Nursing Elites

1. A client with active pulmonary tuberculosis (TB) is to be started on intravenous rifampin therapy. The client should be informed by the nurse that this medication can cause which of the following adverse effects?

• A. Constipation
• B. Black-colored stools
• C. Staining of teeth
• D. Body secretions turning a red-orange color

Correct answer: D

Rationale: The correct answer is D: Body secretions turning a red-orange color. Rifampin is known to cause body secretions, such as urine, sweat, tears, and sputum, to turn a harmless red-orange color. This is a common and expected side effect of rifampin therapy. Choices A, B, and C are incorrect. Constipation is not a common adverse effect of rifampin. Black-colored stools and staining of teeth are not associated with rifampin therapy. It is important for the nurse to educate the client about the harmless red-orange discoloration that may occur with this medication.

2. How can the nurse best explain the difference between angina and a myocardial infarction to a client presenting with severe chest pain?

• A. “Angina usually resolves with rest, and is rarely fatal, while a myocardial infarction necessitates immediate treatment and can be life-threatening.”
• B. “There is a clear distinction between the two. You will receive treatment based on the diagnosis of a myocardial infarction.”
• C. “Both conditions result from a clot obstructing the coronary arteries. Angina occurs with the blockage of a small vessel, whereas a myocardial infarction occurs with a blockage of a large vessel.”
• D. “Angina may not cause as intense chest pain, whereas a myocardial infarction always presents with severe chest pain.”

Correct answer: A

Rationale: When educating a client about the differences between angina and a myocardial infarction, it is crucial to emphasize key distinguishing factors. Angina typically improves with rest and is not usually life-threatening, whereas a myocardial infarction requires urgent intervention as it can be life-threatening. This explanation helps the client understand the urgency and severity associated with a myocardial infarction compared to angina.

3. A drug ending in the suffix (azole) is considered a ______.

• A. H
• B. ACE inhibitor
• C. Antifungal
• D. Beta agonist

Correct answer: C

Rationale: Drugs ending in the suffix -azole are commonly associated with antifungal medications. Examples include fluconazole, ketoconazole, and itraconazole. These medications are used to treat fungal infections by inhibiting the growth of fungi. Therefore, the correct answer is option C, 'Antifungal'. Options A, B, and D do not accurately describe drugs ending in -azole.

4. A client in the operating room received a dose of Succinylcholine. During the operation, the client suddenly develops rigidity, and their body temperature begins to rise. The healthcare provider should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: C

Rationale: Muscle rigidity and a sudden rise in temperature are manifestations of malignant hyperthermia. Dantrolene acts on skeletal muscles to reduce metabolic activity and treat malignant hyperthermia effectively. Neostigmine (choice A) is used to reverse the effects of non-depolarizing neuromuscular blockers, not to treat malignant hyperthermia. Naloxone (choice B) is an opioid antagonist used for opioid overdose. Vecuronium (choice D) is a non-depolarizing neuromuscular blocker and is not used to treat malignant hyperthermia.

5. A child is prescribed Amoxicillin 20 mg/kg/day PO to be administered every 12 hr. The child weighs 44 lb. The available medication is amoxicillin suspension 250 mg/5 mL. How many mL should be given per dose?

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

Correct answer: A

Rationale: To calculate the dosage per administration: Convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the nurse should administer 4 mL of amoxicillin suspension per dose. Choice B, 5 mL, is incorrect because the calculation shows that 4 mL is the correct dose. Choices C and D are also incorrect as they are not in line with the calculated dosage based on the weight of the child and the concentration of the medication.

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