Routes of Administration

The patient's heart rate is 28 bpm and the systolic blood pressure is 80 mmHg. One dose of atropine 0.5 mg IV push has been administered with no response. The patient is unstable, but conscious. Which next intervention is appropriate? 

The patient with narrow QRS complex supraventricular tachycardia is found to be hemodynamically stable. Which initial intervention is appropriate? 

Which is the correct ratio of crystalloid fluid administration to estimated blood loss to resuscitate the patient in hemorrhagic shock?

The patient with a central venous catheter develops substernal chest pain, hypotension, and cough. There is evidence of air in the line. Which action does the nurse take first​?

The patient receiving sliding scale insulin requests the subcutaneous insulin to be injected into the abdomen. Immediately prior to administration, the nurse notes the site is stringy, slightly indurated, and has several fat masses. Which action by the nurse is appropriate?

The patient with diabetes insipidus has been prescribed vasopressin. The nurse instructs the student nurse about which characteristic of the medication?

Which statement is true regarding single use items?

The nurse is preparing to discharge the patient following surgical creation of an arteriovenous fistula. For which complication is this patient most at risk?

The patient with dementia has experienced unintentional weight loss of 20 pounds due to decreased food intake. The patient's caregiver asks the nurse about nutritional drinks and shakes. Which response by the nurse is most appropriate?

An adult weighing 70 kg just arrived to the emergency department (ED) with burns on the front of both legs and the genital region. Using the Parkland formula, how much fluid is to be administered to the patient over the next 8 hours?

The provider orders albumin for a patient with traumatic amputation and hemorrhage. Which patient characteristic prompts the nurse to clarify the order with the provider?

The patient with arteriovenous malformation who takes a monoamine oxidase inhibitor for depression develops an upper respiratory infection. The nurse requests a prescription for which medication?

The 5-year-old patient has been prescribed phenytoin for the treatment of seizures. Which statement by the patient’s mother prompts the nurse to contact the provider for an alternative prescription?

The nurse plans which intervention for the patient with toxic epidermal necrolysis?

The nurse is administering intravenous fluids to the patient with toxic epidermal necrolysis. Which parameters are most helpful to assess when determining the appropriate fluid rate for the patient?

The patient developed toxic epidermal necrolysis after receiving phenytoin for seizures. The nurse prioritizes nursing interventions to address which life-threatening comorbidities? Select all that apply.

The patient presents to the women’s health clinic with complaints of itching and burning on urination with a white, curd-like vaginal discharge. The provider reports the cervix appears normal on exam. The nurse prints patient information for which medication course?

The registered nurse is observing the licensed practical/vocational nurse (LPN/LVN) administering pantoprazole during morning medication rounds. Which action by the LPN/LVN prompts the nurse to intervene and provide additional education?

The patient has been prescribed an irrigation for the right eye. The nurse assists the patient into which position?

The nurse is supervising the student nurse in the irrigation of the patient’s right eye. Which action by the student nurse prompts the nurse to intervene with additional education?

The patient presents to the urgent care clinic complaining of eye pain and feeling like there’s a foreign object in the eye. The provider examines the patient and orders a 500 mL irrigation of sterile saline. After warming the solution to 37°C and positioning the patient, the nurse begins to administer the irrigation. The patient cries out in pain and jerks away from the nurse. Which response by the nurse is most appropriate?

The nurse is preparing the patient for an ophthalmoscopic exam in which cyclopentolate drops must be instilled to allow for better visualization of the retina. Which characteristics, if present in the patient’s medical history, prompt the nurse to hold the drops and contact the provider for further instruction? Select all that apply.

Which instruction does the nurse give the patient prior to administering cyclopentolate eye drops?

The nurse is educating the patient on self-administering antibiotic eye drops. Which instruction does the nurse include?

Which statement describes the nurse's legal responsibility in administering regular insulin to the mentally competent adult patient? 

The patient is brought to the floor from the post-anesthesia care unit following orthopedic surgery. Which action does the nurse take first?

The nurse is providing medication teaching to the mother of a 4-year-old patient with recurrent otitis media infections who requires daily instillation of antibiotic drops into the ear. Which action indicates effective teaching?

The nurse is educating the 2-year-old patient’s parents on how to instill ear drops to treat acute otitis media. Which statement indicates a need for further teaching?

The patient has been prescribed amoxicillin for the treatment of sinusitis. The patient states, “I thought I just had a cold. I don’t want to take antibiotics for a cold.” Which response by the nurse is most appropriate?

The patient with palpitations and sharp chest pain that is worse with inspiration than expiration is brought to the emergency department (ED). Upon auscultation of heart sounds, the nurse notes a scratching noise, like leather rubbing together. Breath sounds are clear and equal bilaterally. Complete blood count is notable for leukocytosis; cardiac enzymes are within normal limits. The nurse prepares the patient for which treatment?

The 5-year-old child is brought to the emergency department (ED) after a fall at school that has resulted in a broken wrist. The nurse notes the child is thin, with curved femurs and kyphosis. Metaphyseal fraying and cupping is noted on x-ray of the wrist. There is evidence of old fractures that healed poorly, as if they hadn’t been set properly. Upon review of the patient’s medical history, it does not appear that the patient has received ongoing well-child care. After laboratory evaluation, the child is diagnosed with rickets. The nurse prepares information on which medication for the family?

The pediatric patient has simple otitis externa (swimmer’s ear) and is afebrile. The nurse prepares educational materials for which treatment?

Which statement is true regarding the administration of intravenous potassium?

The nurse is using the Finnegan scoring system to assess a neonate for opioid withdrawal. The first score is 9 and the second score is 14. Which statement is accurate?

Which is an example of hypertonic intravenous (IV) fluid?

At which age does the nurse instruct the parent to bring the child in to the clinic for the measles, mumps, and rubella (MMR) vaccine?

A six-year-old child presents to a primary care appointment with curved tibias and fibulas, protruding forehead, pigeon chest, and protruding abdomen. Which vitamin deficiency does the nurse immediately suspect?

The patient has been receiving sildenafil 5 mg by mouth, three times daily. Which assessment finding indicates the drug has had the intended effect?

The patient receiving bosentan therapy for pulmonary arterial hypertension presents to the emergency department (ED) complaining of dyspnea. Which nursing assessment is most important for this patient?

The patient presents to the emergency department (ED) and states, “I don’t know what happened! I was walking and ran into a door with my right shoulder. I closed my right eye and my vision was normal, but when I closed my left eye, I couldn’t see anything at all!” The patient’s assessment is otherwise normal. The nurse reports this to the provider immediately for assessment. Which question is most important for the nurse to ask the patient while waiting for the provider to write orders for treatment?

The nurse has received an order to insert a nasojejunal tube. The nurse measures the patient as 15 cm from the nose to the tragus and an additional 30 cm to the xiphoid process. What is the total length of tube that should be inserted for this patient?

Following a major natural disaster, the charge nurse receives instruction from superiors to pair patients as roommates to increase the number of available rooms. The first patient to be paired is a 42-year-old patient with cellulitis who has a 103°C fever and tachycardia. The charge nurse places her in a room with which patient?

The nurse has instituted a process improvement project to reduce the number of central line-associated bloodstream infections (CLABSI) in the intensive care unit. During the first month after instituting the process change, the incidence of CLABSIs dropped from 8 the previous month to 2 for the month. Which action by the nurse is most appropriate?

The nurse receives report of four issues at 0800. Which situation is addressed first?

The nurse preceptor is supervising the graduate nurse during shift handoff. Which statements by the graduate nurse would prompt the veteran nurse to clarify for the oncoming nurse? Select all that apply.

The patient who underwent a partial thyroidectomy 1 day ago complains of tingling in the lips and tongue. Upon assessment, the nurse notes increased deep tendon reflexes. Which order does the nurse question for this patient?

The 74-year-old otherwise healthy patient presents to the clinic complaining of severe pain and burning of the skin over the right flank. Upon assessment, the nurse notes two lines of vesicles that curve laterally away from the spine on the right side. The nurse provides which instruction to the patient regarding treatment?

The 32-year-old female patient (60 kg) is brought via ambulance to the emergency department following a water drinking competition. The patient has a Glasgow Coma score of 6, oxygen saturation of 94% on room air, heart rate of 62 bpm, and respiratory rate of 16 breaths per minute. The nurse anticipates administering which medication?

The nurse is helping to recruit patients for a study about the effectiveness of a new delivery system for somatropin. The nurse filters the records for patients with which conditions? Select all that apply.

The patient is started on subcutaneous heparin injections 7500 units q12h for deep vein thrombosis prophylaxis at 0900. When does the nurse plan to obtain the activated partial thromboplastin time (aPTT) to determine effectiveness of therapy?