Pharmacological and Parenteral Therapies

The patient is admitted to the hospital with systemic syphilis infection. The patient is ordered to receive a 14-day course of penicillin G 20 million units/day intravenously. Prior to administering the medication, the nurse checks the patient’s allergies and learns the patient experienced anaphylaxis after receiving ampicillin. Which action does the nurse take?

A patient’s central line appears occluded. Which method does the nurse use to determine if the catheter occlusion is internal?

A nurse is caring for a patient who is recovering from total hip replacement surgery. The patient has required increasing doses of IV morphine for pain control. The patient is again reporting 10/10 pain despite receiving 10 mg of morphine from the nurse, which is the top of the range ordered by the physician. The nurse monitors which of the following most closely?

The parent reports giving the child 1 teaspoon of ibuprofen suspension. The nurse charts which volume in milliliters?

The nurse reviews which components of total parenteral nutrition (TPN) prior to administering them? Select all that apply.

The nurse is teaching the child with asthma how to use a metered-dose inhaler. Which instructions does the nurse include? Select all that apply.

A patient with gram-negative sepsis is in the ICU after cardiac arrest. He requires a vasopressor for severe hypotension. Which patient characteristic would prompt the nurse to hold the infusion and contact the provider?

Which is the mechanism of action of naproxen sodium?

Local anesthetics have which mechanism of action?

The 42 weeks gestation pregnant woman is about to undergo labor induction. The nurse anticipates administering which medication?

The physician writes an order for diphenhydramine 250 mg PRN for sleep. Which part of the order does the nurse question?

The patient with congestive heart failure in the cardiac intensive care unit (CICU) is ordered to receive IV furosemide once per day. The lab just called and reported the patient’s serum potassium is 2.9 mEq/L. The next dose of furosemide is due now. Which is the appropriate nursing action?

The nurse is caring for a patient with pneumonia and fulminant pulmonary arterial hypertension. The patient is intubated and mechanically ventilated receiving inhaled nitric oxide (iNO). Additionally, the patient has a central line with multiple continuous infusions, including norepinephrine, vecuronium, morphine, and propofol. During the shift, the nurse begins to have difficulty breathing, a dry throat, syncope, and chest pain. Which action does the nurse take first?

The patient receiving inhaled nitric oxide (iNO) is at risk for which adverse event?

Which test does the nurse expect will be used to determine the effectiveness of the fosphenytoin dose?

The nurse learns the patient who takes fosphenytoin was prescribed apixaban two months ago. The nurse assesses the patient for which complication caused by taking these two medications together?

The unresponsive patient is brought to the emergency department via ambulance. During an abbreviated neurologic exam, the nurse notes the following pupils, estimated to be 1 mm and fixed: The nurse prepares to administer which medication?

The patient has been taking apixaban for 4 weeks. Which monitoring test does the nurse review to evaluate the efficacy of the medication?

The 2.1 kg neonate with hypoxic ischemic encephalopathy is in status epilepticus that is refractory to 2 loading doses of phenobarbital. The provider has ordered 20 mg/kg to be administered intravenously STAT. The pharmacy dispenses the medication in a concentration of 50 mg/mL. How many milliliters does the nurse administer? Input your answer to the hundredth decimal.

The 4.5 kg neonate with hypoxic ischemic encephalopathy is in status epilepticus that is refractory to 2 loading doses of phenobarbital. The provider has ordered 20 mg/kg to be administered intravenously over 15 minutes STAT. The pharmacy dispenses the medication in a concentration of 50 mg/mL. What rate will the nurse program the pump to administer the medication? Round your answer to the tenth decimal place.

The 64-year-old male patient with chronic obstructive pulmonary disease related to a 42-pack-year history of smoking is receiving ipratropium bromide. Which symptom indicates the patient is experiencing an adverse effect of this medication?

Which statement by the patient with asthma indicates a need for further teaching?

The nurse plans care for the patient who is receiving theophylline for the treatment of refractory asthma. Which nursing intervention does the nurse include to assess for complications of the drug?

The condition of the patient with a pulmonary hypertensive crisis due to pneumonia has improved. Which order does the nurse question?

The patient who takes milk of magnesia every day is at risk for which electrolyte imbalance?

The nurse is reviewing a patient’s medications during discharge. Which further education can the nurse provide regarding spironolactone when the patient asks, “I thought that I took a furosemide pill for my water?”

The nurse questions the order for an infusion of 0.45% NaCl in the patient with which condition?

Which patient characteristic prompts the nurse to hold the infusion of Lactated Ringer’s and contact the provider?

The 16-year-old patient passed out from the heat while playing football and now requires an infusion of Lactated Ringer’s solution for moderate dehydration. The patient’s heart rate is 118 bpm, blood pressure is 100/72 mmHg, and temperature is 37.5°C. Which gauge of intravenous catheter does the nurse select for insertion into this patient?

The patient calls the nurse to the room to report pain at the site of an IV. The nurse notes warmth, redness, and purulent drainage. Which action does the nurse take first?

The patient receiving a rapid infusion of Lactated Ringer’s solution for dehydration calls out to report difficulty breathing and a racing heart. Upon assessment, the nurse notes decreased level of consciousness and severe hypotension. Which assessment does the nurse make first?

The patient receiving a continuous infusion of total parenteral nutrition (TPN) through a peripherally inserted central catheter (PICC) line reports sudden onset dizziness, dyspnea, and tachycardia. Upon assessment, the nurse notes the patient is difficult to arouse. The IV tubing is noted to be cracked and have air in it. Which action does the nurse take first?

The nurse suspects the patient has experienced an air embolism from the peripherally inserted central catheter (PICC). Place the steps the nurse takes to intervene in the correct order.

The nurse is instructing the patient on how to move in bed after an open abdominal surgery. Which statement by the nurse is appropriate?

Which term does the nurse use to describe the patient who takes oxycodone daily for pain associated with deteriorating knee cartilage and requests a higher dosage for breakthrough pain?

The patient with poorly controlled type II diabetes mellitus reports burning pain in the feet and legs that keep him up at night. The nurse passes this report along the provider and advocates for which medication for the patient?

Fentanyl must be used with caution in which patient?

The elderly patient receiving a continuous morphine infusion for the treatment of cancer pain is at risk for opioid-induced respiratory depression. The nurse selects which monitoring device to most quickly detect a change in the patient’s respiratory drive?

The patient receiving a continuous hydromorphone infusion for severe cancer pain is found to be unconscious with a respiratory rate of 7 breaths per minute. Which action does the nurse take first?

Which patient is at greatest risk for respiratory depression due to the inability to adequately excrete fentanyl?

The nurse is evaluating discharge teaching for the patient receiving hydrocodone/acetaminophen for the treatment of acute pain due to femur fracture. Which statement by the patient indicates teaching was effective?

What is the main rationale for prescribing hydrocodone with acetaminophen?

The nurse has received an update from the unlicensed assistive personnel about four patients. Which patient does the nurse assess first?

The patient with scoliosis experiences severe pain due to muscle spasms related to the misalignment of the spine. Which medication does the nurse anticipate to be ordered for this condition?

The patient with chronic renal failure has been prescribed erythropoietin. The nurse informs the patient the drug has which intended effect?

Which statements are true regarding intravenous immunoglobulin? Select all that apply.

Which statements are true regarding peripherally inserted central catheters (PICCs)? Select all that apply.

The patient is being discharged from hospital on total parenteral nutrition (TPN). Which information does the nurse include in discharge teaching?

Which medication may be prescribed for the treatment of anorexia and cachexia related to cancer?

The nurse is examining the waveform produced by the patient's central venous pressure (CVP) catheter. Atrial contraction occurs at which point on the waveform?