Nursing Central Venous Access Quiz
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Questions and Answers

Which adverse effect should the nurse monitor for in a client receiving care?

  • Orthostatic hypotension
  • Atelectasis (correct)
  • Photosensitivity
  • Skin pressure point integrity
  • What initial drug groups may be ordered for a client with an average blood pressure reading of 164/92 mm Hg?

  • Thiazide diuretics (correct)
  • Calcium channel blockers
  • Beta-blockers (correct)
  • Direct-acting vasodilators (correct)
  • Which medication could interact with a new prescription for ACE inhibitors?

  • A potassium supplement (correct)
  • A nonsteroidal anti-inflammatory drug (correct)
  • An oral anticoagulant
  • A benzodiazepine
  • How does atenolol (Tenormin) primarily assist in managing angina?

    <p>Slows heart rate and reduces contractility</p> Signup and view all the answers

    What adverse effect should be monitored in a patient receiving sublingual nitroglycerin?

    <p>Decreased blood pressure</p> Signup and view all the answers

    Angina occurs when which condition arises?

    <p>Oxygen supply is insufficient for heart demands</p> Signup and view all the answers

    Which of these medications is an initial choice for managing hypertension?

    <p>Angiotensin II receptor blockers</p> Signup and view all the answers

    Which substance should be cautiously monitored when a patient is prescribed ACE inhibitors?

    <p>NSAIDs</p> Signup and view all the answers

    How many grams of mannitol will the patient receive from a 100ml vial of 20% mannitol?

    <p>27.5g</p> Signup and view all the answers

    When using a combination of NPH and regular insulin, why is it critical for the client to know the peak times?

    <p>The risk of hypoglycemia is highest during the peak times of insulins</p> Signup and view all the answers

    Before administering morning lispro insulin, which action is most critical for the nurse to perform?

    <p>Check the client's blood glucose levels</p> Signup and view all the answers

    After an insulin overdose, if a client is waking up but still incoherent, what should the nurse advise?

    <p>Wait for her to wake up on her own</p> Signup and view all the answers

    What should be the nurse's immediate concern if a client on Levothyroxine reports nervousness and palpitations?

    <p>Measure the client’s heart rate and blood pressure</p> Signup and view all the answers

    What is the appropriate volume to prepare for the infusion if 3.5g of mannitol is needed?

    <p>19 ml</p> Signup and view all the answers

    What action should a nurse avoid when a client is experiencing symptoms of hypoglycemia?

    <p>Allowing them to rest without monitoring</p> Signup and view all the answers

    Why is it essential for a client with Type 1 diabetes to have knowledge of their insulin peak times?

    <p>To manage exercise timing effectively</p> Signup and view all the answers

    What is the best action for a nurse to take when an 11-year-old patient is struggling to use an inhaler correctly?

    <p>Provide a spacer for use with the inhaler</p> Signup and view all the answers

    Which drug should be administered for a patient with bronchitis and a productive cough?

    <p>An expectorant</p> Signup and view all the answers

    What therapeutic response can antihistamine-type drugs provide for upper respiratory issues?

    <p>Allergic symptoms</p> Signup and view all the answers

    Before administering magnesium hydroxide for constipation, the nurse should first assess which factor?

    <p>Bowel sounds</p> Signup and view all the answers

    When considering the use of bismuth subsalicylate (Pepto-Bismol) for diarrhea, which factor is most important for the nurse to consider?

    <p>Cause of the diarrhea</p> Signup and view all the answers

    Before administering ondansetron (Zofran) prior to chemotherapy, which past medical history condition should be reviewed?

    <p>Allergy to egg or soy products</p> Signup and view all the answers

    For a patient experiencing post-operative constipation, which drug would be least appropriate?

    <p>An antidiarrheal</p> Signup and view all the answers

    Which patient assessment is critical before administering an expectorant?

    <p>Hydration status</p> Signup and view all the answers

    What is the most appropriate time for a client to receive proton pump inhibitors?

    <p>Half an hour before meal</p> Signup and view all the answers

    Which drug order should a nurse question when treating gastroesophageal reflux disease?

    <p>Antibiotics</p> Signup and view all the answers

    What should the nurse instruct a 21-year-old female patient taking ampicillin regarding oral contraceptives?

    <p>The antibiotic may decrease the effectiveness of oral contraceptives</p> Signup and view all the answers

    If a client reports abnormal vaginal discharge after taking cefotaxime, what condition might they be exhibiting symptoms of?

    <p>Superinfection</p> Signup and view all the answers

    In what order should a nurse administer blood cultures, sputum cultures, and an ampicillin dose for a patient with a fever and productive cough?

    <p>Blood and sputum cultures, ampicillin dose</p> Signup and view all the answers

    Which instruction should be given to a patient prescribed a proton pump inhibitor?

    <p>Avoid taking it with antacids</p> Signup and view all the answers

    What is the priority assessment related to a Central Venous Access Device (CVAD) infusion?

    <p>Chest assessment</p> Signup and view all the answers

    Which patient would be a candidate for insertion of a central line?

    <p>A patient with septicemia</p> Signup and view all the answers

    What is a common misconception about the interaction between antibiotics and oral contraceptives?

    <p>All antibiotics make oral contraceptives ineffective</p> Signup and view all the answers

    What influence does a drug that stimulates gastric peristalsis have on additional oral medications?

    <p>Decreased absorption</p> Signup and view all the answers

    What is the primary reason for questioning an order of antibiotics in a patient with gastroesophageal reflux disease?

    <p>They can have no significant benefit in this condition</p> Signup and view all the answers

    In a patient with hepatitis and hepatic impairment, what is expected regarding the duration of action of medications?

    <p>Increase</p> Signup and view all the answers

    What is the correct order of the phases of pharmacokinetics?

    <p>Drug metabolites are secreted through passive glomerular filtration into renal tubules- phase 4</p> Signup and view all the answers

    If a drug delivers 500 mg and has a half-life of 4 hours, how many milligrams will remain after 1 half-life?

    <p>250 mg</p> Signup and view all the answers

    Which pharmacodynamic principle is most closely associated with a drug's affinity for receptors?

    <p>Potency</p> Signup and view all the answers

    In the context of a patient receiving a medication with a high first-pass effect, what is the expected impact on oral bioavailability?

    <p>Decreased bioavailability</p> Signup and view all the answers

    Study Notes

    Central Venous Access Device (CVAD)

    • Priority assessment for a patient with a CVAD includes chest assessment to monitor for complications.
    • Candidates for central line insertion include those with septicemia and chemotherapy-related immunocompromise.

    Medication Interactions

    • Drug stimulating gastric peristalsis can decrease absorption of additional oral medications.
    • Hepatic impairment increases the duration of action for most medications.

    Pharmacokinetics Phases

    • Phase 1: Drug moves from the intestinal lumen into mesenteric blood.
    • Phase 2: Drug binds to plasma protein albumin.
    • Phase 3: Liver enzymes transform the drug into inactive metabolites.
    • Phase 4: Drug metabolites are excreted via renal tubules.

    Drug Half-Life and Affinity

    • A drug at 500mg with a half-life of 4 hours will have 250mg remaining after one half-life.
    • Drugs with high receptor affinity are closely associated with potency.

    Hypertension Management

    • Initial drug groups for hypertension may include beta-blockers, calcium channel blockers, and thiazide diuretics.
    • ACE inhibitors may interact with nonsteroidal anti-inflammatory drugs and potassium supplements.

    Angina Management

    • Atenolol acts by slowing the heart rate and reducing contractility to help manage angina.
    • Sublingual nitroglycerin can cause decreased blood pressure, requiring monitoring for this adverse effect.

    Insulin Management

    • NPH and regular insulin require knowledge of peak times due to hypoglycemia risk during peak action.
    • Before administering lispro insulin, ensure breakfast availability and check blood glucose levels.

    Insulin Overdose Response

    • If a patient regains consciousness after glucagon administration but remains groggy, wait for further recovery before offering food.

    Pediatric Inhaler Use

    • Providing a spacer can help facilitate proper inhaler technique in a child unable to demonstrate correct usage.

    OTC Medications

    • Recommendations for bismuth subsalicylate depend on the cause of diarrhea and age of the child.

    Chemotherapy and Drug Review

    • Ondansetron should be reviewed for allergies to egg or soy before chemotherapy administration.

    Proton Pump Inhibitors

    • Proton pump inhibitors should be taken half an hour before meals for optimal effectiveness.

    Antibiotic Counseling

    • Ampicillin may decrease the effectiveness of oral contraceptives; patients should use contraception as prescribed.
    • Abnormal vaginal discharge after cefotaxime may indicate superinfection.

    Blood Culture Protocol

    • Correct sequence for a patient with fever and respiratory signs is to perform blood and sputum cultures before antibiotic administration.

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    Description

    Test your understanding of vital assessments related to Central Venous Access Devices (CVAD) and the appropriate patients for central line insertion. This quiz focuses on clinical judgment essential for nursing care in acute settings. Strengthen your knowledge in essential nursing practices.

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