Chapter 11: Parenteral Administration: Intravenous Route

Basic Pharmacology for Nurses 17th Ed by Clayton - Willihnganz

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Chapter 11: Parenteral Administration: Intravenous Route

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. A patient is diagnosed with cancer and requires 6 months of chemotherapy infusions. Which type of intravenous (IV) access device will likely be used?
a. Peripheral venous access device
b. Midline catheter
c. Winged needle venous access device
d. Implantable venous infusion port

 

 

ANS:  D

Implantable venous infusion ports are placed into central veins for long term therapy. Chemotherapy treatment is often irritating and best tolerated in the larger central veins. Peripheral lines are not used for administration of chemotherapy because of the risk of extravasation. A midline catheter is intended only for a 2 to 4 week interval, less than the projected length of time for chemotherapy infusion. Winged needles are for use in peripheral veins that are too small for ongoing infusion of chemotherapy.

 

DIF:    Cognitive Level: Application           REF:   Page 147 | Page 149

OBJ:   5                    TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment

 

  1. The nurse notes that a patient with cardiac disease has IV heparin infusing and that it is behind by 2 hours. What is the best nursing action?
a. Increase the IV rate and recheck in 1 hour.
b. Change the infusion rate to TKO.
c. Discontinue the solution using aseptic technique.
d. Contact the health care provider for consultation.

 

 

ANS:  D

The patient has a history of cardiac problems and is receiving a critical care medication, IV heparin. In this case, contacting the patient’s health care provider would be appropriate to avoid harm. Increasing the infusion rate might place the patient into fluid overload and might infuse too much heparin in a short time. Reducing the infusion rate to TKO or discontinuing the solution would put the schedule even further behind.

 

DIF:    Cognitive Level: Application           REF:   Page 154        OBJ:   8

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment

NOT:  CONCEPT(S): Clinical Judgment; Safety; Collaboration; Communication

 

  1. What is the composition of hypotonic intravenous solutions such as 0.45% NaCl?
a. Fewer dissolved particles than blood
b. Approximately the same number of dissolved particles as blood
c. Higher concentrations of dissolved particles than blood
d. Electrolytes and dextrose

 

 

ANS:  A

Hypotonic solutions have fewer dissolved particles than blood. Half normal saline does not contain dextrose.

 

DIF:    Cognitive Level: Knowledge            REF:   Page 150        OBJ:   3

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment; Fluid and Electrolyte Balance; Cellular Regulation

 

  1. Which condition would the nurse expect to be treated with an isotonic solution?
a. Fluid overload
b. Hemorrhagic shock
c. Cellular dehydration
d. Cerebral edema

 

 

ANS:  B

Isotonic solutions have approximately the same osmolality as blood. Isotonic fluids are ideal replacement fluids for patients experiencing an intravascular fluid deficit that occurs in conditions such as acute blood loss from hemorrhage and gastrointestinal bleeding. Isotonic fluids increase vascular volume, thus counteracting hypovolemia and hypotension. Administering isotonic solutions for fluid overload would exacerbate the problem. Hypotonic solutions are administered for cellular dehydration. Hypertonic solutions are administered for cerebral edema.

 

DIF:    Cognitive Level: Application           REF:   Page 150        OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment; Fluid and Electrolyte Balance; Cellular Regulation

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