Quiz
INP4 Quiz 1: IV med admin, peri-op pain, NG, ostomy, TPN, infection control
Questions in this quiz (90)
1The IV site is changed only as needed
- ATrue
- BFalse
2It is ok to stop a heparin or antibiotic infusion
- ATrue
- BFalse
3How many cc to flush a SL lock?
- A2cc
- B3cc
- C5cc
- D10cc
41cc and 1ml are the same thing
- ATrue
- BFalse
5PRBs are often used for
- Atrauma/surgery
- Blow BP
- Cto correct fluid volume
- Dfor active bleeding to coagulate blood
6albumin is used to
- Atreat blood loss from trauma/surgery
- Bto correct fluid volume (draw fluid back into the vessels)
- Cfor active bleeding to coagulate blood
- Dto decrease BP
7The difference between blood type, screen & cross match is only good for 72 hours
- ATrue
- BFalse
8what enters the blood stream and has a systemic effect?
- Aanalgesics
- Banesthetics
- Cnormal saline
- Dantiemetics
9The top port of the primary IV line is used to connect a PCA
- ATrue
- BFalse
10You are unconscious when given this type of anesthesia
- Alocal
- Bregional
- Cgeneral
11dermatomes need to be tested after patient has had this type of anesthetic
- Alocal
- Bgeneral
- Cregional
12what dermatome marks the umbilicus?
- AT8
- BT9
- CT10
- DT11
13Patients with an epidural will also have a foley catheter
- ATrue
- BFalse
14Spinal are injected in what region?
- AL1-L2
- BT11-T12
- CL3-L4
- DT1-T2
15The onset of an epidural is much faster then a spinal
- ATrue
- BFalse
16What caused a spinal headache?
- Adehydration
- Blow BP
- CCSF leaking out the injection site
- Danesthesia has spread to the brain
17LPNs fill out PCA forms
- ATrue
- BFalse
18Check all the apply
To avoid risk of bleeding or hematoma...- ADo not give dalteparin for at least 4 hours after epidural catheter is removed
- BDo not give heparin for at least 2 hours after an epidural is removed
- CDo not remove epidural within 12 hours of a deltaparin or heparin injection
19There is a risk of patients with PCAs getting addicted to opiods
- ATrue
- BFalse
20When 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
- ATrue
- BFalse
21Which type of anesthesia requires the airway to be maintained by a endotracheal tube & ventilator?
- Alocal
- Bregional
- Cgeneral
22local anesthetic is used for most major surgeries
- ATrue
- BFalse
23pick the correct order of how things return when regional anesthetic wears off
- Apain, sensation, motor
- Bmotor, sensation, pain
- Csensation, pain, motor
- Dsensation, motor, pain
24urinary retention is a side effect of general anesthesia
- ATrue
- BFalse
25check all that apply
potential complications post surgery:- Ahemorrhage
- Bpnemonia
- CPE
- DDVT
- Eparalytic ileus
- Fwound infection
26match the term: excision/ removal
- Aectomy
- Boscopy
- Costomy
- Dplasty
27match the term: forming an opening
- Aectomy
- Boscopy
- Costomy
- Dplasty
28match the term: surgical repair
- Aectomy
- Boscopy
- Cplasty
- Dotomy
29match the term: anastamosis
- Aforming an opening
- Bsurgical joining of two ducts, vessel or bowel
- Ccollapse of alveoli
- Dvisual examination with an instrument
30match the term: Minimal depression of the LOC with maintenance of protective airway refleces
- Ageneral sedation
- Bconscious sedation
- Clocal sedation
- Dregional sedation
31pick the correct motor block score:
-no motor block, able to fully flex knees and feet- A0
- B1
- C2
- D3
32a motor block score of 3 would indicate that the patient...
- Ahas no motor block and can fully flex knees and feet
- Bis only able to move knees and feet (unable to raise extended legs)
- Cable to move feet only
- Dunable to move hips, knees or feet (unable to flex ankle joint)
33check all the post-operative exercises that should be done 10x per hour
- Adeep breathing
- Bcoughing
- Cleg exercises
- Dturning and re-positioning
- Edangling
- Fincentive spirometer
34what is the most common purpose of the NG tube?
- Adecompression of the GI tract (suction)
- Bfeeding
- Ccompression
- Dlavage
35which tube type is used for decompression of the GI tract
- Aentroflex tube
- Bsaleum sump tube
- Cstandard suction tube
- Da 12-14fr catheter tube
36LPNs can insert & remove NG tubes
- ATrue
- BFalse
37Assessment of the NG tube, pick the correct scenario
- Asuction is set between 40-80mmHg, HOB elevated to 30 degrees, NG tube taped securely to bridge of nose and pinned to gown
- Bsuction is set between 40-80mmHg, HOB elevated to 30 degrees, NG tube taped securely to cheek and gown
- Csuction set above 80mmHg, HOB elevated to 45 degrees, NG tube taped securely to bridge of nose and pinned to gown
- Dsuction is set between 40-80mmHg, bed is supine, NG tube taped securely to bridge of nose and pinned to gown
38gastric aspirate is alkaline, ph is 7+
- ATrue
- BFalse
39when giving NG medications...
- ATurn 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
- BTurn 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
- CTurn off NG suction, flush NGT with 30-50ml of warm tap water pre & post med admin, turn NG suction back on
- DLeave NG suction on, flush NGT with 30-50ml of warm tap water pre & post med admin
40What to report to physician, check all the apply in regards to NG tubes
- ANG tube drainage: coffee grounds, hemolyzed sanguinous drainage, dark brown granular appearance
- Bexcessive losses: more than 500-1000 mls per hour
- Cminimal losses: less than 30ml/hr
- DNG tube drainage: bile coloured aspirate
41During TPN, the client pump is alarming, the screen indicates upstream occlusion.
The LPN would assess between...- AThe bag and the pump
- Bthe pump and the patient
42TPN can be a shock to a malnourished body
- ATrue
- BFalse
43Name 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.- ARefeeding symdrome
- BMalabsorption syndrome
- Ctoxic shock syndrome
- Dcushing's syndrome
44The pump has broke down for a client receiving TPN and a new one may take a hour to find, what should be done?
- AGive TPN PIV by gravity
- BGive D5W PIV by gravity
- CD10W PIV by gravity
- DNo need to do anything, wait the hour and restart TPN with new pump
45In regards to TPN:
after the initiation of a lipid, the client starts complaining of SOB and chest pain... what do you do?- Araise the head of the bed and do a chest assessment to check for crackels
- Bthis is likely a fat embolism, follow air embolism protocol and call a code blue!
- Ctake an O2 sat, get the patient to do DB & C, re-assess
- Dcheck for a prn order of nitro spray
46TPN can be administered via a PICC or PIV
- ATrue
- BFalse
47A patient on TPN would have an NPO diet
- ATrue
- BFalse
48Max hang time for TPN and/or lipids
- ATPN 24 hours, Lipids 12 hours
- BTPN & Lipds 24 hours
- CTPN & Lipds 4 hours
- DTPN 12 hours & Lipds 6 hours
49Upon initial initiation of TPN, blood glucose is checked Q6h x48, then daily.
What is the rational for this- Ano rational, standard policy and will very by employer
- Bbecause TPN has a high concentration of dextrose, can cause hyperglycemia
- CPatients may become hypoglycemic on TPN
- Dto monitor for refeeding syndrome
50Name the main metabolic problems that can occur with TPN
- Ahyperglycemia, fluid overload, refeeding syndrome, rebound hypoglycemia, hepatic dysfunction
- Bhypoglycemia, dehydration, refeeding syndrome, rebound hyperglycemia, hepatic dysfunction
- CNausea, vomitting and diarrhea
- Dinfected IV, phlebitis and air embolis,
51You suspect the patient has an air embolus - what is the protocol?
- Acheck O2 sat, listen for crackles in the lungs, slow the infusion, raise head of bed, notify RN
- Bmoitor 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
- Cmoitor 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
- Dmoitor for chest pain, SOB, rapid weak pulse, lie patient supine (unless contraindicated), check O2 sat, notify RN if <95% on RA
52A patient will never discontinue TPN, it is given at the end stages of life as comfort care
- ATrue
- BFalse
53an ileostomy is placed where?
- Aany part of the colon (ascending, transverse, descending)
- Bend of the ileum
- Cthe ideal conduit
54paralytic ileus is an indicator for a colostomy
- ATrue
- BFalse
55an ileostomy is permanent
- ATrue
- BFalse
56a cold stoma is a healthy stoma
- ATrue
- BFalse
57a black stoma is a beautiful stoma
- ATrue
- BFalse
58a person with a colostomy will lose 1.5-2L of fluids daily
- ATrue
- BFalse
59After a bowel surgery, it is normal for bowel sounds & gas to have not returned by POD1.
- ATrue
- BFalse
60How is C-diff spread?
- Apoor hand hygiene
- Bairborn
- Cdroplets
61Name 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.- Aairborne precautions
- Bdroplet precautions
- Ccontact precaustions
- Dstandard precautions
62Name 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.- Astandard
- Bcontact
- Cdroplet
- Dairborne
63Name 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.- Astandard
- Bairborne
- Cdroplet
- Dcontact
64Contact 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.”
- ATrue
- BFalse
65Hospitals 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:- Apositive pressure
- Bnegative pressure
- Cstandard pressure
66"___________________" 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.
- Anegative and negative
- Bnegative and positive
- Cpositive and negative
- Dpositive and positive
67A hospital-acquired infection (HAI), also known as a "_____________________", is an infection that is acquired in a hospital or other health care facility.
- Anosocomial infection
- Btransient flora
- Clatrogenic infection
- Dexogenous infection
- Eendogenous infection
68The chain of infection order
- Aan infectious agent (pathogen), a reservoir, a portal of exit, a mode of transportation, a portal of entry (to host), a susceptible host
- Ban infectious agent (pathogen), portal of exit, a reservoir, a mode of transportation, a susceptible host, a portal of entry (to host),
- Can infectious agent (pathogen), a portal of entry (to host), a susceptible host, a reservoir, a portal of exit, a mode of transportation
- Dan infectious agent (pathogen), a susceptible host, a portal of entry (to host), a mode of transportation, a reservoir, a portal of exit
69check all that apply - modes of how pathogens are spread
- Acontact (direct & indirect)
- Bdroplet (respiratory secretions)
- Cairborne (particles suspended in air)
- Dvehicle (through contaminated substances)
- Evectorborne (through fleas, ticks, lice, pests)
- Fsterileborne (through sterilized products)
70What is not in the LPN scope in regards to PIVs
- Ahang/change non-med bags such as NS, D5W, Ringer's lactate etc
- Badjust IV rate as required on a manual and/or pump
- Ccare and maintenance of a SL lock
- Dremove SL/ discontinue IV
- Eprime a primary and/or secondary line
- Fhang IV meds and red label bags
71KCL (potassium) can be hung by an LPN if prepared by a pharmacist and the LPN has additional training
- ATrue
- BFalse
72LPNs can assess and change a dressing on a central IV line
- ATrue
- BFalse
73The medication line is hung ______________ than the primary line
- Ahigher
- Blower
- Csame level
74increased pulse, increased bp, increased resps, edema, weight gain, lung crackles and increased urination are signs of what?
- Aphlebitis
- Bfluid overload
- Cair embolism
- Docclusion
- Einfection
75Blood must be initiated (hung & infusing) by RN within _________ of leaving blood bank. Once out of fridge, a bag of blood is only usable for ___________.
- A30min, 4 hours
- B60min, 4 hours
- C30min, 6 hours
- D4 hours, 24 hours
76Name the correct term:
A large volume of fluid or dose of a drug given intravenously and rapidly at one time.- Aan IV bolus
- Ba TKVO
- Ca DRIP
- Dan IV infusion
77In regards to TPN
lipids are fatty acids/glycerol and contain twice as many calories per gram than Carbohydrates and proteins- ATrue
- BFalse
78Too many amino acids create a positive nitrogen balance in our bodies and this not helpful
- ATrue
- BFalse
79Carbohydrates are our main source of energy
- ATrue
- BFalse
80If 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- ATrue
- BFalse
81In 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.- ATrue
- BFalse
82When might kayexalate be ordered for a patient?
- Abefore bowel surgery to clear out the GI system
- Bwhen potassium levels are high
- Cwhen potassium levels are low
- Dto wake up a sleepy bowel
83post-surgery patients are often prescribed more than 1 opioid medication
- ATrue
- BFalse
84choose all the apply in regards to PCAs
- Aonly the patient can press the button
- Ba family member or nurse can press the button for the patient
- Crequires a PIV
- Dusually initiated by the RN in PAR
- Eaverage length of use is 7 days
- Fa basal rate of pain medication is always transfusing and the PCA is in addition
- Git is often under used due to patient fear of addicion
- Hit is often overused due to patient addiction
- Ipatient education is required
- JLPNs can monitor: dose, med concentration, lockout, basal rate, attempts, and delivered
85A spinal is given into the epidural space
- ATrue
- BFalse
86check all that apply
Effects of anesthesia can be maintained as long as required for- Aepidurals
- Bspinals
- Clocal
- Dgeneral
87There is such thing as a patient controlled epidural (PCEA)
- ATrue
- BFalse
88Which route of med admin has the fastest onset
- AIV
- BIM
- CPO
- DSQ
- ESL
- FTransdermal
89LPNs need to take report from the PAR nurse and collaborate with RNs when receiving "fresh" post-op patients
- ATrue
- BFalse
90Pick the correct terminology:
An area of skin innervated by the sensory fibers of a single dorsal root of a spinal nerve- Adermatome
- Bafferent nerve
- Cefferent nerve
- Dmotor/sensory nerve
- Eneuron
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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 09/12/2017.
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- Laurie White
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