NUR 2480 Answers to Pharmacology Practice Questions- Miami Regional University Florida
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NUR 2480
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NUR 2480
NUR 2480 Answers to Pharmacology Practice Questions- Miami Regional University Florida/NUR 2480 Answers to Pharmacology Practice Questions- Miami Regional University Florida/NUR 2480 Answers to Pharmacology Practice Questions- Miami Regional University Florida/NUR 2480 Answers to Pharmacology Pract...
nur 2480 answers to pharmacology practice questions miami regional university floridanur 2480 answers to pharmacology practice questions miami regional university floridanur 2480 answers to pharma
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Pharmacology and Intravenous Therapy – Answers and Rationales
1. A nurse notes that the site of a client’s peripheral intravenous (IV) catheter is reddened,
warm, painful, and slightly edematous near the insertion point of the catheter. On the
basis of this assessment, the nurse first:
Removes the IV catheter Correct
Slows the rate of infusion
Notifies the healthcare provider
Checks for loose catheter connections
Rationale: Phlebitis is an inflammatory process in the vein. Phlebitis at an IV site may be
indicated by client discomfort at the site or by redness, warmth, and swelling in the area of the
catheter. The IV catheter should be removed and a new IV line inserted at a different site.
Slowing the rate of infusion and checking for loose catheter connections are not correct
responses. The healthcare provider would be notified if phlebitis were to occur, but this is not the
initial action.
Test-Taking Strategy: Use the process of elimination, focusing on the data in the question.
Eliminate slowing the rate of infusion and checking the connection, because they are comparable
or alike in that they indicate continuation of IV therapy. Although the healthcare provider would
be notified of this occurrence, the word “first” should direct you to select the option of removing
the IV catheter. Review the signs of phlebitis and the actions to be taken when it occurs if you
had difficulty with this question.
2. A nurse hangs a 500-mL bag of intravenous (IV) fluid for an assigned client. One hour
later the client complains of chest tightness, is dyspneic and apprehensive, and has an
irregular pulse. The IV bag has 100 mL remaining. Which of the following actions should
the nurse take first?
Removing the IV
Sitting the client up in bed
Shutting off the IV infusion Correct
Slowing the rate of infusion
,Rationale: The client’s symptoms are indicative of speed shock, which results from the rapid
infusion of drugs or a bolus infusion. In this case, the nurse would note that 400 mL has infused
over 60 minutes. The first action on the part of the nurse is shutting off the IV infusion. Other
actions may follow in rapid sequence: The nurse may elevate the head of the bed to aid the
client’s breathing and then immediately notify the healthcare provider. Slowing the infusion rate
is inappropriate because the client will continue to receive fluid. The IV does not need to be
removed. It may be needed to manage the complication.
Test-Taking Strategy: Use the process of elimination, focusing on the data in the question. Note
the question contains the strategic word “first.” Recognizing the signs of speed shock and
recalling the appropriate interventions should also direct you to the option of shutting off the IV
infusion. Review the initial nursing actions for speed shock if you had difficulty with this
question.
3. A nurse discontinues infusion of a unit of packed red blood cells (RBCs) because the
client is experiencing a transfusion reaction. After discontinuing the transfusion, which of
the following actions does the nurse take next?
Removing the IV catheter
Contacting the healthcare provider Correct
Changing the solution to 5% dextrose in water
Obtaining a culture of the tip of the catheter device removed from the client
Rationale: If the nurse suspects a transfusion reaction, the transfusion is stopped and normal
saline solution infused at a keep-vein-open rate pending further physician prescriptions. The
nurse then contacts the physician. Dextrose in water is not used, because it may cause clotting or
hemolysis of blood cells. Normal saline solution is the only type of IV fluid that is compatible
with blood. The nurse would not remove the IV catheter, because then there would be no IV
access route through which to treat the reaction. There is no reason to obtain a culture of the
catheter tip; this is done when an infection is suspected.
Test-Taking Strategy: Use the process of elimination, focusing on the strategic word “next.”
Knowing that the IV should not be removed will assist you in the elimination process. Recalling
that normal saline solution is the only type of IV fluid that is compatible with blood will also
help you answer correctly. To select from the remaining options, note that infection is not the
concern; this will help you eliminate the option of obtaining a culture of the catheter tip. Review
care of the client experiencing a transfusion reaction if you had difficulty with this question.
, 4. The nurse determines that the client is exhibiting signs of a hemolytic transfusion
reaction while receiving a blood transfusion. Place the actions the nurse should perform
in the correct order, with number 1 the first action and number 5 the last action:
The correct order is:
Stopping the infusion of blood
Hanging an IV bag of normal saline solution (NS) at a keep-vein-open (KVO) rate
Notifying the healthcare provider
Obtaining vital signs/oxygen saturation
Documenting the findings
Rationale: If a transfusion reaction is suspected, the transfusion is immediately stopped and NS
infused, pending further physician prescriptions. Next, the healthcare provider should be
notified. Ensuring patent IV access also helps maintain the client’s intravascular volume. NS is
the solution of choice, rather than solutions containing dextrose, because red blood cells do not
clump with NS. Vital signs and oxygen saturation are monitored closely. Finally, the nurse
documents the findings and the client’s response to the interventions.
Test-Taking Strategy: Note that the client is experiencing a having a hemolytic transfusion
reaction. The question sets forth the problem; the nurse must determine the order in which
interventions should be performed. First, the blood transfusion is stopped and an isotonic
solution infused. Next the nurse should notify the healthcare provider, check vital signs and
oxygen saturation data, and assess the client closely. Once prescriptions from the healthcare
provider have been initiated, the nurse should document the event and client’s response. Review
the prioritization of interventions for a transfusion reaction if you had difficulty with the
question.
5. A client with heart failure is being given furosemide (Lasix) and digoxin (Lanoxin). The
client calls the nurse and complains of anorexia and nausea. Which action should the
nurse take first?
Administering an antiemetic
Administering the daily dose of digoxin
Discontinuing the morning dose of furosemide
, Checking the result of laboratory testing for potassium on the sample drawn 3 hours ago
Correct
Rationale: Anorexia and nausea are symptoms commonly associated with digoxin toxicity, which
is compounded by hypokalemia. Early clinical manifestations of digoxin toxicity include
anorexia and mild nausea, but they are frequently overlooked or not associated with digoxin
toxicity. Hallucinations and any change in pulse rhythm, color vision, or behavior should be
investigated and reported to the healthcare provider. The nurse should first check the results of
the potassium level, which will provide additional when the nurse calls the physician, an
important follow-up action. The nurse should also check the digoxin reading if one is available.
The nurse would not administer an antiemetic without further investigating the client’s problem.
Because digoxin toxicity is suspected, the nurse would withhold the digoxin until the physician
has been consulted. The nurse would not discontinue a medication without a prescription to do
so.
Test-Taking Strategy: Note the strategic word “first” and use the steps of the nursing process to
answer the question. The correct option is the only one that addresses assessment. Review
nursing interventions for suspected digoxin toxicity if you had difficulty with this question.
6. A physician prescribes the administration of parenteral nutrition (PN), to be started at a
rate of 50 mL/hr by way of infusion pump through an established subclavian central line.
After the first 2 hours of the PN infusion, the client suddenly complains of difficulty
breathing and chest pain. The nurse immediately:
Obtains blood for culture
Clamps the PN infusion line Correct
Obtains a sample for blood glucose testing
Obtains an electrocardiogram (ECG)
Rationale: One complication of a subclavian central line is embolism, caused by air or thrombus.
Sudden onset of chest pain shortly after the initiation of PN may mean that this complication has
developed. The infusion is clamped (the line should not be discontinued, however), the client
turned on the left side with the head down, and the physician notified immediately. Depending
on agency protocol, the rapid response team would also be called. Blood cultures are not
necessary in this situation, because infection is not the concern. Likewise, there is no useful
reason for checking the blood glucose level. An ECG may be obtained, but this is not the
immediate priority. If the client shows signs of an air embolism, the nurse should examine the
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