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 been prescribed an anticoagulant for atrial fibrillation. Which of the following instructions should the nurse include?

• A. Take the medication with food to prevent nausea.
• B. Avoid activities that may cause injury.
• C. Monitor your heart rate daily before taking the medication.
• D. Avoid alcohol while taking this medication.

Correct answer: B

Rationale: The correct instruction for a client prescribed an anticoagulant for atrial fibrillation is to avoid activities that may cause injury. Anticoagulants increase the risk of bleeding, so it is important to prevent situations that could lead to injury or trauma. Choice A is incorrect because anticoagulants are not typically affected by food intake. Choice C is not necessary for all anticoagulant medications, and heart rate monitoring is more relevant for other conditions. Choice D is not directly related to the action of anticoagulants and is not a priority instruction for this medication.

3. A client is being educated by a healthcare provider about managing Digoxin toxicity. Which statement by the client demonstrates an understanding of the teaching?

• A. I will take an extra dose of Digoxin if I miss one.
• B. I should notify my healthcare provider if I experience visual changes.
• C. I will stop taking Digoxin if my heart rate is below 70 bpm.
• D. I should take antacids to alleviate gastrointestinal upset.

Correct answer: B

Rationale: The correct answer is B. Visual changes, such as yellow or blurred vision, can be indicative of digoxin toxicity. It is crucial for clients to inform their healthcare provider promptly if they encounter these symptoms. Prompt medical attention can help manage potential toxicity and prevent complications. Choices A, C, and D are incorrect because taking an extra dose of Digoxin, stopping Digoxin based on heart rate alone, and using antacids for gastrointestinal upset are not appropriate actions when managing Digoxin toxicity.

4. A client has a new prescription for Valsartan. Which of the following adverse effects should the nurse monitor?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypercalcemia

Correct answer: A

Rationale: Corrected Rationale: Valsartan is an angiotensin II receptor blocker (ARB) that can cause hyperkalemia by affecting the renin-angiotensin-aldosterone system. The nurse should closely monitor the client's potassium levels due to the risk of hyperkalemia, which can lead to serious cardiac complications. Choice B, hypoglycemia, is not a common adverse effect of Valsartan. Choice C, bradycardia, is not directly associated with Valsartan use. Choice D, hypercalcemia, is not a typical adverse effect of Valsartan.

5. A healthcare provider is caring for a group of clients who are not protected against Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following clients?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man who has essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for this vaccine, making it safe to administer to this client. Choice A is incorrect because administering the Varicella vaccine is contraindicated during pregnancy due to the risk of transmission to the fetus. Choice B is incorrect because a severe allergy to neomycin is a contraindication to the Varicella vaccine, which contains a trace amount of neomycin. Choice C is incorrect because the Varicella vaccine is not recommended for infants under 12 months of age.

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