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

Laurie White
Quiz by Laurie White, updated more than 1 year ago
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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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Resource summary

Question 1

Question
The IV site is changed only as needed
Answer
  • True
  • False

Question 2

Question
It is ok to stop a heparin or antibiotic infusion
Answer
  • True
  • False

Question 3

Question
How many cc to flush a SL lock?
Answer
  • 2cc
  • 3cc
  • 5cc
  • 10cc

Question 4

Question
1cc and 1ml are the same thing
Answer
  • True
  • False

Question 5

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

Question 6

Question
albumin is used to
Answer
  • 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

Question 7

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

Question 8

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

Question 9

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

Question 10

Question
You are unconscious when given this type of anesthesia
Answer
  • local
  • regional
  • general

Question 11

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

Question 12

Question
what dermatome marks the umbilicus?
Answer
  • T8
  • T9
  • T10
  • T11

Question 13

Question
Patients with an epidural will also have a foley catheter
Answer
  • True
  • False

Question 14

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

Question 15

Question
The onset of an epidural is much faster then a spinal
Answer
  • True
  • False

Question 16

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

Question 17

Question
LPNs fill out PCA forms
Answer
  • True
  • False

Question 18

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

Question 19

Question
There is a risk of patients with PCAs getting addicted to opiods
Answer
  • True
  • False

Question 20

Question
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
Answer
  • True
  • False

Question 21

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

Question 22

Question
local anesthetic is used for most major surgeries
Answer
  • True
  • False

Question 23

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

Question 24

Question
urinary retention is a side effect of general anesthesia
Answer
  • True
  • False

Question 25

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

Question 26

Question
match the term: excision/ removal
Answer
  • ectomy
  • oscopy
  • ostomy
  • plasty

Question 27

Question
match the term: forming an opening
Answer
  • ectomy
  • oscopy
  • ostomy
  • plasty

Question 28

Question
match the term: surgical repair
Answer
  • ectomy
  • oscopy
  • plasty
  • otomy

Question 29

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

Question 30

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

Question 31

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

Question 32

Question
a motor block score of 3 would indicate that the patient...
Answer
  • 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)

Question 33

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

Question 34

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

Question 35

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

Question 36

Question
LPNs can insert & remove NG tubes
Answer
  • True
  • False

Question 37

Question
Assessment of the NG tube, pick the correct scenario
Answer
  • 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

Question 38

Question
gastric aspirate is alkaline, ph is 7+
Answer
  • True
  • False

Question 39

Question
when giving NG medications...
Answer
  • 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

Question 40

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

Question 41

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

Question 42

Question
TPN can be a shock to a malnourished body
Answer
  • True
  • False

Question 43

Question
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.
Answer
  • Refeeding symdrome
  • Malabsorption syndrome
  • toxic shock syndrome
  • cushing's syndrome

Question 44

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

Question 45

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

Question 46

Question
TPN can be administered via a PICC or PIV
Answer
  • True
  • False

Question 47

Question
A patient on TPN would have an NPO diet
Answer
  • True
  • False

Question 48

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

Question 49

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

Question 50

Question
Name the main metabolic problems that can occur with TPN
Answer
  • 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,

Question 51

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

Question 52

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

Question 53

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

Question 54

Question
paralytic ileus is an indicator for a colostomy
Answer
  • True
  • False

Question 55

Question
an ileostomy is permanent
Answer
  • True
  • False

Question 56

Question
a cold stoma is a healthy stoma
Answer
  • True
  • False

Question 57

Question
a black stoma is a beautiful stoma
Answer
  • True
  • False

Question 58

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

Question 59

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

Question 60

Question
How is C-diff spread?
Answer
  • poor hand hygiene
  • airborn
  • droplets

Question 61

Question
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.
Answer
  • airborne precautions
  • droplet precautions
  • contact precaustions
  • standard precautions

Question 62

Question
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.
Answer
  • standard
  • contact
  • droplet
  • airborne

Question 63

Question
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.
Answer
  • standard
  • airborne
  • droplet
  • contact

Question 64

Question
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.”
Answer
  • True
  • False

Question 65

Question
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:
Answer
  • positive pressure
  • negative pressure
  • standard pressure

Question 66

Question
"___________________" 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.
Answer
  • negative and negative
  • negative and positive
  • positive and negative
  • positive and positive

Question 67

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

Question 68

Question
The chain of infection order
Answer
  • 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

Question 69

Question
check all that apply - modes of how pathogens are spread
Answer
  • 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)

Question 70

Question
What is not in the LPN scope in regards to PIVs
Answer
  • 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

Question 71

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

Question 72

Question
LPNs can assess and change a dressing on a central IV line
Answer
  • True
  • False

Question 73

Question
The medication line is hung ______________ than the primary line
Answer
  • higher
  • lower
  • same level

Question 74

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

Question 75

Question
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 ___________.
Answer
  • 30min, 4 hours
  • 60min, 4 hours
  • 30min, 6 hours
  • 4 hours, 24 hours

Question 76

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

Question 77

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

Question 78

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

Question 79

Question
Carbohydrates are our main source of energy
Answer
  • True
  • False

Question 80

Question
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
Answer
  • True
  • False

Question 81

Question
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.
Answer
  • True
  • False

Question 82

Question
When might kayexalate be ordered for a patient?
Answer
  • 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

Question 83

Question
post-surgery patients are often prescribed more than 1 opioid medication
Answer
  • True
  • False

Question 84

Question
choose all the apply in regards to PCAs
Answer
  • 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

Question 85

Question
A spinal is given into the epidural space
Answer
  • True
  • False

Question 86

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

Question 87

Question
There is such thing as a patient controlled epidural (PCEA)
Answer
  • True
  • False

Question 88

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

Question 89

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

Question 90

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