Nursing Elites

1. A client is admitted for a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine is known to produce psychological effects, such as hallucinations. Therefore, individuals with schizophrenia are at increased risk of experiencing exacerbation of their symptoms if given Ketamine, making it a contraindication for its use as an intravenous anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for Ketamine use as an intravenous anesthetic.

2. What is the antidote for Warfarin?

• A. Vitamin D
• B. Vitamin C
• C. Vitamin K
• D. Vitamin B6

Correct answer: C

Rationale: Vitamin K is the antidote for Warfarin toxicity as it helps reverse the anticoagulant effects of Warfarin. Warfarin works by inhibiting vitamin K-dependent clotting factors, and administering vitamin K can replenish these factors, thereby counteracting the anticoagulant effects of Warfarin. Vitamin D, Vitamin C, and Vitamin B6 do not have the specific mechanism to counteract the anticoagulant effects of Warfarin, making them incorrect choices.

3. A healthcare professional is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare professional should recognize that the medication affected which of the following systems in the client?

• A. Cardiovascular
• B. Immune
• C. Central nervous
• D. Gastrointestinal

Correct answer: C

Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders caused by certain medications affecting the central nervous system. These effects can include symptoms like tremors, rigidity, and bradykinesia. Medications like typical antipsychotics induce extrapyramidal effects by interfering with dopamine transmission in the central nervous system. Choices A, B, and D are incorrect as extrapyramidal effects are specifically related to the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.

4. A client is receiving discharge teaching for a new prescription of Fluoxetine for PTSD. Which of the following statements should be included in the teaching?

• A. You may experience a decreased desire for intimacy while taking this medication.
• B. You should take this medication in the evening to help promote sleep.
• C. You may experience fewer urinary adverse effects if you urinate just before taking this medication.
• D. You should wear sunglasses when outdoors due to the light sensitivity caused by this medication.

Correct answer: A

Rationale: One of the potential adverse effects of fluoxetine and other SSRIs is a decreased libido, which can impact intimacy. It is essential for the nurse to educate the client about this possible side effect to promote awareness and understanding of the medication's effects.

5. A healthcare professional is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The healthcare professional should set the IV pump to deliver how many mL/hr?

• A. 200 mL/hr
• B. 150 mL/hr
• C. 100 mL/hr
• D. 250 mL/hr

Correct answer: A

Rationale: To calculate the flow rate in mL/hr: (Volume in mL / Time in hours) = Flow rate in mL/hr. In this case, (100 mL / 0.5 hr) = 200 mL/hr. The correct calculation is: 100 mL (volume) / 0.5 hr (time) = 200 mL/hr. Therefore, the correct answer is 200 mL/hr. Choice B (150 mL/hr), C (100 mL/hr), and D (250 mL/hr) are incorrect as they do not match the calculated flow rate needed for the administration of clindamycin.

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