INP4 Quiz 1: IV med admin, peri-op pain, NG, ostomy, TPN, infection control

Descrição

NCLEX Nursing Quiz sobre INP4 Quiz 1: IV med admin, peri-op pain, NG, ostomy, TPN, infection control, criado por Laurie White em 09-12-2017.
Laurie White
Quiz por Laurie White, atualizado more than 1 year ago
Laurie White
Criado por Laurie White mais de 6 anos atrás
322
2

Resumo de Recurso

Questão 1

Questão
The IV site is changed only as needed
Responda
  • True
  • False

Questão 2

Questão
It is ok to stop a heparin or antibiotic infusion
Responda
  • True
  • False

Questão 3

Questão
How many cc to flush a SL lock?
Responda
  • 2cc
  • 3cc
  • 5cc
  • 10cc

Questão 4

Questão
1cc and 1ml are the same thing
Responda
  • True
  • False

Questão 5

Questão
PRBs are often used for
Responda
  • trauma/surgery
  • low BP
  • to correct fluid volume
  • for active bleeding to coagulate blood

Questão 6

Questão
albumin is used to
Responda
  • treat blood loss from trauma/surgery
  • to correct fluid volume (draw fluid back into the vessels)
  • for active bleeding to coagulate blood
  • to decrease BP

Questão 7

Questão
The difference between blood type, screen & cross match is only good for 72 hours
Responda
  • True
  • False

Questão 8

Questão
what enters the blood stream and has a systemic effect?
Responda
  • analgesics
  • anesthetics
  • normal saline
  • antiemetics

Questão 9

Questão
The top port of the primary IV line is used to connect a PCA
Responda
  • True
  • False

Questão 10

Questão
You are unconscious when given this type of anesthesia
Responda
  • local
  • regional
  • general

Questão 11

Questão
dermatomes need to be tested after patient has had this type of anesthetic
Responda
  • local
  • general
  • regional

Questão 12

Questão
what dermatome marks the umbilicus?
Responda
  • T8
  • T9
  • T10
  • T11

Questão 13

Questão
Patients with an epidural will also have a foley catheter
Responda
  • True
  • False

Questão 14

Questão
Spinal are injected in what region?
Responda
  • L1-L2
  • T11-T12
  • L3-L4
  • T1-T2

Questão 15

Questão
The onset of an epidural is much faster then a spinal
Responda
  • True
  • False

Questão 16

Questão
What caused a spinal headache?
Responda
  • dehydration
  • low BP
  • CSF leaking out the injection site
  • anesthesia has spread to the brain

Questão 17

Questão
LPNs fill out PCA forms
Responda
  • True
  • False

Questão 18

Questão
Check all the apply To avoid risk of bleeding or hematoma...
Responda
  • Do not give dalteparin for at least 4 hours after epidural catheter is removed
  • Do not give heparin for at least 2 hours after an epidural is removed
  • Do not remove epidural within 12 hours of a deltaparin or heparin injection

Questão 19

Questão
There is a risk of patients with PCAs getting addicted to opiods
Responda
  • True
  • False

Questão 20

Questão
When a new med infusion is prescribed via IV and the drug guide does not say that it IS or IS NOT compatible with the current med in the PCA, you can assume it's compatible and prime a secondary line
Responda
  • True
  • False

Questão 21

Questão
Which type of anesthesia requires the airway to be maintained by a endotracheal tube & ventilator?
Responda
  • local
  • regional
  • general

Questão 22

Questão
local anesthetic is used for most major surgeries
Responda
  • True
  • False

Questão 23

Questão
pick the correct order of how things return when regional anesthetic wears off
Responda
  • pain, sensation, motor
  • motor, sensation, pain
  • sensation, pain, motor
  • sensation, motor, pain

Questão 24

Questão
urinary retention is a side effect of general anesthesia
Responda
  • True
  • False

Questão 25

Questão
check all that apply potential complications post surgery:
Responda
  • hemorrhage
  • pnemonia
  • PE
  • DVT
  • paralytic ileus
  • wound infection

Questão 26

Questão
match the term: excision/ removal
Responda
  • ectomy
  • oscopy
  • ostomy
  • plasty

Questão 27

Questão
match the term: forming an opening
Responda
  • ectomy
  • oscopy
  • ostomy
  • plasty

Questão 28

Questão
match the term: surgical repair
Responda
  • ectomy
  • oscopy
  • plasty
  • otomy

Questão 29

Questão
match the term: anastamosis
Responda
  • forming an opening
  • surgical joining of two ducts, vessel or bowel
  • collapse of alveoli
  • visual examination with an instrument

Questão 30

Questão
match the term: Minimal depression of the LOC with maintenance of protective airway refleces
Responda
  • general sedation
  • conscious sedation
  • local sedation
  • regional sedation

Questão 31

Questão
pick the correct motor block score: -no motor block, able to fully flex knees and feet
Responda
  • 0
  • 1
  • 2
  • 3

Questão 32

Questão
a motor block score of 3 would indicate that the patient...
Responda
  • has no motor block and can fully flex knees and feet
  • is only able to move knees and feet (unable to raise extended legs)
  • able to move feet only
  • unable to move hips, knees or feet (unable to flex ankle joint)

Questão 33

Questão
check all the post-operative exercises that should be done 10x per hour
Responda
  • deep breathing
  • coughing
  • leg exercises
  • turning and re-positioning
  • dangling
  • incentive spirometer

Questão 34

Questão
what is the most common purpose of the NG tube?
Responda
  • decompression of the GI tract (suction)
  • feeding
  • compression
  • lavage

Questão 35

Questão
which tube type is used for decompression of the GI tract
Responda
  • entroflex tube
  • saleum sump tube
  • standard suction tube
  • a 12-14fr catheter tube

Questão 36

Questão
LPNs can insert & remove NG tubes
Responda
  • True
  • False

Questão 37

Questão
Assessment of the NG tube, pick the correct scenario
Responda
  • suction is set between 40-80mmHg, HOB elevated to 30 degrees, NG tube taped securely to bridge of nose and pinned to gown
  • suction is set between 40-80mmHg, HOB elevated to 30 degrees, NG tube taped securely to cheek and gown
  • suction set above 80mmHg, HOB elevated to 45 degrees, NG tube taped securely to bridge of nose and pinned to gown
  • suction is set between 40-80mmHg, bed is supine, NG tube taped securely to bridge of nose and pinned to gown

Questão 38

Questão
gastric aspirate is alkaline, ph is 7+
Responda
  • True
  • False

Questão 39

Questão
when giving NG medications...
Responda
  • Turn off NG suction, flush NGT with 30-50ml of warm tap water pre & post med admin, do not turn NG tube back on until 30min post med admin
  • Turn off NG suction, flush NGT with 5ml of warm tap water pre & post med admin, do not turn NG tube back on until 30min post med admin
  • Turn off NG suction, flush NGT with 30-50ml of warm tap water pre & post med admin, turn NG suction back on
  • Leave NG suction on, flush NGT with 30-50ml of warm tap water pre & post med admin

Questão 40

Questão
What to report to physician, check all the apply in regards to NG tubes
Responda
  • NG tube drainage: coffee grounds, hemolyzed sanguinous drainage, dark brown granular appearance
  • excessive losses: more than 500-1000 mls per hour
  • minimal losses: less than 30ml/hr
  • NG tube drainage: bile coloured aspirate

Questão 41

Questão
During TPN, the client pump is alarming, the screen indicates upstream occlusion. The LPN would assess between...
Responda
  • The bag and the pump
  • the pump and the patient

Questão 42

Questão
TPN can be a shock to a malnourished body
Responda
  • True
  • False

Questão 43

Questão
Name the syndrome: Defined as the potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding eg. TPN (whether enterally or parenterally). These shifts result from hormonal and metabolic changes and may cause serious clinical complications.
Responda
  • Refeeding symdrome
  • Malabsorption syndrome
  • toxic shock syndrome
  • cushing's syndrome

Questão 44

Questão
The pump has broke down for a client receiving TPN and a new one may take a hour to find, what should be done?
Responda
  • Give TPN PIV by gravity
  • Give D5W PIV by gravity
  • D10W PIV by gravity
  • No need to do anything, wait the hour and restart TPN with new pump

Questão 45

Questão
In regards to TPN: after the initiation of a lipid, the client starts complaining of SOB and chest pain... what do you do?
Responda
  • raise the head of the bed and do a chest assessment to check for crackels
  • this is likely a fat embolism, follow air embolism protocol and call a code blue!
  • take an O2 sat, get the patient to do DB & C, re-assess
  • check for a prn order of nitro spray

Questão 46

Questão
TPN can be administered via a PICC or PIV
Responda
  • True
  • False

Questão 47

Questão
A patient on TPN would have an NPO diet
Responda
  • True
  • False

Questão 48

Questão
Max hang time for TPN and/or lipids
Responda
  • TPN 24 hours, Lipids 12 hours
  • TPN & Lipds 24 hours
  • TPN & Lipds 4 hours
  • TPN 12 hours & Lipds 6 hours

Questão 49

Questão
Upon initial initiation of TPN, blood glucose is checked Q6h x48, then daily. What is the rational for this
Responda
  • no rational, standard policy and will very by employer
  • because TPN has a high concentration of dextrose, can cause hyperglycemia
  • Patients may become hypoglycemic on TPN
  • to monitor for refeeding syndrome

Questão 50

Questão
Name the main metabolic problems that can occur with TPN
Responda
  • hyperglycemia, fluid overload, refeeding syndrome, rebound hypoglycemia, hepatic dysfunction
  • hypoglycemia, dehydration, refeeding syndrome, rebound hyperglycemia, hepatic dysfunction
  • Nausea, vomitting and diarrhea
  • infected IV, phlebitis and air embolis,

Questão 51

Questão
You suspect the patient has an air embolus - what is the protocol?
Responda
  • check O2 sat, listen for crackles in the lungs, slow the infusion, raise head of bed, notify RN
  • moitor for chest pain, SOB, rapid weak pulse, place on left side trendelenburg position (unless contraindicated), administer O2, notify RN/ call a code blue if necessary
  • moitor for chest pain, SOB, rapid weak pulse, place on right side trendelenburg position (unless contraindicated), administer O2, notify RN/ call a code blue if necessary
  • moitor for chest pain, SOB, rapid weak pulse, lie patient supine (unless contraindicated), check O2 sat, notify RN if <95% on RA

Questão 52

Questão
A patient will never discontinue TPN, it is given at the end stages of life as comfort care
Responda
  • True
  • False

Questão 53

Questão
an ileostomy is placed where?
Responda
  • any part of the colon (ascending, transverse, descending)
  • end of the ileum
  • the ideal conduit

Questão 54

Questão
paralytic ileus is an indicator for a colostomy
Responda
  • True
  • False

Questão 55

Questão
an ileostomy is permanent
Responda
  • True
  • False

Questão 56

Questão
a cold stoma is a healthy stoma
Responda
  • True
  • False

Questão 57

Questão
a black stoma is a beautiful stoma
Responda
  • True
  • False

Questão 58

Questão
a person with a colostomy will lose 1.5-2L of fluids daily
Responda
  • True
  • False

Questão 59

Questão
After a bowel surgery, it is normal for bowel sounds & gas to have not returned by POD1.
Responda
  • True
  • False

Questão 60

Questão
How is C-diff spread?
Responda
  • poor hand hygiene
  • airborn
  • droplets

Questão 61

Questão
Name the required precaution: Used for patients/residents that have an infection that can be spread by contact with the person’s skin, mucous membranes, feces, vomit, urine, wound drainage, or other body fluids, or by contact with equipment or environmental surfaces that may be contaminated by the patient/resident or by his/her secretions and excretions.
Responda
  • airborne precautions
  • droplet precautions
  • contact precaustions
  • standard precautions

Questão 62

Questão
Name the type of precaution: Used for patients/residents that have an infection that can be spread through close respiratory or mucous membrane contact with respiratory secretions.
Responda
  • standard
  • contact
  • droplet
  • airborne

Questão 63

Questão
Name the type of precaution: Used for patients/residents that have an infection that can be spread over long distances when suspended in the air. These disease particles are very small and require special respiratory protection and room ventilation.
Responda
  • standard
  • airborne
  • droplet
  • contact

Questão 64

Questão
Contact precautions are a set of basic infection prevention practices intended to prevent transmission of infectious diseases from one person to another. Because we do not always know if a person has an infectious disease, contact precautions are applied to every person every time to assure that transmission of disease does not occur. These precautions were formerly known as “universal precautions.”
Responda
  • True
  • False

Questão 65

Questão
Hospitals have pressurized rooms for patients with compromised immune systems. Air will flow out of the room instead of in, so that any airborne microorganisms (e.g., bacteria) that may infect the patient are kept away. This type of pressure is called:
Responda
  • positive pressure
  • negative pressure
  • standard pressure

Questão 66

Questão
"___________________" room pressure is an isolation technique used in hospitals and medical centers to prevent cross-contaminations from room to room. It includes a ventilation system that generates "________________" pressure to allow air to flow into the isolation room but not escape from the room, as air will naturally flow from areas with higher pressure to areas with lower pressure, thereby preventing contaminated air from escaping the room. This technique is used to isolate patients with airborne contagious diseases such as tuberculosis, measles, or chickenpox.
Responda
  • negative and negative
  • negative and positive
  • positive and negative
  • positive and positive

Questão 67

Questão
A hospital-acquired infection (HAI), also known as a "_____________________", is an infection that is acquired in a hospital or other health care facility.
Responda
  • nosocomial infection
  • transient flora
  • latrogenic infection
  • exogenous infection
  • endogenous infection

Questão 68

Questão
The chain of infection order
Responda
  • an infectious agent (pathogen), a reservoir, a portal of exit, a mode of transportation, a portal of entry (to host), a susceptible host
  • an infectious agent (pathogen), portal of exit, a reservoir, a mode of transportation, a susceptible host, a portal of entry (to host),
  • an infectious agent (pathogen), a portal of entry (to host), a susceptible host, a reservoir, a portal of exit, a mode of transportation
  • an infectious agent (pathogen), a susceptible host, a portal of entry (to host), a mode of transportation, a reservoir, a portal of exit

Questão 69

Questão
check all that apply - modes of how pathogens are spread
Responda
  • contact (direct & indirect)
  • droplet (respiratory secretions)
  • airborne (particles suspended in air)
  • vehicle (through contaminated substances)
  • vectorborne (through fleas, ticks, lice, pests)
  • sterileborne (through sterilized products)

Questão 70

Questão
What is not in the LPN scope in regards to PIVs
Responda
  • hang/change non-med bags such as NS, D5W, Ringer's lactate etc
  • adjust IV rate as required on a manual and/or pump
  • care and maintenance of a SL lock
  • remove SL/ discontinue IV
  • prime a primary and/or secondary line
  • hang IV meds and red label bags

Questão 71

Questão
KCL (potassium) can be hung by an LPN if prepared by a pharmacist and the LPN has additional training
Responda
  • True
  • False

Questão 72

Questão
LPNs can assess and change a dressing on a central IV line
Responda
  • True
  • False

Questão 73

Questão
The medication line is hung ______________ than the primary line
Responda
  • higher
  • lower
  • same level

Questão 74

Questão
increased pulse, increased bp, increased resps, edema, weight gain, lung crackles and increased urination are signs of what?
Responda
  • phlebitis
  • fluid overload
  • air embolism
  • occlusion
  • infection

Questão 75

Questão
Blood must be initiated (hung & infusing) by RN within _________ of leaving blood bank. Once out of fridge, a bag of blood is only usable for ___________.
Responda
  • 30min, 4 hours
  • 60min, 4 hours
  • 30min, 6 hours
  • 4 hours, 24 hours

Questão 76

Questão
Name the correct term: A large volume of fluid or dose of a drug given intravenously and rapidly at one time.
Responda
  • an IV bolus
  • a TKVO
  • a DRIP
  • an IV infusion

Questão 77

Questão
In regards to TPN lipids are fatty acids/glycerol and contain twice as many calories per gram than Carbohydrates and proteins
Responda
  • True
  • False

Questão 78

Questão
Too many amino acids create a positive nitrogen balance in our bodies and this not helpful
Responda
  • True
  • False

Questão 79

Questão
Carbohydrates are our main source of energy
Responda
  • True
  • False

Questão 80

Questão
If the order may read “replace NG losses 2:1” with D5NS with 20 MEq of KCL” it means every 12 hours the nurse will tally NG losses and replace with twice the amount of IV solution over the next 12 hours
Responda
  • True
  • False

Questão 81

Questão
In regards to NG tubes Excessive gastric content loss may yield metabolic alkalosis but, a) the kidneys may compensate, and b) NG may only be short term – so alkalosis may only be mild.
Responda
  • True
  • False

Questão 82

Questão
When might kayexalate be ordered for a patient?
Responda
  • before bowel surgery to clear out the GI system
  • when potassium levels are high
  • when potassium levels are low
  • to wake up a sleepy bowel

Questão 83

Questão
post-surgery patients are often prescribed more than 1 opioid medication
Responda
  • True
  • False

Questão 84

Questão
choose all the apply in regards to PCAs
Responda
  • only the patient can press the button
  • a family member or nurse can press the button for the patient
  • requires a PIV
  • usually initiated by the RN in PAR
  • average length of use is 7 days
  • a basal rate of pain medication is always transfusing and the PCA is in addition
  • it is often under used due to patient fear of addicion
  • it is often overused due to patient addiction
  • patient education is required
  • LPNs can monitor: dose, med concentration, lockout, basal rate, attempts, and delivered

Questão 85

Questão
A spinal is given into the epidural space
Responda
  • True
  • False

Questão 86

Questão
check all that apply Effects of anesthesia can be maintained as long as required for
Responda
  • epidurals
  • spinals
  • local
  • general

Questão 87

Questão
There is such thing as a patient controlled epidural (PCEA)
Responda
  • True
  • False

Questão 88

Questão
Which route of med admin has the fastest onset
Responda
  • IV
  • IM
  • PO
  • SQ
  • SL
  • Transdermal

Questão 89

Questão
LPNs need to take report from the PAR nurse and collaborate with RNs when receiving "fresh" post-op patients
Responda
  • True
  • False

Questão 90

Questão
Pick the correct terminology: An area of skin innervated by the sensory fibers of a single dorsal root of a spinal nerve
Responda
  • dermatome
  • afferent nerve
  • efferent nerve
  • motor/sensory nerve
  • neuron

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