Nursing Elites

1. A preschooler weighing 44 lb is to receive Amoxicillin 20 mg/kg/day PO divided equally every 12 hr. The available amoxicillin suspension is 250 mg/5 mL. How many mL should the nurse administer per dose?

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

Correct answer: A

Rationale: To calculate the dosage per administration: First, convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, calculate the required dosage per dose: (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. To determine the mL per dose, divide the required dosage by the concentration of the amoxicillin suspension: (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the correct answer is 4 mL. Choice B (5 mL) is incorrect because the correct calculation yields 4 mL. Choices C (6 mL) and D (3 mL) are also incorrect as they do not align with the accurate calculation based on the provided information.

2. What is the antidote for Heparin?

• A. Protamine sulfate
• B. Vitamin K
• C. Naloxone
• D. Toradol

Correct answer: A

Rationale: The correct answer is A: Protamine sulfate. Heparin is an anticoagulant that prevents blood clotting. Protamine sulfate is the antidote for Heparin as it binds to heparin, neutralizing its anticoagulant effects. Vitamin K is not the antidote for Heparin; it is used to reverse the effects of warfarin, another anticoagulant. Naloxone is an opioid antagonist for opioids, and Toradol is a nonsteroidal anti-inflammatory drug (NSAID) for pain relief. Therefore, the correct antidote for Heparin is Protamine sulfate.

3. A healthcare professional is reviewing the medication administration record for a client who is receiving transdermal Fentanyl for severe pain. Which of the following medications should the healthcare professional expect to cause an adverse effect when administered concurrently with Fentanyl?

• A. Ampicillin
• B. Diazepam
• C. Furosemide
• D. Prednisone

Correct answer: B

Rationale: Diazepam, a CNS depressant, can lead to severe sedation when administered concurrently with an opioid like Fentanyl due to their additive central nervous system depressant effects. This interaction can potentiate respiratory depression and other CNS effects, increasing the risk of adverse outcomes.

4. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.

5. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?

• A. Clopidogrel (Plavix)
• B. Morphine
• C. Aspirin (ASA)
• D. Metoprolol (Lopressor)

Correct answer: A

Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.

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