Nursing Elites

1. A client has a new prescription for clonidine to treat hypertension. Which of the following instructions should the nurse include?

• A. Discontinue the medication if a rash develops.
• B. Expect increased salivation during the first few weeks of therapy.
• C. Avoid driving until the client's reaction to the medication is known.
• D. Stop the medication if you experience a dry mouth.

Correct answer: C

Rationale: The correct instruction for a client starting clonidine therapy for hypertension is to avoid driving until their reaction to the medication is known. Clonidine can cause drowsiness, so engaging in activities like driving that require alertness should be avoided until the individual understands how the medication affects them. Choices A, B, and D are incorrect because they do not address the specific side effect of drowsiness associated with clonidine that could impair driving abilities. Discontinuing the medication if a rash develops, expecting increased salivation, or stopping the medication for dry mouth are not primary concerns related to clonidine therapy for hypertension.

2. A client has a new prescription for Efavirenz, an NNRTI. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime to prevent drowsiness.
• B. Take this medication with a glass of milk.
• C. Take this medication with a glass of juice.
• D. Take this medication at the same time every day.

Correct answer: A

Rationale: The correct instruction is to take Efavirenz at bedtime to prevent drowsiness and manage central nervous system side effects like dizziness and vivid dreams. While it is important to take the medication at the same time daily for consistent blood levels, the emphasis should be on bedtime to minimize the impact of these side effects. Choices B and C suggesting taking the medication with milk or juice are incorrect and not relevant to optimizing Efavirenz therapy.

3. When preparing to administer IV Acyclovir for Herpes Zoster, what action should the nurse take?

• A. Infuse the medication over 1 hour.
• B. Monitor the client's blood pressure every 15 minutes during infusion.
• C. Administer a stool softener.
• D. Monitor the client's blood glucose level every 4 hours during infusion.

Correct answer: A

Rationale: The correct action for the nurse is to infuse IV Acyclovir over at least 1 hour to prevent nephrotoxicity. Rapid infusion can lead to adverse effects, so a slow infusion rate is crucial for patient safety. Monitoring blood pressure, administering a stool softener, or monitoring blood glucose levels are not directly related to the administration of IV Acyclovir for Herpes Zoster.

4. 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.

5. A client has been prescribed Prednisone for asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take this medication with food to prevent nausea.
• B. Take this medication at bedtime to reduce drowsiness.
• C. Take this medication in the morning to reduce insomnia.
• D. Avoid sudden changes in position.

Correct answer: C

Rationale: Prednisone is best taken in the morning to reduce the risk of insomnia, a common side effect of corticosteroids. Instructing the client to take the medication in the morning aligns with the goal of minimizing the impact of insomnia, which can disrupt sleep patterns and affect overall well-being. Choices A, B, and D are incorrect. Taking Prednisone with food does not primarily focus on preventing nausea; taking it at bedtime does not primarily reduce drowsiness, and avoiding sudden changes in position is not a specific instruction related to Prednisone use for asthma.

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