Nursing Elites

1. Following a stroke, a client has been started on clopidogrel (Plavix). Why is this medication being administered?

• A. To prevent stroke in high-risk patients, such as those with prosthetic heart valves
• B. To decrease blood pressure
• C. To increase heart rate
• D. To provide antiplatelet activity in patients who cannot tolerate aspirin

Correct answer: D

Rationale: Clopidogrel (Plavix) is an antiplatelet medication that inhibits platelet aggregation, reducing the risk of blood clots. It is commonly used in patients who have had a stroke and cannot tolerate aspirin due to allergies or intolerances. Choosing clopidogrel in these cases helps prevent further clot formation and reduces the risk of recurrent strokes.

2. A client has a new prescription for rituximab. Which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The correct answer is B: Fever. The nurse should instruct the client to report fever as it can be an indication of an infection, which is a potential complication of rituximab therapy. Monitoring for fever is crucial to detect early signs of infection and prevent complications. Dizziness (choice A), urinary frequency (choice C), and dry mouth (choice D) are not typically associated with rituximab therapy and are not the primary concerns that the nurse needs to address with the client.

3. A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

• A. Document that the client experienced an anaphylactic reaction to the medication.
• B. Change the IV infusion site.
• C. Decrease the infusion rate on the IV.
• D. Apply cold compresses to the neck area.

Correct answer: C

Rationale: Flushing and tachycardia are signs of Red Man Syndrome, which can be mitigated by decreasing the infusion rate.

4. A preschooler weighing 44 lb is to receive Amoxicillin 20 mg/kg/day PO divided equally every 12 hr. The available amoxicillin suspension is 250 mg/5 mL. How many mL should the nurse administer per dose?

• A. 4 mL
• B. 5 mL
• C. 6 mL
• D. 3 mL

Correct answer: A

Rationale: To calculate the dosage per administration: First, convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, calculate the required dosage per dose: (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. To determine the mL per dose, divide the required dosage by the concentration of the amoxicillin suspension: (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the correct answer is 4 mL. Choice B (5 mL) is incorrect because the correct calculation yields 4 mL. Choices C (6 mL) and D (3 mL) are also incorrect as they do not align with the accurate calculation based on the provided information.

5. A client is prescribed Metformin. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin A1c
• D. Serum creatinine

Correct answer: D

Rationale: The correct answer is D: Serum creatinine. Metformin can potentially cause lactic acidosis, particularly in patients with impaired renal function. Monitoring serum creatinine levels is crucial to assess kidney function and detect any adverse effects of Metformin on renal health. Choices A, B, and C are incorrect as blood glucose, creatine kinase, and hemoglobin A1c levels are not directly monitored to assess for potential adverse effects of Metformin. Blood glucose monitoring is typically done to assess the efficacy of antidiabetic medications like Metformin, while creatine kinase levels are indicative of muscle damage and hemoglobin A1c reflects long-term blood sugar control.

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