Question 1

A client scheduled to undergo subtotal thyroidectomy is taking a potassium iodide solution. The client complains to the nurse that she is experiencing a brassy taste in her mouth when taking the medication. Which instruction should the nurse provide to the client?

Accepted Answer

Answer reason: Potassium iodide solutions can cause an unpleasant metallic/brassy taste and local irritation because they are concentrated and irritating to the oral mucosa. Diluting the dose in a full glass of water reduces direct contact with the mouth and throat and improves tolerability while maintaining the intended preoperative iodine effect. This symptom alone is not a hallmark of iodine toxicity (iodism), which would be more concerning with findings like severe mucosal irritation, salivary gland swelling, or systemic symptoms, so immediate provider notification is not the best first instruction. Advising dose reduction is unsafe because it alters the prescribed regimen and could decrease therapeutic effectiveness before thyroid surgery.

Question 2

A nurse is providing education to a school-age child newly diagnosed with asthma about how to use a metered-dose inhaler. In which order should the nurse teach the child to perform the following steps? (All steps must be used.)?

Accepted Answer

Answer reason: Proper metered-dose inhaler technique requires preparing the canister first so the medication is adequately mixed and the delivered dose is accurate. After shaking, the child should place the mouthpiece in the mouth to ensure a sealed path for aerosol delivery. The medication should then be inhaled slowly during actuation to maximize deposition in the lower airways rather than the oropharynx. Finally, holding the breath for 5–10 seconds increases time for particle sedimentation and improves lung absorption, whereas skipping the breath-hold reduces therapeutic effect.

Question 3

The nurse has given instructions to a client who has just been prescribed cholestyramine (Questran). Which statement by the client indicates a need for further instructions?

Accepted Answer

Answer reason: " Cholestyramine is a bile acid sequestrant supplied as a powder that must be mixed thoroughly with fluid and should not be taken dry; it can be mixed with water or other noncarbonated beverages/soft foods to improve tolerance. Saying it should only be taken with water reflects incorrect administration teaching and increases the risk the client will take it improperly or avoid doses. It is appropriate that the client expects cholesterol lowering, since this medication reduces LDL by binding bile acids in the gut. Constipation is common, so emphasizing dietary fiber (and adequate fluids) is appropriate, and vitamin supplementation may be needed because it can reduce absorption of fat-soluble vitamins.

Question 4

For a postoperative client, the health care provider (HCP) prescribed multimodal therapy, which includes acetaminophen, nonsteroidal anti-inflammatory drugs, as needed (PRN) opioids, and nonpharmaceutical interventions. The client continuously asks for the PRN opioid, and the nurse suspects that the client may have a drug abuse problem. Which action by the nurse is best?

Accepted Answer

Answer reason: Pain management should be based on the client’s reported pain and the ordered regimen, not on unverified assumptions about substance use. A PRN opioid order indicates it may be administered when pain criteria are met, and withholding it due to suspicion risks undertreating pain and causing physiologic stress and delayed recovery. Clients with substance use disorder can still have legitimate acute postoperative pain and require appropriate analgesia with monitoring for oversedation and respiratory depression. Teaching about appropriate opioid use can occur, but it should not replace timely analgesia when indicated. Changing the prescription based solely on suspicion is not the nurse’s role and can introduce bias and unsafe pain control.

Question 5

A client with type 1 diabetes has a prescription for 30 units of insulin glargine at bedtime. Fingerstick blood glucose measurements are prescribed before meals and at bedtime with regular insulin based on a sliding scale. At 9 PM, the client's blood glucose measurement is 180 mg/dL (10.0 mmol/L). What action should the nurse take? Click on the exhibit button for additional information?

Accepted Answer

Answer reason: A bedtime glucose of 180 mg/dL warrants correction with short-acting regular insulin per sliding scale while still giving the prescribed basal dose to maintain overnight glycemic control. Giving both agents as separate injections preserves predictable pharmacokinetics and reduces risk for unexpected hypo/hyperglycemia. Mixing either order is unsafe with glargine, and adding an extra snack is not indicated solely to “cover” a corrective dose when the glucose is elevated.

Question 6

An older adult client takes multiple prescription medications plus several over-the-counter medications. Which intervention by the clinic nurse is most important in reducing the risk for drug interactions?

Accepted Answer

Answer reason: Using one pharmacy allows automated interaction screening across all prescriptions and enables the pharmacist to reconcile duplications, contraindications, and high-risk combinations in real time. A medication list and “brown bag” review improve accuracy of what the patient is taking, but they rely on patient recall/bringing items and do not provide the same continuous, system-level interaction checking at the point of dispensing. A pill organizer helps adherence but does not reduce interaction risk and can obscure identification of individual products.

Question 7

A nurse is preparing to administer ophthalmic solution to a client. Which of the following is an appropriate action by the nurse?

Accepted Answer

Answer reason: Safe eye-drop administration places medication into the lower conjunctival sac without contaminating the dropper tip or traumatizing the cornea. Positioning the dropper a short distance above the sac allows accurate delivery while preventing the bottle from touching the eye or eyelashes, reducing infection risk. Drops are not placed in the inner canthus because this increases immediate drainage through the nasolacrimal duct and reduces local effect. Using the upper conjunctival sac and client looking down are less appropriate because the cornea is more exposed and blinking/rolling can increase discomfort and misplacement.

Question 8

The nurse is preparing to administer a first dose of prescribed pentamidine isethionate intravenously to a client. Before administering the dose, which safety measure should the nurse consider for this client?

Accepted Answer

Answer reason: IV pentamidine can cause significant hypotension, particularly with initial dosing and if infused too rapidly, so a preventive safety step is to position the client to support blood pressure and reduce syncope/fall risk. Keeping the client supine helps maintain venous return and improves hemodynamic stability during administration. This also facilitates close monitoring and rapid intervention if dizziness, diaphoresis, or BP drop occurs. A semi-Fowler’s position may worsen orthostatic effects and does not address the primary immediate infusion-related risk.

Question 9

A nurse is teaching a client with type 1 diabetes mellitus who jogs daily about the preferred sites for insulin absorption. What is the most appropriate site for a client who jogs?

Accepted Answer

Answer reason: A client who jogs daily should avoid injecting into areas that will be heavily exercised (especially the legs) to reduce exercise-induced rapid absorption and hypoglycemia risk. The abdominal subcutaneous tissue provides the most consistent and predictable absorption among common sites and is least affected by leg muscle use during jogging. Injecting into the legs is a common distractor because it can significantly accelerate absorption during running. Using a consistent site with rotation within that area supports stable glycemic control and safer exercise.

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Medication Administration Practice Test 16

Medication Administration NCLEX Practice Test

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A client scheduled to undergo subtotal thyroidectomy is taking a potassium iodide solution. The client complains to the nurse that she is experiencing a brassy taste in her mouth when taking the medication. Which instruction should the nurse provide to the client?

A nurse is providing education to a school-age child newly diagnosed with asthma about how to use a metered-dose inhaler. In which order should the nurse teach the child to perform the following steps? (All steps must be used.)?

The nurse has given instructions to a client who has just been prescribed cholestyramine (Questran). Which statement by the client indicates a need for further instructions?

An older adult client takes multiple prescription medications plus several over-the-counter medications. Which intervention by the clinic nurse is most important in reducing the risk for drug interactions?

A nurse is preparing to administer ophthalmic solution to a client. Which of the following is an appropriate action by the nurse?

The nurse is preparing to administer a first dose of prescribed pentamidine isethionate intravenously to a client. Before administering the dose, which safety measure should the nurse consider for this client?

A nurse is teaching a client with type 1 diabetes mellitus who jogs daily about the preferred sites for insulin absorption. What is the most appropriate site for a client who jogs?

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