NURS 306 MC questions part uno
1. D
A is incorrect because the nurse should change the IV solution every 24 hours
to reduce the risk of infection
B is incorrect because the dressing should every 96 hours
C is uncorrected because the nurse should check the client at least every 4
hours to monitor the IV insertion site for infection, phlebitis, or infiltration and
to monitor the client's fluid status: A nurse is caring for a client who is receiving
a continuous IV infusion through a short-peripheral device. Which of the following
actions should the nurse take?
A. Ensure the client's IV solution is changed every 48 hours
B. Replace the client's transparent IV dressing every 24 hours
C. Check the client's IV site every 8 hours
D. Change the client's IV tubing every 96 hours
2. A
It is possible that the catheter is up against a valve or near a nerve and is
causing more pain than an IV catheter insertion should. The nurse should
remove the source of the pain and establish peripheral IV access elsewhere: A
nurse is preparing a client for outpatient surgery. After the nurse inserts the IV
catheter, the client reports pain in the insertion area. Which of the following actions
should the nurse take?
A. Remove the catheter and insert another into a different area
B. Administer an analgesic PO
C. Request a prescription for placement of a central venous access device
D. Administer a local anesthetic
3. B
This is to prevent bacteria from developing in the tubing
A is incorrect because the nurse should obtain BG every 4 hours
C is incorrect because the client's IV site dressing should be changed every
48 to 72 hours
D is incorrect because the patient should be weighed daily: A nurse is assess-
ing a client who is receiving total parenteral nutrition (TPN) therapy via an infusion
pump. Which of the following actions should the nurse take?
A. Obtain the client's blood glucose every 12 hours
, NURS 306 MC questions part uno
B. Change the IV tubing every 24 hours
C. Change the IV site dressing every 4 days
D. Weigh the client every other day
4. C, D, F: The nurse is caring for an older adult who is receiving multiple packed
red blood cell transfusions. Which assessment findings indicate possible transfusion
circulatory overload? Select all that apply.
A. Bradycardia
B. Acute confusion
C. Dyspnea
D. Hypertension
E. Depression
F. Bounding pulse
5. C: Which statement about blood transfusion capabilities is correct?
A. Donor type B can donate to recipient blood type O
B. Donor type AB can donate to anyone
C. Donor type O can donate to anyone
D. Donor type A can donate to recipient blood type AB
E. Donor type A can donate to recipient blood type B
6. Everything but F: What action should the nurse taken when witnessing a possi-
ble blood transfusion reaction? (Select all that apply)
A. Send the blood bag and tubing to the blood bank for analysis
B. Stop the transfusion
C. Notify the primary care provider
D. Maintain an IV infusion with 0.9% sodium chloride
E. Check vital signs
F. Obtain blood cultures
7. D
My dude is giving hyperglycemia: A patient started on total parenteral nutrition
(TPN) is complaining of thirst and states he has urinated 4 times over the past hour.
Which action by the nurse is a priority?
A. Obtain a urine specimen for culture and sensitivity
B. Notify the provider
C. Immediately stop the TPN infusion and notify the provider
D. Check capillary glucose levels
, NURS 306 MC questions part uno
8. D: A nurse is caring for an older client who exhibits dehydration-induced confu-
sion. Which intervention by the nurse is the best?
A. Increase the IV flow rate to 250 mL/hr
B. Measure intake and output every 4 hours
C. Place the client in a high-Fowler position
D. Assess the client further for fall risk
9. C: After starting IV access, what is best for the nurse to document immediately
after the procedure?
A. Type, amount, and flow rate of IV fluid. Condition of the IV site
B. The type of IV fluid hung and equipment used
C. The date, time, venipuncture site, type, the gauge of the catheter, and IV fluid
hung
D. The type of catheter used and the number of venipuncture attempts
10. A, C, E: The nurse started the transfusion of 1 unit of PRBs. Which clinical
findings indicate a complication of allergic reaction? (Select all that apply)
A. Urticaria
B. Lower back pain
C. Pruritus
D. Chills
E. Wheezing
11. A: The nurse is caring for a client who just had a peripherally inserted central
catheter (PICC) insertion. Which of the following actions tells the nurse that a student
nurse understands the care of the client with a PICC line?
A. Use 10 mL normal saline to flush the line
B. Cover the insertion site with a 4x4 gauze to prevent bleeding
C. May perform blood pressure monitoring on the affected arm
D. Able to shower at home without restrictions
12. B: The client receiving TPN via a central venous catheter (CVC) is scheduled for
an IV antibiotic. The nurses' first action is to:
A. Turn off the TPN for 30 minutes to run the antibiotic
B. Ensure that the client has a separate line for the antibiotic
C. Check the TPN for compatibility with the antibiotic
D. Flush the TPN line with normal saline then run the antibiotic
, NURS 306 MC questions part uno
13. A: The nurse is preparing to administer a blood transfusion. Which action is the
most important?
A. Put on a pair of gloves
B. Document transfusion
C. Place the client in isolation
D. Place the client on NPO status
14. D
A is incorrect because soft restraints should be used, not mittens
B is incorrect because oral care should be every 2 hours
C is incorrect because ventilator settings should be checked every 8 hours
against the computer: A nurse is caring for a patient who is receiving mechanical
ventilation via endotracheal tube. Which of the following actions should the nurse
take?
A. Apply mittens if self-extubation is attempted
B. Perform oral care once per shift
C. Monitor ventilator settings as needed
D. Document tube placement in centimeters at the lips
15. C
ABC's bruh. Airway takes priority always: A patient has been brought to the
emergency department with a life-threatening chest injury. What action by the nurse
takes priority?
A. Apply oxygen at 100%
B. Assess the respiratory rate
C. Ensure a patent airway
D. Administer 1L crystalloid fluid bolus
16. C
The nurse should recognize that the client is ready for discharge when the
spouse demonstrates an ability to perform the procedure that will need to
be performed independently at home.: A nurse is caring for a client with a
tracheostomy. The client's partner has been taught to perform suctioning. Which of
the following actions by the partner should indicate to the nurse a readiness for the
client's discharge?
1. D
A is incorrect because the nurse should change the IV solution every 24 hours
to reduce the risk of infection
B is incorrect because the dressing should every 96 hours
C is uncorrected because the nurse should check the client at least every 4
hours to monitor the IV insertion site for infection, phlebitis, or infiltration and
to monitor the client's fluid status: A nurse is caring for a client who is receiving
a continuous IV infusion through a short-peripheral device. Which of the following
actions should the nurse take?
A. Ensure the client's IV solution is changed every 48 hours
B. Replace the client's transparent IV dressing every 24 hours
C. Check the client's IV site every 8 hours
D. Change the client's IV tubing every 96 hours
2. A
It is possible that the catheter is up against a valve or near a nerve and is
causing more pain than an IV catheter insertion should. The nurse should
remove the source of the pain and establish peripheral IV access elsewhere: A
nurse is preparing a client for outpatient surgery. After the nurse inserts the IV
catheter, the client reports pain in the insertion area. Which of the following actions
should the nurse take?
A. Remove the catheter and insert another into a different area
B. Administer an analgesic PO
C. Request a prescription for placement of a central venous access device
D. Administer a local anesthetic
3. B
This is to prevent bacteria from developing in the tubing
A is incorrect because the nurse should obtain BG every 4 hours
C is incorrect because the client's IV site dressing should be changed every
48 to 72 hours
D is incorrect because the patient should be weighed daily: A nurse is assess-
ing a client who is receiving total parenteral nutrition (TPN) therapy via an infusion
pump. Which of the following actions should the nurse take?
A. Obtain the client's blood glucose every 12 hours
, NURS 306 MC questions part uno
B. Change the IV tubing every 24 hours
C. Change the IV site dressing every 4 days
D. Weigh the client every other day
4. C, D, F: The nurse is caring for an older adult who is receiving multiple packed
red blood cell transfusions. Which assessment findings indicate possible transfusion
circulatory overload? Select all that apply.
A. Bradycardia
B. Acute confusion
C. Dyspnea
D. Hypertension
E. Depression
F. Bounding pulse
5. C: Which statement about blood transfusion capabilities is correct?
A. Donor type B can donate to recipient blood type O
B. Donor type AB can donate to anyone
C. Donor type O can donate to anyone
D. Donor type A can donate to recipient blood type AB
E. Donor type A can donate to recipient blood type B
6. Everything but F: What action should the nurse taken when witnessing a possi-
ble blood transfusion reaction? (Select all that apply)
A. Send the blood bag and tubing to the blood bank for analysis
B. Stop the transfusion
C. Notify the primary care provider
D. Maintain an IV infusion with 0.9% sodium chloride
E. Check vital signs
F. Obtain blood cultures
7. D
My dude is giving hyperglycemia: A patient started on total parenteral nutrition
(TPN) is complaining of thirst and states he has urinated 4 times over the past hour.
Which action by the nurse is a priority?
A. Obtain a urine specimen for culture and sensitivity
B. Notify the provider
C. Immediately stop the TPN infusion and notify the provider
D. Check capillary glucose levels
, NURS 306 MC questions part uno
8. D: A nurse is caring for an older client who exhibits dehydration-induced confu-
sion. Which intervention by the nurse is the best?
A. Increase the IV flow rate to 250 mL/hr
B. Measure intake and output every 4 hours
C. Place the client in a high-Fowler position
D. Assess the client further for fall risk
9. C: After starting IV access, what is best for the nurse to document immediately
after the procedure?
A. Type, amount, and flow rate of IV fluid. Condition of the IV site
B. The type of IV fluid hung and equipment used
C. The date, time, venipuncture site, type, the gauge of the catheter, and IV fluid
hung
D. The type of catheter used and the number of venipuncture attempts
10. A, C, E: The nurse started the transfusion of 1 unit of PRBs. Which clinical
findings indicate a complication of allergic reaction? (Select all that apply)
A. Urticaria
B. Lower back pain
C. Pruritus
D. Chills
E. Wheezing
11. A: The nurse is caring for a client who just had a peripherally inserted central
catheter (PICC) insertion. Which of the following actions tells the nurse that a student
nurse understands the care of the client with a PICC line?
A. Use 10 mL normal saline to flush the line
B. Cover the insertion site with a 4x4 gauze to prevent bleeding
C. May perform blood pressure monitoring on the affected arm
D. Able to shower at home without restrictions
12. B: The client receiving TPN via a central venous catheter (CVC) is scheduled for
an IV antibiotic. The nurses' first action is to:
A. Turn off the TPN for 30 minutes to run the antibiotic
B. Ensure that the client has a separate line for the antibiotic
C. Check the TPN for compatibility with the antibiotic
D. Flush the TPN line with normal saline then run the antibiotic
, NURS 306 MC questions part uno
13. A: The nurse is preparing to administer a blood transfusion. Which action is the
most important?
A. Put on a pair of gloves
B. Document transfusion
C. Place the client in isolation
D. Place the client on NPO status
14. D
A is incorrect because soft restraints should be used, not mittens
B is incorrect because oral care should be every 2 hours
C is incorrect because ventilator settings should be checked every 8 hours
against the computer: A nurse is caring for a patient who is receiving mechanical
ventilation via endotracheal tube. Which of the following actions should the nurse
take?
A. Apply mittens if self-extubation is attempted
B. Perform oral care once per shift
C. Monitor ventilator settings as needed
D. Document tube placement in centimeters at the lips
15. C
ABC's bruh. Airway takes priority always: A patient has been brought to the
emergency department with a life-threatening chest injury. What action by the nurse
takes priority?
A. Apply oxygen at 100%
B. Assess the respiratory rate
C. Ensure a patent airway
D. Administer 1L crystalloid fluid bolus
16. C
The nurse should recognize that the client is ready for discharge when the
spouse demonstrates an ability to perform the procedure that will need to
be performed independently at home.: A nurse is caring for a client with a
tracheostomy. The client's partner has been taught to perform suctioning. Which of
the following actions by the partner should indicate to the nurse a readiness for the
client's discharge?
