Nclex-Rn Practice Questions-Physıologıcal Integrıty-Pharmacological And Parenteral Therapies Part 5
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Question 1 |
A client who takes morphine sulfate (morphine) for pain control may have which potential nursing diagnose as part of the care plan?
A | Impaired gas exchange. |
B | Disturbed body image. |
C | Imbalanced nutrition. |
D | Excess fluid volume. |
Question 2 |
The nurse teaches an elderly client about the use of subcutaneous therapy (hypodermoclysis) for fluid infusion. Which statement by the client indicates an understanding of the therapy?
A | I understand this therapy can be used for extended periods of time. |
B | I don’t have any bleeding problems, so that should make it OK for me to have this therapy. |
C | I will be getting massive amounts of fluids through this injection. |
D | I was told that large-sized needles have to be used for this therapy. |
Question 3 |
A nurse gives a subcutaneous injection of heparin sodium (Heparin). Which is a true statement regarding this injection?
A | Massage the area after heparin is administered subcutaneously. |
B | Aspiration before injection can cause hematoma formation. |
C | Give the injection each time in the same general area. |
D | Hold the skin taut when giving the injection. |
Question 4 |
A client receiving an injection of morphine requests “my buttocks be used for the injection.” The nurse explains that this site is not preferred because it is in close proximity to:
A | The femoral nerve. |
B | The peroneal nerve. |
C | The phrenic nerve. |
D | The sciatic nerve. |
Question 5 |
The nurse prepares to give an intramuscular injection to a client. Which is considered the safest and preferred site for intramuscular injections?
A | Vastus lateralis. |
B | Dorsogluteal. |
C | Ventrogluteal. |
D | Deltoid. |
Question 6 |
The nurse uses an intradermal injection to administer a tuberculin test. Which statement indicates the injection is administered correctly?
A | An area of redness is present at the injection site. |
B | A small bleb or wheal is seen at the site of injection. |
C | The client states the site itches slightly. |
D | The bevel of the needle points downward as it is withdrawn. |
Question 7 |
An ampule of promethazine hydrochloride (Phenergan) is opened by the nurse. Why should the nurse choose to use a filter needle to draw this medication into the syringe?
A | Light can change this medication chemically and cause precipitates. |
B | Rapidly shaking the vial to bring the medication to the bottom can cause physical property changes. |
C | Very small particles of the glass vial can be drawn through a regular needle. |
D | Particles from the nurse’s hands can drop into the vial when it is opened. |
Question 8 |
The medication hyaluronidase is sometimes added to the fluid used for subcutaneous therapy (hypodermoclysis). What is the action of this medication?
A | Hyaluronidase increases absorption of the fluids being given. |
B | Hyaluronidases decreases pain at the injection site. |
C | Hyaluronidase provides protection against an allergic reaction to the fluid administration. |
D | Hyaluronidase prevents infectious processes from developing when the fluids are infused. |
Question 9 |
A physician writes an order for total parenteral nutrition (TPN) to be discontinued for a client who has been receiving it for one month. The nurse knows which statement is true regarding this order?
A | Stopping total parenteral nutrition (TPN) can cause hyperglycemia in the client. |
B | Reducing the drip rate gradually is necessary for client safety. |
C | Weighing the client before and immediately after the feeding ensures nutrition. |
D | Assessing the client for cerebral edema is important after discontinuing the feeding. |
Question 10 |
Lipid emulsions for total parenteral nutrition (TPN) and partial parenteral nutrition (PPN) originate from different fat products. Which is a true statement regarding lipid emulsions?
A | Intralipid originates from safflower oil. |
B | Liposyn III is created from safflower oil. |
C | Liposyn II is a combination of safflower and soybean oil. |
D | Interlipid comes from soybean oil. |
Question 11 |
A client is diagnosed with malnutrition secondary to cirrhosis. Which laboratory study supports a diagnosis of malnutrition?
A | Decreased serum transferrin level. |
B | Increased serum albumin level. |
C | Normal cholesterol level. |
D | Elevated BUN. |
Question 12 |
Trace elements are found in total parenteral nutrition (TPN). Which is a trace element found in TPN?
A | Iodine. |
B | Potassium. |
C | Magnesium. |
D | Sodium. |
Question 13 |
In which client should partial parenteral nutrition (PPN) not be implemented?
A | Hepatitis C. |
B | Emphysema. |
C | Mesenteric occlusion. |
D | Chronic renal failure. |
Question 14 |
A home health client receives total parenteral nutrition (TPN) and complains of weakness, nausea, intermittent vomiting, and malaise. Which laboratory value should the nurse most likely expect to see?
A | Positive glucosuria. |
B | Decreased pH. |
C | Decreased calcium. |
D | Increased ketones. |
Question 15 |
A client who receives total parenteral nutrition (TPN) will most likely require which medication on a routine basis?
A | Sodium supplementation. |
B | Furosemide (Lasix). |
C | Insulin. |
D | Ceftriaxone (Rocephin). |
Question 16 |
Which nursing diagnosis is the highest priority for the client taking analgesic agents?
A | Risk for infection. |
B | Risk for injury. |
C | Risk for impaired gas exchange. |
D | Risk for constipation. |
Question 17 |
Lipid emulsions are part of total parenteral nutrition (TPN) and partial parenteral nutrition (PPN). What do lipid emulsions supply?
A | Proteins. |
B | Carbohydrates. |
C | Electrolytes. |
D | Fats. |
Question 18 |
The purpose of total parenteral nutrition (TPN) is to maintain nutrition. Varied energy sources supply different amounts of calories for the body’s use. How many kilocalories does 1 gram of fat yield?
A | 3.4 kcal. |
B | 4 kcal. |
C | 9 kcal. |
D | 15 kcal. |
Question 19 |
The nurse prepares to give an injection to an elderly client. When the nurse aspirates prior to injecting, a small amount of blood is noted in the syringe. Which action is most appropriate for the nurse to take?
A | Pull back slightly on the needle and attempt aspiration again. |
B | Push the needle into the muscle at least 1 cm and give the injection. |
C | Withdraw the needle and restart the process with new medication and equipment. |
D | Administer the medication more slowly than normal. |
Question 20 |
A 2-month-old child receives a dose of ceftriaxone (Rocephin) intramuscularly. Which is the preferred site of injection for this client?
A | Vastus lateralis. |
B | Dorsogluteal. |
C | Ventrogluteal. |
D | Deltoid. |
Question 21 |
The nurse prepares to administer a subcutaneous injection of 0.3 mL of epinephrine to a client. Which syringe should the nurse use?
A | 3-mL syringe. |
B | Tuberculin syringe. |
C | Insulin syringe. |
D | Carpuject syringe. |
Question 22 |
A key nursing task is to administer injections to clients. This requires the nurse’s knowledge of needle sizes and lengths. Which needle size is the largest?
A | 25 gauge. |
B | 22 gauge. |
C | 20 gauge. |
D | 18 gauge. |
Question 23 |
A client receives partial parenteral nutrition (PPN). The nurse notes the fluid has a dextrose content of 30%. Which nursing action takes priority?
A | This fluid content is normal, and no action is necessary. |
B | Notify the physician and ask for clarification of the order. |
C | Slow the drip rate to a keep open rate. |
D | Stop the infusion immediately. |
Question 24 |
A client who is being discharged home will be giving his own enoxaparin sodium (Lovenox) subcutaneously. Which statement by the client indicates the need for further education?
A | I remember that I need to hold the needle at a 45 angle. |
B | I know to pinch the skin up for the injection. |
C | I will not pull back on the plunger before injecting the medicine. |
D | I am going to use the right side of my lower abdomen all the time. |
Question 25 |
A client is to receive an injection of methylprenisolone sodium succinate (Solu-Medrol) 125 mg. The vial on hand has 125 mg per 2 mL. Which is the least likely site to use for this medication?
A | Vastus lateralis. |
B | Dorsogluteal. |
C | Ventrogluteal. |
D | Deltoid. |
Question 26 |
A client who receives total parental nutrition (TPN) has an increase in urinary output. The client’s pulse is 130 beats/minute and blood pressure is 98/50 mm Hg. The client’s mucous membranes are dry. Which circumstance is most likely responsible for the client’s symptoms?
A | Excess insulin. |
B | Increased rate of administration. |
C | Hypocalcemia. |
D | Hypermagnesemia. |
Question 27 |
The nurse making rounds prior to shift change realizes that the total parenteral nutrition (TPN) on one client is behind by about 200 mL. Which action should the nurse take?
A | Increase the rate so that it will catch up faster. |
B | Run in 200 mL of the TPN solution so it will be on time. |
C | Leave the solution running as is and notify the physician. |
D | Slow the rate in an effort to keep the patient from needing more insulin. |
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