Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin.
Which of the following information should the nurse include in the teaching?
A. Plan to self-administer this medication for the next 6 months.
Choice A is wrong because the duration of treatment depends on the individual’s response and blood levels of vitamin B. Some people may need to use this medication for longer than 6 months.
B. Administer the medication into one nostril once per week.
This is the recommended dosage for cyanocobalamin nasal spray for pernicious anemia and vitamin B12 deficiency. Cyanocobalamin nasal gel is used to prevent a lack of vitamin B12 that may be caused by various factors.
C. Lie down for 1 hour after administering the medication.
Choice C is wrong because there is no need to lie down for 1 hour after administering the medication. This may cause nasal irritation or drainage.
D. Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose.
Choice D is wrong because using a nasal decongestant 15 minutes before the medication may interfere with the absorption of cyanocobalamin. If you have a stuffy nose, you should talk to your doctor about alternative ways to take vitamin B.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Pharmacology 2019 Proctored Exam. Take the full exam now
Full Explanation
This is the recommended dosage for cyanocobalamin nasal spray for pernicious anaemia and vitamin B12 deficiency. Cyanocobalamin nasal gel is used to prevent a lack of vitamin B12 that may be caused by various factors.
Choice A is wrong because the duration of treatment depends on the individual’s response and blood levels of vitamin B. Some people may need to use this medication for longer than 6 months.
Choice C is wrong because there is no need to lie down for 1 hour after administering the medication.
This may cause nasal irritation or drainage.
Choice D is wrong because using a nasal decongestant 15 minutes before the medication may interfere with the absorption of cyanocobalamin. If you have a stuffy nose, you should talk to your doctor about alternative ways to take vitamin B.
Similar Questions
A nurse is assessing a client who has hypermagnesemia.
Which of the following medications should the nurse prepare to administer?
A. Calcium gluconate.
Calcium gluconate is used to treat hypermagnesemia because it can help calm some symptoms such as impaired breathing, irregular heartbeat, and hypotension. Calcium also helps normalize the neuromuscular function that is affected by excess magnesium.
B. Acetylcysteine.
Acetylcysteine is wrong because it is used to treat acetaminophen overdose and prevent kidney damage from contrast dye. It has no role in treating hypermagnesemia.
C. Flumazenil.
Flumazenil is wrong because it is used to reverse the effects of benzodiazepines, a class of sedative drugs. It has no role in treating hypermagnesemia.
D. Protamine sulfate.
Protamine sulfate is wrong because it is used to reverse the effects of heparin, an anticoagulant drug. It has no role in treating hypermagnesemia. Normal ranges for magnesium are 1.7 to 2.3 mg/dL or 0.7 to 1.1 mmol/L. Hypermagnesemia is defined as a magnesium level above 2.6 mg/dL or 1.5 mmol/L.
Full Explanation
Calcium gluconate is used to treat hypermagnesemia because it can help calm some symptoms such as impaired breathing, irregular heartbeat, and hypotension. Calcium also helps normalize the neuromuscular function that is affected by excess magnesium.
Choice B. Acetylcysteine is wrong because it is used to treat acetaminophen overdose and prevent kidney damage from contrast dye.
It has no role in treating hypermagnesemia.
Choice C. Flumazenil is wrong because it is used to reverse the effects of benzodiazepines, a class of sedative drugs.
It has no role in treating hypermagnesemia.
Choice D. Protamine sulfate is wrong because it is used to reverse the effects of heparin, an anticoagulant drug.
It has no role in treating hypermagnesemia.
Normal ranges for magnesium are 1.7 to 2.3 mg/dL or 0.7 to 1.1 mmol/L. Hypermagnesemia is defined as a magnesium level above 2.6 mg/dL or 1.5 mmol/L.
A nurse is assessing for allergies with a client who is scheduled to receive the influenza vaccine.
Which of the following allergies should the nurse report to the provider as a possible contraindication to receiving the vaccine?
A. Shellfish.
Choice A is wrong because shellfish is not an ingredient in a flu vaccine and is not a contraindication to receiving the vaccine.
B. Eggs.
According to the CDC, people with severe, life-threatening allergies to any ingredient in a flu vaccine (other than egg proteins) should not get that vaccine. However, people with egg allergy can get a flu vaccine. The CDC also states that people who have had a severe allergic reaction to a dose of influenza vaccine should not get that flu vaccine again and might not be able to receive other influenza vaccines. Therefore, a nurse should report an egg allergy to the provider as a possible contraindication to receiving the vaccine.
C. Milk.
Choice C is wrong because milk is not an ingredient in a flu vaccine and is not a contraindication to receiving the vaccine.
D. Peanuts.
Choice D is wrong because peanuts are not an ingredient in a flu vaccine and are not a contraindication to receiving the vaccine.
Full Explanation
According to the CDC, people with severe, life-threatening allergies to any ingredient in a flu vaccine (other than egg proteins) should not get that vaccine. However, people with egg allergy can get a flu vaccine. The CDC also states that people who have had a severe allergic reaction to a dose of influenza vaccine should not get that flu vaccine again and might not be able to receive other influenza vaccines. Therefore, a nurse should report an egg allergy to the provider as a possible contraindication to receiving the vaccine.
Choice A is wrong because shellfish is not an ingredient in a flu vaccine and is not a contraindication to receiving the vaccine.
Choice C is wrong because milk is not an ingredient in a flu vaccine and is not a contraindication to receiving the vaccine.
Choice D is wrong because peanuts are not an ingredient in a flu vaccine and are not a contraindication to receiving the vaccine.
A nurse is assessing a client who is receiving a peripheral IV infusion and notes infiltration of fluid into the tissues surrounding the insertion site. Which of the following actions should the nurse take?
A. Apply pressure to the IV site.
Choice A is wrong because applying pressure to the IV site can increase the risk of tissue damage and infection. Pressure can also obstruct blood flow and cause thrombophlebitis.
B. Elevate the extremity.
This will help reduce swelling and discomfort caused by the infiltration of fluid into the tissues. Elevating the extremity also promotes venous return and prevents further fluid accumulation.
C. Slow the infusion rate.
Choice C is wrong because slowing the infusion rate will not stop the infiltration of fluid into the tissues. Slowing the infusion rate can also delay the delivery of medication or fluid to the client.
D. Flush the IV catheter.
Choice D is wrong because flushing the IV catheter can worsen the infiltration of fluid into the tissues. Flushing the IV catheter can also introduce air or bacteria into the bloodstream and cause complications. Normal ranges for peripheral IV infusion are dependent on the type and volume of fluid, the size and location of the catheter, and the condition of the client. Generally, peripheral IV infusion rates should not exceed 100 mL/hr for adults and 60 mL/hr for children.
Full Explanation
This will help reduce swelling and discomfort caused by the infiltration of fluid into the tissues. Elevating the extremity also promotes venous return and prevents further fluid accumulation.
Choice A is wrong because applying pressure to the IV site can increase the risk of tissue damage and infection.
Pressure can also obstruct blood flow and cause thrombophlebitis.
Choice C is wrong because slowing the infusion rate will not stop the infiltration of fluid into the tissues.
Slowing the infusion rate can also delay the delivery of medication or fluid to the client.
Choice D is wrong because flushing the IV catheter can worsen the infiltration of fluid into the tissues.
Flushing the IV catheter can also introduce air or bacteria into the bloodstream and cause complications.
Normal ranges for peripheral IV infusion are dependent on the type and volume of fluid, the size and location of the catheter, and the condition of the client. Generally, peripheral IV infusion rates should not exceed 100 mL/hr for adults and 60 mL/hr for children.