MATERNITY/OB PN HESI SPECIALTY V2

.Tap the side of the syringe barrel to remove air bubbles. a. 4, 1, 5, 3, 6, 2 b. 1, 4, 5, 3, 2, 6 c. 4, 5, 3, 1, 2, 6 d. 1, 4, 5, 3, 6, 2 ANS: C When preparing medication from a vial, the steps are as follows: Firmly and briskly wipe the surface of the rubber seal with an alcohol swab and allow to dry; pull back on the plunger to draw an amount of air into the syringe equal to the volume of medication to be aspirated from the vial; inject air into the airspace of the vial; invert the vial while keeping firm hold on the syringe and plunger; fill the syringe with medication; and tap the side of the syringe barrel carefully to dislodge any air bubbles. 39. A nurse is attempting to administer an oral medication to a child, but the child refuses to take the medication. A parent is in the room. Which statement by the nurse to the parent is best? a. “Please hold your child’s arms down, so I can give the full dose.” “I will prepare the medication for you and observe if you would like b. to try to administer the medication.” “Let’s turn the lights off and give your child a moment to fall asleep before administering the medication.” “Since your child loves applesauce, let’s add the medication to it, so your child doesn’t resist.” ANS: B Children often have difficulties taking medication, but it can be less traumatic for the child if the parent administers the medication and the nurse supervises. Another nurse should help restrain a child if needed; the parent acts as a comforter, not a restrainer. Holding down the child is not the best option because it may further upset the child. Never administer an oral medication to a sleeping child. Don’t mix medications into the child’s favorite foods, because the child might start to refuse the food. 40. An older-adult patient needs an IM injection of antibiotic. Which site is best for the nurse to use? a. Deltoid b. Dorsal gluteal c. Ventrogluteal d. Vastus lateralis ANS: C The ventrogluteal site is the preferred and safest site for all adults, children, and infants. While the vastus lateralis is a large muscle that could be used it is not the preferred and safest. The dorsal gluteal site is a location for a subcutaneous injection, and this patient requires an IM injection. The deltoid is easily accessible, but this muscle is not well developed and is not the preferred site. 41. A nurse is preparing an intravenous IV piggyback infusion. In which order will the nurse perform the steps, starting with the first one? 1. Compare the label of the medication with the medication administration record at the patient’s bedside. 2. Connect the tubing of the piggyback infusion to the appropriate connector on the upper Y-port. 3. Hang the piggyback medication bag above the level of the primary fluid bag. 4. Clean the main IV line port with an antiseptic swab. 5. Connect the infusion tubing to the medication bag. 6. Regulate flow. a. 5, 2, 1, 4, 3, 6 b. 5, 2, 1, 3, 4, 6 c. 1, 5, 4, 3, 2, 6 d. 1, 5, 3, 4, 2, 6 ANS: D When preparing and administering IV piggybacks, use the following steps: Compare the label of medication with the medication administration record at the patient’s bedside; connect the infusion tubing to the medication bag; hang the piggyback medication bag above the level of the primary fluid bag; clean the main IV line port with an antiseptic swab; connect the tubing of the piggyback infusion to the appropriate connector on the upper Y-port; and regulate flow. 42. A nurse is administering oral medications to patients. Which action will the nurse take? Remove the medication from the wrapper, and place it in a cup labeled a. with the patient’s information. Place all of the patient’s medications in the same cup, except medications with assessments. Crush enteric-coated medication, and place it in a medication cup with water. Measure liquid medication by bringing liquid medication cup to eye level. ANS: B Placing medications that require preadministration assessment in a separate cup serves as a reminder to check before the medication is given, making it easier for the nurse to withhold medication if necessary. Medications should not be removed from their package until they are in the patient’s room because this makes identification of the pill easier and reduces contamination. When measuring a liquid, the nurse should use the meniscus level to measure; make sure it is at eye level on a hard surface like a countertop. Enteric coated medications should not be crushed. 43. A nurse is performing the three accuracy checks before administering an oral liquid medication to a patient. When will the nurse perform the second accuracy check? a. At the patient’s bedside b. Before going to the patient’s room c. When checking the medication order d. When selecting medication from the unit-dose drawer ANS: B Before going to the patient’s room, compare the patient’s name and name of medication on the label of prepared drugs with MAR for the second accuracy check. Selecting the correct medication from the stock supply, unit-dose drawer, or automated dispensing system (ADS) is the first check. The third accuracy check is comparing names of medications on labels with MAR at the patient’s bedside. Checking the orders is not one of the three accuracy checks but should be done if there is any confusion about an order. 44. A nurse is preparing to administer an antibiotic medication at 1000 to a patient but gets busy in another room. When should the nurse give the antibiotic medication? a. By 1030 b. By 1100 c. By 1130 d. By 1200 ANS: A Give time-critical scheduled medications (e.g., antibiotics, anticoagulants, insulin, anticonvulsants, and immunosuppressive agents) at the exact time ordered (within 30 minutes before or after scheduled dose). Give non–time critical scheduled medications within a range of either 1 or 2 hours of scheduled dose. 1100, 1130, and 1200 are too late. 45. The nurse is administering medications to several patients. Which action should the nurse take? Advise a patient after a corticosteroid inhaler treatment to rinse mouth a. with water. Administer an intravenous medication through tubing that is infusing blood. Pinch up the deltoid muscle of an adult patient receiving a vaccination. Aspirate before administering a subcutaneous injection in the abdomen. ANS: A If the patient uses a corticosteroid, have him or her rinse the mouth out with water or salt water or brush teeth after inhalation to reduce risk of fungal infection. Piercing a blood vessel during a subcutaneous injection is very rare. Therefore, aspiration is not necessary when administering subcutaneous injections. When giving immunizations to adults: to avoid injection into subcutaneous tissue, spread the skin of the selected vaccine administration site taut between the thumb and forefinger, isolating the muscle. Never administer IV medications through tubing that is infusing blood, blood products, or parenteral nutrition solutions.