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 Warfarin?

• A. Vitamin D
• B. Vitamin C
• C. Vitamin K
• D. Vitamin B6

Correct answer: C

Rationale: Vitamin K is the antidote for Warfarin toxicity as it helps reverse the anticoagulant effects of Warfarin. Warfarin works by inhibiting vitamin K-dependent clotting factors, and administering vitamin K can replenish these factors, thereby counteracting the anticoagulant effects of Warfarin. Vitamin D, Vitamin C, and Vitamin B6 do not have the specific mechanism to counteract the anticoagulant effects of Warfarin, making them incorrect choices.

3. A client is receiving vancomycin. Which of the following laboratory results should be monitored to evaluate the therapeutic effect of this medication?

• A. BUN
• B. Creatinine
• C. Hemoglobin
• D. White blood cell count

Correct answer: B

Rationale: Corrected Rationale: Creatinine levels should be monitored to evaluate vancomycin's effect on kidney function. Vancomycin can be nephrotoxic, so monitoring creatinine levels helps assess renal function and ensure that the medication is not causing harm to the kidneys. Monitoring BUN (choice A) is important for assessing kidney function but is not as specific as monitoring creatinine levels. Hemoglobin (choice C) and white blood cell count (choice D) are not directly related to evaluating the therapeutic effect of vancomycin.

4. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?

• A. Spironolactone
• B. Furosemide
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: A

Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.

5. A client has a new prescription for Iron supplements. Which of the following instructions should be included?

• A. Take the medication with a glass of milk.
• B. Avoid taking the medication with orange juice.
• C. Increase fiber intake to prevent constipation.
• D. Expect stools to be bright red.

Correct answer: C

Rationale: The correct answer is C: 'Increase fiber intake to prevent constipation.' Iron supplements commonly cause constipation as a side effect. Increasing fiber intake can help alleviate this issue by promoting regular bowel movements and preventing constipation. Choice A is incorrect as iron absorption is hindered when taken with milk. Choice B is not directly related to iron supplements. Choice D is incorrect as iron supplements do not typically cause bright red stools.

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