NURSING 1429041
Module 8 Exam
Questions.
Module 8: Exam
1. A nurse notes that the site of a client’s peripheral intravenous (IV) catheter is
... [Show More] reddened, warm, painful, and slightly edematous
near the insertion point of the catheter. On the basis of this assessment, the nurse should take which action first?
o Remove the IV catheter
o Slow the rate of infusion
o Notify the health care provider
o Check for loose catheter connections
2. A nurse hangs a 500-mL bag of intravenous (IV) fluid for an assigned client. One hour later the client complains of chest
tightness, is dyspneic and apprehensive, and has an irregular pulse. The IV bag has 100 mL remaining. Which action should the
nurse take first?
o Remove the IV
o Sit the client up in bed
o Shut off the IV infusion
o Slow the rate of infusion
3. A nurse discontinues an infusion of a unit of packed red blood cells (RBCs) because the client is experiencing a transfusion
reaction. After discontinuing the transfusion, which action should the nurse take next?
o Remove the IV catheter
o Contact the health care provider
o Change the solution to 5% dextrose in water
o Obtain a culture of the tip of the catheter device removed from the client
4. The nurse determines that the client is exhibiting signs of a hemolytic transfusion reaction while receiving a blood transfusion.
The nurse should perform these actions in which priority order? Arrange the actions in the order that they should be
performed. All options must be used.
Correct
o Stopping the infusion of blood
o Hanging an IV bag of normal saline solution (NS) at a keep-vein-open (KVO) rate
o Notifying the health care provider
o Obtaining vital signs/oxygen saturation
o Documenting the findings
5. A client with heart failure is being given furosemide and digoxin. The client calls the nurse and complains of anorexia and
nausea. Which action should the nurse take first?
o Administer an antiemetic
o Administer the daily dose of digoxin
o Discontinue the morning dose of furosemide
o Check the result of laboratory testing for potassium on the sample drawn 3 hours ago
6. The health care provider (HCP)prescribes the administration of total parenteral nutrition (TPN), to be started at a rate of 50
mL/hr by way of infusion pump through an established subclavian central line. After the first 2 hours of the TPN infusion, the
client suddenly complains of difficulty breathing and chest pain. The nurse should take which immediate action?
o Obtain blood for culture
o Clamp the TPN infusion line
o Obtain an electrocardiogram (ECG)
o Obtain a sample for blood glucose testing
7. The health care provider prescribes 2000 mL of 5% dextrose and normal saline 0.45% for infusion over 24 hours. The drop factor
is 15 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round to the nearest whole number).
o 21
8. A nurse is assessing a peripheral intravenous (IV) site and notes blanching, coolness, and edema at the insertion site. What
should the nurse do first?
o Remove the IV
o Apply a warm compress [Show Less]