Nursing Elites

1. A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching?

• A. I will give my child a dose as soon as wheezing starts.
• B. My child should rinse out his mouth after using the inhaler.
• C. My child should exhale completely before placing the inhaler in his mouth.
• D. If my child has difficulty breathing in the dose, a spacer can be used.

Correct answer: A

Rationale: The correct answer is A. Cromolyn sodium is a preventive medication and should not be used as a rescue inhaler when wheezing starts. This indicates a need for further teaching as the parent should understand that cromolyn sodium is not meant for immediate relief of symptoms. Choice B is correct as rinsing the mouth after using the inhaler helps reduce the risk of oral thrush, a common side effect. Choice C is correct as exhaling completely before using the inhaler helps ensure proper inhalation of the medication. Choice D is correct as a spacer can be used if the child has difficulty coordinating breathing with the inhaler, improving medication delivery.

2. A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects?

• A. Allergic response
• B. Superinfection
• C. Renal toxicity
• D. Hepatotoxicity

Correct answer: B

Rationale: Candidiasis is a type of superinfection that can occur when antibiotics, like tetracycline, disrupt the normal flora, allowing overgrowth of fungi. Option A, allergic response, is incorrect because candidiasis is not typically an allergic reaction. Option C, renal toxicity, and option D, hepatotoxicity, are incorrect as they refer to adverse effects on the kidneys and liver, respectively, which are not directly related to the development of candidiasis.

3. A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal doses daily to a toddler who weighs 22 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number)

• A. 20 mg
• B. 15 mg
• C. 10 mg
• D. 30 mg

Correct answer: A

Rationale: To calculate the dosage per dose, first, convert the toddler's weight from pounds to kilograms: 22 lb / 2.2 = 10 kg. Then, multiply the weight by the dosage: 4 mg × 10 kg = 40 mg/day. Since this total daily dose is divided into 2 equal doses, the nurse should administer 20 mg per dose. Therefore, the correct answer is 20 mg. Choice B (15 mg) is incorrect because it does not account for the correct weight conversion and dosage calculation. Choice C (10 mg) is incorrect as it only considers the weight conversion but doesn't multiply it by the dosage. Choice D (30 mg) is incorrect as it miscalculates the dosage by not dividing the total daily dose into 2 equal parts.

4. A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number)

• A. 5 mL
• B. 6 mL
• C. 4 mL
• D. 7 mL

Correct answer: A

Rationale: To calculate the amount of amoxicillin in mL needed per dose, we can use the formula: 50 mg/mL = 250 mg / X mL. Cross multiply to solve for X: 50X = 250. Divide both sides by 50 to find X, which equals 5 mL per dose. Therefore, the nurse should administer 5 mL of amoxicillin per dose. Choice B, 6 mL, is incorrect as it does not match the calculated result. Choice C, 4 mL, is incorrect as it is too low based on the calculation. Choice D, 7 mL, is incorrect as it is too high based on the calculation.

5. A healthcare professional is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the healthcare professional should recognize that which of the following findings is a contraindication to the administration of diltiazem?

• A. Hypotension
• B. Tachycardia
• C. Decreased level of consciousness
• D. History of diuretic use

Correct answer: A

Rationale: Diltiazem, a calcium channel blocker, can cause hypotension. Administering it to a client who already has hypotension could exacerbate this condition. Therefore, hypotension is a contraindication to the administration of diltiazem. Incorrect Choices: B) Tachycardia is not a contraindication for administering diltiazem in atrial fibrillation as it is commonly used to control the heart rate. C) Decreased level of consciousness may require evaluation but is not a direct contraindication to diltiazem administration. D) History of diuretic use is not a contraindication if the client is not currently experiencing hypotension.

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