Online Nursing Practice Test about Pharmacology (71-75)

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71. A nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which of the following is part of the plan for preparation and administration of the potassium?

a) obtaining a controlled IV infusion pump
b) monitoring urine output during administration
c) diluting in appropriate amount of normal saline
d) preparing the medication for bolus administration  

72. A client is brought to the emergency room stating that he has accidentally been taking two times his prescribed dose of warfarin (Coumadin) for the past week. After noting that the client has no evidence of obvious bleeding, the nurse plans to do which of the following next?

a) prepares to administer the antidote
b) draws a sample for type crossmatch and transfuse the client
c) draws a sample for an activated partial thromboplastin (aPTT)
d) draws a sample for prothrombin (PT) and international normalized ration (INR) level

73. Methylergonovine (Methergine) is prescribed for a woman to treat postpartum hemorrhage. Before administration of methylergonovine, the priority nursing assessment is to check the:

a) uterine tone
b) blood pressure
c) amount of lochia
d) deep tendon reflexes

74. A nurse is preparing to administer beractant (survanta) to a premature infant who has respiratory distress syndrome. The nurse plans to administer the medication by which of the following routes?

a) intradermal
b) intratracheal
c) subcutaneous
d) intramuscular

75. A nurse is caring for a client who is receiving oxytocin (Pitocin) to induce labor. The nurse discontinuous the oxytocin infusion if which of the following is noted on assessment of the client?

a) fatigue
b) drowsiness
c) uterine hyperstimulation
d) early decelerations of the fetal heart rate




ANSWERS AND RATIONALE

71) D
- potassium chloride administered intravenously must always be diluted in IV fluid and infused via a pump or controller. The usual concentration of IV potassium chloride is 20 to 40 mEq/L. Potassium chloride is never given by bolus (IV push). Giving potassium chloride by IV push can result in cardiac arrest. Dilution in normal saline is recommended, but dextrose solution is avoided because this type of solution increases intracellular potassium shifting. The IV bag containing the potassium chloride is always gently agitated before hanging. The IV site is monitored closely because potassium chloride is irritating to the veins and the risk of phlebitis exists.

72) D
- the next action is to draw a sample for PT and INR level to determine the client's anticoagulation status and risk for bleeding. These results will provide information as to how to best treat this client if an antidote (vitamin K) or blood transfusion is needed. The aPTT monitors the effects of heparin therapy.

73) B
- methylergonovine, an ergot alkaloid, is an agent that is used to prevent or control postpartum hemorrhage by contracting the uterus. Methylergonovine causes continuous uterine contractions and may elevate blood pressure. A priority assessment before the administration of the medication is to check the blood pressure. The physician should be notified if hypertension is present. Although options A, C, and D may be components of postpartum assessment, option B, blood pressure, is related specifically to the administration of this medication.

74) B
- respiratory distress is common in a premature neonates and may be due to lung immaturity as a result of surfactant deficiency. The mainstay of treatment is the administration of exogenous surfactant, which is administered by the intratracheal route. Option A, C, and D are not routes of administration for this medication.

75) C
- oxytocin stimulates uterine contractions and is a common pharmacological method to induce labor. An adverse reaction associated with administration of this medication is hyperstimulation of uterine contractions. Therefore, oxytocin infusion must be stopped when any signs of uterine hyperstimulation are present. Drowsiness and fatigue may be caused by the labor experience. Early decelerations of the fetal heart rate are reassuring sign and do not indicate fetal distress.


Related Topics:

• Online Nursing Practice Test about Pharmacology (76-80)
• Go back to Online Nursing Practice Test about Pharmacology (1-5) to start the test from the beginning.