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What is the threshold of dextrose concentrations that can safely be administered through a peripheral IV?
- A. Dextrose concentrations below 20% can be safely administered through a peripheral IV; dextrose concentrations above 20% should not be administered through a peripheral IV.
- B. Dextrose concentrations below 5% can safely be administered through a peripheral IV; dextrose concentrations above 5% should not be administered through a peripheral IV.
- C. Dextrose concentrations below 10% can safely be administered through a peripheral IV; dextrose concentrations above 10% should not be administered through a peripheral IV.
- D. Dextrose concentrations above 5% can safely be administered through a peripheral IV; dextrose concentrations below 5% should not be administered through a peripheral IV.
Correct Answer: C
Rationale: Administering dextrose concentrations above 10% through a peripheral IV can lead to phlebitis. It is safe to administer dextrose concentrations below 10% through a peripheral IV.
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The nurse is storing vaccines for future use. What should the nurse do so they are properly stored? Select all that apply.
- A. Place all vaccines in a temperature-controlled refrigerator.
- B. Complete periodic checks of the expiration date on the vaccines.
- C. Place bulk supplies of vaccines in a temperature-controlled freezer.
- D. Avoid storing vaccines on the shelf in the door of the refrigerator.
- E. Do not store food or beverage in the same refrigerator or freezer as the vaccines.
Correct Answer: B,D,E,F
Rationale: A: Not all vaccines are refrigerated; some vaccines will be inactivated by refrigeration and freezing. B: Periodic checking for expiration dates is necessary to ensure that outdated vaccines are not administered. C: Not all bulk supplies should be placed in a freezer; some vaccines are inactivated by freezing. D: When refrigeration is required, a main shelf inside the refrigerator is best because a shelf in the door will have frequent temperature changes that will alter the potency of the vaccine. E: Storing food and beverage in the same unit may result in frequent opening of the unit, leading to greater chance of temperature instability and light exposure. Contamination may also result. F: Aluminum foil or packaging can be used to protect light-sensitive vaccines.
The client has a new prescription for metoclopramide. The nurse notifies the HCP because the client has a contraindication for metoclopramide use. Which information in the client's medical record most likely prompted the nurse's notification of the HCP?
- A. Use of nasogastric suctioning
- B. History of diabetes mellitus
- C. History of seizure disorders
- D. Chemotherapy treatment for cancer
Correct Answer: C
Rationale: A: The use of NG suctioning alone would not prevent metoclopramide use. Metoclopramide can be administered through the NG tube; the tube is then clamped for an hour after administration until absorption occurs. B: Metoclopramide should be used with caution with DM, but it is not contraindicated. C: The client's history of a seizure disorder would contraindicate the use of metoclopramide. Because metoclopramide (Reglan) blocks dopamine receptors in the chemoreceptor trigger zone of the CNS, it is contraindicated in seizure disorders. D: Metoclopramide is used in the treatment of nausea and vomiting for clients receiving chemotherapy.
The nurse is discharging the child with sickle cell disease who has undergone a splenectomy. The child has an allergy to penicillin. The nurse should anticipate teaching about which prophylactic medication?
- A. Epoetin
- B. Amoxicillin
- C. Morphine sulfate
- D. Erythromycin ethylsuccinate
Correct Answer: D
Rationale: A: Epoetin (Epogen) stimulates the bone marrow to produce RBCs. In sickle cell disease, increasing the production of sickled RBCs can worsen the condition. B: Amoxicillin (Amoxil) is contraindicated when allergies to penicillin are present. C: Opioids such as morphine sulfate are administered in sickle cell crises or for severe pain; it is usually not given prophylactically. D: The ability to fight infection is decreased following a splenectomy. Daily prophylactic antibiotics are given. Erythromycin ethylsuccinate (E.E.S.) is a macrolide antibiotic and safe to administer when a penicillin allergy exists.
Which of the following is not considered one of the main mechanisms of Type II Diabetes treatment?
- A. Medications
- B. Nutrition
- C. Increased activity
- D. Continuous Insulin
Correct Answer: D
Rationale: Insulin is not required in continuous treatment for every Type II diabetic, as many can manage with lifestyle changes and oral medications.
The nurse applies a fentanyl transdermal patch to the client for the first time. Shortly after application, the client is experiencing pain. Which nursing action is most appropriate?
- A. Remove the transdermal patch and apply a new one.
- B. Administer a short-acting opioid analgesic medication.
- C. Rub the transdermal patch to enhance drug absorption.
- D. Call the HCP to request a higher-dosed fentanyl patch.
Correct Answer: B
Rationale: A: Removing the patch is unnecessary; effective analgesia may take 12 to 24 hours. B: The nurse should administer a short-acting opioid analgesic. When the first fentanyl (Duragesic) transdermal patch is applied, effective analgesia may take 12 to 24 hours because absorption is slow. C: Transdermal patches should not be rubbed to enhance absorption; it can cause the delivery of the medication to fluctuate. D: It is premature to request a higher dose of fentanyl.