Nursing Elites

1. A client has a new prescription for Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include in the discharge teaching?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct instruction for Nitroglycerin sublingual tablets is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. This regimen helps in relieving angina symptoms effectively. Option A of taking one tablet every 15 minutes is too infrequent and may delay symptom relief. Option C of taking one tablet at bedtime is not appropriate as Nitroglycerin is used for immediate relief of angina. Option D of taking one tablet on an empty stomach is irrelevant since Nitroglycerin is not affected by food intake.

2. 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.

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. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?

• A. Vitamin K
• B. Calcium carbonate
• C. Acetaminophen
• D. Ranitidine

Correct answer: C

Rationale: The correct answer is Acetaminophen. Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking warfarin. Warfarin works by inhibiting the clotting factors dependent on vitamin K, so Vitamin K intake should be consistent but not excessive. Calcium carbonate and ranitidine do not significantly increase the risk of bleeding when used concurrently with Warfarin.

5. A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?

• A. Bursitis
• B. Sinusitis
• C. Depression
• D. Glaucoma

Correct answer: D

Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma, as it can worsen the condition. Glaucoma is a condition characterized by increased intraocular pressure, and using Oxybutynin can further elevate this pressure, potentially leading to serious complications such as vision impairment or damage to the optic nerve. Choices A, B, and C are incorrect as bursitis, sinusitis, and depression are not contraindications for Oxybutynin use. Therefore, the correct answer is D, Glaucoma.

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