fundamentals test 2 quater 2

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A nurse is administering a subcutaneous injection to a client. What is the maximum volume that the nurse may administer by this route?

1 mL

All of the following situations indicate that the intravenous route for medication administration is appropriate except:

A client who wishes to avoid painful intradermal injections.

A hypotonic solution contains a greater amount of dissolved substances as normally found in plasma.

False

Mary Jones was just diagnosed with pneumonia and her provider has ordered ceftriaxone 250mg IM. Which of the following questions is it most important for the nurse to ask Mary prior to giving this injection?

Are you allergic to any antibiotics or other medications?

A nurse needs to administer a prescribed medication to a client using IV push. In which of the following ways is the medication being administered to the client?

Bolus administration

As part of a postsurgical client's regimen for deep vein thrombosis prevention, she is to receive 5000 units of heparin subcutaneously b.i.d. How can the nurse reduce this client's risk of bruising at the injection sites?

By changing the needle after withdrawing the drug from the vial

A client who was involved in a motor vehicle accident is bleeding very heavily. Which of the following would be required to best replace the circulating blood?

Colloid solution

Following aseptic guidelines means that which of the following steps should be done prior to withdrawing any medication from a vial.

Disinfect the rubber stopper prior to insertion of needle.

A nurse needs to administer an intramuscular injection to a client in the client's dorsogluteal site. Which of the following actions should the nurse perform first to locate the appropriate landmarks and avoid damaging the sciatic nerve?

Divide the buttock into four imaginary quadrants.

A nurse is caring for a client with an intravenous catheter. When administering medication by IV push through the port, the nurse pinches the tubing upstream from the port when instilling the medication. Which of the following reasons explains the nurse's action?

Ensures that the medication reaches the client

During an assessment of an elderly client, the nurse notes an increase in pulse and respiration rates, and notes that the client has warm skin. The nurse also notes a decrease in the client's blood pressure. The nurse recognizes that what medical diagnosis may be responsible?

Hypovolemia

A nurse is administering an injection to a client with the needle at a 15-degree angle. Which of the following injections can be administered at this angle?

Intradermal

A nurse is using an 18-gauge needle to administer a medication to a client. The nurse knows that when compared to a 27-gauge needle, an 18-gauge needle has which of the following features?

Larger diameter

Fluid is moving constantly between compartments in the body through several different mechanisms in order to regulate fluid and electrolyte balance. Osmosis can be described as:

Movement of water across a semipermeable membrane from areas of low solute concentration to areas of high solute concentration.

A nurse is providing care for an elderly client whose analgesia has been ordered by the IV route. While reviewing the client's medication administration record, the nurse observes that the dosage range differs from that of most young adult clients. What is the most likely rationale for this difference?

Older adults are often more susceptible to toxic drug effects than younger adults

A client with dehydration is being administered IV fluids. During rounds, the nurse noticed that the skin immediately surrounding the client's IV site was reddish in color and showing signs of inflammation. The nurse recognizes that what phenomenon is likely responsible?

Phlebitis

A hospital is in the process or replacing the current stock of conventional syringes and needles with new, redesigned models. What is the priority outcome that is sought by this change?

Reduction in nurses' risks of needlestick injuries

A recent nursing graduate who now works on an acute medicine unit administers many intravenous medications to clients on the unit. The nurse is vigilant when checking the five rights of safe medication administration because intravenous (IV) medications carry a heightened possibility of what nursing diagnosis?

Risk for Injury

A group of nursing students have begun learning about the rationale and technique for administering injections. The students should identify which of the following parts of a syringe? Select all that apply.

Tip Barrel Plunger

A nurse is bunching (pinching) the tissue of a client when administering a subcutaneous injection. What is the reason for bunching when injecting subcutaneously?

To avoid instilling medication within the muscle

A nurse has admitted a client during a night shift and has completed and documented a nursing assessment. The nurse is now creating the client's medication administration record (MAR). What is the primary purpose of the MAR?

To facilitate the safe and timely administration of drugs to clients

When administering an IV solution, the nurse ensures that the solution is placed at least 18 to 24 in. above the site of the infusion. For which of the following reasons should the nurse maintain this position for the IV solution?

To overcome the pressure within the client's vein

Implanted catheters have a self-sealing port pierced through the skin with a special needle for the administration of IV medications or solutions.

True

True or False. You are a student nurse. You work hard to study and practice skills. Sometimes it's overwhelming, but you're doing a great job. All of this hard work will be worth it. You're on your way to being an amazing nurse!

True

A nurse needs to document an accurate fluid output assessment of an acutely ill client. Which of the following actions should the nurse perform?

Weigh the client's wet linen or dressing.


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