Nursing Elites

1. 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.

2. A nurse is providing teaching to a client who has asthma and is beginning to take montelukast. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will use this medication as a rescue inhaler during asthma attacks.
• B. I should take this medication once daily in the evening.
• C. I need to have my blood levels checked regularly while taking this medication.
• D. I should take this medication before exercising to prevent bronchospasm.

Correct answer: B

Rationale: Montelukast is typically taken once daily in the evening for long-term control of asthma symptoms. It helps prevent asthma attacks by reducing inflammation in the airways. While montelukast can also be used for exercise-induced bronchospasm in some cases, it is generally not a rescue medication and should be taken regularly, not on an as-needed basis.

3. When starting therapy with raloxifene, a client should monitor for which of the following adverse effects?

• A. Leg cramps
• B. Hot flashes
• C. Urinary frequency
• D. Hair loss

Correct answer: B

Rationale: The correct answer is B: Hot flashes. When initiating therapy with raloxifene, clients should be advised to monitor for hot flashes as they are a common adverse effect associated with this medication. Hot flashes are a well-known side effect of raloxifene due to its action on estrogen receptors. Leg cramps (Choice A), urinary frequency (Choice C), and hair loss (Choice D) are not typically associated with raloxifene therapy. Therefore, monitoring for hot flashes is crucial to manage and address this common side effect appropriately.

4. What should you monitor when administering Clopidogrel to a patient?

• A. Signs of thrombotic thrombocytopenic purpura
• B. Bleeding during therapy
• C. CBC with differential and platelet count
• D. All of the above

Correct answer: D

Rationale: When administering Clopidogrel, it is crucial to monitor for signs of thrombotic thrombocytopenic purpura, bleeding during therapy, and changes in CBC with differential and platelet count. Thrombotic thrombocytopenic purpura is a rare but serious condition associated with Clopidogrel use, characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, fever, and renal dysfunction. Monitoring for signs of thrombotic thrombocytopenic purpura is essential to detect this potentially life-threatening condition early. Monitoring for bleeding helps to assess the risk of hemorrhagic events, a known side effect of Clopidogrel. Additionally, regular monitoring of CBC with differential and platelet count is necessary to evaluate the drug's impact on blood cell counts and detect any abnormalities that may require intervention. Therefore, monitoring all these parameters is vital to ensure patient safety and appropriate management during Clopidogrel therapy.

5. A client reports taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

• A. Sedation
• B. Nasal congestion
• C. Productive cough
• D. Constipation

Correct answer: B

Rationale: The correct answer is B: Nasal congestion. When used for more than 5 days, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion, which is an adverse effect to be assessed in the client. Sedation (choice A) is not a common adverse effect of phenylephrine. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with phenylephrine use.

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