Routes of Administration

The 18-year-old female patient tells the nurse, “I would like to change my contraceptive method before I go away to college. I’m afraid I will forget to take the pill every day and I have had issues finding the right balance of hormones. Honestly, I don’t have a boyfriend and can’t see myself getting married or having kids until well after college.” The nurse reviews the chart and notes the patient’s medical history is negative for any infections or diseases. The patient’s BMI is 32 and metabolic panel is normal. Which contraceptive method does the nurse recommend to this patient?

The 22-year-old woman has selected the Depo-Provera injection as her preferred method of contraception. Which information, if present in the patient’s chart, prompts the nurse to hold the medication and alert the physician?

The patient had a contraceptive implant placed 14 months ago. The implant must be replaced in how many months? Enter your answer using a whole number.

The patient had a copper intrauterine device placed at aged 21. At what age will the patient be when it must be replaced if the patient desires to continue contraception? Enter your answer using a whole number.

The nurse helps the patient into which position in preparation for the removal of an intrauterine device?

The 14-year-old patient was admitted following surgical reduction of an open femur fracture. The patient, who has reported good pain control with the patient-controlled analgesia (PCA) pump, is sleeping peacefully. During hourly rounding, the nurse observes the parent press the button to administer the bolus of pain medication. Which action by the nurse is appropriate?

The nurse advocates for the use of secukinumab in which patient?

The patient receiving patient-controlled analgesia (PCA) with morphine is found to be sleeping deeply and minimally responsive. Which action does the nurse take first?

The nurse is setting up a patient-controlled analgesia (PCA) for the infusion of hydromorphone. Which drugs does the nurse have readily available? Select all that apply.

The nurse is planning care for the patient who will undergo hip replacement surgery in a month. When is the best time to provide teaching about the use of a patient-controlled analgesia (PCA) pump?

The 3.2 kg patient with persistent pulmonary hypertension of the newborn (PPHN) has the following order: Infuse norepinephrine 0.05 mcg/kg/min IV and titrate q15 minutes by 0.05 mcg/kg/min to maintain mean arterial pressure between 45 and 55 mm Hg. Overnight, the norepinephrine had been titrated to 0.25 mcg/kg/min for persistent hypotension. At 0900, the MAP rose to 62 mm Hg and the nurse decreased the infusion from 0.25 mcg/kg/min to 0.20 mcg/kg/min. At 0905, the patient’s blood pressure fell to 42 mm Hg. Which action does the nurse take first?

The patient has experienced an extravasation of norepinephrine in the right forearm. It is cool to the touch, firm, and pale. Distal to peripheral pulses are not well felt and the fingertips are dusky. Which order does the nurse clarify with the provider?

The nurse assesses the peripheral IV site of the patient who is receiving norepinephrine, which was started for profound, life-threatening hypotension and finds the hand to be firm to the touch, cool, and pale. Which action does the nurse take?

The asymptomatic patient tested positive for Neisseria gonorrhoeae during routine screening for sexually transmitted infections (STI). The nurse anticipates administering which medications? Select all that apply.

The 32-weeks-pregnant woman who presents with genital lesions is diagnosed with herpes simplex virus-2. The nurse prepares a patient information handout for which medication for this patient?

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?

The nurse requests analgesia for the 76-year-old patient who must undergo cleansing and dressing change for a healing stage 3 pressure ulcer on the coccyx. In response, the provider ordered topical EMLA cream to be applied to the wound 30 minutes before the procedure. Which action by the nurse is appropriate?

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

The patient is being transferred from a nursing home to an acute care facility. The receiving nurse performs which actions during the medication reconciliation process? Select all that apply.

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?

Local anesthetics have which mechanism of action?

The nurse administers two different drugs to a patient. Neither drug appears to have the desired effect. Which term describes this drug interaction?

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 nurse makes which patient top priority?

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?

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

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.

Fentanyl must be used with caution in which patient?

The patient’s father is observed pressing the patient’s patient-controlled analgesia (PCA) pump while the patient is asleep. The nurse attempts to arouse the patient, who only opens the eyes after being pinched. Once aroused, the patient is able to raise the hand upon request. When asked what the year is, the patient responds with the previous year. The nurse reports the patient’s condition to the provider with which number on the Glasgow Coma Scale? Enter your response using a whole number.

The nurse is preparing the patient for a computed tomography (CT) scan of the brain following a blow to the head. Which instruction does the nurse give the patient?

The patient with severe anxiety and claustrophobia is administered intravenous midazolam prior to an outpatient magnetic resonance imaging (MRI) scan of the brain. The nurse informs the patient’s companion that the patient can leave at which time following the procedure?

Which actions does the nurse take to prevent infection around the use of a peripheral IV? 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?

The hospitalized patient is found to be in ventricular tachycardia on electrocardiogram. Upon assessment, no pulse or respiratory effort are noted. Which medication is administered first?

Which drug, if ordered for the patient with second-degree heart block, does the nurse hold and contact the provider?

The patient who presented to the emergency department complaining of chest pain is found to have a heart rate of 32 beats per minute and a blood pressure of 90/50 mm Hg. The nurse prepares to administer which medication?