Nursing Practice Iii

NLE Pre-board December 2007 Practice 3 Situation 1 - Concerted work efforts among members of the surgical team is essential to the success of the surgical procedure. 1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there is a need for sterile supply which is not in the sterile field, who hands out these items by opening its outer cover? a. Circulating nurse b. Anesthesiologist c. Surgeon d. Nursing aide 2. The OR team performs distinct roles for one surgical procedure to be accomplished within a prescribed time frame and deliver a standard patient outcome. White the surgeon performs the surgical procedure, who monitors the status of the client like urine output, blood loss?

Situation 2 - You are assigned in the Orthopedic Ward where clients are complaining of pain in varying degrees upon movement of body parts. 6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain. Which of the following observation would prompt you to call the doctor? a. Dressing is intact but partially soiled b. Left foot is cold to touch and pedal pulse is absent c. Left leg in limited functional anatomic position d. BP 114/78, pulse of 82 beats/minute 7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol at 5 pm. The next dose of Demerol 50 mg I.M. is given: a. When the client asks for the next dose b. When the patient is in severe pain c. At 11pm d. At 12pm

a. Scrub nurse b. Surgeon c. Anesthesiologist d. Circulating nurse

8. You continuously evaluate the client's adaptation to pain. Which of the following behaviors-indicate appropriate adaptation?

3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of the floor or ward where the patient is confined. For orthopedic cases, what department is usually informed to be present in the OR?

a. The client reports pain reduction and decreased activity b. The client denies existence of pain c. The client can distract himself during pain episodes d. The client reports independence from watchers

a. Rehabilitation department b. Laboratory department c. Maintenance department d. Radiology department

9. Pain in Ortho cases may not be mainly due to the surgery. There might be other factors such as cultural or psychological that influence pain. How can you alter these factors as the nurse?

4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team who else to be present when a client undergoes laparoscopic surgery? a. Information technician b. Biomedical technician c. Electrician d. Laboratory technicial 5. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to be alerted to coordinate closely with the patient's family for immediate blood component therapy? a. Security Division b. Chaplaincy c. Social Service Section d. Pathology department

a. Explain all the possible interventions that may cause the client to worry. b. Establish trusting relationship by giving his medication on time c. Stay with the client during pain episodes d. Promote client's sense of control and participation in pain control by listening to his concerns 10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case? a. Instruct client to observe strict bed rest b. Check for epidural catheter drainage c. Administer analgesia through epidural catheter as prescribed d. Assess respiratory rate carefully

Situation 3 - Records are vital tools in any institution and should be properly maintained for specific use and time. 11. The patient's medical record can work as a double-edged swords. When can the medical record become the doctor's/nurse worst enemy? a. When the record is voluminous b. When a medical record is subpoenaed in court c. When it is missing d. When the medical record is inaccurate, incomplete, and inadequate 12. Disposal of medical records in government hospitals/institutions must be done in close coordination with what agency? a. Department of Interior and Local Government (DILG) b. Metro Manila Development Authority (MMDA) c. Records Management Archives Office (RMAO) d. Depart of Health (DOH) 13. In the hospital, when you need-the medical record of a discharged patient for research, you will request permission through: a. Doctor in charge b. The hospital director c. The nursing Service d. Medical records section 14. You readmitted a client who was in another department a month ago. Since you will need the previous chart, from whom do you request the old chart? a. Central supply section b. Previous doctor's clinic c. Department where the patient was previously admitted d. Medical records section 15. Records Management and Archives Offices of the DOH is responsible for implementing its policies on record, disposal. You know that your institution is covered by this policy it; a. Your hospital is considered tertiary b. Your hospital is in Metro Manila c. It obtained permit to operate from DOH d. Your hospital is Philhealth accredited Situation 4 - In the OR, there are safety protocols that should be followed. The OR nurse should be well versed with all these to safeguard the safety and quality to patient delivery outcome. 16. Which of the following should be

given highest priority when receiving patient in the OR? a. Assess level of consciousness b. Verify patient identification and informed consent c. Assess vital signs d. Check for jewelry, gown, manicure and dentures 17. Surgeries like I and D (incision and drainage) and debribement are relatively short procedures but considered ‘dirty cases’. When are these; procedures best scheduled? a. Last case b. In between cases c. According to availability of anesthesiologist d. According to the surgeon's preference 18. OR nurses should be aware that maintaining the client's safety is the overall goal of nursing care during the intraoperative phase. As the circulating nurse, you make certain that throughout the procedure... a. the surgeon greets his client before induction of anesthesia b. the surgeon and anestheriologist are in tandem c. strap made of strong non-abrasive material are fastened securely around the joints of the knees and ankles and around the 2 hands around an arm board d. client is monitored throughout the surgery by the assistant anesthesiologist 19. Another nursing check that should not be missed before the induction of general anesthesia is: a. check for presence underwear b. check for presence dentures c. check patient's d. check baseline vital signs 20. Some different habits and hobbies affect postoperative respiratory function. If your client smokes 3 packs of cigarettes a day for the part 10 years, you will anticipate increased risk for: a. perioperative anxiety and stress b. delayed coagulation time c. delayed wound healing d. postoperative respiratory function Situation 5 - Nurses hold a variety of roles when providing care to a perioperative patient. 21. Which of the following role would be the responsibility of the scrub nurse? a. Assess the readiness of the client prior to

surgery b. Ensure that the airway is adequate c. Account for the number of sponges, needles, supplies, Used during the surgical procedure d. Evaluate the type of anesthesia appropriate for the surgical client 22. As a perioperative nurse, how can you best meet the safety need of the client after administering preoperative narcotic? a. Put side rails up and ask client not to get out of bed b. Send the client to ORD with the family c. Allow client to get up to go to the comfort room d. Obtain consent form 23. It is the responsibility of the pre-op, nurse to do skin prep for patients undergoing surgery. If hair at the operative site is not shaved, what should be done to make suturing easy and lessen chance of incision infection? a. Draped b. Pulled c. Clipped d. Shampooed 24. It is also the nurse's function to determine when infection is developing in the surgical incision. The perioperative nurse should observe for what signs of impending infection? a. Localized heat and redness b. Serosanguinous exudates and skin blanching c. Separation of the incision d. Blood clots and scar tissue are visible 25. Which of the following nursing intervention is done when examining the incision wound and changing the dressing? a. Observe the dressing and type and odor of drainage if any b. Get patient's consent c. Wash hands d. Request the client to expose the incision wound

27. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse, what its indication the nurse will say is: a. Relax smooth muscles of the bronchial airway b. Promote expectoration c. Prevent thickening of secretions d. Suppress cough 28. You will give health instructions to Carlo, a case of bronchial asthma. The health instruction will include the following EXCEPT: a. Avoid emotional stress and extreme temperature b. Avoid pollution like smoking c. Avoid pollens, dust seafood d. Practice respiratory isolation 29. The asthmatic client asked you what breathing technique he can best practice when asthmatic attack starts. What will be the best position? a. Sit in high-Fowler's position with extended legs b. Sit-up with shoulders back c. Push on abdomen during exhalation d. Lean forward 30-40 degrees with each exhalation 30. As a nurse you are always alerted to monitor status asthmaticus who will likely and initially manifest symptoms of: a. metabolic alkalosis b. respiratory acidosis c. respiratory alkalosis d. metabolic acidosis Situation 7 - Joint Commission on Accreditation of Hospital Organization (JCAHP) patient safety goals and requirements include the care and efficient use of technology in the OR arid elsewhere in the healthcare facility. 31. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm systems?

26. Which of She following nursing actions should be initiated first?

a. limit suppliers to a few so that quality is maintained b. implement a regular inventory of supplies and equipment c. Adherence to manufacturer's recommendation d. Implement a regular maintenance and testing of alarm systems

a. Promote emotional support b. Administer oxygen at 6L/min c. Suction the client every 30 min d. Administer bronchodilator by nebulizer

32. Over dosage of medication or anesthetic can happen even with the aid of technology like infusion pump, sphymomanometer, and similar

Situation 6 - Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min and he appears to be in acute respiratory distress.

devices/machines. As a staff, how can you improve the safety of using infusion pumps? a. Check the functionality of the pump before use b. Select your brand of infusion pump like you do with your cellphone C. Allow the technician to set the; infusion pump before use d. Verify the flow rate against your computation 33. JCAHOs universal protocol for surgical and invasive procedures to prevent wrong site, wrong person, and wrong procedures/surgery includes the following EXCEPT: a. Mark the operative site if possible b. Conduct pre-procedure verification process c. Take a video of the entire intra-operative procedure d. Conduct time out immediately before starting the procedure 34. You identified a potential risk of pre and post operative clients. To reduce the risk of patient harm resulting from fall, you can implement the following EXCEPT: a. Assess potential risk of fail associated with the patient's the following EXCEPT: medication regimen b. Take action to address any identified risks through Incident Report (IR) c. Allow client to walk with relative to the OF? d. Assess and periodically reassess individual client's risk for falling 35. As a nurse you know you can improve on accuracy of patient's identification by 2 patient identifiers, EXCEPT: a. identify the client by his/her wrist tag and verify with family members b. identify client by his/her wrist tag and call his/her by name c. call the client by his/her case and bed number d. call the patient by his/her name and bed number Situation 8 - Team efforts is best demonstrated in the OR 36. If you are the nurse in charge for scheduling surgical cases, what important information do you need to ask the surgeon? a. Who is your internist b. Who is your assistant and anesthesiologist, and what is your preferred

time and type of surgery? c. Who are your anesthesiologist, internist, and assistant d. Who is your anesthesiologist. 37. In the OR, the nursing tandem for every surgery is: a. Instrument technician and circulating nurse b. Nurse anesthetist, nurse assistant, and instrument technician c. Scrub nurse and nurse anesthetist d. Scrub and circulating nurses 38. While team effort is needed in the OR for efficient and quality patient care delivery, we should limit the number of people in the room for infection control. Who comprise this team? a. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly b. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist c. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist d. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse 39. When surgery is on-going, who coordinates the activities outside, including the family? a. Orderly/clerk b. Nurse supervisor c. Circulating nurse d. Anaesthesiologist 40. The breakdown in teamwork is often times a failure in: a. Electricity b. Inadequate supply c. Leg work d. Communication Situation 9 - Colostomy is a surgically created anus- It can be temporary or permanent, depending on the disease condition. 41. Skin care around the stoma is critical. Which of the following is not indicated as a skin care barriers? a. Apply liberal amount of mineral oil to the area b. Use karaya paste and rings around the stoma c. Clean the area daily with soap and water before applying bag d. Apply talcum powder twice a day 42. What health instruction will enhance regulation of a colostomy (defecation) of clients? a. Irrigate after lunch everyday

b. Eat fruits and vegetables in all three meals c. Eat balanced meals at regular intervals d. Restrict exercise to walking only 43. After ileostomy, which of the following condition is NOT expected? a. increased weight b. Irritation of skin around the stoma c. Liquid stool d. Establishment of regular bowel movement 44. The following are appropriate nursing interventions during colostomy irrigation EXCEPT: a. Increase the irrigating solution flow rate when abdominal cramps is felt b. Insert 2-4 inches of an adequately lubricated catheter to the stoma c. Position client in semi-Fowler d. Hand the solution 18 inches above the stoma 45. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be drained? a. Sensation of taste b. Sensation of pressure c. Sensation of smell d. Urge to defecate Situation 10 - As a beginner in research, you are aware that sampling is an essential element of the research process. 46. What does a sample group represent? a. Control group b. Study subjects c. General population d. Universe 47. What is the most important characteristics of a sample? a. Randomization b. Appropriate location c. Appropriate number d. Representativeness 48. Random sampling ensures that each subject has: a. Been selected systematically b. An equal change of selection c. Been selected based on set criteria d. Characteristics that match other samples 49. Which of the following sampling methods allows the use of any group of research subject? a. Purposive

b. Convenience c. Snow-bail d. Quota 50. You decided to include 5 barangays in your municipality and chose a sampling method that would get representative samples from each barangay. What should be the appropriate method for you to use in this care? a. Cluster sampling b. Random sampling c. Stratifies sampling d. Systematic sampling Situation 11 -After an abdominal surgery, the circulating and scrub nurses have critical responsibility about sponge and Instrument count. 51. When is the first sponge/instrument count reported? a. Before closing the subcutaneous layer b. Before peritoneum is closed c. Before dosing the skin d. Before the fascia is sutured 52. What major supportive layer of the abdominal wall must be sutured with long tensile strength such as cotton or nylon or silk suture? a. Fascia b. Muscle c. Peritoneum d. Skin 53. Like sutures, needles also vary in shape and uses. If you are the scrub nurse for a patient who is prone to keloid formation and has a low threshold of pain, what needle would you prepare? a. Round needle b. A traumatic needle c. Reverse cutting needle d. Tapered needle 54. Another alternative "suture" for skin closure is the use of _______________: a. Staple b. Therapeutic glue c. Absorbent dressing d. invisible suture 55. Like any nursing interventions, counts should be documented. To whom does the scrub nurse report any discrepancy of country so that immediate 'and appropriate action in instituted? a. Anesthesiologist b. Surgeon c. Or nurse supervisor d. Circulating nurse

Situation 12 - As a nurse, you should be aware and prepared of the different roles you play. 56. What role do you play, when you hold all clients’ information entrusted to you in the strictest confidence? a. Patient's advocate b. Educator c. Patient's Liaison d. Patient's arbiter 57. As a nurse, you can help improve the effectiveness of communication among healthcare givers a. Use of reminders of what to do b. Using standardized list of abbreviations, acronyms, and symbols c. One-on-one oral endorsement d. Text messaging and e-mail 58. As a nurse, your primary focus in the workplace is the client's safety. However, personal safety is also a concern. You can communicate hazards to your coworkers through the use of the following EXCEPT: a. Formal training b. Posters c. Posting IR in the bulletin board d. Use of labels and signs 59. As a nurse, what is one of the best way to reconcile medications across the continuum of care? a. Endorse on a case-to-case basis b. Communication a complete list of the patient's medication to the next provider of service c. Endorse in writing d. Endorse the routine and 'stat' medications every shift 60. As a nurse, you protect yourself and co-workers from misinformation and misrepresentations through the following EXCEPT: a. Provide information to clients about a variety of services that can help alleviate the client's pain and other conditions b. Advising the client, by virtue of your expertise, that which can contribute to the client's well-being c. Health education among clients and significant others regarding the use of chemical disinfectant d. Endorsement thru trimedia to advertise your favorite disinfectant solution 61. A one-day postoperative abdominal surgery client has been complaining of severe throbbing abdominal pain

described as 9 in a 1-10 pain rating. Your assessment reveals bowel sounds on all quadrants and the dressing is dry and intact. What nursing intervention would you take? a. Medicate client as prescribed b. Encourage client to do imagery c. Encourage deep breathing and turning d. Call surgeon stat 62. Pentoxicodone 5 mg IV every 8 hours was prescribed for post abdominal pain. Which will be your priority nursing action? a. Check abdominal dressing for possible swelling b. Explain the proper use of PCA to alleviate anxiety c. Avoid overdosing to prevent dependence/tolerance d. Monitor VS, more importantly RR . 63. The client complained of abdominal and pain. Your nursing intervention that can alleviate pain is: a. Instruct client to go to sleep and relax b. Advice the client to close the lips and avoid deep breathing and talking c. Offer hot and clear soup d. Turn to sides frequently and avoid too much talking 64. Surgical pain might be minimized by which nursing action in the OR: a. Skill of surgical team and lesser manipulation b. Appropriate preparation For the scheduled procedure c. Use of modem technology in closing the wound d. Proper positioning and draping of clients 65. One very common cause of postoperative pain is: a. Forceful traction during surgery b. Prolonged surgery c. Break in aseptic technique d. Inadequate anesthetic Situation 14 - You were on duty at the medical ward when Zeny came in for admission for tiredness, cold intolerance, constipation, and weight gain. Upon examination, the doctor's diagnosis was hypothyroidism. 66. Your independent nursing care for hypothyroidism includes: a. administer sedative round the clock b. administer thyroid hormone replacement c. providing a cool, quiet, and comfortable environment

d. encourage to drink 6-8 glasses of water 67. As the nurse, you should anticipate to administer which of the following medications to Zeny who is diagnosed to be suffering from hypothyroidism? a. Levothyroxine b. Lidocaine c. Lipitor d. Levophed 68. Your appropriate nursing diagnosis for Zeny who is suffering from hypothyroidism would probably include which of the following? a. Activity intolerance related to tiredness associated with disorder b. Risk to injury related to incomplete eyelid closure c. Imbalance nutrition related to hypermetabolism d. Deficient fluid volume related to diarrhea 69. Myxedema coma is a life threatening complication of long standing and untreated hypothyroidism with one of the following characteristics. a. Hyperglycemia b. hypothermia c. hyperthermia d. hypoglycemia

b. lying on the unaffected side with the bed elevated 30-40 degrees c. lying prone with the head of the bed lowered 15-30 degrees d. sitting on the edge of the bed with her feet supported and arms and head on a padded overhead table 73. During thoracentesis, which of the following nursing intervention will be most crucial? a. Place patient in a quiet and cool room b. Maintain strict aseptic technique c. Advice patient to sit perfectly still during needle insertion until it has been withdrawn from the chest d. Apply pressure over the puncture site as soon as the needle is withdrawn 74. To prevent leakage of fluid in the thoracic cavity, how wilt you position the client after thoracentesis? a. Place flat in bed b. Turn on the unaffected side c. Turn on the affected side d. On bed rest 75. Chest x-ray was ordered after thoracentesis. When you client asks what is the reason for another chest x-ray, you will explain:

70. As a nurse, you know that the most common type of goiter is related to a deficiency

a. to rule out pneumothorax b. to rule out any possible perforation c. to decongest d. to rule out any foreign: body

a. thyroxine b. thyrotropin c. iron d. iodine

Situation 16 - In the hospital, you are aware that we are helped by the .use of a variety of equipment/devices to enhance quality patient care delivery;

Situation 15 - Mrs. Pichay is admitted to your ward. The MD ordered "Prepared for thoracentesis this pm to remove excess air from the pleural cavity."

76. You are initiate an IV line to your patient, Kyle, 5, who is febrile. What IV administration set will you prepare?

71. Which of the following nursing responsibility is essential in Mrs. Pichay who will undergo thoracentesis?

a. Blood transfusion set b. Macroset c. Volumetric chamber d. Microset

a. Support, and reassure client during the procedure b. Ensure that informed consent has been signed c. Determine if client has allergic reaction to local anesthesia d. Ascertain if chest x-rays and other tests have been prescribed and completed

77. Kyle is diagnosed to have measles. What will your protective personal attire include?

72. Mrs. Pichay who is for thoracentesis is assisted by the nurse to any of the following positions, EXCEPT:

78. What will you do to ensure that Kyle, who is febrile, will have a liberal oral fluid intake?

a. straddling a chair with arms and head resting on the back of the chair

a. Provide a glass of fruit every meal b. Regulate his IV to 30 drops per minute

a. Gown b. Eyewear c. Face mask d. Gloves

c. Provide a calibrated pitcher of drinking water and juice at the bedside and monitor intake and output d. Provide a writing pad to record his intake 79. Before bedtime, you went to ensure Kyle's safety in 'bed. You will do which of the following: a. Put the lights on b. Put the side rails up c. Test the call system d. Lock the doors 80. Kyle's room is fully mechanized. What do you teach the watcher and Kyle to alert the nurse for help? a. How to lock side rails b. Number of the telephone operator c. Call system d. Remote control Situation 17 - Tony, 11 years old, has 'kissing tonsils' and is scheduled for tonsillectomy and adenoidectomy or T and A. 81. You are the nurse of Tony who will undergo T and A in the morning. His mother asked you if Tony will be put to sleep. Your teaching will focus on: a. spinal anesthesia b. anesthesiologist’s preference c. local anesthesia d. general anesthesia 82. Mothers of children undergoing tonsillectomy and adenoidectomy usually ask what food prepared and give their children after surgery. You as the nurse will say: a. balanced diet when fully awake b. hot soup when awake c. ice cream when fully awake d. soft diet when fully awake 83. The RR nurse should monitor for the most common postoperative complication of: a. hemorrhage b. endotracheal tube perforation c. esopharyngeal edema d. epiglottis 84. The PACU nurse will maintain postoperative T and A client in what position? a. Supine with neck hyperextended and supported with pillow b. Prone with the head on pillow and tuned to the side c. Semi-Fowler's with neck flexed d. Reverse trendelenburg with extended

neck 85. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy. You as the RN will make sure that the family knows to: a. offer osteorized feeding b. offer soft foods for a week to minimize discomfort while swallowing c. supplement his diet with vitamin C rich juices to enhance heating d. offer clear liquid for 3 days to prevent irritation Situation 18 - Rudy was diagnosed to have chronic renal failure. Hemodialysis is ordered that an A-V shunt was surgically created. 86. Which of the following action would be of highest priority with regards to the external shunt? a. Avoid taking BP or blood sample from the arm with shunt b. Instruct the client not to exercise the arm with the shunt c. Heparinize the shunt daily d. Change dressing of the shunt daily 87. Diet therapy for Rudy, who has acute renal failure, is tow-protein, low potassium and sodium. The nutrition instruction should include: a. Recommend protein of high biologic value like eggs, poultry and lean meat b. Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes c. Allowing the client cheese, canned foods, and other processed food d. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet 88. Rudy undergoes hemodialysis for the first time and was scared of disequilibrium syndrome. He asked you how this can be prevented. Your response is: a. maintain a conducive comfortable and cool environment b. maintain fluid and electrolyte balance c. initial hemodialysis shall be done for 30 minutes only so as not to rapidly remove the waste from the blood than from the brain d. maintain aseptic technique throughout the hemodialysis 89. You are assisted by a nursing aide with the care of the client with renal failure. Which delegated function to the aide would you particularly check? a. Monitoring and recording I and O b. Checking bowel movement

c. Obtaining vital signs d. Monitoring diet

c. Ureterolithiasis d. Urolithiasis

90. A renal failure patient was ordered for creatinine clearance. As the nurse you will collect

Situation 20 - At the medical-surgical ward, the nurse must also be concerned about drug interactions.

a. 48 jour urine specimen b. first morning urine c. 24 hour urine specimen d. random urine specimen

96. You have a client with TPN. You know that in TPN, like blood transfusion, there should be no drug incorporation. However, the MD's order read; incorporate insulin to present TPN. Will you follow the order?

Situation 19 - Fe is experiencing left sharp pain and occasional hematuria. She was advised to undergo IVP by her physician. 91. Fe was so anxious about the procedure and particularly expressed her low pain threshold. Nursing health instruction will include: a. assure the client that the pain is associated with the warm sensation during the administration of the Hypaque by IV b. assure the client that the procedure painless c. assure the client that contrast medium will be given orally d. assure the client that x-ray procedure like IVP is only done by experts 92. What will the nurse monitor and instruct the client and significant others, post IVP? a. Report signs and symptoms for delayed allergic reactions b. Observe NPO for 6 hours c. Increase fluid intake d. Monitor intake and output 93. Post IVP, Fe should excrete the contrast medium. You instructed the family to include more vegetables in the diet and a. increase fluid intake b. barium enema c. cleansing enema d. gastric lavage 94. The IVP reveals that Fe has small renal calculus that can be passed out spontaneously. To increase the chance of passing the stones, you instructed her to force fluids and do which of the following? a. Balanced diet b. Ambulance more c. Strain all urine d. Bed rest 95. The presence of calculi in the urinary tract is called: a. Colelithiasis b. Nephrolithiasis

a. No, because insulin will induce hyperglycemia in patients with TPN b. Yes, because insulin is chemically stable with TPN and can enhance blood glucose level c. No, because insulin is not compatible with TPN d. Yes, because it was ordered by the MD 97. The RN should also know that some drugs have increased absorption when infused in PVC container. How will you administer drugs such as insulin, nitroglycerine hydralazine to promote better therapeutic drug effects? a. Administer by fast drip b. Inject the drugs as close to the IV injection site c. Incorporate to the IV solution d. Use volumetric chamber 98. One patient has a 'runaway' IV of 50% dextrose. To prevent temporary excess of insulin transient hyperinsulin reaction, what solution should you prepare in anticipation of the doctors order? a. Any IV solution available to KVO b. Isotonic solution c. Hypertonic solution d. Hypotonic solution 99. How can nurse prevent drug interaction including absorption? a. Always flush with NSS after IV administration b. Administering drugs with more diluents c. Improving on preparation techniques d. Referring to manufacturer's guidelines 100. In insulin administration, it should be understood that our body normally releases insulin according to our blood glucose level. When is insulin and glucose level highest? a. After excitement b. After a good night's rest c. After an exercise d. After ingestion of food

ANSWER KEY ** I will try to look for the answer key to these questions **