Pharmacological and Parenteral Therapies - Part 3

1. Which of the following is a disadvantage of administering intravenous medications through the IV-push method?

A. It is impossible to determine the full effect of the drug on the client.

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B. The drug may be irritating to the client's veins.

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C. The peak onset of action is slower when a drug is given IV-push.

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D. None of the above.

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2. A nurse is preparing to administer an ophthalmic medication to Mrs. W. Which of the following statements demonstrates that the nurse is performing this procedure correctly?

A. Open your eyes wide and look toward the floor."

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B. I will hold your eyelashes to keep your eye open."

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C. I'm going to give this drop in the lower part of your eye."

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D. Try to keep your eyes open after I give this medicine."

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3. Which of the following effects does obesity have on drug distribution?

A. Drugs are distributed more quickly in obese persons because blood flow is increased through fat tissue.

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B. Drugs are distributed more slowly in obese persons because blood flow is decreased through fat tissue.

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C. Obesity has a paradoxical effect on drug distribution in that blood flow is decreased but distribution is increased.

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D. Obesity has no effect on drug distribution.

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4. Which of the following is an example of libel?

A. A client overhears a nurse telling her assistant that he is too high maintenance.

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B. A client reads disparaging remarks that a nurse has written about him in his chart.

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C. A nurse fails to notify a physician when a client's hemoglobin level is 8.1 gm/dL.

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D. A nurse administers narcotic pain medication to a client in pain but does not have an order.

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5. Mr. R is being seen in his physician’s office for swollen and painful joints. The most obvious joint affected is his great toe, which has become large, red, and painful. Which of the following medications is most appropriate for this condition?

A. Docusate sodium.

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B. Bismuth subsalicylate.

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C. Allopurinal.

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D. Cromolyn sodium.

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6. Which of the following interventions reduces the risk of infection when administering an intramuscular injection?

A. Draw up the solution approximately 5 minutes before administration.

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B. Keep the tip of the needle covered until administration.

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C. Clean the skin with an antiseptic swab in a Â½-inch radius.

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D. Check the client's temperature immediately after administering the injection.

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7. A nurse is attempting to start an IV in a client’s arm and is having difficulty with finding a vein to use. The client’s skin is cold. Which intervention of the nurse may improve this situation?

A. Raise the client's hand so that it remains at a level above the heart.

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B. Place a warm pack on the clients arm for 5 minutes before looking for a vein.

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C. Instruct the client to drink a quart of warm water.

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D. Apply a tourniquet 12 inches above the IV site.

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8. A client is being admitted on a routine basis for fluids to correct an electrolyte balance. Which of the following sites is most appropriate for starting an IV in this client?

A. A vein in the antecubital fossa.

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B. A vein in the dominant hand.

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C. A vein in the foot.

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D. A vein in the non-dominant hand.

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9. Which of the following interventions best helps to facilitate insertion of an intravenous catheter?

A. Ask the client to look away during the procedure.

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B. Puncture the skin at a 5 to 10-degree angle.

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C. Advance the catheter until resistance is met.

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D. Secure the device at a 45-degree angle to the skin.

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10. A client with an IV is complaining of pain at the insertion site. There is a bruise at the site, the skin is tender, and the IV fluid will not flow. Which of the following conditions is the most likely cause of these symptoms?

A. Hematoma.

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B. Phlebitis.

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C. Extravasation.

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D. Venous spasm.

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11. Which of the following solutions is compatible with administration of packed red blood cells?

A. Lactated Ringer's.

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B. 0.9% Normal Saline.

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C. D5 Â½ Normal Saline.

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D. Normosol-R.

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12. Which of the following is an example of a colloid solution?

A. 5% Dextrose in water (D5W).

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B. Albumin.

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C. Lactated Ringer's.

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D. Normal Saline.

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13. A nurse is preparing to administer packed red cells for Mr. H when she realizes that he does not have an IV. What is the minimum size of catheter the nurse must use in this situation?

A. 30 gauge.

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B. 28 gauge.

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C. 24 gauge.

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D. 20 gauge.

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14. A nurse is caring for a client who has been ordered to receive a rapid infusion of packed cells to support his intravascular blood volume. She starts to administer the blood at a fast drip rate and realizes that the blood is not infusing. Which of the following actions may the nurse perform to correct this situation?

A. Raise the client's arm above his head.

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B. Place the client in the Trendelenburg position.

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C. Place a pressure bag around the blood container.

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D. Start a new IV and simultaneously administer a second unit of blood.

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15. Which of the following is an example of effective time management?

A. Always agreeing to others' requests for help.

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B. Arranging long meetings to discuss important data.

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C. Using multiple forms of technology to communicate or educate others.

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D. Working in a secluded area to minimize interruptions.

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16. Which of these clients is the best candidate for using patient-controlled analgesia?

A. An 86-year old man in the memory disorders unit.

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B. A 6-year old boy with a tibia-fibula fracture.

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C. A 56-year old man post-op day #1 after a hernia repair.

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D. A 70-year old woman with end-stage brain cancer.

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17. Which of the following clients is most likely to benefit from receiving a peripheral nerve block?

A. A client undergoing a cesarean section.

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B. A client undergoing an appendectomy.

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C. A client undergoing a cervical discectomy.

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D. A client undergoing a total knee replacement.

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18. A nurse has been given an order for a 20 cc bolus to a client with a central line. The only syringes she has available are 5 or 10 cc in size. What is the most appropriate action of the nurse?

A. Give 4 boluses of 5 cc each.

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B. Give 2 boluses of 10 cc each.

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C. Find a 20 cc syringe.

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D. Either b or c.

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19. Mr. L is in the emergency room with a traumatic amputation. The physician determines that he needs a rapid infusion of packed red cells. Mr. L is unconscious and the nurse does not know his blood type. Which of the following blood types might be the safest to use in this situation?

A. Type A-.

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B. Type AB+.

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C. Type B-.

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D. Type O-.

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20. Which of the following describes a benefit of using a GroshongÂ® tunneled catheter?

A. It does not require regular heparin flushes.

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B. It is less prone to kinks in the line when compared with other central catheters.

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C. It can easily be placed at the bedside by a certified nurse.

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D. It does not require an x-ray to confirm placement.

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21. Which of the following interventions should the nurse perform when changing a cap on a central line catheter?

A. Open the supplies just before starting.

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B. Unclamp the catheter.

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C. Cleanse the catheter cap with povidone-iodine.

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D. Change each lumen on different days of the week.

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22. A nurse is teaching a client to care for a BroviacÂ® catheter at home. Which statement from the client indicates understanding of the teaching?

A. I don't need to wash my hands unless they are visibly soiled."

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B. If there is drainage at the insertion site, I should notify my physician."

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C. I should wash my hands after I take off the old dressing."

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D. I should use either rubbing alcohol or water to clean the end of the catheter."

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23. Which of the following actions should the nurse consider when working with a multi-dose medication vial?

A. Discard the vial after two uses.

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B. Clean the stopper with 70% alcohol before each use.

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C. Puncture the vial with only one needle and connect multiple syringes.

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D. All of the above.

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24. What common drug can be administered to treat wheezing in a patient with infectious pneumonitis?

A. Dexamethasone.

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B. ibuprofen.

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C. albuterol.

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D. None of the above.

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25. Choose the BEST answer. To ensure adequate protection for legal issues, offices should maintain patients’ charts for:

A. 10 years.

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B. Forever.

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C. until the age of majority.

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D. 2 years after the patient was last seen in the office.

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26. If a doctor’s order calls for the administration of 500 mg of medication, how many grams should be given?

A. 500

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B. 50

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C. 0.5.

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D. 5

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27. Which of the following medications would be given to treat vomiting?

A. Simvistatin.

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B. Acetaminophen.

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C. Lisinopril.

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D. Promethazine.

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28. Which of the following drugs would be used to treat GERD?

A. Claritin.

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B. Nexium.

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C. Nuprin.

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D. Celebrex.

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29. Of the following medications, which is not used to treat depression?

A. sertraline hydrochloride.

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B. paroxetine hydrochloride.

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C. Citalopram.

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D. Nifedipine.

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30. A doctor’s order is written to give a patient a medication using a non-parenteral route. Which of the following is a non-parenteral route of medication administration?

A. Rectal Suppository.

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B. Intracardiac.

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C. IV drip.

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D. IM injection.

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Pharmacological and Parenteral Therapies – Part 3

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