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Workman: Understanding Pharmacology Chapter 06: Dosage Calculation of Intravenous Solutions and Drugs Test Bank MULTIPLE CHOICE 1. What is the most important advantage for intravenous (IV) infusion of drugs? a. Anyone can administer IV drugs. b. The drug reaches the bloodstream immediately. c. Drugs given intravenously cost less than drugs given orally. d. The patient is not required to be alert to swallow the drug. 2. How does the “drop factor” affect IV infusions? a. Fluid with a larger drop factor infuses more slowly than fluid with a smaller drop factor. b. Smaller drop factors occur with smaller needles (or cannulas) and larger drop factors occur with larger needles. c. The smaller the drop factor, the fewer the number of drops needed to administer 1 mL of infusion fluid. d. The larger the drop factor, the fewer the number of drops needed to administer 1 mL of infusion fluid. 3. A patient is to receive 1000 mL intravenously of dextrose 5% in lactated Ringer’s solution in 8 hours. When the nurse checks the intravenous (IV) bag after 2 hours, 700 mL remain in the bag. How many milliliters have already infused? a. 100 b. 300 c. 700 d. 1000 4. A patient is to receive 125 mL of intravenous fluid per hour and the drop factor is 10 gtt per mL. The nurse counts the 15-second drip rate to be 8 gtt per minute. What is the nurse’s best action? a. Nothing, the IV flow rate is correct. b. Turn the rate down to 5 gtt/15 seconds. c. Turn the rate up to 11 gtt/15 seconds. d. Turn the rate up to 15 gtt/15 seconds. 5. How is extravasation different from infiltration? a. Infiltration occurs in the hand, whereas extravasation occurs in the arm. b. Both conditions lead to swelling, but extravasation causes tissue damage. c. Infiltration is swelling accompanied by pain, whereas extravasation is not painful. Elsevier items and derived items © 2011 by Saunders, an imprint of Elsevier Inc. Test Bank 6-2 d. Extravasation causes phlebitis along with tissue swelling, whereas infiltration causes fluid overload along with swelling. 6. An IV infusion order for a patient reads “1000 mL dextrose 5% in normal saline intravenously, immediately.” What additional information does the nurse ask the prescriber to provide? a. Drip rate b. Drop factor c. Duration d. Start time 7. Which precaution is most important for the nurse to teach a patient who is receiving intravenous (IV) drug therapy? a. “Turn on your call light if the IV machine starts to beep for any reason.” b. “Do not use the arm that has the IV running in it for any reason whatsoever.” c. “Call me immediately if you start to feel any pain or burning in the arm with the IV.” d. “If you think the IV is running too slowly, just push the up-arrow button on the machine once or twice.” 8. While examining a patient’s peripheral intravenous (IV) site, the nurse observes a red streak along the length of the vein. On palpation, the vein feels hard and cordlike. What is the nurse’s best action? a. Check for a blood return and notify the prescriber. b. Discontinue the infusion and remove the IV needle. c. Apply ice packs to the vein and continue the infusion. d. Change the IV fluid to normal saline and redress the site. 9. Which problem is a major disadvantage of an intravenous (IV) pump? a. The alarms are so sensitive that nurses tend to ignore them when they sound frequently. b. Patients and families can override the automatic features and reset the infusion rate. c. It can “run away” and cause a patient to experience fluid overload. d. It can continue to push fluid into the tissue when infiltration occurs. 10. The intravenous (IV) site of a patient who has been receiving IV therapy for 2 days is red and has a small amount of pus oozing from around the needle. What is the nurse’s best action? a. Document the finding as an expected response to long-term IV therapy as the only action. b. Immediately notify the prescriber to get an order to discontinue the IV therapy. c. Use an iodine solution to clean the site and replace the dressing. d. Discontinue the IV therapy and notify the prescriber. Elsevier items and derived items © 2011 by Saunders, an imprint of Elsevier Inc. Test Bank 6-3 11. A patient is receiving an intravenous (IV) infusion of solution containing 60 mEq/L of potassium chloride. Which nursing action allows early detection of complications common to this therapy? a. Lowering the IV bag below the level of the IV site to obtain a blood return b. Palpating the vein above the IV site in which the cannula is placed c. Placing a light source on the tissue around the IV site d. Checking the pulse distal (lower than) to the IV 12. A patient is prescribed 25 mg by intravenous (IV) push of a drug that is a known chemical irritant. The drug vial contains 100 mg/mL of the drug. To reduce the risk for chemical trauma when administering this drug, what is the nurse’s best action? a. Immediately after injecting the drug by IV push, apply firm pressure over the site for 1 minute. b. Dilute the drug with 9.75 mL of an appropriate solution before administration. c. Apply a cold compress to the IV site for 10 minutes before administering the drug. d. Apply a cold compress to the IV site for 10 minutes after administering the drug. 13. An 82-year-old patient returns to the floor after being gone for 1 hour for an x-ray examination. On return, the nurse notes that 700 mL of fluid have infused during the last hour and the patient is short of breath. What is the nurse’s best action? a. Check the intravenous (IV) site and document the findings. b. Slow the IV rate and notify the prescriber immediately. c. Discontinue the IV therapy and notify the prescriber immediately. d. Notify the prescriber and ask whether the IV therapy should be discontinued. ESSAY 1. What is the hourly flow rate for 250 mL of normal saline to be administered over 2 hours? _____ mL/hour 2. A patient is to receive 1000 mL of D5W intravenously over 6 hours. The nurse selects a tubing set with a drop factor of 15 gtt/mL. How many drops per minute are needed to infuse this fluid in the prescribed time? _____ gtt per minute 3. A patient is to receive 100 mL of normal saline over the next 5 hours with microdrip tubing. How many drops per minute does the nurse administer to infuse this fluid in the prescribed time? _____ gtt per minute Elsevier items and derived items © 2011 by Saunders, an imprint of Elsevier Inc.