Routes of Administration

The 4-hour-old neonate in the nursery begins making rhythmic movements with the hands and smacking of the lips. An electroencephalogram is performed, and seizures are observed. The nurse prepares to administer which medication?

The nurse is caring for a patient admitted for nephrolithiasis. The patient is experiencing severe pain and the provider writes the following order: “5 mg MSO4.” Which action by the nurse is most appropriate?

The nurse is assigned to a 55-year-old patient admitted for diabetic ketoacidosis. The provider writes the patient’s insulin regimen on the admission orders as follows, - “insulin NPH 25 IU.” Which action by the nurse is most appropriate? 

Following nephrectomy surgery, the patient is groggy and continuously pulls at the IV inserted in the right arm. Which intervention is most appropriate to protect the IV?

The 29-year-old female patient who presents at six weeks postpartum for a routine checkup requests to start taking oral contraceptives again. The patient reports successful breastfeeding and a desire to continue for the next year. Which oral contraceptive is recommended for this patient?

The nurse is providing disease management education to the parents of a 10-year-old patient newly diagnosed with type 1 diabetes mellitus. Which instruction is appropriate to give the family? 

The patient has a peripherally inserted central catheter (PICC) for the long-term administration of parenteral nutrition, oxacillin, and gentamicin. Which assessment findings, if present in the patient, indicate the patient is experiencing a complication of the PICC line? Select all that apply.

The patient presents to the emergency room complaining that his heart is racing and he feels dizzy. His heart rate is 220 bpm, his blood pressure is 80/40 mmHg, and his capillary refill is 5 seconds. He is diaphoretic and is becoming increasingly lethargic. The nurse anticipates which order first?

The patient with a heart rate of 233 bpm has been diagnosed with supraventricular tachycardia on electrocardiogram (ECG). The nurse prepares to administer which medication?

The patient with severe abdominal pain and distention, elevated white blood cell count, fever, and disorientation is diagnosed with toxic megacolon due to Clostridium difficile infection. Which order for this patient does the nurse question?

The 39-week-gestation neonate is born to a mother with chorioamnionitis. The provider has ordered ampicillin 75 mg/kg/day in divided doses every 8 hours and administered intravenously. The neonate weighs 4.2 kg. How many milligrams does the nurse administer with each dose? Enter your answer using a whole number.

The 25-week-gestation neonate is ordered to receive ampicillin 100 mg/kg/day intravenously divided into doses every 12 hours immediately after birth. The neonate weighs 745 grams. The pharmacy dispenses ampicillin in a 5 mL vial that contains 125 mg. How many milliliters will the nurse administer with each dose? Round your answer to the nearest tenth decimal.

The 32-week-gestation, 1.9 kg neonate has been prescribed intravenous ampicillin for concerns for sepsis. The dose is 150 mg/kg/d divided into 2 doses administered over 15 minutes. The pharmacy dispenses the medication in a 5 mL vial that contains 250 mg of medication. At what rate will the nurse program the medication to infuse? Round your answer to the nearest tenth decimal.

An infant has been admitted to the hospital for gastroenteritis. Friends of the family stayed in the room while the patient’s father talks to other family members in the lobby. The nurse prepares to remove an infiltrated IV line and place a new one. The visitor stops the nurse and insists that the nurse obtains consent from the parents. Which is the most appropriate response?

The nurse is instructing the student nurse on proper sterile technique. Which statements are included in the teaching? Select all that apply.

The nurse determines the patient’s nasogastric (NG) tube is not maintaining good flow. Which intervention is appropriate?

The nurse instructs the patient with diabetes mellitus to store prefilled insulin syringes in which location?

A child with “staring fits” is diagnosed with absence seizures. The nurse prepares patient education materials on which medication?

The patient is undergoing placement of an antibiotic-impregnated central line catheter for vancomycin infusions. Which statements are true about this type of catheter? Select all that apply.

The nurse is performing an assessment of an infant born 8 hours ago. The infant’s POC blood glucose level is 25 mg/dL. Which action does the nurse take first?

The nurse is assisting the physician with insertion of a central venous catheter into the patient's left internal jugular vein. Into which position does the nurse place the patient? 

The nurse must reconstitute a medication for intravenous administration. Using a syringe, the nurse draws up an appropriate amount of diluent. Which action does the nurse should take next?

A patient with longstanding alcohol abuse problems is admitted for COPD exacerbation. After reaching the floor, the patient becomes disoriented, anxious, tachycardic, diaphoretic, and tremulous. His oxygen saturation is 95% on 2 L supplemental oxygen via nasal cannula. Which intervention is most appropriate for this patient?

The nurse is inserting a nasogastric (NG) tube. To ease the process and increase chances for success, which instruction does the nurse give the patient to perform during insertion?

The provider orders an infusion of 10mL/kg/hr for the patient who weighs 154 lbs. The nurse arranges the IV infusion pump to dispense which flow rate?

The nurse is caring for the patient with intestinal obstruction who is receiving total parenteral nutrition (TPN). The nurse reviews which lab results to ensure the patient is tolerating the infusion? Select all that apply. 

The patient with an ileus is on bed rest after abdominal surgery. A nasogastric tube (NG) is in place because of severe vomiting and significant abdominal distention. Which statement is true regarding management of this patient? 

The nurse is preparing to insert a peripherally inserted central catheter (PICC) into the right upper extremity. The goal of the procedure is for the tip to terminate in which location?

The nurse is preparing a Haemophilus influenzae type b (Hib) immunization for the 2-month-old patient. The baby’s mother states, “I recently read the influenza vaccine isn’t given until at least a year. Are you sure he should be getting this now?” Which response by the nurse is most appropriate?

The nurse reviewing the vaccination record of a 12-month-old infant expects the infant to have completed which vaccine series?

The nurse is preparing for the well-baby visit of the 6-month-old who is up-to-date on vaccines. Which vaccinations does the nurse prepare for the visit? Select all that apply.

The 13-year-old female patient presents to the clinic in January to begin the vaccine series for human papillomavirus. The nurse instructs the patient’s mother to schedule an appointment for the next vaccine in the series during which month at the earliest?

The baby born at 32 weeks’ gestation to a mother who is hepatitis B surface antigen negative (HBsAg-negative) is taken to the Neonatal Intensive Care Unit (NICU) for care. The neonate, who weighs 1.8 kg, requires continuous positive airway pressure of 7 cm H20, intravenous fluids containing dextrose, and intravenous caffeine. After getting consent from the mother, when is the most appropriate time to administer the hepatitis B vaccine to the baby?

The 34-week-gestation neonate is born weighing 1.7 kg to a mother who is hepatitis B surface antigen (HBsAg) positive; all other infectious disease serologies are negative. Which orders are appropriate for this patient? Select all that apply.

The 1.9 kg neonate is born precipitously via vaginal delivery to a 32-year-old mother who received no prenatal care or infectious disease serology testing before delivery. The mother has a history of intravenous drug use. Which intervention does the nurse perform first?

The patient whose mother chose not to vaccinate him presents to the clinic the day after his 18th birthday to receive all eligible vaccinations. The nurse uses which statement to counsel the patient about the hepatitis B vaccine series?

The nurse is providing discharge education to the patient regarding immunizations following a hematopoietic stem cell transplant. When does the nurse instruct the patient to visit the clinic for the Haemophilus influenzae type b (Hib) vaccine?

The public health nurse encourages which individuals to receive the hepatitis A vaccine? Select all that apply.

The 18-year-old healthy female presents to the clinic requesting to receive the vaccinations her mother refused for her when she was a child. Reviewing the chart, the nurse notes the patient never received the measles, mumps, rubella (MMR) vaccine. Prior to administering the vaccination, which test is most important?

The nurse has provided discharge instructions to the patient with type II diabetes. How does the nurse assess the patient’s understanding of the teaching?

The nurse is providing discharge education to the 48-year-old patient with a third grade reading level about his new prescription for valsartan. Which is the best way for the nurse to assess the patient’s understanding of the teaching?

The 7-year-old child with pica is brought to the emergency room (ER) with decreased level of consciousness after ingesting lead paint. His blood lead level (BLL) is determined to be 72 mcg/dL. The nurse prepares to administer which medication?

The nurse is providing medication instructions for iron supplements to a patient with anemia. Which information is included?

Which medication is a beta blocker?

Which comorbidities increase the risk for refeeding syndrome in the chronically ill patient who is started on total parenteral nutrition (TPN)? Select all that apply.

The nurse notices that the patient’s peripheral IV insertion site is red and indurated. What action does the nurse perform first?

The patient presents to the emergency department with abdominal pain, dehydration, a blood glucose level of 425 mg/dL. Blood testing reveals metabolic acidosis, hypokalemia, and ketones. The patient is alert and conversant, but in moderate distress. The nurse anticipates administering which medication?

The patient with a severe peanut allergy was inadvertently exposed to peanuts at work. Dyspnea persists despite the patient using the epinephrine autoinjector and emergency medical services was contacted. Which concentration of epinephrine does the first responder prepare for intramuscular injection?

The registered nurse is caring for a 48-year-old patient with a surgical wound infected with methicillin-resistant Staphylococcus aureus (MRSA) requiring q6h intravenous antibiotic infusions and dressing changes twice per shift. The patient with which diagnosis is most appropriate to be added to this nurse’s assignment?

The nurse is preparing the patient for a magnetic resonance imaging (MRI) scan with intravenous contrast. Which question is most important for the nurse to ask the patient?