someone sees me place the
unused portion on the narcotic in the sharps container.”
11. A client is prescribed an ophthalmic medication. Which of the
following actions should the nurse perform?
a. Instruct the client to look down while administering the
medication.
b. Instruct the client to look toward their nose while
administering the medication.
c. See if the client can administer their own medication.
d. Instill the medication in the lower conjunctival sac
12. Research shows that the primary reason nurses make
medication errors is related to:
a. The complexity of making accurate drug calculations.
b. Events that distract the nurse during the administration
process.
c. The presence of multiple drugs with similar generic and
trade names.
d. Heavy client assignments that require massive
medication administrations.
13. The nurse discovers that she has made a medication error.
Which of the following should be her first response?
a. Record the error on the medication sheet immediately.
b. Notify the physician regarding course of action.
c. Check the patient’s condition to note any possible
effect of the error.
d. Complete the incident report, explaining how the
mistake was made.
14. The nurse is caring for a client who is experiencing severe
pain and is insistent about “getting some relief quickly.” Which
©2011 Keith Rischer/www.KeithRN.com
0.987
0.1
implement
Understand
apply
Implement
Understand
apply
0.922
0.0
implement
Understand
apply
0.896
0.1
implement
Understand
Apply
Evaluate
0.974
-0.1
implement
Understand
apply
1.000
0.0
of the following prn medication orders available to you is most
likely to produce the quickest pain relief?
a.
Percocet orally
b.
Lidocaine patch topically
c.
Demerol intramuscularly
d.
Morphine sulfate intravenously
15. The nurse recognizes which of her patients as being at
greatest risk for developing a possible allergic reaction?
a. A 69-year-old client receiving an antibiotic for a
respiratory tract infection
b. A 45-year-old prescribed a decongestant as needed for
seasonal allergies
c. A 50-year-old client prescribed a therapeutic dose of an
antihypertensive medication
d. A 26-year-old receiving steroids for the initial flare-up of
rheumatoid arthritis
16. On beginning the administration of an intravenous medication
on your patient they develop a rash and complain of difficulty
breathing. The nurse quickly identifies this as a symptom of
a(n):
a.
Toxic effect
b.
Anaphylactic allergic reaction
c.
Idiosyncratic reaction
d.
Side effect
17. You administer Percocet, an oral narcotic for pain in your
patient after surgery. According to Davis Drug Guide the onset
of this medication is 15 minutes, the peak is 60 minutes, and
the duration is 4-6 hours. The BEST time to reassess your
patient’s response to this medication is:
a. 15 minutes
b. 30 minutes
c. 60 minutes
d. 2 hours
18. Your patient with hypertension has just been started on
Atenolol, whose mechanism of action is to block stimulation of
beta 1 (cardiac) adrenergic receptors on the heart. Therefore
you will anticipate which of the following therapeutic effects:
a. decreased respiratory rate
b. decreased heart rate
c. decreased blood pressure
d. both B&C
©2011 Keith Rischer/www.KeithRN.com
Assess
implement
Understand
Apply
evaluate
0.779
0.3
Assess
implement
Understand
Apply
evaluate
0.922
0.2
Assess
implement
Understand
Apply
Evaluate
0.987
-0.1
assess
Understand
Apply
Evaluate
0.935
0.1
19. Your morning vital signs on your patient are T-98.8, P-64, RAssess
Understand
0.987
0.0
20, BP-86/66. Your patient is to receive Atenolol 25 mg po.
implement Apply
Based on your knowledge of medications, the best initial
Analyze
nursing action would be to:
evaluate
a. Give the medication as ordered
b. Hold the medication
c. Notify the charge nurse and then administer
d. Call the physician
20. Your morning vital signs on your patient are T-98.4, P-68, RAssess
Understand
0.948
0.1
20, BP-96/66. (These findings are consistent with previous
implement Apply
vital signs.) Your patient is to receive Lisinopril 20 mg po an
Analyze
ACE inhibitor. Based on your knowledge of medications, the
evaluate
best nursing action would be to:
a. Give the medication as ordered
b. Hold the medication
c. Notify the charge nurse and then administer
d. Call the physician
KEY:
Cognitive Level:
Item Discrimination = how well an item distinguishes between high and low scoring students.
Remembering
 0 is OK if it’s info that everyone absolutely needs to know, i.e. key content.
Understanding
 .2 to .3 is desirable for most
Applying
 .4 or higher is OK for just a few questions. If all were .4, most of our students would fail the test.
Analyzing
 Negative discrimination means a problem, like a poorly written question, mis-speaking in lecture, not fully clarifying a
Evaluating
topic, or an error on the answer key.
Creating
Add the item analysis statistics to the blueprint after you administer the test. Use these stats for improving you test items.
©2011 Keith Rischer/www.KeithRN.com
FINAL EXAM
Question
Course
Objective
MEDICATION ADMINISTRATION-ORAL
1.
Step in the
Nursing
Process
Assess
Implement
evaluate
Cognitive
Level
(Blooms)
Apply
Analyze
Difficulty Item
Response
Level
Discrim.
0.972
0.1
assess
Apply
0.931
-0.1
Assess
implement
apply
0.972
0.1
Your morning vital signs on your patient are: T98.4, P-68, R-20, BP-86/46.
Your patient is to receive Furosemide (Lasix) 40
mg po. Based on your knowledge of
medications, the best nursing action would be
to:
a.
Give the medication as ordered
b.
Hold the medication
c.
Notify the charge nurse and then
administer
d.
Call the physician
2. Your patient has Diabetes and has end stage renal
disease as a result. Which aspect of
pharmokinetics will be influenced by their renal
disease and needs to be considered by the
nurse when administering medications:
a.
Absorption
b.
Distribution
c.
Metabolism
d.
Excretion
3. You have an order to administer Morphine 2-6 mg IV
prn to this same patient with renal disease. How
will your knowledge of pharmokinetics influence
your decision to administer what dosage of
©2011 Keith Rischer/www.KeithRN.com
Morphine?
a.
Give the higher dose of Morphine
because a larger dose is needed to get the
desired effect
b.
Give the lower dose of Morphine
because a smaller dose is needed to prevent
possible toxicity
c.
Give the lower dose of Morphine
because a smaller dose is needed to relieve the
pain
d.
give.
It makes no difference which dose you
4, A client is nauseated, has been vomiting for several
hours, and needs to receive an antiemetic
(antinausea) medication. The nurse recognizes
that which of the following is accurate?
Assess
implement
Apply
Analyze
0.611
0.1
implement
Apply
0.972
0.1
a.
An enteric-coated medication should be
given.
b.
Medication will not be absorbed as easily
because of the nausea.
c.
Parenteral administration is the route of
choice.
d.
A rectal suppository must be
administered.
5. The nurse is documenting administration of a
medication that is scheduled at 0800, 1400 and
2000. The medication that the nurse is
documenting is:
a.
Morphine sulfate, 10 mg q4h prn
b.
Propranolol (Inderal), 10 mg po b id
©2011 Keith Rischer/www.KeithRN.com
c.
Diazepam, 5 mg po tid
d.
Cephalexin (Keflex), 500 mg po q8h
6. Morphine given intravenously (IV) has a time action
profile of: onset 5
minutes, peak 20 minutes
and duration of 4-5 hours. Based on this
information, once administered when would you
expect this medication to BEGIN to lower pain:
a.
5 minutes
b.
20 minutes
c.
60 minutes
d.
4-5 hours
7. During the admission interview the client reports to
the nurse that she is “a little allergic to penicillin.”
Which of the following questions asked by the
nurse is most likely to provide the most relevant
information regarding the client’s possible
allergy to penicillin?
Implement
evaluate
Apply
evaluate
0.861
0.2
assess
Apply
0.944
0.2
Assess
evaluate
Apply
Evaluate
0.528
0.3
a.
“Who told you that you are allergic to
penicillin?”
b.
“What makes you think you are allergic
to penicillin?”
c.
“Can you describe what happens when
you take penicillin?”
d.
“What do you take for an infection since
you are allergic to penicillin?”
8. A client on the medical unit receives regular insulin
10 units at 7:00 AM. The nurse is alert to a
possible hypoglycemic reaction by:
a.
7:30 AM
©2011 Keith Rischer/www.KeithRN.com
b.
10:00 AM
c.
12:30 PM
d.
2:00 PM
©2011 Keith Rischer/www.KeithRN.com