IV’s, TPN, & Blood NCLEX-like Critical Thinking Questions

The charge nurse is performing a chart review on a client on TPN. Which of the following should concern the charge nurse?

A client is admitted with dehydration.  Vital signs: Temp 99.0 °F,  BP 98/50,  HR 110,  RR 20.  The physician orders a bolus of 500ml Normal Saline.  The nurse starts an IV and as the nurse inserts the IV catheter the client flinches and complains of an electric shock-like pain.  Which action should the nurse take FIRST?

The nurse is educating the family of a client with hypovolemic shock on the indications of Lactated Ringer’s (LR).  Which of the following is the best statement by the nurse to describe the purpose of this intravenous solution?

The experienced nurse instructs the new nurse to NEVER start TPN on which of the following accesses?

The nurse will be starting TPN on this catheter.  What is the most specific name for this catheter?

The nurse is caring  for a client with gastric cancer who has been started on TPN? Which of the following are important nursing interventions?

A client with a hemoglobin of 6.4 mg/dl is receving a blood transfusion.  The client complains of itchiness and nausea.  What is the first action that the nurse should take?

The nurse is administering one unit of blood to a client with severe anemia. Which of the following interventions should the nurse implement?

The physician orders IV calcium to be given after the client receives 2 units of packed red blood cells.  The nurse demonstrates understanding of why IV calcium is ordered when she states that ?

The nurse is preparing to transfuse a unit of blood. Which of the following safety measures should the nurse take?

The nurse is caring for a client who is receiving a blood transfusion.  The client develops the following symptoms: red urine, back pain, fever, chills, tachycardia and hypotension.  The nurse immediately stops the transfusion, disconnects the blood and tubing from the client.  The nurse initiates an IV infusion of normal saline and monitors the client’s urine output. The nurse returns the blood and tubing to the blood bank and notifies the physician.  Which of the following blood transfusion reactions is the client most likely experiencing?

Match the IV complication with the intervention

The nurse is caring for a client on TPN. The client gained 4 lbs in 2 days.  Which of the following is the priority concern?

The nurse demonstrates correct knowledge of the administration of Packed Red Blood Cells when the nurse performs which of the following actions? Select all that apply.

The nurse is administering an antibiotic to a client who suddenly complains of anxiety and scratchy throat.  Which are the following priority actions should the nurse implement first?