Pharmacology: Medication Administration Practice Questions
Test yourself on Medication Administration with 13 original NCLEX-RN practice questions. Pick an answer to see instant feedback and a full explanation.
Free original practice questions for study purposes. Open Exam Prep is an independent study resource and is not affiliated with, endorsed by, or sponsored by the makers of NCLEX-RN.
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1. A nurse is preparing to administer a subcutaneous injection of insulin to an adult client. Which needle angle is most appropriate for an average-weight adult?
Explanation. Subcutaneous injections are given at a 45- to 90-degree angle depending on the amount of subcutaneous tissue and needle length; for an average adult with a short (5/8-inch) needle, 90 degrees is appropriate, while a longer needle or thinner client uses 45 degrees. A 10- to 15-degree angle is used for intradermal injections. Z-track is used for irritating IM medications, not insulin.
2. A nurse is about to administer a medication and follows the rights of medication administration. Which action best verifies the right patient?
Explanation. The Joint Commission requires at least two patient identifiers (e.g., name and date of birth, or comparing the name band to the MAR) that are NOT the room or bed number, since clients can be moved. Room number and bed assignment are unreliable. Matching the medication to the diagnosis is a separate verification step, not patient identification.
3. A nurse is administering eye drops to a client. Where should the nurse instill the drops?
Explanation. Eye drops are instilled into the conjunctival sac formed by gently pulling down the lower lid; this avoids the sensitive cornea and reduces blink reflex. Dropping onto the cornea causes discomfort and reflex blinking. After instillation, apply gentle pressure to the inner canthus (nasolacrimal duct) to reduce systemic absorption, but the drop is not placed there.
4. A nurse must give an intramuscular injection of a viscous, irritating medication to an adult. Which technique reduces tissue irritation and prevents medication tracking?
Explanation. The Z-track technique pulls the skin and subcutaneous tissue laterally before injecting; releasing it seals the medication in the muscle and prevents irritating drugs (such as iron dextran) from tracking back through tissue. Massaging the site after a Z-track injection should be avoided because it promotes leakage and irritation.
5. A nurse receives a verbal medication order from a provider during a code situation. What is the priority safety action?
Explanation. For verbal/telephone orders, the nurse should write down (or enter) the order and then read it back to the prescriber for confirmation (read-back). This closed-loop communication prevents errors. In emergencies the order may be carried out, but read-back verification remains the key safety step; documentation follows.
6. The prescriber orders 750 mg of a drug. The medication is available as 250 mg per 5 mL. How many milliliters should the nurse administer?
Explanation. Use the formula (Desired/Have) x Quantity: (750 mg / 250 mg) x 5 mL = 3 x 5 = 15 mL. Always double-check the volume; 15 mL is reasonable for a liquid oral medication.
7. A nurse is administering medications through a nasogastric (NG) tube. Which action is most important to prevent tube occlusion?
Explanation. Flushing with water before, between, and after each medication prevents drug interactions and tube clogging. Medications should generally be given separately, not mixed together. Enteric-coated and sustained-release tablets should NOT be crushed because crushing destroys their protective coating and can cause overdose or gastric irritation.
8. A nurse prepares to administer a transdermal nitroglycerin patch. Which action is correct?
Explanation. The previous patch must be removed (and the skin cleaned) before applying a new patch to prevent overdose, and sites should be rotated to a clean, dry, non-hairy area on the trunk. Patches should never be cut, as this can alter the controlled-release mechanism. Distal extremities are not preferred because of variable absorption.
9. A nurse is giving a rectal suppository to an adult client. What is the correct technique?
Explanation. The client is placed in the left lateral (Sims) position to follow the natural curve of the rectum, and the suppository must be inserted past the internal anal sphincter (about 4 inches in adults) against the rectal wall for absorption. Bearing down expels the suppository; the client should relax and breathe through the mouth.
10. A nurse is administering an oral medication to a client at high risk for aspiration. Which intervention is most appropriate?
Explanation. Clients at risk for aspiration should be placed upright (high Fowler's) and their swallowing assessed before and during administration to prevent aspiration. Supine positioning increases aspiration risk. Extended-release tablets should not be crushed, and rapid large boluses increase aspiration risk—small sips are safer.
11. A nurse discovers that a medication error occurred and the wrong dose was given. What is the priority nursing action after recognizing the error?
Explanation. After a medication error the priority is client safety: assess the client for adverse effects and notify the prescriber so corrective measures can be ordered. Documentation in the medical record and a separate incident/occurrence report follow, but the incident report is NOT filed in the client's chart. The error must never be hidden from the client.
12. A nurse is administering heparin subcutaneously. Which technique is correct to minimize bruising?
Explanation. For subcutaneous heparin, the nurse should NOT aspirate or massage the site (this increases bruising/hematoma risk) and should inject into the abdomen at least 2 inches (5 cm) from the umbilicus. Heparin is given subcutaneously, not IM (deltoid). A 15-degree angle is for intradermal injections, not subcutaneous heparin.
13. An order reads: Administer 1,000 mL of 0.9% sodium chloride IV over 8 hours. The drop factor is 15 gtt/mL. What is the flow rate in drops per minute (round to the nearest whole number)?
Explanation. Flow rate = (total volume x drop factor) / total time in minutes. Time = 8 hr x 60 = 480 min. (1000 mL x 15 gtt/mL) / 480 min = 15000 / 480 = 31.25, which rounds to 31 gtt/min.
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FAQ
What are the 'rights' of medication administration I should memorize for NCLEX?
Know the core six: right patient, right drug, right dose, right route, right time, and right documentation. Many programs add right reason, right response, right to refuse, and right education. NCLEX commonly tests patient identification (two identifiers), verifying the order, and assessing therapeutic/adverse response.
How should I approach dosage calculation questions on the NCLEX?
Use a consistent formula such as (Desired/Have) x Quantity for solid/liquid doses, and (Volume x drop factor)/time in minutes for IV flow rates. Always check units, convert when needed (e.g., mg to g, hours to minutes), and round only at the final step per the question's instructions. Double-check whether the answer is reasonable.
Which medications or forms should never be crushed or cut, and why does NCLEX test this?
Do not crush or cut enteric-coated, sustained-release, extended-release tablets, or transdermal patches. Altering them destroys the protective coating or controlled-release mechanism, causing dose dumping (overdose), gastric irritation, or loss of effect. This is a frequent safety concept on the exam, especially with NG tube and patch questions.