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DHCA Nursing Exam study materials
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DHCA Nursing Exam practice questions

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Question 1Patient Safety and Infection Control

A nurse is preparing to insert a peripheral IV catheter. Which action best prevents a catheter-related bloodstream infection at the insertion site?

  1. Cleaning the site with alcohol for 5 seconds before puncture
  2. Applying antibiotic ointment to the site after insertion
  3. Performing hand hygiene and using sterile technique with a chlorhexidine-based antiseptic Correct answer.
  4. Changing the transparent dressing every 24 hours regardless of condition

Explanation

Preventing catheter-related infection centers on hand hygiene, maximal sterile barriers where indicated, and skin antisepsis with chlorhexidine-based solution allowed to dry fully. Antibiotic ointments are not recommended for routine catheter sites, and dressing changes follow condition-based schedules rather than fixed daily replacement.

Question 2Patient Safety and Infection Control

Which is the single most effective routine action for reducing transmission of healthcare-associated pathogens between patients?

  1. Wearing a mask during all patient interactions
  2. Disinfecting stethoscopes after each shift
  3. Performing hand hygiene at the correct moments Correct answer.
  4. Wearing gloves for every patient contact

Explanation

Hand hygiene at the World Health Organization's five moments is the cornerstone of infection prevention and interrupts the main route of cross-transmission via contaminated hands. Gloves supplement but never replace hand hygiene, and masks are indicated only for specific transmission precautions.

Question 3Patient Safety and Infection Control

A patient with active pulmonary tuberculosis is admitted. Which precaution set should the nurse initiate?

  1. Airborne precautions with an N95 respirator and negative-pressure room Correct answer.
  2. Contact precautions with gown and gloves
  3. Standard precautions only
  4. Droplet precautions with a surgical mask within 3 feet

Explanation

Pulmonary tuberculosis spreads by airborne droplet nuclei, so airborne precautions require a fit-tested N95 or higher respirator and a negative-pressure airborne infection isolation room. Contact and droplet precautions alone do not address airborne transmission.

Question 4Patient Safety and Infection Control

When performing hand hygiene with an alcohol-based hand rub, which technique is correct?

  1. Rinse hands with water after the rub has dried
  2. Use a small amount and rub only the palms together
  3. Apply to dry hands and rub all surfaces until completely dry Correct answer.
  4. Apply to wet hands and immediately dry with a paper towel

Explanation

Alcohol-based hand rub should be applied to dry hands and rubbed over all surfaces, including fingertips and thumbs, until the product evaporates completely. Wet hands dilute the product and reduce efficacy, and rinsing afterward is unnecessary.

Question 5Patient Safety and Infection Control

A nurse is caring for a patient with Clostridioides difficile infection. Which hand hygiene action is required after contact with the patient or environment?

  1. No hand hygiene if gloves were worn
  2. Alcohol rub followed by an alcohol wipe
  3. Soap and water handwashing Correct answer.
  4. Alcohol-based hand rub alone

Explanation

C. difficile spores are not reliably killed by alcohol, so soap and water handwashing with friction is required to physically remove spores. Gloves do not eliminate the need for hand hygiene.

Question 6Patient Safety and Infection Control

Which action best prevents a surgical site infection in the immediate postoperative period?

  1. Keeping the incision covered and dry per protocol and performing hand hygiene before wound care Correct answer.
  2. Using a shared reusable cloth to clean the incision area
  3. Applying hydrogen peroxide to the incision daily
  4. Removing the dressing within 2 hours of surgery

Explanation

Postoperative wound care focuses on maintaining a clean, dry, covered incision and performing hand hygiene before any wound contact. Hydrogen peroxide is cytotoxic and not recommended for routine clean incisions, and dressings are maintained per surgeon protocol.

Question 7Patient Safety and Infection Control

A nurse receives a needlestick injury from a hollow-bore needle after caring for a patient with unknown HIV status. What is the priority first action?

  1. Apply a tight tourniquet above the injury
  2. Wash the site with soap and water and report the exposure immediately Correct answer.
  3. Squeeze the site firmly to express blood
  4. Wait for the source patient's test results before seeking care

Explanation

Immediate care for a percutaneous exposure is washing the site with soap and water, followed by prompt reporting so post-exposure prophylaxis can be evaluated within hours. Squeezing, tourniquets, and caustic agents are not recommended.

Question 8Patient Safety and Infection Control

Which statement about standard precautions is accurate?

  1. They require gowns for every patient contact
  2. They apply only to patients with known bloodborne pathogens
  3. They apply to all patients regardless of diagnosis Correct answer.
  4. They replace transmission-based precautions

Explanation

Standard precautions are applied to all patients because infection status is often unknown, and they include hand hygiene, gloves, and other barriers based on anticipated exposure. Transmission-based precautions are added when a specific pathogen requires them.

Question 9Patient Safety and Infection Control

A patient is on contact precautions for a multidrug-resistant organism. Which practice is correct?

  1. Dedicate equipment to the patient or disinfect it between patients Correct answer.
  2. Cohort the patient with immunocompromised patients
  3. Discontinue precautions once the patient feels well
  4. Use the same gown for multiple patients in the same room

Explanation

Contact precautions require single-patient or dedicated equipment when possible, or disinfection between patients, to prevent indirect transmission. Cohorting with immunocompromised patients and reusing gowns between patients increase transmission risk.

Question 10Patient Safety and Infection Control

Which action reduces the risk of ventilator-associated pneumonia in an intubated patient?

  1. Keeping the head of the bed flat
  2. Using the same suction catheter for the entire shift
  3. Routine suctioning every 15 minutes regardless of need
  4. Maintaining the head of the bed elevated 30 to 45 degrees Correct answer.

Explanation

Elevating the head of the bed 30 to 45 degrees reduces aspiration of oropharyngeal secretions, a key VAP prevention measure. Suctioning is performed as needed, and closed or sterile techniques are used per protocol.

Question 11Patient Safety and Infection Control

A nurse is preparing to administer a medication via a central venous catheter. Which action best prevents central line-associated bloodstream infection?

  1. Changing the catheter every 48 hours
  2. Flushing the line with tap water before use
  3. Scrubbing the hub with an antiseptic for the recommended contact time before access Correct answer.
  4. Leaving the line uncapped between uses

Explanation

Disinfecting the catheter hub with an appropriate antiseptic and allowing the recommended contact time before access reduces intraluminal contamination. Routine scheduled catheter replacement and uncapped lines increase infection risk.

Question 12Patient Safety and Infection Control

Which personal protective equipment is removed last when doffing after contact precautions?

  1. Gown
  2. Face shield
  3. Gloves
  4. Mask or respirator Correct answer.

Explanation

After removing gloves and gown, the mask or respirator is removed last, using the ties or straps without touching the front, followed by hand hygiene. Removing the mask earlier risks contamination during remaining doffing steps.

Question 13Patient Safety and Infection Control

A patient is admitted with suspected norovirus gastroenteritis. Which precaution is most appropriate?

  1. Airborne precautions
  2. Standard precautions only
  3. Contact precautions Correct answer.
  4. Droplet precautions

Explanation

Norovirus spreads primarily through the fecal-oral route and contaminated surfaces, so contact precautions with attention to environmental cleaning and soap and water hand hygiene are indicated. Droplet and airborne precautions do not target this route.

Question 14Patient Safety and Infection Control

Which practice is essential when preparing and administering parenteral medications to prevent bloodstream infection?

  1. Storing multidose vials at room temperature indefinitely
  2. Reusing a single syringe for multiple patients if the needle is changed
  3. Disinfecting the medication vial septum before each access Correct answer.
  4. Using the same IV tubing for multiple patients after flushing

Explanation

Disinfecting the vial septum before each access reduces contamination of the medication, and single-use supplies should never be shared. Multidose vials have defined beyond-use dates and storage requirements.

Question 15Patient Safety and Infection Control

A nurse observes a colleague about to recap a needle after an injection. What is the best response?

  1. Suggest recapping using two hands
  2. Suggest bending the needle before disposal
  3. Allow recapping because it is faster
  4. Recommend immediate disposal in a sharps container without recapping Correct answer.

Explanation

Needles should be disposed of immediately in a puncture-resistant sharps container without recapping, which is the most effective way to prevent needlestick injuries. Recapping, bending, or breaking needles increases injury risk.

Question 16Patient Safety and Infection Control

Which environmental cleaning practice best reduces transmission of pathogens from high-touch surfaces?

  1. Disinfecting high-touch surfaces routinely and when contaminated Correct answer.
  2. Fogging rooms with disinfectant after every patient discharge
  3. Using the same cloth for multiple patient rooms
  4. Cleaning surfaces only when visibly soiled

Explanation

Routine and targeted disinfection of high-touch surfaces interrupts indirect contact transmission, and cleaning must occur even when soil is not visible. Cloths must not be shared across patient rooms.

Question 17Patient Safety and Infection Control

A patient with a known history of methicillin-resistant Staphylococcus aureus (MRSA) colonization is readmitted. Which action is most appropriate?

  1. Place on contact precautions per facility policy until criteria for discontinuation are met Correct answer.
  2. Place on airborne precautions
  3. Assume colonization has resolved and use standard precautions only
  4. Require all visitors to wear N95 respirators

Explanation

Patients with known MRSA colonization are managed with contact precautions according to facility policy until defined decolonization or clearance criteria are met. MRSA is not airborne, so respirators are not required for routine care.

Question 18Patient Safety and Infection Control

Which action is correct when a nurse must perform a sterile procedure at the bedside?

  1. Reach across the sterile field to access supplies
  2. Turn away from the sterile field to answer a question
  3. Keep the sterile field in view and above waist level at all times Correct answer.
  4. Consider items below waist level sterile if not visibly soiled

Explanation

Sterile technique requires that the field remain in view, above waist level, and not be reached across, because items below waist level or out of view are considered contaminated. Turning away also risks contamination.

Question 19Patient Safety and Infection Control

A nurse is caring for a patient with an indwelling urinary catheter. Which action reduces the risk of catheter-associated urinary tract infection?

  1. Irrigating the catheter routinely every shift
  2. Maintaining a closed drainage system and dependent loop Correct answer.
  3. Keeping the drainage bag above the level of the bladder
  4. Disconnecting the catheter to obtain urine samples daily

Explanation

A closed drainage system with unobstructed flow and a dependent loop prevents urine stasis and reflux, which are major contributors to CAUTI. Routine irrigation and unnecessary disconnections introduce organisms.

Question 20Patient Safety and Infection Control

A nurse is caring for a patient with an active herpes zoster rash that is disseminated. Which precaution is appropriate?

  1. Contact precautions only
  2. Droplet precautions only
  3. Standard precautions only
  4. Airborne and contact precautions Correct answer.

Explanation

Disseminated herpes zoster requires airborne and contact precautions because varicella-zoster virus can spread by the airborne route and through contact with vesicular fluid. Localized zoster in an immunocompetent patient is typically managed with standard precautions plus covering the lesions.

Question 21Patient Safety and Infection Control

A nurse is evaluating a colleague's hand hygiene before entering a patient room. The colleague uses alcohol-based rub for 5 seconds and touches the door handle before entering. Which is the best analysis?

  1. The technique is adequate because alcohol kills most organisms
  2. Hand hygiene should be performed only after patient contact
  3. Gloves would eliminate the need for hand hygiene
  4. The duration is too short and the door handle may recontaminate the hands Correct answer.

Explanation

Effective alcohol-based hand rub requires adequate volume and duration, typically 20 to 30 seconds, to cover all surfaces and allow drying; touching a contaminated door handle afterward can recontaminate the hands. Hand hygiene is required both before and after patient contact.

Question 22Patient Safety and Infection Control

A patient is placed on droplet precautions for influenza. Which action indicates a need for correction?

  1. The nurse uses a fit-tested N95 respirator for routine room entry Correct answer.
  2. The nurse wears a surgical mask when entering the room
  3. The patient wears a mask during transport
  4. The nurse performs hand hygiene before and after care

Explanation

Droplet precautions require a surgical mask for routine care; an N95 respirator is reserved for airborne precautions or aerosol-generating procedures. Masks on the patient during transport and hand hygiene are appropriate.

Question 23Patient Safety and Infection Control

A nurse is reviewing a plan to prevent infection in a patient with a new central venous catheter. Which combination best reflects evidence-based prevention?

  1. Insertion without a mask and daily catheter flushing with tap water
  2. Weekly dressing changes regardless of condition and routine antibiotic ointment
  3. Maximal sterile barrier at insertion, chlorhexidine skin antisepsis, and daily review of catheter necessity Correct answer.
  4. Routine catheter replacement every 72 hours and antibiotic prophylaxis

Explanation

CLABSI prevention bundles emphasize maximal sterile barriers at insertion, chlorhexidine antisepsis, and daily assessment of whether the line is still needed. Routine replacement and prophylactic antibiotics are not recommended, and tap water must never be used.

Question 24Patient Safety and Infection Control

A nurse is assessing a postoperative patient for signs of infection. Which finding most suggests a surgical site infection requiring prompt reporting?

  1. Serous drainage with intact approximated edges
  2. A temperature of 37.2 degrees Celsius in the morning
  3. Mild incisional discomfort on the first postoperative day
  4. Increasing pain, warmth, and purulent drainage at the incision Correct answer.

Explanation

Increasing pain, warmth, erythema, and purulent drainage are classic signs of a surgical site infection and require prompt evaluation. Early mild discomfort and small serous drainage can be expected postoperative findings.

Question 25Patient Safety and Infection Control

A nurse is caring for a patient with a Clostridioides difficile infection and notes a coworker using alcohol rub after exiting the room. What is the best analysis of this practice?

  1. The practice is acceptable if the coworker used a double volume of rub
  2. The practice is incorrect because soap and water is needed to remove spores Correct answer.
  3. The practice is correct if gloves were worn
  4. The practice is correct because alcohol kills spores

Explanation

C. difficile spores survive alcohol exposure, so mechanical removal with soap and water handwashing is required after contact with the patient or environment. Increasing the volume of alcohol rub does not overcome spore resistance.

Question 26Patient Safety and Infection Control

A nurse is preparing to suction a patient with a new tracheostomy. Which action best protects both the patient and the nurse during the procedure?

  1. Apply a surgical mask and eye protection in addition to standard precautions Correct answer.
  2. Remove gloves before touching the suction canister to save supplies
  3. Don sterile gloves and a gown before entering the room
  4. Wear a gown only if secretions are visible on the linens

Explanation

Suctioning generates splashes and aerosols of respiratory secretions, so a surgical mask and eye protection are added to gloves under standard precautions. Gloves alone do not protect the mucous membranes of the face. Protection is based on anticipated exposure, not on whether secretions are currently visible.

Question 27Patient Safety and Infection Control

A nurse is caring for a patient who has been placed in airborne precautions for suspected pulmonary tuberculosis. Which room assignment is correct?

  1. A semiprivate room with a curtain drawn between beds
  2. A private room with negative-pressure airflow and the door kept closed Correct answer.
  3. A private room with positive-pressure airflow and the door kept open
  4. A private room with the door closed and no special ventilation

Explanation

Airborne precautions require a private room with negative-pressure airflow, at least 6 to 12 air exchanges per hour, and the door kept closed to contain droplet nuclei. Positive pressure would push contaminated air outward into the corridor. Standard private rooms and curtains do not remove airborne particles.

Question 28Patient Safety and Infection Control

A nurse is teaching a patient's family about preventing the spread of infection at home after discharge. Which instruction best reflects the principle of source control?

  1. Have the patient wear a mask when others are within 6 feet during respiratory illness Correct answer.
  2. Disinfect every surface in the home twice daily regardless of illness
  3. Keep all windows closed to prevent airborne organisms from entering
  4. Stop all household hand hygiene once the patient feels better

Explanation

Source control means containing respiratory secretions at their origin, so a mask on the infected person reduces emission of infectious particles to others nearby. Environmental measures and hand hygiene support but do not replace source control. Hand hygiene should continue throughout and after illness.

Question 29Patient Safety and Infection Control

A nurse is reviewing the care plan for a patient with a new colostomy. Which combination of practices best reduces the risk of infection at the stoma site?

  1. Performing hand hygiene, using clean technique, and inspecting the stoma and peristomal skin at each pouch change Correct answer.
  2. Using sterile gloves and a sterile drape for every routine pouch change
  3. Changing the pouch only when it leaks and cleaning the stoma with alcohol
  4. Applying a tight belt over the pouch to keep it sealed for several days

Explanation

A colostomy is a clean, not sterile, procedure; consistent hand hygiene, clean technique, and regular inspection allow early detection of skin breakdown or infection. Routine sterile setup is unnecessary for a stoma on intact skin. Alcohol is irritating to stoma mucosa and peristomal skin.

Question 30Patient Safety and Infection Control

A nurse is caring for a patient whose blood pressure cuff and stethoscope are labeled for single-patient use. Which action best reflects correct handling of this equipment to prevent pathogen transmission?

  1. Share the equipment with other patients after wiping it once at the end of the shift
  2. Dedicate the equipment to that patient and clean it between uses according to policy Correct answer.
  3. Store the equipment in the hallway cart so it is available for any patient
  4. Use the equipment on other patients only if the current patient has no known infection

Explanation

Equipment that cannot be dedicated to a single patient must be cleaned and disinfected between patients, and items that are difficult to clean should be dedicated to one patient. Keeping the labeled equipment with that patient and cleaning it per policy prevents indirect contact transmission via contaminated surfaces.

Question 31Pharmacology and Medication Administration

A nurse is preparing to administer a scheduled dose of digoxin. Which assessment finding should be obtained before giving the dose?

  1. Urine specific gravity
  2. Apical heart rate for one full minute Correct answer.
  3. Deep tendon reflexes
  4. Blood glucose level

Explanation

Digoxin slows conduction through the AV node, so the apical pulse must be counted for a full minute before each dose; a rate below the ordered threshold (commonly 60/min in adults) warrants holding the dose and notifying the prescriber.

Question 32Pharmacology and Medication Administration

Which route provides the most rapid onset of action for a medication in an emergency?

  1. Oral
  2. Transdermal
  3. Intravenous Correct answer.
  4. Subcutaneous

Explanation

Intravenous administration places drug directly into the bloodstream, bypassing absorption and producing the fastest onset, which is why it is preferred in emergencies.

Question 33Pharmacology and Medication Administration

A patient is prescribed warfarin. Which laboratory value should the nurse monitor to evaluate therapeutic effect?

  1. International normalized ratio Correct answer.
  2. Platelet count
  3. Creatinine clearance
  4. Serum potassium

Explanation

Warfarin inhibits vitamin K–dependent clotting factors, and the INR is the standard measure of its anticoagulant effect and bleeding risk.

Question 34Pharmacology and Medication Administration

Which abbreviation on a medication order should the nurse clarify because it is on the Do Not Use list?

  1. U for units Correct answer.
  2. mg for milligram
  3. PO for by mouth
  4. mL for milliliter

Explanation

The abbreviation "U" for units is error-prone because it can be misread as a zero or a four, so it is prohibited and must be written out as "unit."

Question 35Pharmacology and Medication Administration

A nurse is administering a medication via a nasogastric tube. Which action is correct?

  1. Flush the tube with water before and after the dose Correct answer.
  2. Mix the medication with enteral formula
  3. Crush sustained-release tablets before instilling
  4. Administer each medication without flushing between them

Explanation

Flushing before and after each dose confirms tube patency and clears residual medication from the tubing so the full dose reaches the stomach and the tube does not clog.

Question 36Pharmacology and Medication Administration

Which class of medication commonly requires monitoring of serum drug levels because of a narrow therapeutic index?

  1. Bulk-forming laxatives
  2. Aminoglycoside antibiotics Correct answer.
  3. Topical corticosteroids
  4. Thiazide diuretics

Explanation

Aminoglycosides such as gentamicin have a narrow therapeutic index with risk of nephrotoxicity and ototoxicity, so peak and trough serum levels are monitored to keep concentrations in the safe range.

Question 37Pharmacology and Medication Administration

A patient reports a new rash and facial swelling shortly after starting a new antibiotic. What is the nurse's priority action?

  1. Document the finding and reassess at the next shift
  2. Apply a topical antihistamine and continue the drug
  3. Stop the drug and notify the provider immediately Correct answer.
  4. Slow the infusion rate and continue monitoring

Explanation

Rash with facial swelling suggests a hypersensitivity reaction that can progress to airway compromise; the drug should be stopped and the prescriber notified at once.

Question 38Pharmacology and Medication Administration

Which statement correctly describes the purpose of the rights of medication administration?

  1. They permit omission of documentation when a dose is refused
  2. They allow nurses to substitute a comparable drug when one is unavailable
  3. They authorize independent dose changes based on patient weight
  4. They reduce errors by verifying the right patient, drug, dose, route, and time Correct answer.

Explanation

The rights of medication administration are verification steps that prevent errors by confirming patient identity, drug, dose, route, and timing, along with documentation and reason.

Question 39Pharmacology and Medication Administration

A patient is prescribed 0.5 g of a medication. The pharmacy supplies 250 mg tablets. How many tablets should the nurse administer?

  1. 3
  2. 1
  3. 4
  4. 2 Correct answer.

Explanation

Convert grams to milligrams: 0.5 g equals 500 mg. Dividing the ordered 500 mg by 250 mg per tablet gives 2 tablets.

Question 40Pharmacology and Medication Administration

An order reads 1000 mL of fluid over 8 hours. What is the correct flow rate in mL per hour?

  1. 125 mL/hr Correct answer.
  2. 80 mL/hr
  3. 100 mL/hr
  4. 150 mL/hr

Explanation

Divide the total volume by the total time: 1000 mL divided by 8 hours equals 125 mL/hr.

Question 41Pharmacology and Medication Administration

A patient taking a loop diuretic reports muscle weakness and palpitations. Which electrolyte should the nurse suspect is abnormal?

  1. Potassium Correct answer.
  2. Chloride
  3. Calcium
  4. Sodium

Explanation

Loop diuretics increase renal potassium excretion, and hypokalemia produces muscle weakness and dysrhythmias; potassium should be checked and replaced as ordered.

Question 42Pharmacology and Medication Administration

Which instruction is most important to give a patient prescribed sublingual nitroglycerin for angina?

  1. Chew the tablet before placing it under the tongue
  2. Swallow the tablet with a full glass of water
  3. Take the tablet only after a meal
  4. Sit or lie down before taking the tablet Correct answer.

Explanation

Nitroglycerin causes vasodilation and can produce orthostatic hypotension and syncope, so the patient should be seated or lying down when taking it.

Question 43Pharmacology and Medication Administration

A patient on long-term prednisone therapy is admitted for an acute illness. Why should the corticosteroid not be stopped abruptly?

  1. Abrupt withdrawal causes rebound hypertension
  2. Abrupt withdrawal causes immediate hypoglycemia
  3. Abrupt withdrawal increases infection risk acutely
  4. Abrupt withdrawal can cause adrenal insufficiency Correct answer.

Explanation

Long-term corticosteroids suppress the hypothalamic-pituitary-adrenal axis, so sudden discontinuation can precipitate adrenal crisis; doses are tapered to allow gland recovery.

Question 44Pharmacology and Medication Administration

Which finding indicates a patient is experiencing an adverse effect of an opioid analgesic?

  1. Blood pressure of 138/86 mm Hg
  2. Heart rate of 88 beats/min
  3. Temperature of 37.2 degrees C
  4. Respiratory rate of 8 breaths/min Correct answer.

Explanation

Opioids depress the medullary respiratory center; a respiratory rate of 8/min signals clinically significant respiratory depression requiring immediate intervention.

Question 45Pharmacology and Medication Administration

A patient is receiving intravenous vancomycin. Which assessment finding should prompt the nurse to slow the infusion?

  1. New onset of tinnitus
  2. Dark urine with reduced output
  3. Bilateral crackles at the lung bases
  4. Flushing of the face and neck during the infusion Correct answer.

Explanation

Rapid vancomycin infusion can cause histamine-mediated flushing of the face and upper body, sometimes called red man syndrome; slowing the rate usually resolves it.

Question 46Pharmacology and Medication Administration

A nurse must give two medications through the same peripheral IV line. What is the best practice before administering the second drug?

  1. Verify compatibility and flush the line between drugs Correct answer.
  2. Administer both drugs rapidly to save time
  3. Use the same line without flushing to preserve patency
  4. Combine both drugs in one syringe

Explanation

Checking compatibility and flushing between doses prevents precipitation and inactivation of drugs that are chemically incompatible in the same line.

Question 47Pharmacology and Medication Administration

A patient with a history of peptic ulcer disease is prescribed a nonsteroidal anti-inflammatory drug. Which concern is most relevant?

  1. Increased risk of gastrointestinal bleeding Correct answer.
  2. Risk of hyperkalemia from sodium retention
  3. Risk of hypoglycemia
  4. Reduced effectiveness of the analgesic

Explanation

NSAIDs inhibit prostaglandin synthesis, which reduces gastric mucosal protection and increases the risk of ulceration and bleeding, especially in patients with prior ulcer disease.

Question 48Pharmacology and Medication Administration

Which action best reflects correct technique for administering a subcutaneous injection of insulin?

  1. Aspirate before injecting to check for blood return
  2. Insert the needle at a 90-degree angle into subcutaneous tissue Correct answer.
  3. Inject into the deltoid muscle for faster absorption
  4. Massage the site vigorously after injection

Explanation

Insulin is given into subcutaneous tissue, and a 90-degree angle is appropriate for most sites and needle lengths; aspiration and massage are no longer recommended.

Question 49Pharmacology and Medication Administration

A patient is prescribed a medication with a known teratogenic effect. Which action is most appropriate before administration to a person of childbearing potential?

  1. Withhold all medications until the provider arrives
  2. Rely on the patient's statement that pregnancy is impossible
  3. Administer the drug and document the risk afterward
  4. Confirm pregnancy status and verify the drug is indicated Correct answer.

Explanation

Before giving a known teratogen, the nurse verifies pregnancy status and confirms the indication and counseling; this prevents fetal harm while ensuring needed therapy.

Question 50Pharmacology and Medication Administration

Which medication requires the nurse to hold the dose and notify the provider when the heart rate is 52 beats/min?

  1. Metoprolol Correct answer.
  2. Ondansetron
  3. Acetaminophen
  4. Furosemide

Explanation

Beta-blockers such as metoprolol lower heart rate and are typically held when the rate falls below 60/min, pending provider notification, to avoid symptomatic bradycardia.