Pharmacological and Parenteral Therapies

Question 1

A nurse is preparing to administer IV potassium chloride (KCl) 40 mEq to a client with hypokalemia. Which action is essential before administration?

Accepted Answer

Confirm the client has adequate urine output and dilute KCl in IV fluid before infusing

Answer

Administer the KCl as an IV push over 2 minutes for rapid correction

Answer

Administer KCl undiluted to avoid fluid overload in the client

Answer

Give the KCl intramuscularly if IV access is not available

Question 2

A client receiving heparin infusion has an aPTT result of 180 seconds (therapeutic range 60-100 seconds). The nurse's priority action is to:

Accepted Answer

Stop the heparin infusion and notify the provider immediately

Answer

Continue the infusion at the current rate and recheck aPTT in 6 hours

Answer

Increase the infusion rate because the client's aPTT needs to be higher

Answer

Administer vitamin K as the antidote for heparin toxicity

Question 3

A nurse is teaching a client who is newly prescribed metformin for type 2 diabetes. Which instruction is most important?

Accepted Answer

Avoid alcohol and contact the provider if you experience persistent nausea, vomiting, or muscle pain

Answer

Take metformin only when blood glucose exceeds 200 mg/dL

Answer

Metformin commonly causes hypoglycemia — always carry glucose tablets

Answer

Double the dose if a dose is missed to maintain blood glucose control

Question 4

A nurse is inserting a peripheral IV in a client's forearm. After successful venipuncture, blood is visible in the flash chamber. The nurse's next step is to:

Accepted Answer

Advance the catheter while withdrawing the needle stylet, then connect tubing

Answer

Remove the needle and catheter and apply pressure to the site

Answer

Pull the needle back slightly and advance the catheter over the bevel

Answer

Tape the needle in place and begin the infusion immediately

Question 5

A nurse is administering a blood transfusion. Fifteen minutes after starting, the client reports chills, back pain, and has developed a fever of 39.2°C (102.6°F). Which action should the nurse take first?

Accepted Answer

Stop the transfusion, maintain IV access with normal saline, and notify the provider

Answer

Slow the infusion rate and continue monitoring for symptom resolution

Answer

Administer diphenhydramine and acetaminophen and resume the transfusion

Answer

Increase the infusion rate to complete the transfusion before symptoms worsen

Question 6

A nurse is preparing to administer digoxin 0.25 mg PO to a client with heart failure. Before giving the dose, the nurse assesses an apical pulse of 52 beats per minute. The nurse should:

Accepted Answer

Hold the dose and notify the provider, as the pulse is below 60 beats per minute

Answer

Administer the dose because the pulse is within 10 beats of normal

Answer

Give half the dose and reassess the pulse in 30 minutes

Answer

Administer the medication and document the pulse rate in the chart