Nursing Elites

1. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function and potential worsening heart failure. This finding should be reported promptly to the provider for further evaluation and management to prevent complications. Weight loss, while significant, may be expected with diuretic use. A blood pressure of 104/60 mm Hg is within normal range and can be managed. A potassium level of 3.5 mEq/L is slightly low but not an immediate concern.

2. A preschooler weighing 44 lb is to receive Amoxicillin 20 mg/kg/day PO divided equally every 12 hr. The available amoxicillin suspension is 250 mg/5 mL. How many mL should the nurse administer per dose?

• A. 4 mL
• B. 5 mL
• C. 6 mL
• D. 3 mL

Correct answer: A

Rationale: To calculate the dosage per administration: First, convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, calculate the required dosage per dose: (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. To determine the mL per dose, divide the required dosage by the concentration of the amoxicillin suspension: (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the correct answer is 4 mL. Choice B (5 mL) is incorrect because the correct calculation yields 4 mL. Choices C (6 mL) and D (3 mL) are also incorrect as they do not align with the accurate calculation based on the provided information.

3. A client has a new prescription for Simvastatin. Which of the following client statements indicates an understanding of the teaching?

• A. I will take this medication at bedtime.
• B. I should avoid eating grapefruit while taking this medication.
• C. I will need to monitor my blood sugar closely while taking this medication.
• D. I will stop taking the medication if I develop muscle pain.

Correct answer: B

Rationale: The correct answer is B. Grapefruit can increase the levels of simvastatin in the blood, leading to an increased risk of serious side effects, including muscle pain or damage. Therefore, it is crucial for the client to avoid consuming grapefruit while taking this medication to prevent potential complications.

4. A client is prescribed Propylthiouracil (PTU) for the treatment of Graves' disease. Which adverse effect should the client be instructed to report?

• A. Sore throat.
• B. Drowsiness.
• C. Urinary retention.
• D. Heat intolerance.

Correct answer: A

Rationale: The correct answer is A: Sore throat. A sore throat and fever can indicate agranulocytosis, a serious adverse effect of PTU that can lead to a decreased white blood cell count. This condition requires immediate medical attention to prevent complications. Choice B, drowsiness, is not typically associated with PTU and is not a common adverse effect that needs to be reported. Choice C, urinary retention, is not a typical adverse effect of PTU; therefore, it is not the correct answer. Choice D, heat intolerance, is a symptom commonly seen in hyperthyroidism, which PTU is used to treat, so it is not an adverse effect that needs to be specifically reported.

5. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?

• A. 22 gtt/min
• B. 24 gtt/min
• C. 20 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect as it results from a miscalculation. Choices C and D, 20 gtt/min and 18 gtt/min respectively, are also incorrect calculations based on the given parameters.

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