NCAS Fundamentals 5 — Questions and Answers
Question 1: A nurse is caring for a patient receiving total parenteral nutrition (TPN). Which complication should the nurse monitor for most closely?
- Hypoglycemia from excessive insulin release
- Hyperglycemia due to high dextrose concentration (Correct answer)
- Metabolic alkalosis from amino acid infusion
- Hyponatremia due to water retention
Correct answer: Hyperglycemia due to high dextrose concentration
TPN solutions contain high concentrations of dextrose, placing patients at significant risk for hyperglycemia requiring close blood glucose monitoring.
Question 2: A patient is prescribed potassium chloride 40 mEq IV. The nurse knows that the safe infusion rate for IV potassium should not exceed:
- 40 mEq/hour
- 10 mEq/hour (Correct answer)
- 20 mEq/hour
- 60 mEq/hour
Correct answer: 10 mEq/hour
IV potassium should not exceed 10 mEq/hour peripherally to prevent cardiac arrhythmias and vein irritation.
Question 3: When performing tracheal suctioning, which action reduces the risk of hypoxemia?
- Apply suction while inserting the catheter
- Pre-oxygenate with 100% oxygen before suctioning (Correct answer)
- Suction continuously for 30 seconds to clear secretions
- Use a clean (non-sterile) technique for the procedure
Correct answer: Pre-oxygenate with 100% oxygen before suctioning
Pre-oxygenating with 100% oxygen before suctioning compensates for the oxygen removed during the suctioning procedure.
Question 4: A patient with a urinary catheter complains of bladder spasms and the urge to void despite the catheter being in place. What should the nurse do first?
- Remove the catheter and insert a new one
- Assess catheter patency and check for kinks or obstruction (Correct answer)
- Administer an antispasmodic medication immediately
- Irrigate the catheter with 500 mL of normal saline
Correct answer: Assess catheter patency and check for kinks or obstruction
Catheter-related bladder spasms are often caused by obstruction or kinking of the catheter, so checking patency is the first assessment step.
Question 5: A nurse is preparing to apply antiembolism stockings (TEDs). Which assessment finding is a contraindication to their use?
- History of deep vein thrombosis greater than 6 months ago
- Peripheral arterial disease with absent pedal pulses (Correct answer)
- Lower extremity edema that pits 1+
- Bilateral knee replacement 4 weeks ago
Correct answer: Peripheral arterial disease with absent pedal pulses
Peripheral arterial disease with absent pulses is a contraindication because compression stockings further reduce already compromised arterial blood flow.
Question 6: A nurse is caring for a postoperative patient whose urinary output has been 20 mL/hour for the past 3 hours. What is the priority nursing action?
- Document the finding and reassess in 1 hour
- Notify the physician and assess for signs of fluid deficit (Correct answer)
- Encourage the patient to drink more oral fluids
- Increase the IV fluid rate to 200 mL/hour without an order
Correct answer: Notify the physician and assess for signs of fluid deficit
Urine output below 30 mL/hour indicates oliguria, which may signal hypovolemia or acute kidney injury requiring prompt physician notification.
Question 7: When caring for a patient in contact precautions, which personal protective equipment (PPE) must be donned before entering the room?
- N95 respirator and eye shield only
- Gown and gloves (Correct answer)
- Surgical mask and gloves only
- Gown, gloves, N95 respirator, and face shield
Correct answer: Gown and gloves
Contact precautions require a gown and gloves upon room entry to prevent transmission of organisms spread by direct or indirect contact.
NCAS Fundamentals 5
A nurse is caring for a patient receiving total parenteral nutrition (TPN).
Which complication should the nurse monitor for most closely?