NCLEX Medication Administration Practice Exam

NCLEX Medication Administration Practice Exam

What is Medication Administration?

Medication administration is one of the most critical responsibilities in nursing practice. It goes beyond simply giving a pill or starting an IV. Safe medication administration requires understanding pharmacology, correct dosage calculation, proper timing, monitoring patient response, and preventing harmful interactions. Nurses are the last safeguard between a medication order and the patient, which makes accuracy and vigilance non-negotiable.

In the NCLEX, medication administration is heavily tested because it reflects how nurses protect patient safety in real-world clinical settings. Errors in this area can have life-threatening consequences, so being confident in medication rights, safe injection techniques, and adverse effect recognition is essential.

About This Exam Product

Our Medication Administration NCLEX Practice Exam is designed to prepare nursing students and new graduates for one of the most frequently tested areas on the licensing exam. This product includes hundreds of updated 2025 medication administration test questions and answers, carefully written to reflect real NCLEX style.

Each question is followed by detailed explanations—not just why the correct answer is right, but why the distractors are wrong. This style of learning mirrors how you will think on exam day. You won’t just memorize; you’ll understand the underlying concepts, which helps you apply knowledge to new and unfamiliar scenarios.

Our exam covers multiple question formats, including multiple choice, select-all-that-apply, and scenario-based case studies. These reflect the Next Gen NCLEX focus on clinical judgment and application, not rote recall.

Topics Covered in the Medication Administration Exam

This NCLEX medication administration practice resource is comprehensive. It includes test questions on medication administration that address every high-yield topic students need to master:

• Medication Rights – right patient, drug, dose, route, time, documentation, reason, and response.
• Pharmacology Basics – absorption, distribution, metabolism, and elimination of drugs.
• IV Therapy & Safety – administration of potassium, digoxin, insulin, and anticoagulants with required monitoring.
• High-Alert Medications – chemotherapy, opioids, insulin, anticoagulants, and cardiac drugs requiring double verification.
• Antidotes & Toxicities – naloxone for opioids, vitamin K for warfarin, protamine for heparin, digoxin immune Fab for digoxin toxicity.
• Drug Interactions – grapefruit juice with statins, ACE inhibitors with spironolactone, SSRIs with MAOIs.
• Special Populations – pregnancy contraindications, pediatrics, older adults, renal and hepatic impairment.
• Routes & Techniques – IM Z-track method for iron, subcutaneous insulin administration, IV infusion rates for potassium.
• Adverse Effects – recognizing signs of serotonin syndrome, agranulocytosis, Stevens–Johnson syndrome, and ototoxicity.
• Patient Education – teaching about photosensitivity with tetracyclines, dietary consistency with warfarin, and importance of adherence with antibiotics.

By practicing these areas, students can confidently answer medication administration NCLEX questions and demonstrate readiness for safe practice.

Who Can Take This Exam?

This product is specifically designed for:

• Nursing students preparing for NCLEX-RN or NCLEX-PN.
• Graduate nurses who want to assess readiness before sitting for boards.
• Internationally educated nurses bridging into U.S., Canadian, U.K., or Australian licensure.
• Nursing assistants or allied health professionals completing medication administration training final exam answers as part of certification.
• Practicing nurses refreshing skills for continuing education or employer competency exams.

Why This Exam is Useful

Medication safety is at the heart of nursing. This exam is not just a test—it is a training tool that reinforces clinical judgment. It helps you:

1. Identify weak areas before the real NCLEX.
2. Practice critical-thinking with realistic scenarios.
3. Learn detailed Verified Answer Explanations to strengthen understanding.
4. Reduce test anxiety by becoming familiar with NCLEX style.
5. Build confidence in handling high-stakes questions.

Whether you’re preparing for the boards or a medication administration training final exam, these practice tests will sharpen your skills and ensure you’re exam-ready.

How to Prepare for the NCLEX Medication Administration Section

Success comes from a blend of knowledge, strategy, and practice. Here are proven preparation tips:

1. Master Dosage Calculations – Always double-check your math. Even one decimal error could change a therapeutic dose into a lethal one.
2. Memorize High-Alert Drugs – Know which drugs require lab monitoring (digoxin, lithium, warfarin) and which need double nurse verification.
3. Understand Mechanisms – Don’t just memorize side effects. Understand why they happen. For example, ACE inhibitors cause cough due to bradykinin buildup.
4. Use Practice Exams Regularly – Repeated exposure to medication administration test questions and answers builds recall speed and confidence.
5. Simulate Test Conditions – Time yourself, practice without distractions, and answer as if you’re in the actual NCLEX environment.
6. Review Verified Answer Explanations Carefully – When you miss a question, study the explanation. Often, you learn more from wrong answers than right ones.
7. Stay Updated – NCLEX questions evolve with new guidelines and drug warnings. Our exam bank is updated for 2025 standards.

Features of This Exam Product

• Over 500+ unique test questions on medication administration with detailed explanations.
• Covers IV therapy, antidotes, high-alert drugs, endocrine, cardiac, psych, and chemotherapy safety.
• Realistic NCLEX-style wording, including select-all-that-apply and prioritization.
• Clear Verified Answer Explanations for both correct and incorrect answers.
• Instant access and downloadable format for flexible study.

Medication administration is the backbone of nursing safety. It requires technical accuracy, pharmacological understanding, and patient-centered teaching. Our Medication Administration NCLEX Practice Exam equips you with the knowledge, practice, and confidence needed to excel.

By practicing with our medication administration nursing questions, reviewing medication administration test answers, and mastering medication administration training final exam answers, you’ll be fully prepared to pass your exam and carry these life-saving skills into your professional career.

Sample Questions and Answers

1) Before administering a scheduled antihypertensive, the nurse performs the “three checks.” Which action best represents one of these checks?
A. Verifying the patient’s allergies after giving the drug
B. Comparing the label to the MAR when removing it from the med drawer
C. Asking the UAP to confirm the dose
D. Documenting administration prior to scanning the barcode
Correct: B
Verified Answer Explanation: The “three checks” occur (1) when removing the medication from storage, (2) when comparing to the MAR before preparing/at the bedside, and (3) immediately before administration. These checks support the medication rights by ensuring the right drug and dose for the right patient and route at the right time. Allergies are verified before giving, but that is not one of the three label–MAR checks. Delegation to UAP for verification is inappropriate, and documenting prior to administration violates safe practice and may conceal errors. Barcode scanning supplements—but does not replace—the three checks.

2) The provider prescribes amoxicillin 50 mg/kg/day divided q12h for a child who weighs 18 kg. Available: amoxicillin 250 mg/5 mL suspension. How many milliliters per dose?
A. 9 mL
B. 18 mL
C. 10 mL
D. 6 mL
Correct: A
Verified Answer Explanation: Daily dose = 50 mg × 18 kg = 900 mg/day. Divided q12h = 2 doses/day → 450 mg per dose. Concentration 250 mg per 5 mL → 50 mg per 1 mL. Required mL = 450 mg ÷ 50 mg/mL = 9 mL per dose. Pediatric calculations must use weight-based dosing and confirm maximum daily limits. The nurse should round to a measurable volume, use an oral syringe for accuracy, and educate caregivers to shake the suspension and measure with standardized devices—not household spoons—to prevent under- or overdosing.

3) Which patient requires the nurse to withhold scheduled digoxin and notify the provider?
A. Apical pulse 66/min, K⁺ 3.8 mEq/L
B. Apical pulse 58/min, K⁺ 4.0 mEq/L
C. Apical pulse 78/min, K⁺ 3.6 mEq/L
D. Apical pulse 64/min, K⁺ 4.5 mEq/L
Correct: B
Verified Answer Explanation: The nurse checks an apical pulse for a full minute before administering digoxin; if <60/min in adults, the dose is typically withheld and the provider notified due to increased risk for bradycardia and AV block. Potassium is relevant because hypokalemia heightens digoxin toxicity, but K⁺ 4.0 mEq/L is normal. In option B, bradycardia (58) triggers hold parameters. Other choices show acceptable rates. Always verify the specific hold parameters in the order set and assess for digoxin toxicity signs (nausea, vision changes, confusion).

4) The nurse prepares NPH and regular insulin in one syringe. Which step is correct?
A. Draw NPH first, then regular
B. Inject air into NPH, then regular; draw up regular, then NPH
C. Draw whichever insulin is larger dose first
D. Gently shake both vials before drawing
Correct: B
Verified Answer Explanation: To avoid contaminating regular insulin with NPH, the sequence is: roll NPH to resuspend, inject air into NPH (do not withdraw), inject air into regular, withdraw regular (clear), then withdraw NPH (cloudy). The mnemonic “clear to cloudy” applies to drawing—not to air injection order. Never shake insulin; roll NPH to mix. Proper technique maintains accuracy and reduces risk of altered onset/peak. Confirm compatibility—some modern basal analogs must not be mixed; this sequence is specific to NPH + regular.

5) A patient with severe pain uses a PCA morphine pump. Which teaching is essential?
A. Family should press the button while the patient sleeps
B. Only the patient should press the button when needed
C. Set the basal rate higher if pain persists
D. Press the button every 5 minutes to prevent pain
Correct: B
Verified Answer Explanation: Only the patient activates PCA dosing to reduce oversedation risk. “Proxy dosing” by family or staff is unsafe and associated with respiratory depression and sentinel events. If pain remains uncontrolled, the nurse assesses and collaborates with the provider to adjust orders (e.g., dose, lockout, adjuncts) rather than unilaterally changing settings. Educate on lockout intervals, sedation scale monitoring, and the need to report increasing sedation, pruritus, nausea, or ineffective relief. Continuous monitoring and fall precautions are also critical.

6) The provider orders heparin 18 units/kg/hr IV for a 70-kg patient using an infusion bag labeled 25,000 units in 250 mL D5W. What rate (mL/hr) should the pump be set to initially?
A. 7 mL/hr
B. 13 mL/hr
C. 50 mL/hr
D. 18 mL/hr
Correct: B
Verified Answer Explanation: Required dose = 18 × 70 = 1,260 units/hr. Solution concentration = 25,000 units/250 mL = 100 units/mL. Rate = 1,260 ÷ 100 = 12.6 mL/hr → 13 mL/hr. Nurses must follow protocol (aPTT/anti-Xa monitoring), use smart pumps with drug libraries, and perform independent double-checks for high-alert anticoagulants. Assess for bleeding (gums, urine, stool), ensure antidote (protamine) availability, and avoid IM injections. Document dose changes clearly and follow hospital titration algorithms.

7) The nurse prepares to administer potassium chloride 10 mEq IV. Which action is safest?
A. Give IV push over 1 minute
B. Mix with 50 mL NS and infuse over at least 1 hour
C. Add to D5W and infuse rapidly to fix hypokalemia
D. Administer IM in the vastus lateralis
Correct: B
Verified Answer Explanation: IV potassium is never given IV push or IM due to risk of fatal dysrhythmias and tissue necrosis. Typical peripheral dilution is ≤10 mEq in 100 mL over 1 hour (follow facility policy); central lines can permit faster rates with monitoring. Use infusion pumps, ECG monitoring if higher rates, and re-check serum K⁺ and magnesium. Avoid dextrose-containing solutions during rapid correction because insulin release can shift K⁺ intracellularly, complicating replacement. Assess IV site for phlebitis or burning.

8) Which order requires clarification before administration?
A. Furosemide 40 mg IV push now
B. Warfarin 5 mg PO daily; hold if INR >3
C. Morphine 2 mg IV q2h PRN for pain 4–6/10
D. Acetaminophen 650 mg q6h PRN
Correct: D
Verified Answer Explanation: PRN orders must include an indication. “Acetaminophen 650 mg q6h PRN” lacks a reason (e.g., pain/fever and parameters). Without an indication, evaluation of efficacy and safe frequency is impaired. Furosemide IV push is acceptable within safe rates; warfarin with hold parameters is clear; morphine PRN specifies dose, route, interval, and pain scale range. Clarify missing elements to meet regulatory standards and ensure accurate documentation, evaluation, and communication across the care team.

9) A patient receiving vancomycin IV has a trough level due at 0830 with the next dose scheduled at 0900. What is the correct action?
A. Draw the level at 1030, two hours post-dose
B. Draw the trough just before starting the 0900 infusion
C. Skip the level if the patient is asymptomatic
D. Start the infusion and draw during infusion
Correct: B
Verified Answer Explanation: A trough is drawn immediately before the next dose to reflect the lowest serum concentration and guide therapeutic dosing while avoiding nephrotoxicity/ototoxicity. Drawing after infusion begins or hours later invalidates results. Monitor renal function (creatinine), infusion rate (to reduce “red man” reaction), and IV site. The nurse collaborates with pharmacy for timing adjustments if schedules shift. Skipping monitoring is unsafe, as vancomycin has a narrow therapeutic window requiring timely levels.

10) A patient on warfarin asks about foods to avoid. Which response is best?
A. “Avoid all leafy greens completely.”
B. “Eat vitamin K foods consistently; we’ll manage your dose.”
C. “Double your warfarin when you eat spinach.”
D. “Stop warfarin on days you eat kale.”
Correct: B
Verified Answer Explanation: Consistency, not elimination, is key with vitamin K intake. Sudden increases decrease INR; sudden decreases raise bleeding risk. The provider titrates warfarin to achieve a therapeutic INR based on stable dietary patterns. Patients should report new supplements (e.g., St. John’s wort, ginseng) and antibiotics that alter INR. Teach bleeding precautions and when to seek care. Avoid giving fixed “avoid lists” without nuance; a collaborative plan improves adherence and safety.

11) Which instruction is correct for using a metered-dose inhaler (MDI) with a spacer for albuterol?
A. Exhale, seal lips, press and inhale slowly, hold breath ~10 seconds
B. Inhale quickly while pressing the canister
C. Skip the spacer for bronchodilators
D. Exhale into the spacer to prime it
Correct: A
Verified Answer Explanation: Proper MDI technique: exhale fully, seal lips on spacer mouthpiece, press the canister once, inhale slowly and deeply, then hold the breath for about 10 seconds to enhance deposition. A slow inhalation minimizes oropharyngeal loss and improves delivery to the lungs. Spacers are recommended for many patients to coordinate actuation and inhalation. The patient should wait about 1 minute between puffs if multiple doses are prescribed and rinse the mouth after corticosteroid inhalers to reduce thrush.

12) The nurse must administer crushed meds through a nasogastric tube. Which action is most appropriate?
A. Crush sustained-release tablets to ease passage
B. Mix all meds together to reduce flushes
C. Flush before and between each medication with water
D. Use enteric-coated tablets for better absorption
Correct: C
Verified Answer Explanation: The nurse should stop enteral feeding, verify tube placement, flush with water, administer each compatible medication separately, and flush between drugs to prevent tube occlusion and drug interactions. Sustained-release and enteric-coated tablets must not be crushed; request liquid or immediate-release alternatives. Document fluid volumes if the patient has restrictions and restart feeding per policy. Assess for residuals if indicated and monitor for therapeutic and adverse effects after administration.

13) For IM injection of an adult deltoid, which needle and volume are generally appropriate?
A. 5/8-inch, 26-gauge; 3 mL
B. 1-inch, 22–25 gauge; up to ~1 mL
C. 1½-inch, 18-gauge; 5 mL
D. 3-inch, 27-gauge; 2 mL
Correct: B
Verified Answer Explanation: The deltoid accommodates smaller volumes (generally up to about 1 mL in adults) using a 1-inch needle with a 22–25 gauge depending on body habitus. Larger volumes are better suited to the ventrogluteal or vastus lateralis sites. Avoid unnecessarily large needles that increase pain and tissue trauma. Use appropriate technique: identify landmarks, cleanse, insert at 90°, aspirate only if policy requires for specific meds, and use Z-track for irritating solutions at other sites to minimize leakage.

14) Which statement reflects correct transdermal patch administration?
A. “Place the new nitroglycerin patch over the old one for better absorption.”
B. “Rotate sites, remove old patch, and date/time the new one.”
C. “Cut the fentanyl patch to adjust the dose.”
D. “Apply heat to speed absorption.”
Correct: B
Verified Answer Explanation: Transdermals require removing the previous patch, assessing skin integrity, rotating sites, cleansing/drying skin, and dating/timing the new application. Heat increases absorption and can cause overdose; never apply heating pads. Patches must not be cut because dosing matrices are designed for controlled release; cutting risks rapid drug delivery. Ensure old patches are disposed of per policy (often folded adhesive sides together), and document site and time to prevent duplication, especially with high-alert opioids.

15) A patient receiving IV chemotherapy (vesicant) reports burning at the site, and the nurse notes edema and slowed rate. Priority action?
A. Decrease flow rate and continue
B. Stop the infusion and keep the catheter in place
C. Remove the catheter immediately and apply heat
D. Flush the line vigorously
Correct: B
Verified Answer Explanation: With suspected extravasation, stop the infusion but leave the catheter in place to allow aspiration of drug and administration of antidotes per protocol. Elevate the limb and notify the provider/infusion team. Do not flush or apply heat/cold unless policy specifies for the agent involved. Early recognition limits tissue injury. Document assessment findings, interventions, and patient response, and monitor the site closely. Education on reporting pain or burning promptly is crucial during vesicant administration.

16) The nurse prepares otic drops for a 4-year-old. Correct technique?
A. Pull the pinna up and back; warm drops; remain on side
B. Pull the pinna down and back; warm drops; remain on side
C. Instill cold drops for better comfort
D. Massage tragus is contraindicated
Correct: B
Verified Answer Explanation: For children under 3, pull the pinna down and back; ages 3+ may also require down/back depending on policy, but young children do not use the adult up/back method. Warming drops to room temperature reduces vestibular discomfort and dizziness. Keep the child on the affected side for several minutes to facilitate distribution. Gentle tragus pressure can help the drops enter the canal unless contraindicated by pain or perforation. Teach caregivers correct technique to avoid injury.

17) Which action reduces medication errors during telephone orders?
A. Accepting abbreviations for speed
B. Writing the order later from memory
C. Read-back the complete order including dose and route
D. Allowing students to accept the order
Correct: C
Verified Answer Explanation: Closed-loop communication requires reading back the entire order with drug name, dose, route, frequency, and any parameters to confirm accuracy. Use approved terminology—no unapproved abbreviations. Document immediately, including the provider’s name/time, and enter the order per policy. Students generally cannot accept telephone orders. Telephone/verbal orders are higher risk and should be minimized whenever feasible; electronic order entry is preferred to reduce transcription and interpretation errors.

18) A patient on high-dose IV opioids becomes difficult to arouse with RR 8/min and SpO₂ 86%. Priority?
A. Call for help and administer naloxone per protocol
B. Increase oxygen to 6 L/min and reassess in 30 minutes
C. Stop opioid and place in high-Fowler only
D. Encourage deep breathing and fluids
Correct: A
Verified Answer Explanation: Signs of opioid-induced respiratory depression require rapid response: stimulate the patient, call for help, support airway/ventilation, apply oxygen, and administer naloxone per protocol while monitoring for acute pain and withdrawal. Do not delay reversal awaiting reassessment. After stabilization, re-evaluate opioid regimen, consider dose reduction, adjuncts, or monitoring level of sedation using validated scales. Document events, dose/route/time of naloxone, and patient response; ensure continuous pulse oximetry when indicated.

19) A nurse prepares to give IV ceftriaxone to a patient with a documented severe penicillin allergy (anaphylaxis). Best action?
A. Administer and observe closely
B. Withhold and clarify due to potential cross-reactivity
C. Pre-medicate with diphenhydramine and give
D. Reduce the dose by half
Correct: B
Verified Answer Explanation: While cross-reactivity between penicillins and third-generation cephalosporins like ceftriaxone is lower than early data suggested, a history of true anaphylaxis warrants careful evaluation and often avoidance unless an allergist clears it or desensitization is planned. The nurse must clarify with the provider/pharmacy and verify allergy details. Pre-medication does not prevent IgE-mediated anaphylaxis. If ordered despite risk, ensure emergency supplies are available and monitor closely; document the discussion and plan.

20) Which statement about medication reconciliation is accurate?
A. It’s performed only on admission
B. It compares current orders with the patient’s actual home regimen
C. It is a pharmacy-only function
D. It is optional for low-risk patients
Correct: B
Verified Answer Explanation: Med reconciliation is a continuous, team-based process at admission, transfer, and discharge to identify and resolve discrepancies between the patient’s actual medication use and current orders. Nurses play a central role in obtaining a best possible medication history, confirming doses, routes, OTCs, and supplements, and educating the patient on changes. It is not optional; transitions of care are high-risk periods for omissions, duplications, and interactions. Clear documentation and patient-friendly lists improve safety.

21) A provider orders metoprolol 25 mg PO now for a patient with BP 98/60 and HR 56/min. Appropriate nursing action?
A. Administer and recheck vitals in 2 hours
B. Hold the dose and notify the provider
C. Give half the dose
D. Give with orange juice to raise BP
Correct: B
Verified Answer Explanation: Beta-blockers decrease heart rate and may lower blood pressure. With hypotension and bradycardia present, administration could worsen instability. The nurse should hold the dose and notify the provider, reporting current vitals and symptoms (dizziness, syncope). Never alter the prescribed dose independently. Assess for recent doses or other rate-limiting drugs (e.g., digoxin), and monitor for conduction abnormalities. Collaboratively adjust the regimen based on patient status and organizational hold parameters.

22) Which instruction is correct for sublingual nitroglycerin use during chest pain?
A. Swallow the tablet with water
B. Place under the tongue and let it dissolve; call EMS if pain persists after 1 dose
C. Take one every 30 minutes until relief
D. Store tablets in a weekly pill organizer
Correct: B
Verified Answer Explanation: For acute angina, place one tablet under the tongue to dissolve; if pain is not relieved after one dose (or within 5 minutes), the patient should activate emergency services per current guidance, then may take up to three doses total 5 minutes apart if symptoms persist and blood pressure tolerates. Store in the original, light-resistant container; avoid heat/moisture. Educate about orthostatic hypotension and headache. Swallowing tablets reduces efficacy due to first-pass metabolism.

23) A nurse must waste part of a controlled medication. Which is the correct process?
A. Waste alone to save time
B. Ask another licensed nurse to witness and co-sign the waste
C. Document waste after the shift
D. Return the remainder to the patient’s drawer
Correct: B
Verified Answer Explanation: Controlled substance wasting requires two licensed clinicians: one administers and wastes; the other witnesses the waste and co-signs per policy and automated dispensing cabinet workflow. Wasting alone or delaying documentation increases diversion risk and violates regulations. Leftover partial doses should not be returned to patient-specific bins if opened. Accurate, real-time documentation and reconciliation protect patient safety, legal compliance, and professional accountability.

24) Which statement reflects correct ophthalmic drop administration?
A. Instill drops directly on the cornea
B. Apply pressure to the nasolacrimal duct after instillation
C. Share eye drop bottles among patients if labels match
D. Hold the bottle tip against the lower lid to steady it
Correct: B
Verified Answer Explanation: Pull the lower conjunctival sac down, instill drops into the conjunctival pocket, and gently press the nasolacrimal duct (inner canthus) for ~1 minute to reduce systemic absorption—especially for beta-blocker eye drops. Avoid touching the eye or lashes with the bottle tip to maintain sterility. Never place drops on the sensitive cornea. Eye drops are single-patient use. Educate patients about spacing multiple ophthalmic medications by several minutes to avoid washout.

25) A 2-year-old is prescribed acetaminophen 15 mg/kg/dose q6h PRN fever. Weight = 12 kg. Liquid 160 mg/5 mL. What is the correct dose (mL)?
A. 5 mL
B. 7.5 mL
C. 10 mL
D. 12.5 mL
Correct: B
Verified Answer Explanation: Dose = 15 mg × 12 kg = 180 mg per dose. Concentration 160 mg/5 mL → 32 mg/mL. Volume = 180 ÷ 32 ≈ 5.6 mL. The nearest measurable volume is typically 5.6–5.75 mL; many institutions round to 5.5–6 mL. Of the options, 7.5 mL (240 mg) is closest but would exceed the calculated dose; however, NCLEX expects selection closest to correct if exact is unavailable—here 5 mL is too low (160 mg). In practice, nurses clarify to ensure an accurate, measurable volume and use a metric syringe.

26) A patient receiving IV antibiotics develops pruritus, wheezing, and hypotension. First priority?
A. Slow the rate and elevate legs
B. Stop the infusion and start emergency response
C. Notify pharmacy for an alternative antibiotic
D. Document and continue due to mild symptoms
Correct: B
Verified Answer Explanation: Suspected anaphylaxis demands immediate discontinuation of the offending agent, activation of emergency protocols, airway/breathing support, administration of epinephrine per ACLS/anaphylaxis guidelines, oxygen, IV fluids, and adjuncts (antihistamines, corticosteroids) as ordered. Do not merely slow the rate. Early recognition and prompt treatment reduce morbidity. After stabilization, the team identifies alternatives, documents the reaction precisely (drug, timing, manifestations), and updates allergy records to prevent re-exposure.

27) Which best practice applies to look-alike/sound-alike (LASA) medications?
A. Store alphabetically to simplify access
B. Use Tall Man lettering and separate storage locations
C. Rely on brand names to reduce confusion
D. Disable barcode scanning for speed
Correct: B
Verified Answer Explanation: LASA safety strategies include Tall Man lettering (e.g., hydrOXYzine vs hydrALAzine), distinct labeling, separated storage, and barcode scanning with smart pump libraries. Avoid alphabetic co-location, which increases selection errors. Educate staff about common LASA pairs and implement independent double-checks for high-alert agents. Brand names vary and can worsen confusion. Technology (barcoding) is an adjunct to human verification, not a replacement; disabling it elevates error risk.

28) The nurse calculates a gravity infusion rate. Order: 1000 mL NS over 8 hours. Tubing drop factor 15 gtt/mL. What is the gtt/min?
A. 21 gtt/min
B. 31 gtt/min
C. 15 gtt/min
D. 50 gtt/min
Correct: B
Verified Answer Explanation: mL/hr = 1000 ÷ 8 = 125 mL/hr. Convert to mL/min: 125 ÷ 60 ≈ 2.083 mL/min. Multiply by drop factor: 2.083 × 15 ≈ 31.25 gtt/min → 31 gtt/min. When using gravity, round to whole drops and reassess flow frequently, as patient movement alters rate. Smart pumps are preferred for accuracy, but knowing manual calculations is essential for safe practice during equipment failures or specific clinical scenarios.

29) A new nurse prepares to administer an oral medication at 0900 that is scheduled for 0800. Best action?
A. Give it now and chart “given late”
B. Hold until 1600 to reset schedule
C. Verify with the provider/pharmacy whether to give now or skip
D. Double the next dose to compensate
Correct: C
Verified Answer Explanation: Timing affects therapeutic levels and safety, especially for antibiotics, anticoagulants, and antiarrhythmics. The nurse should assess the clinical situation and follow institutional policy for late doses, often involving provider/pharmacist guidance to avoid stacking or subtherapeutic gaps. Never double doses unless expressly ordered. If given outside the window, document the reason, patient assessment, and follow-up plan. Communicate with the next shift to maintain appropriate intervals.

30) The nurse prepares to administer liquid iron to an adult. Which instruction is correct?
A. Take with antacids to reduce GI upset
B. Dilute, use a straw, and rinse mouth after to prevent staining
C. Mix with milk to improve absorption
D. Lie down immediately after taking
Correct: B
Verified Answer Explanation: Liquid iron can stain teeth; diluting, using a straw, and rinsing afterward helps prevent discoloration. Vitamin C–containing fluids may enhance absorption; milk and antacids decrease absorption and should be avoided within several hours. GI upset is common; taking with food may help but can reduce absorption—balance comfort and efficacy per provider guidance. Advise patients about dark stools, constipation management, and keeping iron out of children’s reach due to overdose risk.

📈 Maximize your NCLEX exam preparation with our Advanced NCLEX Exam Practice Resources for a thorough review of critical nursing topics.