Medication administration, dosage calculation and first aid

50 Staff nurse recruitment practice questions on Medication administration, dosage calculation and first aid, part of Fundamentals of Nursing. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

1. Question 1 · Medium

   A labourer has a suspected closed fracture of the forearm. What should the first aider do?

   1. AApply a tight bandage directly over the fracture site
   2. BAsk him to move his fingers and wrist to test the bone
   3. CPull the arm straight to correct the deformity before splinting
   4. DSplint the arm as found, including the joints above and below

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   Answer: D · Splint the arm as found, including the joints above and below

   The aim of first aid is to stop movement at the fracture to reduce pain and further injury. The splint should include the joints above and below. No attempt is made to straighten the bone. Check circulation below the splint after applying it.

   • A: A tight bandage over the break can cut off circulation.
   • B: Movement worsens pain and displacement.
   • C: Straightening can damage nerves and vessels.

2. Question 2 · Hard

   An order reads injection gentamicin 60 mg IM. The vial contains 80 mg in 2 mL. What volume should be drawn up?

   1. A0.75 mL
   2. B1.5 mL
   3. C1.2 mL
   4. D2.7 mL

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   Answer: B · 1.5 mL

   Volume = dose wanted / stock strength x stock volume = 60 / 80 x 2 = 1.5 mL. The concentration is 40 mg per mL, so 60 mg needs 1.5 mL. A quick sense check: 60 mg is three quarters of the vial. Discard the unused drug as per policy.

   • A: 0.75 mL forgets to multiply by the 2 mL stock volume.
   • C: 1.2 mL gives only 48 mg.
   • D: 2.7 mL inverts the ratio and exceeds the vial.

3. Question 3 · Medium

   A patient asks a nurse to put his crushed tablet into his food. Which tablet must never be crushed?

   1. AA plain paracetamol tablet
   2. BA plain folic acid tablet
   3. CA plain chlorpheniramine tablet
   4. DAn enteric-coated aspirin tablet

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   Answer: D · An enteric-coated aspirin tablet

   Enteric coating protects the stomach from the drug, or the drug from stomach acid. Crushing destroys the coating and can cause gastric irritation and bleeding. Sustained-release tablets also must not be crushed because the whole dose is released at once. Check with the pharmacist for a liquid form.

   • A: Plain paracetamol can be crushed safely.
   • B: Plain folic acid can be crushed safely.
   • C: Plain chlorpheniramine can be crushed safely.

4. Question 4 · Easy

   A second nurse must independently check the dose and pump before which of these drugs is given?

   1. AInsulin
   2. BAntacid gel
   3. CVitamin C
   4. DParacetamol

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   Answer: A · Insulin

   High-alert medicines cause serious harm when given in error. Insulin, heparin, concentrated electrolytes, opioids and chemotherapy are typical examples. Many hospitals require a second nurse to check the dose and pump setting. Paracetamol, vitamins and antacids carry much lower risk.

   • B: Antacids are low risk.
   • C: Vitamin C is low risk.
   • D: Paracetamol is not on standard high-alert lists.

5. Question 5 · Easy

   The preferred site for an intramuscular injection in adults, because it has no major nerves or vessels nearby, is the:

   1. ADorsogluteal site
   2. BVentrogluteal site
   3. CDeltoid muscle
   4. DRectus femoris

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   Answer: B · Ventrogluteal site

   The ventrogluteal site lies over the gluteus medius and minimus, away from the sciatic nerve and major vessels. It has thick muscle and thin fat in most adults. Current texts recommend it as the first choice for deep IM injection. The dorsogluteal site risks sciatic nerve injury.

   • A: The dorsogluteal site lies close to the sciatic nerve and superior gluteal artery.
   • C: The deltoid takes only small volumes, about 1 mL.
   • D: Rectus femoris is used mainly for self-injection, not as the preferred adult site.

6. Question 6 · Medium

   Why is the Z-track method used when giving iron dextran by IM injection?

   1. AIt avoids the need to aspirate before injecting
   2. BIt allows a larger volume to be given in the deltoid
   3. CIt seals the drug in the muscle and prevents staining of the skin
   4. DIt speeds the absorption of the drug into the blood

   Answer and explanation in LearnFree account

7. Question 7 · Medium

   A boy is bitten on the leg by a stray dog. What is the most useful immediate first aid for the wound?

   1. AWash it with soap and running water for about 15 minutes
   2. BSuture the wound at once to stop bleeding
   3. CApply chilli paste or oil to the wound
   4. DCover it with a tight dressing and leave it unwashed

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8. Question 8 · Medium

   Before giving a drug, a nurse finds the patient has no wristband. What is the right way to confirm identity?

   1. AAsk a relative in the room if this is the right patient
   2. BAsk the patient to state his full name and age, and check them against the chart
   3. CCheck the bed number on the door against the drug chart
   4. DCall the patient by the name on the chart and wait for a reply

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9. Question 9 · Hard

   A bag holds heparin 20,000 units in 500 mL of saline. To deliver 800 units each hour, the infusion pump should be set at:

   1. A40 mL per hour
   2. B10 mL per hour
   3. C20 mL per hour
   4. D25 mL per hour

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10. Question 10 · Medium

    Why is the injection site not massaged after giving subcutaneous heparin?

    1. AIt can cause bruising and a haematoma
    2. BIt pushes the drug into a vein
    3. CIt causes the drug to leak out of the skin
    4. DIt makes the heparin act too slowly

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11. Question 11 · Medium

    A patient on a heparin infusion is oozing from IV sites and his aPTT is far above range. After stopping the drip, which drug reverses it?

    1. ACalcium gluconate
    2. BDesferrioxamine
    3. CProtamine sulphate
    4. DVitamin K

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12. Question 12 · Hard

    How many drops per minute will deliver one and a half litres of saline in 12 hours with a macro set of 15 drops per mL?

    1. AAbout 21
    2. BAbout 31
    3. CAbout 42
    4. DAbout 125

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13. Question 13 · Medium

    A patient with angina is given a glyceryl trinitrate tablet to take sublingually. How should he take it?

    1. AChew it well and then swallow it
    2. BLet it dissolve under the tongue without swallowing
    3. CSwallow it whole with a glass of water
    4. DDissolve it in water and drink the solution

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14. Question 14 · Easy

    The antidote that reverses respiratory depression from morphine is:

    1. AGlucagon
    2. BNaloxone
    3. CPhysostigmine
    4. DFlumazenil

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15. Question 15 · Easy

    The commonly used IV fluid that is isotonic with plasma is:

    1. A10% dextrose
    2. B0.9% sodium chloride
    3. C0.45% sodium chloride
    4. D3% sodium chloride

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16. Question 16 · Hard

    A woman weighing 50 kg has burns on the whole of both legs. By the rule of nines and Parkland formula, how much fluid is due in 24 hours?

    1. A1,800 mL
    2. B3,600 mL
    3. C9,000 mL
    4. D7,200 mL

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17. Question 17 · Medium

    A drug order written as 'insulin 10 U' is a recognised error risk. What is the danger?

    1. AThe letter U can be read as a zero, giving 100 units
    2. BThe letter U means the route is unclear
    3. CThe letter U can be read as a micrograms sign
    4. DThe letter U means the drug must be given IV

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18. Question 18 · Medium

    A child has swallowed kerosene at home. Which first aid step is correct?

    1. AGive large amounts of milk to absorb it
    2. BDo not induce vomiting and take the child to hospital
    3. CGive castor oil to flush the gut
    4. DMake the child vomit at once with salt water

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19. Question 19 · Easy

    Which drug is the antidote for organophosphate poisoning?

    1. ANeostigmine
    2. BNaloxone
    3. CAdrenaline
    4. DAtropine

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20. Question 20 · Easy

    A subcutaneous injection of insulin is given with the needle inserted at an angle of:

    1. A10 to 15 degrees
    2. B45 to 90 degrees
    3. C180 degrees
    4. D25 degrees only

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21. Question 21 · Medium

    The 'right documentation' in medication administration means the nurse records the drug:

    1. ABefore taking it to the bedside
    2. BImmediately after giving it
    3. CBefore preparing it
    4. DAt the end of the shift

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22. Question 22 · Easy

    The tuberculin syringe commonly used for intradermal tests holds a total volume of:

    1. A2 mL
    2. B10 mL
    3. C1 mL
    4. D5 mL

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23. Question 23 · Medium

    A patient on IV fluids has a cannula site that is cool, swollen and pale, and the drip has slowed. The nurse suspects:

    1. AAir embolism through the line
    2. BInfiltration of fluid into the tissues
    3. CCirculatory overload from the fluid
    4. DPhlebitis of the cannulated vein

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24. Question 24 · Medium

    A worker gets concentrated acid splashed into one eye. The immediate first aid is to:

    1. ARub the eye to remove the acid quickly
    2. BIrrigate the eye with clean water for at least 15 minutes
    3. CNeutralise it with an alkali solution
    4. DCover the eye with a pad and go to hospital

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25. Question 25 · Medium

    A nurse finds that the morning dose of an antibiotic was missed two hours ago. What should she do first?

    1. AGive a double dose with the next scheduled dose
    2. BGive the dose and record it at the original time
    3. COmit the dose and say nothing as it is past due
    4. DCheck the drug's timing rules and inform the doctor before giving it

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