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Clinical Nursing Skills

Review Questions

Clinical Nursing SkillsReview Questions

Review Questions

1 .
The nurse enters the patient’s room to address the IV pump that is alarming. The IV pump notifies the nurse that the infusion is occluded, and the IV fluids are not dripping to the drip chamber. The nurse notes the patient’s IV site is cool, pale, and swollen. The nurse concludes the patient has experienced what complication of IV therapy?
  1. infection
  2. phlebitis
  3. infiltration
  4. thrombosis
2 .
The nurse is precepting a nursing student. What statement by the nursing student would warrant further education?
  1. “Intravenous therapy is used to restore fluids and/or electrolyte balances more efficiently than the oral route.”
  2. “Peripheral parenteral nutrition is used for total replacement of dietary needs.”
  3. “Intravenous medications have a faster onset than oral medications since they are administered directly into the bloodstream.”
  4. “Intravenous infusions can help to eliminate fluctuations between peak and trough concentrations to maintain drugs with a narrow therapeutic window.”
3 .
Upon assessing the patient’s IV, the nurse notices the IV site is red, swollen, warm, and painful. What action should the nurse implement first?
  1. stop the infusion
  2. remove the IV
  3. notify the provider
  4. apply warm compress
4 .
Shortly after initiating an IV medication, the patient reports sudden shortness of breath and a feeling of impending doom. Blood pressure is 94/63, heart rate is 118, respirations are 24, temperature is 98.3°F (36.8°C), and oxygen saturations are 89 percent. The patient appears anxious and exhibits altered mental status. What is the priority nursing action?
  1. Notify the provider immediately.
  2. Place the patient in Trendelenburg position.
  3. Apply oxygen.
  4. Clamp the IV catheter.
5 .
The patient is scheduled to receive TPN. What type of vascular access and IV equipment should the nurse anticipate the patient needing?
  1. peripheral IV catheter; flush
  2. midline catheter; IV pump
  3. PICCs; primary tubing
  4. implanted port; secondary tubing
6 .
The nurse tells the nursing student to get a macrodrip infusion set. What would be considered a microdrip infusion set?
  1. 10 gtt/mL
  2. 15 gtt/mL
  3. 20 gtt/mL
  4. 60 gtt/mL
7 .
A new graduate nurse is flushing a saline locked IV with the preceptor. What actions by the new graduate nurse would warrant further education by the preceptor?
  1. The nurse scrubs the access port with an alcohol swab for fifteen seconds and allows it to dry for thirty seconds before connecting the flush to the IV site.
  2. The nurse pulls down on the plunger of the flush and gently expels the air from the syringe before connecting the flush to the IV site.
  3. The nurse twists the flush onto the access port, opens the clamp on the tubing, and flushes the IV site.
  4. The nurse clamps the tubing and then disconnects the flush from the IV site.
8 .
A new graduate nurse is reviewing types of access devices with the preceptor. What statement by the new graduate nurse demonstrates correct understanding of vascular access devices?
  1. “A PICC line is not a good option if the patient requires long-term IV therapies because the patient cannot shower.”
  2. “Tunneling the CVC increases the risk of infection.”
  3. “Implanted ports can be left in place longer than any other type of central line.”
  4. “Unlike other central lines, nontunneled percutaneous CVCs are not inserted into the superior vena cava.”
9 .
The nurse hears the provider state that a patient needs a hypotonic IV solution. What solution would the nurse expect to administer?
  1. D51/2 NS
  2. LR
  3. D5W
  4. 1/2 NS
10 .
The nursing student is reviewing IV fluid categories with the preceptor. What statement made by the student demonstrates a correct understanding of IV fluid categories?
  1. “Hypertonic solutions are used to treat intracellular dehydration and hypernatremia.”
  2. “Crystalloids contain insoluble molecules that do not easily cross the capillary wall.”
  3. “Hypotonic fluids move water from the intracellular space into the intravascular space.”
  4. “Colloids are used to expand intravascular volume.”
11 .
A patient is admitted to the hospital with dehydration and pneumonia. The patient is an IV drug user and is known to hate having IVs inserted. She now has an IV in the right arm. Upon conducting the shift assessment, the nurse notices the IV site is red, tender, and swollen. What action should the nurse take first?
  1. Notify the provider.
  2. Stop the infusion and remove the IV.
  3. Remove the IV and apply a cool compress.
  4. Apply a warm compress and elevate the extremity.
12 .
The provider places an order for IV D51/2NS at a rate of 75 mL/hr. The drop factor for the IV tubing is 20 gtt/mL. How many drops should fall into the drip chamber per minute?
  1. sixteen
  2. nineteen
  3. twenty
  4. twenty-five
13 .
The nurse is caring for a patient with a central line. What would demonstrate correct understanding of guidelines for caring for a central IV line?
  1. Needleless connectors should be changed no more frequently than every seventy-two hours.
  2. Transparent dressings should be changed every ninety-six hours or when wet or soiled.
  3. Tubing used for secondary medications or intermittent fluids should be changed every twenty-four hours.
  4. Gauze dressings should be changed at least every seven days or when wet or soiled.
14 .
What blood type is known as the “universal donor”?
  1. type A
  2. type B
  3. type AB
  4. type O
15 .
What blood type is known as the “universal recipient”?
  1. type A
  2. type B
  3. type AB
  4. type O
16 .
A patient started receiving their first unit of blood at 14:00. It is now 14:05, and the patient is reporting chills, headache, and anxiousness. Vital signs show the patient’s temperature has increased from 98.4°F (36.9°C) to 99.7°F (37.6°C). What is the nurse’s next action?
  1. Calm the patient, and reassure them they will be okay.
  2. Notify the provider.
  3. Stop the transfusion.
  4. Administer acetaminophen.
17 .
The nurse obtains a unit of blood from the blood bank. The unit of blood is started thirty minutes after receiving it from the blood bank. What is the maximum amount of time in which the blood must be transfused into the patient?
  1. within one to four hours
  2. within four hours
  3. within 3.5 hours
  4. within three hours
18 .
You are initiating a transfusion of PRBCs for a patient. You stay with the patient for the first fifteen minutes. What is your next action?
  1. Run the blood at a rate of 2 mL/min and then increase the rate after fifteen minutes, if tolerated by the patient.
  2. Run the blood at a rate of 120 mL/hr for the duration of the transfusion.
  3. Run the blood at a rate of 120 mL/min and then increase the rate after fifteen minutes, if tolerated by the patient.
  4. Run the blood at a rate of 2 mL/hr for the duration of the transfusion.
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