Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. A patient has been receiving total parenteral nutrition. Upon assessment,
the nurse notes these assessment findings: b lood pressure 160/98 mm Hg
(elevated from previous readings); pulse rate 110 beats/min and weak;
pitting edema on both ankles; and new -onset confusion. The nurse
suspects that the patient is experiencing which condition?
a. Infection
b. Hypogl ycemia
c. Hypergl ycemi a
d. Fluid overload
ANS: D
Fluid overload may occur with parenteral nutrition. It is manifested by
weak pulse, hypertension, tachycardia, confusion, decreased urine
output, and pitting edema.
DIF: Cognitive Level: Anal yzing (Anal ysis)
TOP: Nursing Process: Ev aluation
MSC: NC LEX: Physiological Integrit y: Pharmacological and
Parenteral Therapies
2. The peripheral parenteral nutrition bag that has been infusing into the
patient is empt y, and the nurse realizes that the next bag is not ready. The
nurse should immediatel y hang which of these intravenous solutions until
the new bag arrives?
, a. 10% dextrose in water
b. 20% dextrose in water
c. 0.9% sodium chloride
d. Lactated Ringer ’s solution
ANS: A
If intravenous parenteral nutrition is discontinued abruptl y, rebound
hypogl ycemia may occur. This can be prevented with infusion of 5% to
10% glucose until the parenteral nutrition infusion is ready. For
peripheral infusions, the dextrose must not be more than 10%.
DIF: Cognitive Level: Appl ying (Application)
TOP: Nursing Process: Imple mentation
MSC: NC LEX: Physiological Integrit y: Pharmacological and
Parenteral Therapies
3. The nurse is preparing to administer medications to a patient who is
receiving a feeding via a gastric tube. When reviewing the patient ’s
medication list, the nurse not es a potential concern about a food –drug
interaction if which medication is listed?
a. Multivitamin solution
b. Phenytoin (Dilantin)
c. Metoclopramide (Reglan)
d. Warfarin (Coumadin)
ANS: B
Tube feedings can reduce the absorption of phenytoin, which may
result in seizures. It is recommended that tube feedings be held for at
least 2 hours before and after the administration of phenytoin.
DIF: Cognitive Level: Appl ying (Application)