N1110 Test Blueprint-Parenteral Medications



Parenteral Medications Test Questions/Blueprint

|Question |Course Objective |Step in the Nursing |Cognitive Level |Difficulty |Item |Response |

| | |Process |(Blooms) |Level |Discrim. | |

|1. The nurse is evaluating the integrity of the ventrogluteal injection site. The nurse | |implement |Apply |1.000 |0.0 | |

|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 | |implement |Apply |0.959 |0.1 | |

|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 | | | | | | |

|3. The primary care provider prescribed 2 mL of a medication to be given IM for a 40 year | |implement |Apply |0.959 |0.1 | |

|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 | |implement |Apply |1.000 |0.0 | |

|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:| |implement |Apply |0.946 |0.0 | |

|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 | |implement |apply |0.797 |0.3 | |

|rapid onset is: | | | | | | |

|a. Ultra Lente | | | | | | |

|b. Lispro (Humalog) | | | | | | |

|c. NPH | | | | | | |

|d. Lantus (Glargine) | | | | | | |

|7. The nurse is to administer 30 units of Regular Insulin subcutaneously in the upper arm | |Assess |Apply |0.824 |0.2 | |

|to a 50 year old, 300 pound client. The nurse can grasp approximately 2 inches of the | |implement | | | | |

|client’s tissue at the upper arm. Which of the following is the most appropriate for the | | | | | | |

|nurse to use? | | | | | | |

|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: | |implement |Apply |1.000 |0.0 | |

|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 | |assess |Understand |0.676 |-0.2 | |

|is the: | |implement |apply | | | |

|a. ventrogluteal | | | | | | |

|b. dorsogluteal. | | | | | | |

|c. deltoid | | | | | | |

|d. vastus lateralis. | | | | | | |

|10. Which gauge needle is most appropriate for drawing up a thick, viscous solution from a | |implement |Apply |0.959 |0.0 | |

|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 | |implement |Apply |0.973 |0.1 | |

|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| |implement |apply |0.905 |0.2 | |

|of NPH insulin for injection. The nurse instructs the client to: | | | | | | |

|a. Inject air into the regular insulin and then into the NPH insulin | | | | | | |

|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| |Assess |Understand |0.986 |0.0 | |

|“getting some relief quickly.” Which of the following prescriptions is most likely to | |implement |Apply | | | |

|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 can utilize when administering an| |implement |Apply |0.986 |0.1 | |

|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 | |implement |Understand |0.689 |0.3 | |

|medication was administered by this method to: | | |apply | | | |

|a. Provide faster absorption of the medication | | | | | | |

|b. Reduce discomfort from the needle | | | | | | |

|c. Provide more even absorption of the drug | | | | | | |

|d. Prevent the drug from irritating sensitive tissues | | | | | | |

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 topic, or an error on the answer key. |

|Evaluating | |

|Creating | |

FINAL EXAM

|Question |Course Objective |Step in the Nursing |Cognitive Level |Difficulty |Item |Response |

| | |Process |(Blooms) |Level |Discrim. | |

|. PARENTERAL MEDICATION ADMINISTRATION | |implement |apply |1.000 |0.0 | |

|81. 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. | |Assess |apply |0.958 |0.1 | |

|You will: | |implement | | | | |

|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| |Assess |Apply |0.986 |0.1 | |

|BEST location would be: | |implement | | | | |

|a. Deltoid | | | | | | |

|b. Vastus lateralis | | | | | | |

|c. Abdomen | | | | | | |

|d. Ventro gluteal | | | | | | |

|22. To administer Morphine 8 mg (1.5 mL) IM to this same patient who weighs 228 lbs, | |Assess |Apply |0.958 |0.1 | |

|the correct needle and syringe would be: | |implement | | | | |

|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, | |Implement |apply |0.958 |0.1 | |

|the nurse notices that there is blood in the syringe. The nurse should: | |evaluate | | | | |

|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 | | | | | | |

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