Pharmacological Aspects of Nursing Care 8Th Edition By Broyles Reiss Evans – Test Bank

 

 

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Sample Test

CHAPTER 3: NURSING CLIENTS RECEIVING DRUGS INTRAVENOUSLY

 

TRUE/FALSE

 

1.    The primary reason for using an IV infusion pump is to save the nurse time.

 

ANS:  F

 

	Feedback
Correct	Electronic infusion pumps are used 1) to maintain the patency of the vascular access by maintaining constant pressure and 2) to provide more accurate IV flow rates than the conventional gravity method of administration.
Incorrect

 

 

PTS:   1                    REF:   p. 86              OBJ:   Cognitive Level: Comprehension

 

2.    The purpose of an IV filter is to remove particulate matter.

 

ANS:  T                    PTS:   1                    REF:   p. 86              OBJ:   Cognitive Level: Knowledge

 

3.    IV infusion devices may continue to function properly, even though the site is infiltrated.

 

ANS:  T                    PTS:   1                    REF:   p. 87              OBJ:   Cognitive Level: Knowledge

 

4.    An IV that infuses too rapidly may cause circulatory overload.

 

ANS:  T                    PTS:   1                    REF:   p. 89              OBJ:   Cognitive Level: Knowledge

 

5.    Clients receiving home IV therapy are instructed to change the dressing on central venous catheters using clean technique.

 

ANS:  F

 

	Feedback
Correct	Dressings on central venous catheters should be changed using sterile technique.
Incorrect

 

 

PTS:   1                    REF:   p. 89              OBJ:   Cognitive Level: Comprehension

 

6.    When referring to IV administration tubing, drop factor represents the number of drops in each milliliter of IV fluid.

 

ANS:  T                    PTS:   1                    REF:   p. 90

OBJ:   Cognitive Level: Comprehension

 

MULTIPLE CHOICE

 

1.    Which of the following interventions is essential for the nurse to perform when caring for a client receiving an intravenous drug infusion?

a.	Employ clean technique when handling the intravenous equipment.
b.	Monitor the client during the infusion.
c.	Prime the tubing once the infusion has started.
d.	Use the largest gauge intravenous needle available.

 

 

ANS:  B

 

	Feedback
A	Incorrect: Sterile technique must be used.
B	Correct: The should be monitored at least hourly during intravenous infusion
C	Incorrect: Fluid must be primed through the tubing to remove air before the infusion is initiated.
D	Incorrect: The gauge choice is based on many factors, including the size of the vein where the venipuncture is to be done.

 

 

PTS:   1                    REF:   p. 88 Safe Nursing Practice 3-1

OBJ:   Cognitive Level: Comprehension

 

2.    The venipuncture site for an intravenous infusion in a 12-year-old is most often located in the:

a.	scalp.	c.	foot.
b.	hand.	d.	upper arm.

 

 

ANS:  B

 

	Feedback
A	Incorrect: This is a site for neonates and infants.
B	Correct: This is an appropriate site for older children and adults.
C	Incorrect: This is a site for toddlers.
D	Incorrect: This is a site for adults.

 

 

PTS:   1                    REF:   p. 80              OBJ:   Cognitive Level: Comprehension

 

3.    What is the first action the nurse should perform when administering a drug intravenously through a special administration chamber?

a.	Inject the medication to be administered into the chamber.
b.	Set the intravenous flow rate.
c.	Prime the infusion equipment.
d.	Initiate the infusion at the prescribed rate.

 

 

ANS:  C

 

	Feedback
A	Incorrect: This is done after the tubing has been primed.
B	Incorrect: This is done after the tubing has been primed and the medication administered into the chamber.
C	Correct: The nurse should prime the tubing first to remove air that could result in an air embolism.
D	Incorrect: This is performed after the tubing has been primed.

 

 

PTS:   1                    REF:   p. 80              OBJ:   Cognitive Level: Application

 

4.    Which rate, in general, is a safe dose when administering a medication via an intravenous bolus injection?

a.	0.5 mL per minute	c.	2 mL per minute
b.	1 mL per minute	d.	3 mL per minute

 

 

ANS:  B

 

	Feedback
A	Incorrect: This rate is too slow and will provide a slower onset of action.
B	Correct: As a general rule, IV boluses should be given at a rate of 1 mL per minute for providing appropriate onset of action and protecting the vein.
C	Incorrect: This rate is too fast for an IV bolus.
D	Incorrect: This rate is much too fast for an IV bolus.

 

 

PTS:   1                    REF:   p. 85              OBJ:   Cognitive Level: Comprehension

 

5.    Which sequence of nursing actions is correct for administering a drug by intravenous push through a saline lock?

a.	Flush the setup with prescribed fluid, disinfect the injection port, aspirate, administer the medication, chart.
b.	Disinfect the injection port, administer the medication, flush the setup with the prescribed fluid, chart.
c.	Disinfect the injection port, flush the setup with the prescribed fluid, aspirate, administer the medication, flush again, chart.
d.	Wash hands, flush the setup with the prescribed fluid, aspirate, administer the medication, chart.

 

 

ANS:  C

 

	Feedback
A	Incorrect: The vascular assess should be flushed before and after the medication.
B	Incorrect: The vascular assess should be flushed before and after the medication.
C	Correct: This is the appropriate sequence of nursing actions.
D	Incorrect: The vascular assess should be flushed before and after the medication.

 

 

PTS:   1                    REF:   p. 85, Figure 3-11

OBJ:   Cognitive Level: Application

 

6.    The nurse is caring for a client receiving an intravenous infusion via an electronic infusion device. The device begins to alarm and the nurse addresses this problem as soon as possible because the alarm:

a.	is annoying to the client.
b.	indicates an increase in the rate of the infusion.
c.	denotes the presence of pain at the infusion site.
d.	indicates that the infusion is not flowing properly.

 

 

ANS:  D

 

	Feedback
A	Incorrect: This is not the rationale for the nurse’s action.
B	Incorrect: This is not the rationale for the nurse’s action and is a false statement.
C	Incorrect: This is not a function of an electronic infusion device.
D	Correct: When an electronic infusion device alarm sounds, it indicates the infusion is not flowing properly.

 

 

PTS:   1                    REF:   p. 87              OBJ:   Cognitive Level: Comprehension

 

7.    A client receiving intravenous medication who develops fever, chills, and nausea is likely to have developed:

a.	extravasation of fluid.	c.	a pyrogenic reaction.
b.	tissue necrosis.	d.	pulmonary edema.

 

 

ANS:  C

 

	Feedback
A	Incorrect: This will cause severe pain.
B	Incorrect: This will cause severe pain.
C	Correct: These are manifestations of infection.
D	Incorrect: This will cause shortness of breath.

 

 

PTS:   1                    REF:   p. 89              OBJ:   Cognitive Level: Comprehension

 

8.    The primary purpose of priming all IV tubing before connecting it to the client is to:

a.	prevent air embolism.
b.	ensure that an accurate dose of medication is delivered.
c.	aid in the solution flow through an infusion device.
d.	establish flow rate.

 

 

ANS:  A

 

	Feedback
A	Correct: The purpose of priming IV tubing is to displace (remove) the air that fills the tubing during manufacturing.
B	Incorrect: This is not the purpose of priming IV tubing.
C	Incorrect: This is not the purpose of priming IV tubing.
D	Incorrect: This is not the purpose of priming IV tubing.

 

 

PTS:   1                    REF:   p. 82 | p. 87   OBJ:   Cognitive Level: Comprehension

 

9.    The health care provider prescribes the client to receive 1000 mL of IV fluid every eight hours. At what rate should the nurse program the electronic infusion pump to infuse?

a.	100 mL	c.	150 mL
b.	125 mL	d.	200 mL

 

 

ANS:  B

 

	Feedback
A	Incorrect: The client should receive 125 mL per hour.
B	Correct: Divide 1000 mL by eight hours = 125 mL/hr.
C	Incorrect: The client should receive 125 mL per hour.
D	Incorrect: The client should receive 125 mL per hour.

 

 

PTS:   1                    REF:   p. 90              OBJ:   Cognitive Level: Application

 

10.  The health care provider prescribes the client to receive 60 mL of IV fluid every hour. If the tubing has a drop factor of 60, how many drops per minute should the nurse set the tubing to infuse?

a.	10 gtt	c.	60 gtt
b.	12.5 gtt	d.	125 gtt

 

 

ANS:  C

 

	Feedback
A	Incorrect: The client should receive 60 gtt/min.
B	Incorrect: The client should receive 60 gtt/min.
C	Correct: When using a microdripper, the hourly rate is equal to the number of drops per minute, because there are 60 gtt/mL in a microdripper.
D	Incorrect: The client should receive 60 gtt/min.

 

 

PTS:   1                    REF:   p. 90              OBJ:   Cognitive Level: Application

 

11.  The health care provider prescribes the client to receive 2000 mL of IV fluid per 24 hours. If the tubing has a drop factor of 10, how many drops per minute should the nurse set the IV to infuse?

a.	10 gtt	c.	14 gtt
b.	12 gtt	d.	none of the above

 

 

ANS:  C

 

	Feedback
A	Incorrect: The fluids should infuse at 14 gtt/min.
B	Incorrect: The fluids should infuse at 14 gtt/min.
C	Correct: Divide 2000 mL by 24 hours = 83.33 mL per hour; then divide 83.33 mL by 60 (minutes in an hour) = 1.39; then multiply 1.39 by 10 and round to a whole number.
D	Incorrect: The fluids should infuse at 14 gtt/min.

 

 

PTS:   1                    REF:   p. 90              OBJ:   Cognitive Level: Application

 

12.  When preparing to administer an intravenous push medication via a primary infusion, the nurse must first:

a.	be certain to use a filter needle.
b.	check compatibility of the medication with the infusion fluid.
c.	cleanse the infusion port following medication administration.
d.	disconnect the primary tubing during administration of the bolus.

 

 

ANS:  B

 

	Feedback
A	Incorrect: Filter needles are used when withdrawing medication from an ampule.
B	Correct: Before administering any IV medication, its compatibility with the infusion fluid should be checked.
C	Incorrect: This is performed immediately prior to checking for IV patency before administering an IV bolus.
D	Incorrect: IV bolus medications are administered into an infusion port on the IV tubing.

 

 

PTS:   1                    REF:   p. 83              OBJ:   Cognitive Level: Application

 

13.  When swelling occurs in the tissues surrounding the IV site, the nurse should first:

a.	check for venous backflow.	c.	restart the infusion in a different site.
b.	discontinue the infusion.	d.	apply warm, moist packs to the skin.

 

 

ANS:  A

 

	Feedback
A	Correct: Although infiltration should be suspected, checking for venous flowback is the accepted method of confirming infiltration.
B	Incorrect: After infiltration is confirmed, the IV should be discontinued.
C	Incorrect: This is performed after the IV is discontinued.
D	Incorrect: This is performed after the IV is discontinued.

 

 

PTS:   1                    REF:   p. 81 | p. 88   OBJ:   Cognitive Level: Application

 

14.  The health care provider has prescribed the client to receive 500 mL fluid over four hours. If the drop factor is 15, the nurse will set the infusion to infuse at:

a.	10 gtt/min	c.	31 gtt/min
b.	21 gtt/min	d.	45 gtt/min

 

 

ANS:  C

 

	Feedback
A	Incorrect: This is not the appropriate flow rate.
B	Incorrect: This is not the appropriate flow rate.
C	Correct: Divide 500 mL by four hours = 125 mL/hr; divide 125 mL/hr by 60 minutes = 2.08 mL/min; multiply 2.08 by 15 = 31 gtt/min
D	Incorrect: This is not the appropriate flow rate.

 

 

PTS:   1                    REF:   p. 90              OBJ:   Cognitive Level: Application

 

15.  The health care provider has prescribed the client to receive 250 mL fluid over two hours. At what rate will the nurse set the electronic infusion device?

a.	12.5mL/hr	c.	50 gtt/min
b.	125 gtt/min	d.	125 mL/hr

 

 

ANS:  D

 

	Feedback
A	Incomplete: This is not the correct rate.
B	Incomplete: This is not the correct rate.
C	Incomplete: This is not the correct rate.
D	Correct: Electronic infusion sets infuse based on mL/hr. Divide 250 mL by two hours = 125 mL/hr.

 

 

PTS:   1                    REF:   p. 86-87 | p. 90

OBJ:   Cognitive Level: Application

 

16.  The nurse is initiating an intravenous access. After the vein has been pierced by the IV needle the nurse would expect to see what to indicate that the needle is in the vein?

a.	little puffiness at the IV site	c.	Slight bruising at the site
b.	backflow of blood into the tubing	d.	all of the above

 

 

ANS:  B

 

	Feedback
A	Incorrect: This would indicate the possibility of piercing through the vein.
B	Correct: A backflow of blood in the tubing indicates that the needle is located in the vein.
C	Incorrect: This would indicate the possibility of piercing through the vein.
D	Incorrect: a and c are incorrect.

 

 

PTS:   1                    REF:   p. 81              OBJ:   Cognitive Level: Evaluation

 

17.  When preparing an intravenous infusion the nursing action necessary to prevent air embolism is:

a.	maintain sterile technique during setup.
b.	ensure that electronic infusion pump is set for proper rate and volume.
c.	prime the tubing of the intravenous administration set.
d.	ensure that the client has a patent vascular access.

 

 

ANS:  C

 

	Feedback
A	Incorrect: This action prevents infection but does not prevent air embolism.
B	Incorrect: This action ensures that the client receives the prescribed rate of infusion.
C	Correct: Priming the tubing prevents air embolism.
D	Incorrect: Although the most significant factor for IV infusions, it does not prevent air embolism.

 

 

PTS:   1                    REF:   p. 82 | p. 87   OBJ:   Cognitive Level: Application

 

18.  The client’s family has asked the nurse why they should not turn off the alarm on the client’s IV infusion pump. The nurse’s best response is:

a.	“It’s a nursing responsibility.”
b.	“You have not been trained in the use of the IV infusion device.”
c.	“You may accidentally change the rate of infusion.”
d.	“If the alarm sounds, it needs to be checked by a nurse.”

 

 

ANS:  D

 

	Feedback
A	Incorrect: This does not provide an adequate explanation.
B	Incorrect: This is an inappropriate and unprofessional response.
C	Incorrect: Although it is possible to accidentally change the rate, this is not the best answer.
D	Correct: If the pump alarm sounds, it means the fluids are not infusing properly and a nurse needs to check the pump and fix the problem as soon as possible.

 

 

PTS:   1                    REF:   p. 87              OBJ:   Cognitive Level: Application

 

19.  The nurse assesses the client’s IV site and determines that it has infiltrated. The nurse’s best response is to:

a.	call the health care provider
b.	immediately stop the IV infusion.
c.	apply a cold compress and slow the rate of infusion.
d.	complete an incident report.

 

 

ANS:  B

 

	Feedback
A	Incorrect: This is not the nurse’s first action.
B	Correct: The nurse should immediately stop the infusion, so that no more fluid flows into the tissues surrounding the vein to prevent further tissue trauma.
C	Incorrect: After stopping the infusion, the nurse should follow the protocol of the institution regarding how to treat the site.
D	Incorrect: An incident or variance report generally is not initiated unless serious tissue damage has occurred.

 

 

PTS:   1                    REF:   p. 87              OBJ:   Cognitive Level: Application

 

20.  The client complains of loss of motion in the arm with an IV infusing. The nurse assesses the IV site and notes that the site is red, warm, and swollen. What is the most likely cause and what action should be taken first?

a.	tissue necrosis and the nurse should monitor the site
b.	pyrogenic reaction and the nurse should stop the infusion immediately.
c.	thrombophlebitis and the nurse should stop the infusion immediately.
d.	fluid overload and the nurse should decrease the flow rate and notify the health care provider.

 

 

ANS:  B

 

	Feedback
A	Incorrect: These are not manifestations of tissue necrosis.
B	Correct: A cardinal manifestation is the loss of motion in the limb where the fluids are infusing. The nurse should stop the infusion immediately and follow the facility protocol related to pyrogenic reactions.
C	Incorrect: Although redness and warmth are manifestations of thrombophlebitis, the group of manifestations indicate a pyrogenic reaction.
D	Incorrect: These are not manifestations of fluid overload.

 

 

PTS:   1                    REF:   p. 89              OBJ:   Cognitive Level: Application

 

21.  When thrombophlebitis is suspected in a client receiving antimicrobial agents, the nurse should:

a.	check for venous backflow.	c.	restart the infusion in a different site.
b.	discontinue the infusion.	d.	apply warm, moist packs to the skin.

 

 

ANS:  B

 

	Feedback
A	Incorrect: This is an action related to infiltration.
B	Correct: If the client experiences manifestations of thrombophlebitis, the infusion should be discontinued immediately. When antimicrobials infuse too fast for the size of the vascular access vein, thrombophlebitis often occurs.
C	Incorrect: Although appropriate, the nurse’s first action is to stop the current infusion.
D	Incorrect: Although appropriate, the nurse’s first action is to stop the current infusion.

 

 

PTS:   1                    REF:   p. 88              OBJ:   Cognitive Level: Application

 

22.  When setting up an intravenous infusion the nurse understands that he or she must:

a.	use clean technique.
b.	confirm the prescription for the IV infusion.
c.	explain the procedure to the client.
d.	use aseptic technique.

 

 

ANS:  D

 

	Feedback
A	Incorrect: Aseptic technique must be used to prevent serious and sometimes fatal infections.
B	Incorrect: This should be performed prior to setting up an intravenous infusion.
C	Incorrect: This is done before setting up the intravenous infusion.
D	Correct: Aseptic technique must be used to prevent serious and sometimes fatal infections.

 

 

PTS:   1                    REF:   p. 82              OBJ:   Cognitive Level: Application

 

23.  A nursing student is asked by her instructor what hydrostatic pressure is. Which response by the student best defines hydrostatic pressure:

a.	“It is the amount of pressure necessary to move particles and fluids in and out of vascular volume.”
b.	“It is the force water places against the vessel walls or capillary membranes.”
c.	“It is the measure of solute particles in the vascular system.”
d.	“It is the amount of pressure necessary to diffuse particles in the vascular volume.”

 

 

ANS:  B

 

	Feedback
A	Incorrect: This is the definition of osmotic pressure.
B	Correct: This is the definition of hydrostatic pressure.
C	Incorrect: This defines osmolality.
D	Incorrect: This is a contrived definition.

 

 

PTS:   1                    REF:   p. 74              OBJ:   Cognitive Level: Application

 

24.  A client is prescribed lactated Ringer’s (LR) solution for a surgical procedure. The nurse understands that the purpose for prescribing these IV fluids is:

a.	LR is an isotonic solution that will help maintain the client’s normal osmotic pressure.
b.	LR is the most commonly prescribed IV fluids for clients during and following surgery.
c.	LR is a hypertonic solution necessary to promote renal perfusion during surgery.
d.	LR is a hypotonic solution necessary to promote renal perfusion following surgery.

 

 

ANS:  A

 

	Feedback
A	Correct: This is the purpose for prescribing LR for surgical clients.
B	Incorrect: This is not a valid reason.
C	Incorrect: LR is an isotonic solution.
D	Incorrect: LR is an isotonic solution.

 

 

PTS:   1                    REF:   p. 76              OBJ:   Cognitive Level: Comprehension

 

25.  Dextrose 5% and 0.45% (1/2) normal saline is a commonly used IV solution in many acute health care settings. The nurse understands that this solution is used because:

a.	It is a hypertonic solution used for hydration.
b.	It is a hypotonic solution used to promote renal perfusion.
c.	It is an isotonic solution used to maintain fluid and electrolyte homeostasis.
d.	It is preferred over other hypotonic solutions.

 

 

ANS:  A

 

	Feedback
A	Correct: This solution is hypertonic and is used for hydration and to treat severe dehydration, sodium depletion, and other conditions requiring increased fluid perfusion.
B	Incorrect: Dextrose 5% and 0.45% normal saline is a hypertonic solution.
C	Incorrect: Dextrose 5% and 0.45% normal saline is a hypertonic solution.
D	Incorrect: Dextrose 5% and 0.45% normal saline is a hypertonic solution.

 

 

PTS:   1                    REF:   p. 76              OBJ:   Cognitive Level: Knowledge

 

26.  The nurse is caring for a client receiving IV fluids via an electronic infusion device when the alarm indicating “occlusion” rings on the pump. What should the nurse do first?

a.	Assess all tubings for kinks.
b.	Assess the pump for the proper rate.
c.	Assess the IV fluid bag to be sure adequate volume is in the bag.
d.	Make sure that the pump is plugged into the electrical outlet.

 

 

ANS:  A

 

	Feedback
A	Correct: A common cause of IV occlusions is the presence of kinks in the IV tubing, so these need to be checked and any found removed as soon as possible.
B	Incorrect: This action will not address the occlusion alarm.
C	Incorrect: This action will not address the occlusion alarm.
D	Incorrect: This action will not address the occlusion alarm.

 

 

PTS:   1                    REF:   p. 79              OBJ:   Cognitive Level: Application

 

27.  The nurse is preparing to administer an IV bolus of pain medication to a surgical client and realizes the first action is to:

a.	don sterile gloves.
b.	cleanse the port with alcohol.
c.	wash hands.
d.	draw back the plunger to check for blood return.

 

 

ANS:  C

 

	Feedback
A	Incorrect: Unless the facility protocol states to use sterile gloves, clean gloves can be used, but not until after the nurse’s hands are washed.
B	Incorrect: This is not the first step.
C	Correct: The first action of the nurse is to wash the hands before donning gloves.
D	Incorrect: This is not the first step.

 

 

PTS:   1                    REF:   p. 85              OBJ:   Cognitive Level: Application

 

28.  A client receiving a vesicant medication is experiencing extravasation. The nurse’s first action is to:

a.	slow down the infusion.	c.	stop the infusion.
b.	recalibrate the infusion rate.	d.	obtain an extravasation kit.

 

 

ANS:  C

 

	Feedback
A	Incorrect: The infusion should be stopped immediately to prevent further tissue necrosis.
B	Incorrect: The infusion should be stopped immediately to prevent further tissue necrosis.
C	Correct: The infusion should be stopped immediately to prevent further tissue necrosis.
D	Incorrect: This should be obtained after the infusion is stopped.

 

 

PTS:   1                    REF:   p. 89              OBJ:   Cognitive Level: Application

 

29.  When the client receiving IV fluids complains of pain from the infusion, the nurse should:

a.	increase the rate of infusion to complete it sooner.
b.	gently move the hub of the needle to see if the pain decreases.
c.	Stop the infusion immediately and notify the health care provider.
d.	Document the client’s response and monitor the site.

 

 

ANS:  B

 

	Feedback
A	Incorrect: This will worsen the pain regardless of the cause of the pain.
B	Correct: If tension is the cause of the pain, gently moving the hub of the needle will decrease the pain. Always assess first.
C	Incorrect: Many times, nursing assessment and interventions can eliminate the cause of the pain.
D	Incorrect: Although appropriate, the nurse should assess for the cause of the pain and, if possible, eliminate the cause of the pain.

 

 

PTS:   1                    REF:   p. 89              OBJ:   Cognitive Level: Application

 

30.  A client’s peripheral IV infusion set up was initiated three days ago. The nurse realizes that there is a need to:

a.	change the date on the IV site dressing.
b.	check to see if the IV prescription has changed.
c.	change the client’s IV medications to an oral route.
d.	change (rotate) the IV site.

 

 

ANS:  D

 

	Feedback
A	Incorrect: The IV site and dressing should be changed. A new date needs to be placed on the dressing and the new IV tubing for the new infusion site.
B	Incorrect: Although appropriate, this does not specifically address the information in the question that the client’s IV was initiated three days (72 hours) ago.
C	Incorrect: This is not within the nurse’s scope of practice.
D	Correct: The IV site and IV tubing should be changed every 48-72 hours to prevent complications.

 

 

PTS:   1                    REF:   p. 79              OBJ:   Cognitive Level: Application

 

MULTIPLE RESPONSE

 

1.    When attempting venipuncture, if applying a tourniquet fails to raise an appropriate vein, the nurse may try which of the following:

a.	instruct client to open and close a fist.
b.	tap the vein lightly.
c.	have the health care provider do the venipuncture.
d.	apply an ice pack to the site of the appropriate vein.

 

 

ANS:  A, B

 

	Feedback
Correct	a & b are two appropriate nursing actions.
Incorrect	c & d are not appropriate. In most health care facilities, the health care provider does not perform venipuncture. Applying an ice pack will constrict the vessel, making it not only harder to see, but also too small in diameter to attempt a venipuncture.

 

 

PTS:   1                    REF:   p. 81              OBJ:   Cognitive Level: Application

 

2.    For the client discharged receiving IV fluids, the nurse should instruct the client to notify the nurse:

a.	if redness, swelling, or pain develops at the IV site.
b.	at the client’s next appointment of any problems related to the infusion.
c.	if the client experiences swelling of the legs or shortness of breath.
d.	if the client develops a rash, itching, or hives.

 

 

ANS:  A, C, D

 

	Feedback
Correct	a, c, & d represent manifestations of complications associated with IV therapy, including thrombophlebitis, infiltration, fluid overload, and allergic reaction, respectively.
Incorrect	b. Manifestations of IV therapy problems should be reported immediately to the nurse–not delayed until the client’s next appointment.

 

 

PTS:   1                    REF:   p. 90              OBJ:   Cognitive Level: Application

 

3.    When caring for a client receiving peripheral intravenous fluid infusion in the acute care setting, the nurse is responsible for routinely:

a.	assessing for the 7 rights of medication administration.
b.	evaluating effectiveness of IV therapy.
c.	providing instructions for central venous catheter care at home.
d.	assessing for complications of infusion.

 

 

ANS:  A, B, D

 

	Feedback
Correct	a, b, & d are necessary nursing interventions.
Incorrect	c. These instructions are given only the clients being discharged with a central venous catheter. This client is receiving peripheral infusion.

 

 

PTS:   1                    REF:   p. 79              OBJ:   Cognitive Level: Application

 

4.    The nurse understands that besides extravasation, pain at the site of an IV infusion can result from:

a.	administering medication that is not properly diluted.
b.	administering irritating medications too rapidly.
c.	the IV catheter touching the wall of the vein.
d.	an overload of the circulatory system from hypertonic solutions.

 

 

ANS:  A, B, C

 

	Feedback
Correct	a, b, and c are causes of pain at the site of an IV infusion and should be addressed immediately.
Incorrect	d. Overload of the circulatory system from hypertonic solutions is fluid overload.

 

 

PTS:   1                    REF:   p. 89              OBJ:   Cognitive Level: Comprehension

 

5.    The gauge of the IV needle is determined by which of the following factor(s)?

a.	viscosity of the medication	c.	condition of the vein selected
b.	size of the vein selected	d.	nature of the therapy

 

 

ANS:  A, B, C, D

 

	Feedback
Correct	All of the responses are factors for the nurse to consider when selecting a vein for IV injection.
Incorrect

 

 

PTS:   1                    REF:   p. 77              OBJ:   Cognitive Level: Comprehension

 

CHAPTER 4: CALCULATING MEDICATION DOSAGES

 

TRUE/FALSE

 

1.    Whenever possible, use the metric system in medication prescriptions rather than the apothecary system.

 

ANS:  T                    PTS:   1                    REF:   p. 96

OBJ:   Cognitive Level: Application

 

2.    In the metric system, the liter is the basic unit of weight.

 

ANS:  F

 

	Feedback
Correct	Liter is a measurement of volume in the metric system.
Incorrect

 

 

PTS:   1                    REF:   p. 99              OBJ:   Cognitive Level: Knowledge

 

3.    One milligram is equivalent to 1 milliliter.

 

ANS:  F

 

	Feedback
Correct	Milligram is a measurement of weight and a milliliter is a measurement of volume.
Incorrect

 

 

PTS:   1                    REF:   p. 99              OBJ:   Cognitive Level: Knowledge

 

MULTIPLE CHOICE

 

1.    The abbreviation “O.S.” in a prescription refers to:

a.	right eye.	c.	left eye.
b.	left ear.	d.	right arm.

 

 

ANS:  C

 

	Feedback
A	Incorrect: This abbreviation for right eye is O.D.
B	Incorrect: There is no abbreviation for left ear.
C	Correct: O.S. is the abbreviation for left eye.
D	Incorrect: There is not abbreviation for right arm.

 

 

PTS:   1                    REF:   p. 43              OBJ:   Cognitive Level: Knowledge

 

2.    The abbreviation “gtt” in a prescription refers to a:

a.	gallon.	c.	drop.
b.	gram.	d.	large vessel.

 

 

ANS:  C

 

	Feedback
A	Incorrect: The abbreviation for gallon is gal.
B	Incorrect: The abbreviation for gram is g.
C	Correct: gtt is the abbreviation for drop.
D	Incorrect: There is no abbreviation for large vessel.

 

 

PTS:   1                    REF:   p. 42              OBJ:   Cognitive Level: Knowledge

 

3.    The abbreviation “sol” in a prescription refers to:

a.	suspension.	c.	solvent.
b.	solution.	d.	subcutaneous.

 

 

ANS:  B

 

	Feedback
A	Incorrect: The abbreviation for suspension is susp.
B	Correct: sol. is the abbreviation for solution.
C	Incorrect: Nursing does not use an abbreviation for solvent.
D	Incorrect: The abbreviation for subcutaneous is S.C., s.c., or sub. q.

 

 

PTS:   1                    REF:   p. 42              OBJ:   Cognitive Level: Knowledge

 

4.    The client is to receive medication “p.o.” The nurse knows to administer the medication:

a.	in the eye.	c.	put on.
b.	after midnight.	d.	by mouth.

 

 

ANS:  D

 

	Feedback
A	Incorrect: p.o. is not the abbreviation for in the eye.
B	Incorrect: p.o. is not the abbreviation for after midnight.
C	Incorrect: p.o. is not the abbreviation for put on.
D	Correct: The abbreviation for by mouth is p.o., meaning per os.

 

 

PTS:   1                    REF:   p. 42              OBJ:   Cognitive Level: Application

 

5.    A nurse is asked to administer one antibiotic tablet t.i.d. for seven days. The total number of tablets required is:

a.	30.	c.	21.
b.	14.	d.	70.

 

 

ANS:  C

 

	Feedback
A	Incorrect: The medication is prescribed for three times a day for 7 days = 21 tablets.
B	Incorrect: The medication is prescribed for three times a day for 7 days = 21 tablets.
C	Correct: The medication is prescribed for three times a day for 7 days = 21 tablets
D	Incorrect: The medication is prescribed for three times a day for 7 days = 21 tablets

 

 

PTS:   1                    REF:   p. 43              OBJ:   Cognitive Level: Application

 

6.    A health care provider prescribes 50 mg of a drug. The drug is only available in a 20 mL vial that contains 20 mg/mL of the drug. How much solution must the nurse administer for each dose?

a.	2.5 mL	c.	5 mL
b.	25 mL	d.	0.25 mL

 

 

ANS:  A

 

	Feedback
A	Correct: 50 (prescribed dose) is divided by 20 (on-hand dose) and multiplied by 1 mL = 2.5 mL.
B	Incorrect: This would yield 10 times the prescribed dose.
C	Incorrect: This would yield twice the prescribed dose.
D	Incorrect: This would yield a 5 mg dose.

 

 

PTS:   1                    REF:   p. 102            OBJ:   Cognitive Level: Application