Nursing Elites

1. A client with peptic ulcer disease reports a headache. Which of the following medications should the nurse plan to administer?

• A. Ibuprofen
• B. Naproxen
• C. Aspirin
• D. Acetaminophen

Correct answer: D

Rationale: Acetaminophen is the preferred analgesic for clients with peptic ulcer disease because it does not cause gastrointestinal irritation, unlike Ibuprofen, Naproxen, and Aspirin, which can exacerbate peptic ulcer symptoms and lead to gastrointestinal complications.

2. A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take?

• A. Administer a small test dose before giving the full dose
• B. Infuse the medication over 30 seconds
• C. Monitor client closely for hypertension
• D. Administer cyanocobalamin as an antidote if toxicity occurs

Correct answer: A

Rationale: The correct action the nurse should plan to take when preparing to administer iron dextran IV is to administer a small test dose before giving the full dose. This is done to assess for any allergic reactions that the client may have to the medication. Choice B is incorrect because iron dextran should be infused slowly over a longer period, typically over 1-2 hours to reduce the risk of adverse reactions. Choice C is incorrect because iron dextran administration is more commonly associated with hypotension rather than hypertension. Choice D is incorrect because cyanocobalamin is not used as an antidote for iron dextran toxicity; instead, treatment for iron toxicity may involve supportive care, chelation therapy, or in severe cases, iron antidotes like deferoxamine.

3. A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?

• A. Stop taking the isoniazid for 3 days and the discoloration should go away.
• B. Rifampin can turn body fluids orange.
• C. I'll make an appointment for you to see the provider this afternoon.
• D. Isoniazid can cause bladder irritation.

Correct answer: B

Rationale: The correct answer is B: 'Rifampin can turn body fluids orange.' Rifampin is known to cause orange discoloration of body fluids, including urine. This side effect is harmless and does not indicate a need to stop the medication. Choice A is incorrect because stopping isoniazid will not resolve the orange urine discoloration caused by rifampin. Choice C is unnecessary at this point since the orange urine is a known side effect of rifampin and does not require an urgent provider visit. Choice D is incorrect because bladder irritation is not typically associated with isoniazid.

4. A nurse is planning to administer chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. The amount available is chlorothiazide oral suspension 250 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest tenth)

• A. 2.6 mL
• B. 2.63 mL
• C. 2.7 mL
• D. 2.2 mL

Correct answer: A

Rationale: To find the dose per administration, first convert the toddler's weight to kg: 28.6 lb ÷ 2.2 = 13 kg. Then calculate the total daily dose: 20 mg/kg × 13 kg = 260 mg/day. Since it is divided into two doses, each dose is 130 mg. The concentration of the oral suspension is 250 mg/5 mL = 50 mg/mL. Therefore, to find the volume needed per dose, divide the dose by the concentration: 130 mg ÷ 50 mg/mL = 2.6 mL per dose. Hence, the nurse should administer 2.6 mL per dose. Choices B, C, and D are incorrect as they do not accurately calculate the dosage of chlorothiazide needed per dose based on the toddler's weight and the concentration of the oral suspension.

5. A client at 28 weeks of gestation is experiencing preterm labor. Which of the following medications should the nurse plan to administer?

• A. Oxytocin
• B. Nifedipine
• C. Dinoprostone
• D. Misoprostol

Correct answer: B

Rationale: Nifedipine is the correct choice because it is a calcium channel blocker that helps relax the uterus and stop preterm labor. Oxytocin (Choice A) is used to induce labor, not to stop preterm labor. Dinoprostone (Choice C) and Misoprostol (Choice D) are prostaglandins used to induce labor and ripen the cervix, not to stop preterm labor.

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