PassPoint - Medication and IV Administration

The client has been admitted to the hospital with generalized seizures and the healthcare provider ordered pentobarbital sodium. What discharge teaching will the nurse include about pentobarbital sodium?

"Alcohol can cause drug toxicity with pentobarbital sodium."

The home care nurse is conducting a follow-up visit to a client who was recently discharged to home with intermittent total parental nutrition (TPN) therapy. What statement by the client leads the nurse to determine that additional teaching is needed?

"I will change the I.V. administration tubing every week."

A client with chronic pancreatitis is discharged with a prescription for pancrelipase. Which instruction must the nurse include when providing discharge instructions regarding this medication?

"Swallow this medication whole. Do not chew it."

Which statement by the client indicates an understanding of teaching regarding the use of corticosteroids during preterm labor?

"The corticosteroids may help my baby's lungs mature."

A client is receiving parenteral nutrition through a central venous catheter. As the nurse is changing the dressing at the catheter site, the client asks why this type of catheter is being used instead of a regular peripheral I.V. Which is the best response by the nurse to explain the use of the central venous catheter?

"The nutrients that are being administered are too concentrated for a peripheral I.V."

A client is prescribed buspirone 5 mg two times a day. Which statement(s) indicate that the client has understood the nurse's teaching about this drug? Select all that apply.

-"Buspirone will help me not to worry so much." -"I'll be able to focus better."

During an admission assessment, a nurse asks why a client is being admitted to the facility. The client responds, "The physician found a lump in my prostate gland. I guess I have cancer." Which response by the nurse would be most therapeutic? Select all that apply.

-"There is no way to know whether you have cancer until the surgeon performs a biopsy." -"Are you saying you think you have cancer?" -"If it's cancer, prostate cancer has a very high cure rate."

After suffering an acute myocardial infarction (MI), a client with a history of type 1 diabetes is prescribed metoprolol intravenously. Which nursing interventions are associated with intravenous administration of metoprolol? Select all that apply.

-Monitor glucose level closely. -Monitor for heart block and bradycardia. -Monitor blood pressure closely.

The nurse is preparing to administer a flu shot to an adult client. How would the nurse proceed? Place the steps in sequential order. All options must be used.

-Put gloves on. -Locate the deltoid muscle. -Clean the injection site with an alcohol pad. -Gently stretch the skin taut at the site. -Inject it into the muscle at a 90-degree angle. -Wait 10 seconds before removing needle.

A client with early acute kidney injury has anemia, tachycardia, hypotension, and shortness of breath. The health care provider has prescribed 2 units of packed red blood cells (PRBCs). What should the nurse determine before initiating the blood transfusion? Select all that apply.

-There is an intravenous (IV) access with the appropriate tubing and normal saline as the priming solution. -There is a signed informed consent for transfusion therapy. -Blood typing and cross-matching are documented in the medical record. -The vital signs have been taken and documented in accordance with facility policy and procedure. -The client has an identification bracelet.

A client has a temporary pacemaker in place and requests pain medicine. The nurse has an order to administer morphine sulfate 4 mg I.V. What is available is morphine sulfate 10 mg/mL. How many mL will the nurse need to administer? Round to the nearest tenth.

0.4

The nurse has a prescription to administer ampicillin 250 mg IM. After reconstituting the ampicillin with sterile water for injection, the solution available is 500 mg/mL. How many milliliters should the nurse administer? Record your answer using one decimal place.

0.5

The physician prescribes furosemide, 2 mg/kg PO, as a one-time dose for an infant with fluid overload. The infant's documented weight is 14 lb (6.4 kg). The oral solution contains 10 mg/mL. How many milliliters of solution should the nurse administer? Round the answer to the nearest tenth of a millilter.

1.3

The health care provider has ordered ondansetron 0.15 mg/kg IV to a pediatric client who weighs 40 lb (18.1 kg). The dose on hand is 2 mg/mL. How many milliliters will the nurse administer to the client? Round the answer to the nearest tenth.

1.4

A client with severe pain is prescribed hydromorphone 10 mg by mouth every 4 hours as needed for pain. The client rates the pain as eight on a one-to-ten scale, so the nurse prepares to administer a dose. The oral liquid contained in the unit's opioid stock contains 5 mg/5 ml. How many milliliters of solution should the nurse give to the client? Record your answer using a whole number.

10

A physician orders an infusion of 2,400 ml of I.V. fluid over 24 hours, with half this amount to be infused over the first 10 hours. During the first 10 hours, a client should receive how many milliliters of I.V. fluid per hour?

120 ml/hour

A client has been ordered vancomycin 1400 mg I.V. The medication is placed in 250 mL of normal saline. At which rate should the nurse set the pump to infuse the medication over 90 minutes? Record your answer using a whole number.

167

A healthcare provider orders 500 mg of oxacillin sodium for intramuscular administration. One gram of powdered oxacillin sodium is available. Directions for reconstitution are to add 5.7 mL of sterile water to yield 1 g in 4 mL. How many milliliters should a nurse withdraw from the vial after reconstituting the drug as directed? Record your answer using a whole number.

2

An infusion of lidocaine hydrochloride is running at 30 mL/hour. The dilution is 1,000 mg/250 mL. What dosage is the client receiving per minute? Record your answer using a whole number.

2

A client has an ordered intravenous infusion that is ordered to infuse at 3000 mL of D5W in a 24-hour period (drop factor of 10). Calculate the drops per minute. Record your answer using a whole number.

21

A client is to receive 1 unit of packed red blood cells over 2 hours. There are 250 mL in the infusion bag. The IV administration infusion set delivers 10 gtt/mL. At what flow rate (in drops per minute) should the nurse run the infusion? Record your answer using a whole number.

21

A client who is experiencing an exacerbation of ulcerative colitis is receiving IV fluids that are to be infused at 125 mL per hour. The IV tubing delivers 15 gtt/mL. How quickly should the nurse infuse the fluids in drops per minute to infuse the fluids at the prescribed rate? Record your answer using a whole number.

31

The health care provider orders 1,000 mL D5W to be infused over 8 hours. The IV tubing delivers 15 drops/mL. The nurse should run the IV infusion at a rate of:

31 drops/minute.

The maximum transfusion time for a unit of packed red blood cells (RBCs) is

4 hours.

Two days after a client undergoes repair of a ruptured cerebral aneurysm, a physician orders mannitol, 0.5 g/kg to be infused over 60 minutes. The client weighs 175 lb. The nurse should administer how many grams of mannitol? Record your answer using a whole number.

40

The nurse is preparing 1000 mL D5/N5 to deliver over 6 hours. If the infusion set administers 15 gtt/mL, what is the required flow rate in gtt/min? (Round to the nearest whole number.)

42

After undergoing small-bowel resection, a client is prescribed metronidazole 500 mg intravenously. The mixed solution is 100 ml. The nurse is to administer the drug over 30 minutes. The drop factor of the available intravenous tubing is 15 gtt/ml. What is the drip rate in drops per minute? Record your answer using a whole number. (For example: 62)

50

The health care provider prescribes 30 mg of methylphenidate to a child with autism. The methylphenidate is to be given in two divided doses. The concentration is 10 mg/5 mL. How many milliliters of methylphenidate should the nurse give per dose?

7.5

A client receiving intravenous heparin has developed hematuria and petechiae. What is the nurse's best action?

Administer protamine sulfate.

Immediately after receiving an injection of bupivacaine, the client becomes restless and nervous and reports a feeling of impending doom. What should the nurse do next?

Assess the client's vital signs.

Which instruction is most important for the nurse to include in the teaching plan for a client who is taking phenelzine?

Avoid foods high in tyramine.

A nurse is supervising a student during medication administration to a client. Which action by the student would cause the nurse to intervene during the med pass at the bedside?

Check the room number and the client's name on the bed.

A client's caretaker calls the home care nurse and states accidentally puncturing the central venous catheter after discontinuing the total parenteral nutrition. What instructions should the nurse provide to the caretaker?

Clamp the catheter.

After the discharge of a client from a surgical unit, the housekeeper brings a blue pill to the nurse. The pill was found in the sheets when the linens were removed from the client's bed. The nurse reviews the client's medication administration record, which shows that the client received this medication at 0800. What would be the nurse's priority action?

Complete an incident form and notify the physician.

The nurse is developing a teaching plan with a client who is taking warfarin sodium. What should the nurse include in the plan?

Consult the health care provider (HCP) before undergoing a tooth extraction.

A primigravid client who was successfully treated for preterm labor at 30 weeks' gestation had a history of mild hyperthyroidism before becoming pregnant. What instructions should the nurse include in the plan of care?

Continue taking low-dose oral propylthiouracil as prescribed.

A client who is taking lithium carbonate is going home on a 3-day pass. What is the best health teaching the nurse should provide for this client?

Continue to maintain normal sodium intake while at home.

The nurse is admitting a client with glaucoma. The client brings prescribed eye drops from home and insists on using them in the hospital. What should the nurse do?

Explain to the client that the health care provider (HCP) will write a prescription for the eye drops to be used at the hospital.

The nurse is reviewing the laboratory report with the client's lithium level before administering the 1700 hours dose. The lithium level is 1.8 mEq/L (1.8 mmol/L). What action should the nurse take?

Hold the 1700 hours dose of lithium.

A client with cancer of the stomach tells the nurse, "I cannot bear the pain anymore. Please give me some poison to free myself from this agonizing pain." The nurse faces a value conflict. Which is true in such a condition?

Human need may affect the values conflict.

A client is receiving warfarin for newly diagnosed atrial fibrillation. Which laboratory result would indicate that the nurse should withhold the medication and contact the health care provider?

INR of 4.8

A nursing unit is using an automated medication dispensing system to track dispensing narcotics. What is the advantage of using an automated medication dispensing system?

It keeps a record of narcotic usage.

A client presents with severe headache, blurred vision, anxiety and confusion. The client's blood pressure is 224/137 mm Hg. The family reports that the client has hypertension, but has not been taking the prescribed blood pressure medications. The nurse anticipates giving which medication?

Labetalol

A nurse is preparing to administer digoxin elixir to a client. Which principle regarding this medication is correct?

Liquid digoxin should be measured with a calibrated dropper or syringe.

When preparing the teaching plan for a client about lithium therapy, the nurse should provide which instruction to the client concerning sodium?

Maintain an adequate sodium intake.

The client is admitted for a myocardial infarction and has a heparin drip infusing. Which signs and symptoms would prompt the nurse to stop the infusion and notify the prescribing health care provider?

New onset bleeding from client's rectum

A 6-year-old child with autism has been prescribed risperidone to treat aggression and self-injury behaviors. When educating the family about risperidone, the nurse should include which information?

Notify the child's health care provider if the child is exhibiting lip-smacking behaviors.

An older adult is taking eight medications to manage hypertension, diabetes, and arthritis and reports having nausea, diarrhea, tremors, and unusual thoughts. When investigating the cause of these symptoms, the nurse should consider which reason for underestimating adverse drug reactions in older adults?

Physical or psychological symptoms are attributed to the effects of aging.

A health care provider prescribes gentamicin for a client with peritonitis. The client has preexisting impaired vision and hearing. What should the nurse do?

Question the prescription because gentamicin could cause further hearing impairment.

While attempting to obtain a blood sample from a peripherally inserted central catheter (PICC) line with a nonocclusive dressing, the nurse inadvertently dislodges the catheter. The catheter did not come all the way out and is still partially inserted. What should the nurse do first?

Secure the catheter and call the health care provider.

Twenty minutes after a transfusion of packed red blood cells is initiated, a client reports shivering, headache, and lower back pain. The vital signs show a normal temperature and increased pulse and respiratory rate. What should be the first nursing actions?

Stop the transfusion, continue with saline infusion, and notify the physician regarding a suspected hemolytic reaction.

A female client is treated for trichomoniasis with metronidazole. What should the nurse tell the client about this medication?

The client should avoid alcohol during treatment and for 24 hours after completion of the drug.

The nurse is reconciling medications with a client who is being discharged. Which information indicates there is a discrepancy?

There is a lack of congruence between a client's home medication list and current medication prescriptions.

A client is receiving total parenteral nutrition (TPN), and the nurse is concerned about the complication of fluid volume overload. Which nursing action is most appropriate in the administration of TPN to prevent this complication?

Use an infusion pump to administer the TPN solution.

The nurse should establish baseline data on a client who is starting on long-term gentamicin sulfate therapy. Which is least important for assessment screening in this client?

Visual acuity.

The nurse prepares a teaching plan for a client about imipramine. Which substance should the nurse tell the client to avoid while taking the medication?

alcohol

Which class of medication protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation?

beta-adrenergic blockers

The nurse has administered glycopyrrolate to a client who is going to surgery. Which outcome is expected?

decreased secretions

The client was admitted to the hospital with the diagnosis of iron overload. Over time, an excess of iron can damage the liver and cause heart problems. Which medication does the nurse anticipate the healthcare provider to order?

deferoxamine

A client is admitted to the neurologic intensive care unit for an intracranial hemorrhage. Which medication prescription should the nurse question for this client?

enoxaparin

Clients who are receiving parenteral nutrition (PN) are at risk for development of which complication?

fluid imbalances

Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse would assess the client for which signs and symptoms?

hypertension

If a manual end-of-shift count of controlled substances isn't correct, the nurse's best action is to

immediately report the discrepancy to the nurse-manager, nursing supervisor, and pharmacy.

The health care provider (HCP) has prescribed nitroglycerin to a client with angina. The client also has closed-angle glaucoma. The nurse should contact the HCP to discuss the potential for which drug interaction?

increased intraocular pressure

The nurse is developing a teaching plan with a client who is newly diagnosed with Addison disease. Which topic is most important to include in the teaching plan?

the importance of watching for signs of hyperglycemia

A client's intravenous catheter has become occluded. The nurse knows that the reason for the occlusion is:

thrombosis at the site.

A nurse has inserted a peripheral intravenous catheter. Which type of dressing is most appropriate to use to cover the insertion site?

transparent

The nurse is providing dietary instructions for a client who is taking warfarin. Which menu choice would be most appropriate for this client?

tuna fish sandwich, French fries, and a baked apple

The nurse is evaluating the effectiveness of fluid replacement for a client in hypovolemic shock. Which finding is the best indication that fluid replacement is adequate?

urine output greater than 30 mL per hour

A client is receiving paroxetine 20 mg every morning. After taking the first three doses, the client tells the nurse that the medication upsets the stomach. How should the nurse instruct the client to take the paroxetine?

with some food