Nursing Elites

1. A healthcare professional is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. How many mL/hr should the IV pump be set to deliver?

• A. 200 mL/hr
• B. 150 mL/hr
• C. 100 mL/hr
• D. 250 mL/hr

Correct answer: A

Rationale: To calculate the flow rate in mL/hr: (Volume in mL / Time in hours) = Flow rate in mL/hr. In this case, (100 mL / 0.5 hr) = 200 mL/hr. Therefore, the IV pump should be set to deliver 200 mL/hr to administer clindamycin 200 mg over 30 minutes. Choice A is correct because it provides the accurate flow rate needed for the administration of the medication. Choices B, C, and D are incorrect as they do not calculate the flow rate correctly based on the volume and time specified in the question.

2. A client has a new prescription for Amiodarone. Which of the following instructions should the nurse include?

• A. Take this medication with meals.
• B. Avoid drinking grapefruit juice.
• C. Take this medication at bedtime.
• D. Increase your intake of sodium-rich foods.

Correct answer: B

Rationale: The correct instruction the nurse should include is to advise the client to avoid drinking grapefruit juice while taking Amiodarone. Grapefruit juice can inhibit the metabolism of Amiodarone, leading to increased blood levels of the medication and raising the risk of adverse effects, such as cardiac toxicity. Choices A, C, and D are incorrect. Taking Amiodarone with meals, at bedtime, or increasing intake of sodium-rich foods are not necessary instructions for this medication.

3. A client has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication?

• A. Sodium 140 mEq/L
• B. Potassium 4.5 mEq/L
• C. BUN 55 mg/dL
• D. Glucose 120 mg/dL

Correct answer: C

Rationale: An elevated BUN level of 55 mg/dL should be reported before starting amphotericin B due to its nephrotoxic effects. Amphotericin B can cause kidney damage, and an elevated BUN indicates impaired kidney function, increasing the risk of further renal damage with this medication. Sodium, potassium, and glucose levels are not directly associated with the nephrotoxic effects of amphotericin B, making choices A, B, and D incorrect.

4. A client has a prescription for Heparin. Which of the following laboratory tests should be monitored while the client is receiving Heparin?

• A. Prothrombin time (PT)
• B. Complete blood count (CBC)
• C. International normalized ratio (INR)
• D. Activated partial thromboplastin time (aPTT)

Correct answer: D

Rationale: Activated partial thromboplastin time (aPTT) is the correct laboratory test to monitor while a client is receiving Heparin. This test is used to assess the therapeutic levels of heparin in the blood, ensuring that the dose is within the safe and effective range. Monitoring aPTT helps healthcare providers adjust the dosage of Heparin to prevent complications such as bleeding or clotting.

5. A client with a urinary tract infection (UTI) is prescribed ciprofloxacin. Which instruction should the nurse provide to the client?

• A. If the medication causes an upset stomach, take an antacid at the same time.
• B. Increase your daily fluid intake while taking this medication.
• C. This medication can cause photophobia, so avoid direct sunlight exposure.
• D. You should report any tendon discomfort you experience while taking this medication.

Correct answer: D

Rationale: The correct answer is D. Tendon discomfort is a potential side effect of ciprofloxacin that can lead to tendon rupture and should be reported immediately to prevent serious complications. Monitoring for this adverse effect is crucial for patient safety. Choices A, B, and C are incorrect because: A) Taking an antacid with ciprofloxacin can interfere with its absorption. B) Increasing fluid intake is generally a good recommendation but not specifically related to the side effects of ciprofloxacin. C) Photophobia is not a common side effect of ciprofloxacin; therefore, avoiding direct sunlight exposure is not necessary.

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