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. In an acute mental health facility, a patient experiencing opioid withdrawal has a new prescription for Clonidine. What action should the nurse identify as the priority?

• A. Administer the Clonidine as prescribed.
• B. Provide ice chips to the patient.
• C. Educate the patient on Clonidine's effects.
• D. Obtain baseline vital signs.

Correct answer: D

Rationale: In this scenario, the priority action for the nurse is to obtain baseline vital signs. This is essential for establishing a baseline assessment, especially for a patient undergoing opioid withdrawal and starting a new medication like Clonidine. Monitoring vital signs is crucial for evaluating the patient's response to treatment and detecting any potential complications early on. Administering the medication, providing ice chips, and educating the patient on Clonidine's effects are important tasks but obtaining baseline vital signs takes precedence to ensure the patient's safety and proper management.

3. When teaching a client who has a new prescription for Dextromethorphan to suppress a cough, which adverse effect should the nurse instruct the client to monitor for?

• A. Diarrhea
• B. Anxiety
• C. Sedation
• D. Palpitations

Correct answer: C

Rationale: The correct answer is C: Sedation. Dextromethorphan can cause sedation, so the client should be advised to avoid activities that require alertness. Diarrhea, anxiety, and palpitations are not commonly associated adverse effects of Dextromethorphan.

4. When a client is receiving treatment with methotrexate, which supplement should the nurse instruct the client to take?

• A. Folic acid
• B. Vitamin D
• C. Calcium
• D. Iron

Correct answer: A

Rationale: Folic acid supplementation is crucial for clients undergoing methotrexate treatment because methotrexate functions as a folic acid antagonist. By supplementing with folic acid, the risk of methotrexate toxicity can be minimized, improving the treatment's effectiveness and safety. Vitamin D, calcium, and iron are not specifically recommended in conjunction with methotrexate therapy and may not provide the same protective benefits as folic acid.

5. Which of the following is the antidote for benzodiazepine toxicity?

• A. Flumazenil
• B. Methylene blue
• C. Deferoxamine
• D. Alkalinize urine

Correct answer: A

Rationale: Flumazenil is the specific antidote for benzodiazepine toxicity. It acts as a competitive antagonist at the benzodiazepine binding site on the GABA receptor, reversing the sedative effects of benzodiazepines. Administration of flumazenil is indicated in cases of benzodiazepine overdose or toxicity to rapidly reverse the central nervous system depression caused by these drugs. It is important to note that flumazenil should be used cautiously in patients with a history of seizures or those who are physically dependent on benzodiazepines, as it can precipitate withdrawal symptoms or seizures.

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