Questions 96

NCLEX-PN

NCLEX-PN Test Bank

MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies Questions

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Question 1 of 5

The nurse has completed swaddling the 2-month-old infant, prepared supplies to cannulate the scalp vein for an IV infusion, and cleansed and shaved the hair at the site over the temporal bone. Place the remaining steps in the order that they should be performed by the nurse.

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Return in 60 minutes and reswaddle the infant in a mummy restraint.
With an assistant holding the infant's head, insert a scalp vein needle and observe for blood return.
Apply lidocaine/prilocaine cream to the site selected and unswaddle the infant after the cream application.
Cleanse the shaved area with an antiseptic solution.
Remove the mummy restraint after initiating the infusion and comfort the infant.
Initiate the infusion and cover the infusion needle with a gauze dressing.

Correct Answer: C,A,D,B,F,E

Rationale: C: Apply lidocaine/prilocaine (EML
A) cream to the site selected and unswaddle the infant after the cream application. An anesthetic cream will numb the site and help reduce the infant's pain during insertion. The infant does not need to remain swaddled while the cream reaches its therapeutic effectiveness in about an hour. A: Return in 60 minutes and reswaddle the infant in a mummy restraint. It takes about an hour for the lidocaine/prilocaine cream to reach its therapeutic effectiveness. The infant should be reswaddled to minimize movement during insertion. D: Cleanse the shaved area with an antiseptic solution. Cleansing the area with an antiseptic solution will help prevent inadvertent introduction of microorganisms into the vascular system. B: With an assistant holding the infant's head, insert a scalp vein needle and observe for blood return. Movement of the infant's head can result in loss of the vein access or a needle-stick injury to the infant or nurse. F: Initiate the infusion and cover the infusion needle with a gauze dressing. Once the vein has been successfully cannulated, the site can be dressed and IV fluids started. E: Remove the mummy restraint after initiating the infusion and comfort the infant. The mummy restraint is no longer needed after the IV catheter has been successfully inserted into a scalp vein.

Question 2 of 5

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Question 3 of 5

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Question 4 of 5

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Question 5 of 5

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