Nursing Elites

1. 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.

2. A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include that a severe allergy to which of the following medications is a contraindication to ceftriaxone?

• A. Gentamicin
• B. Clindamycin
• C. Piperacillin
• D. Sulfamethoxazole-trimethoprim

Correct answer: C

Rationale: The correct answer is C. Ceftriaxone, a cephalosporin antibiotic, has a cross-sensitivity with penicillin antibiotics like piperacillin. Therefore, a severe allergy to penicillin or penicillin-related antibiotics would be a contraindication to ceftriaxone. Choices A, B, and D are incorrect because they are not associated with a known cross-sensitivity with ceftriaxone.

3. A client with rheumatoid arthritis is prescribed long-term prednisone therapy. What adverse effect should the client monitor for according to the nurse's instruction?

• A. Stress fractures
• B. Orthostatic hypotension
• C. Gingival ulcerations
• D. Weight loss

Correct answer: A

Rationale: The correct answer is A: Stress fractures. Long-term prednisone therapy can lead to osteoporosis, which increases the risk of stress fractures. Option B, orthostatic hypotension, is not a common adverse effect associated with prednisone use. Option C, gingival ulcerations, is more commonly associated with conditions like periodontal disease or poor oral hygiene rather than prednisone therapy. Option D, weight loss, is not a typical adverse effect of prednisone; in fact, weight gain is more common due to prednisone's impact on metabolism.

4. 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.

5. A healthcare professional is reviewing the laboratory results for a client who has a prescription for filgrastim. The healthcare professional should recognize that an increase in which of the following values indicates a therapeutic effect of this medication?

• A. Erythrocyte count
• B. Neutrophil count
• C. Lymphocyte count
• D. Thrombocyte count

Correct answer: B

Rationale: Filgrastim is a medication used to stimulate the production of neutrophils in patients with neutropenia. Neutrophils are a type of white blood cell that plays a crucial role in fighting off infections. Therefore, an increase in neutrophil count would indicate a therapeutic effect of filgrastim. The other options, such as erythrocyte count (red blood cells), lymphocyte count, and thrombocyte count (platelets), are not directly affected by filgrastim and would not indicate a therapeutic effect of this medication.

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