Laurie White
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NCLEX Nursing Quiz on INP4 Quiz 1: IV med admin, peri-op pain, NG, ostomy, TPN, infection control, created by Laurie White on 12/09/2017.

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

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

Question 1 of 90

1

The IV site is changed only as needed

Select one of the following:

  • True
  • False

Explanation

Question 2 of 90

1

It is ok to stop a heparin or antibiotic infusion

Select one of the following:

  • True
  • False

Explanation

Question 3 of 90

1

How many cc to flush a SL lock?

Select one of the following:

  • 2cc

  • 3cc

  • 5cc

  • 10cc

Explanation

Question 4 of 90

1

1cc and 1ml are the same thing

Select one of the following:

  • True
  • False

Explanation

Question 5 of 90

1

PRBs are often used for

Select one of the following:

  • trauma/surgery

  • low BP

  • to correct fluid volume

  • for active bleeding to coagulate blood

Explanation

Question 6 of 90

1

albumin is used to

Select one of the following:

  • 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

Explanation

Question 7 of 90

1

The difference between blood type, screen & cross match is only good for 72 hours

Select one of the following:

  • True
  • False

Explanation

Question 8 of 90

1

what enters the blood stream and has a systemic effect?

Select one of the following:

  • analgesics

  • anesthetics

  • normal saline

  • antiemetics

Explanation

Question 9 of 90

1

The top port of the primary IV line is used to connect a PCA

Select one of the following:

  • True
  • False

Explanation

Question 10 of 90

1

You are unconscious when given this type of anesthesia

Select one of the following:

  • local

  • regional

  • general

Explanation

Question 11 of 90

1

dermatomes need to be tested after patient has had this type of anesthetic

Select one of the following:

  • local

  • general

  • regional

Explanation

Question 12 of 90

1

what dermatome marks the umbilicus?

Select one of the following:

  • T8

  • T9

  • T10

  • T11

Explanation

Question 13 of 90

1

Patients with an epidural will also have a foley catheter

Select one of the following:

  • True
  • False

Explanation

Question 14 of 90

1

Spinal are injected in what region?

Select one of the following:

  • L1-L2

  • T11-T12

  • L3-L4

  • T1-T2

Explanation

Question 15 of 90

1

The onset of an epidural is much faster then a spinal

Select one of the following:

  • True
  • False

Explanation

Question 16 of 90

1

What caused a spinal headache?

Select one of the following:

  • dehydration

  • low BP

  • CSF leaking out the injection site

  • anesthesia has spread to the brain

Explanation

Question 17 of 90

1

LPNs fill out PCA forms

Select one of the following:

  • True
  • False

Explanation

Question 18 of 90

1

Check all the apply
To avoid risk of bleeding or hematoma...

Select one or more of the following:

  • 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

Explanation

Question 19 of 90

1

There is a risk of patients with PCAs getting addicted to opiods

Select one of the following:

  • True
  • False

Explanation

Question 20 of 90

1

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

Select one of the following:

  • True
  • False

Explanation

Question 21 of 90

1

Which type of anesthesia requires the airway to be maintained by a endotracheal tube & ventilator?

Select one of the following:

  • local

  • regional

  • general

Explanation

Question 22 of 90

1

local anesthetic is used for most major surgeries

Select one of the following:

  • True
  • False

Explanation

Question 23 of 90

1

pick the correct order of how things return when regional anesthetic wears off

Select one of the following:

  • pain, sensation, motor

  • motor, sensation, pain

  • sensation, pain, motor

  • sensation, motor, pain

Explanation

Question 24 of 90

1

urinary retention is a side effect of general anesthesia

Select one of the following:

  • True
  • False

Explanation

Question 25 of 90

1

check all that apply
potential complications post surgery:

Select one or more of the following:

  • hemorrhage

  • pnemonia

  • PE

  • DVT

  • paralytic ileus

  • wound infection

Explanation

Question 26 of 90

1

match the term: excision/ removal

Select one of the following:

  • ectomy

  • oscopy

  • ostomy

  • plasty

Explanation

Question 27 of 90

1

match the term: forming an opening

Select one of the following:

  • ectomy

  • oscopy

  • ostomy

  • plasty

Explanation

Question 28 of 90

1

match the term: surgical repair

Select one of the following:

  • ectomy

  • oscopy

  • plasty

  • otomy

Explanation

Question 29 of 90

1

match the term: anastamosis

Select one of the following:

  • forming an opening

  • surgical joining of two ducts, vessel or bowel

  • collapse of alveoli

  • visual examination with an instrument

Explanation

Question 30 of 90

1

match the term: Minimal depression of the LOC with maintenance of protective airway refleces

Select one of the following:

  • general sedation

  • conscious sedation

  • local sedation

  • regional sedation

Explanation

Question 31 of 90

1

pick the correct motor block score:
-no motor block, able to fully flex knees and feet

Select one of the following:

  • 0

  • 1

  • 2

  • 3

Explanation

Question 32 of 90

1

a motor block score of 3 would indicate that the patient...

Select one of the following:

  • 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)

Explanation

Question 33 of 90

1

check all the post-operative exercises that should be done 10x per hour

Select one or more of the following:

  • deep breathing

  • coughing

  • leg exercises

  • turning and re-positioning

  • dangling

  • incentive spirometer

Explanation

Question 34 of 90

1

what is the most common purpose of the NG tube?

Select one of the following:

  • decompression of the GI tract (suction)

  • feeding

  • compression

  • lavage

Explanation

Question 35 of 90

1

which tube type is used for decompression of the GI tract

Select one of the following:

  • entroflex tube

  • saleum sump tube

  • standard suction tube

  • a 12-14fr catheter tube

Explanation

Question 36 of 90

1

LPNs can insert & remove NG tubes

Select one of the following:

  • True
  • False

Explanation

Question 37 of 90

1

Assessment of the NG tube, pick the correct scenario

Select one of the following:

  • 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

Explanation

Question 38 of 90

1

gastric aspirate is alkaline, ph is 7+

Select one of the following:

  • True
  • False

Explanation

Question 39 of 90

1

when giving NG medications...

Select one of the following:

  • 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

Explanation

Question 40 of 90

1

What to report to physician, check all the apply in regards to NG tubes

Select one or more of the following:

  • 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

Explanation

Question 41 of 90

1

During TPN, the client pump is alarming, the screen indicates upstream occlusion.
The LPN would assess between...

Select one of the following:

  • The bag and the pump

  • the pump and the patient

Explanation

Question 42 of 90

1

TPN can be a shock to a malnourished body

Select one of the following:

  • True
  • False

Explanation

Question 43 of 90

1

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.

Select one of the following:

  • Refeeding symdrome

  • Malabsorption syndrome

  • toxic shock syndrome

  • cushing's syndrome

Explanation

Question 44 of 90

1

The pump has broke down for a client receiving TPN and a new one may take a hour to find, what should be done?

Select one of the following:

  • 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

Explanation

Question 45 of 90

1

In regards to TPN:
after the initiation of a lipid, the client starts complaining of SOB and chest pain... what do you do?

Select one of the following:

  • 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

Explanation

Question 46 of 90

1

TPN can be administered via a PICC or PIV

Select one of the following:

  • True
  • False

Explanation

Question 47 of 90

1

A patient on TPN would have an NPO diet

Select one of the following:

  • True
  • False

Explanation

Question 48 of 90

1

Max hang time for TPN and/or lipids

Select one of the following:

  • TPN 24 hours, Lipids 12 hours

  • TPN & Lipds 24 hours

  • TPN & Lipds 4 hours

  • TPN 12 hours & Lipds 6 hours

Explanation

Question 49 of 90

1

Upon initial initiation of TPN, blood glucose is checked Q6h x48, then daily.
What is the rational for this

Select one of the following:

  • 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

Explanation

Question 50 of 90

1

Name the main metabolic problems that can occur with TPN

Select one of the following:

  • 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,

Explanation

Question 51 of 90

1

You suspect the patient has an air embolus - what is the protocol?

Select one of the following:

  • 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

Explanation

Question 52 of 90

1

A patient will never discontinue TPN, it is given at the end stages of life as comfort care

Select one of the following:

  • True
  • False

Explanation

Question 53 of 90

1

an ileostomy is placed where?

Select one of the following:

  • any part of the colon (ascending, transverse, descending)

  • end of the ileum

  • the ideal conduit

Explanation

Question 54 of 90

1

paralytic ileus is an indicator for a colostomy

Select one of the following:

  • True
  • False

Explanation

Question 55 of 90

1

an ileostomy is permanent

Select one of the following:

  • True
  • False

Explanation

Question 56 of 90

1

a cold stoma is a healthy stoma

Select one of the following:

  • True
  • False

Explanation

Question 57 of 90

1

a black stoma is a beautiful stoma

Select one of the following:

  • True
  • False

Explanation

Question 58 of 90

1

a person with a colostomy will lose 1.5-2L of fluids daily

Select one of the following:

  • True
  • False

Explanation

Question 59 of 90

1

After a bowel surgery, it is normal for bowel sounds & gas to have not returned by POD1.

Select one of the following:

  • True
  • False

Explanation

Question 60 of 90

1

How is C-diff spread?

Select one of the following:

  • poor hand hygiene

  • airborn

  • droplets

Explanation

Question 61 of 90

1

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.

Select one of the following:

  • airborne precautions

  • droplet precautions

  • contact precaustions

  • standard precautions

Explanation

Question 62 of 90

1

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.

Select one of the following:

  • standard

  • contact

  • droplet

  • airborne

Explanation

Question 63 of 90

1

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.

Select one of the following:

  • standard

  • airborne

  • droplet

  • contact

Explanation

Question 64 of 90

1

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.”

Select one of the following:

  • True
  • False

Explanation

Question 65 of 90

1

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:

Select one of the following:

  • positive pressure

  • negative pressure

  • standard pressure

Explanation

Question 66 of 90

1

"___________________" 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.

Select one of the following:

  • negative and negative

  • negative and positive

  • positive and negative

  • positive and positive

Explanation

Question 67 of 90

1

A hospital-acquired infection (HAI), also known as a "_____________________", is an infection that is acquired in a hospital or other health care facility.

Select one of the following:

  • nosocomial infection

  • transient flora

  • latrogenic infection

  • exogenous infection

  • endogenous infection

Explanation

Question 68 of 90

1

The chain of infection order

Select one of the following:

  • 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

Explanation

Question 69 of 90

1

check all that apply - modes of how pathogens are spread

Select one or more of the following:

  • 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)

Explanation

Question 70 of 90

1

What is not in the LPN scope in regards to PIVs

Select one of the following:

  • 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

Explanation

Question 71 of 90

1

KCL (potassium) can be hung by an LPN if prepared by a pharmacist and the LPN has additional training

Select one of the following:

  • True
  • False

Explanation

Question 72 of 90

1

LPNs can assess and change a dressing on a central IV line

Select one of the following:

  • True
  • False

Explanation

Question 73 of 90

1

The medication line is hung ______________ than the primary line

Select one of the following:

  • higher

  • lower

  • same level

Explanation

Question 74 of 90

1

increased pulse, increased bp, increased resps, edema, weight gain, lung crackles and increased urination are signs of what?

Select one of the following:

  • phlebitis

  • fluid overload

  • air embolism

  • occlusion

  • infection

Explanation

Question 75 of 90

1

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 ___________.

Select one of the following:

  • 30min, 4 hours

  • 60min, 4 hours

  • 30min, 6 hours

  • 4 hours, 24 hours

Explanation

Question 76 of 90

1

Name the correct term:
A large volume of fluid or dose of a drug given intravenously and rapidly at one time.

Select one of the following:

  • an IV bolus

  • a TKVO

  • a DRIP

  • an IV infusion

Explanation

Question 77 of 90

1

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

Select one of the following:

  • True
  • False

Explanation

Question 78 of 90

1

Too many amino acids create a positive nitrogen balance in our bodies and this not helpful

Select one of the following:

  • True
  • False

Explanation

Question 79 of 90

1

Carbohydrates are our main source of energy

Select one of the following:

  • True
  • False

Explanation

Question 80 of 90

1

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

Select one of the following:

  • True
  • False

Explanation

Question 81 of 90

1

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.

Select one of the following:

  • True
  • False

Explanation

Question 82 of 90

1

When might kayexalate be ordered for a patient?

Select one of the following:

  • 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

Explanation

Question 83 of 90

1

post-surgery patients are often prescribed more than 1 opioid medication

Select one of the following:

  • True
  • False

Explanation

Question 84 of 90

1

choose all the apply in regards to PCAs

Select one or more of the following:

  • 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

Explanation

Question 85 of 90

1

A spinal is given into the epidural space

Select one of the following:

  • True
  • False

Explanation

Question 86 of 90

1

check all that apply
Effects of anesthesia can be maintained as long as required for

Select one or more of the following:

  • epidurals

  • spinals

  • local

  • general

Explanation

Question 87 of 90

1

There is such thing as a patient controlled epidural (PCEA)

Select one of the following:

  • True
  • False

Explanation

Question 88 of 90

1

Which route of med admin has the fastest onset

Select one of the following:

  • IV

  • IM

  • PO

  • SQ

  • SL

  • Transdermal

Explanation

Question 89 of 90

1

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

Select one of the following:

  • True
  • False

Explanation

Question 90 of 90

1

Pick the correct terminology:
An area of skin innervated by the sensory fibers of a single dorsal root of a spinal nerve

Select one of the following:

  • dermatome

  • afferent nerve

  • efferent nerve

  • motor/sensory nerve

  • neuron

Explanation

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