All practice questions

A nurse is preparing to withdraw a prescribed intravenous medication from a glass ampule. Place the steps for this procedure in the correct chronological order.

A client diagnosed with a massive pulmonary embolism is receiving a continuous intravenous (IV) infusion of unfractionated heparin. The healthcare provider prescribes an intermittent IV antibiotic to be infused over 90 minutes. Upon checking the facility's drug reference guide, the nurse notes that the antibiotic is chemically incompatible with heparin. The client currently has only one patent 20-gauge peripheral IV catheter. Which action is most appropriate for the nurse to take?

A critically ill adult client in the intensive care unit has a triple-lumen central venous catheter. The client is receiving continuous intravenous infusions of total parenteral nutrition (TPN) via the distal lumen, propofol via the medial lumen, and norepinephrine via the proximal lumen. The client's mean arterial pressure acutely drops to $45\text{ mm Hg}$. The healthcare provider prescribes a stat $500\text{ mL}$ bolus of $0.9\%$ sodium chloride and the initiation of a continuous vasopressin infusion. Which of the following is the most appropriate nursing action?

During bedside rounds, a rapid response team nurse evaluates a client with sepsis-induced encephalopathy. The client is severely agitated and continuously pulling at their central venous catheter and indwelling urinary catheter. Place the following safety interventions in the correct sequence of escalation, starting from the first priority action to the measure of last resort.

An intensive care nurse is managing an intubated client who is severely agitated and attempting to remove the endotracheal tube. After less restrictive measures have failed, the nurse initiates the application of bilateral soft wrist restraints. Arrange the following nursing actions in the correct chronological order from first to last.

A nurse is developing a plan of care for a 72-year-old client who recently suffered an ischemic stroke and is now receiving continuous enteral nutrition via a nasogastric (NG) tube. Which of the following actions should the nurse include to minimize the risk of complications? Select all that apply.

A nurse is preparing to administer a prescribed intravenous (IV) push medication through a client's continuous IV infusion line. Which action is essential for the nurse to perform prior to injecting the medication?

A client experiencing an acute exacerbation of chronic obstructive pulmonary disease (COPD) becomes increasingly lethargic. Recent arterial blood gas (ABG) analysis reveals a pH of 7.25, PaCO2 of 72 mm Hg, HCO3 of 28 mEq/L, and PaO2 of 58 mm Hg. To reduce the risk of impending respiratory failure, which intervention should the nurse implement first?

During the overnight shift in the neurosurgical intensive care unit, the nurse assumes care of a client who underwent a supratentorial tumor resection earlier in the day. Upon the hourly evaluation, the client demonstrates lethargy but withdraws purposefully from noxious stimuli. The physiological monitor displays a blood pressure of $172/64$ mmHg, an apical pulse of $52$ beats per minute, and an irregular respiratory pattern of $10$ breaths per minute. The indwelling catheter drainage system has collected $550$ mL of pale urine over the last $60$ minutes with a specific gravity of $1.003$. An arterial blood gas panel drawn on $40\%$ supplemental $O_2$ reveals a $pH$ of $7.28$, $PaCO_2$ of $54$ mmHg, $HCO_3^-$ of $24$ mEq/L, and $PaO_2$ of $88$ mmHg. Based on this diagnostic data, which action must the nurse prioritize to prevent lethal decompensation?

A nurse is caring for a client with an acute exacerbation of chronic obstructive pulmonary disease (COPD) who is experiencing severe hypoxia-induced restlessness. The client is persistently attempting to remove their continuous positive airway pressure (CPAP) mask and peripheral intravenous (IV) catheter. Arrange the following nursing actions in the correct sequence for managing this client's behavior, progressing from the initial nursing process step to the most restrictive intervention. All options must be used.

A client is scheduled to receive a bolus enteral formula via an established nasogastric (NG) tube. Which sequence of actions must the nurse execute to safely deliver this nutritional support? Arrange the clinical steps in the correct chronological order from first to last.

A nurse is evaluating a newborn to determine the 5-minute APGAR score. The newborn's assessment findings are as follows:

- Heart rate: 112 beats/min
- Respiratory effort: Slow, weak cry
- Muscle tone: Some flexion of extremities
- Reflex irritability: Grimace in response to stimulation
- Color: Body pink, hands and feet cyanotic

Calculate the newborn's APGAR score.

A nurse is caring for a client in the intensive care unit who is experiencing a hypertensive emergency. The client weighs $209\text{ lbs}$. The healthcare provider prescribes a continuous intravenous infusion of sodium nitroprusside at $3\text{ mcg/kg/min}$. The pharmacy dispenses a premixed IV bag containing $50\text{ mg}$ of sodium nitroprusside in $250\text{ mL}$ of $5\%$ dextrose in water (D5W).

At what rate, in $\text{mL/hr}$, should the nurse set the infusion pump? (Record your answer using one decimal place.)

An adolescent client admitted to an acute behavioral health facility begins throwing furniture and physically threatening peers. After verbal de-escalation and pharmacological interventions fail to calm the client, four-point mechanical restraints are applied to prevent immediate severe injury. Which action must the registered nurse implement next?

A registered nurse (RN) is preparing to administer intravenous (IV) medications and fluids to a critically ill client. Which of the following actions by the RN demonstrate safe pharmacological and parenteral therapy practices? Select all that apply.

A catastrophic explosion has occurred at a multi-story indoor shopping complex, resulting in a mass casualty incident. A triage nurse is systematically evaluating victims at the scene using the Simple Triage and Rapid Treatment (START) algorithm. Which victim should the nurse classify as requiring an Immediate (Red) triage tag?

Following a percutaneous liver biopsy, the client is transferred back to the medical-surgical unit. To decrease the risk of internal hemorrhage, what is the most appropriate position for this client?

A nurse is caring for an older adult client who is experiencing acute confusion and repeatedly attempting to pull out their peripheral intravenous (IV) catheter. Which action should the nurse take to maintain patient safety and prevent injury?

Pair the following admitted clients and their diagnoses with the specific infection control precaution category required by current guidelines.

A client with severe acute pancreatitis is receiving total parenteral nutrition (TPN) and a separate intravenous lipid emulsion via a multi-lumen peripherally inserted central catheter (PICC). Which nursing actions are required for the safe administration and monitoring of these parenteral therapies? (Select all that apply.)