Nursing Elites

1. A healthcare provider is completing a client's medical history. The client takes Simvastatin. The healthcare provider should identify which of the following disorders as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in patients with active moderate-to-severe liver disorders, such as active hepatitis C, especially when they are already taking a statin like simvastatin. This combination can increase the risk of liver problems and is not recommended due to the potential for further liver damage. Choices A, B, and D are not directly contraindications for adding Ezetimibe to the client's medications.

2. A child is prescribed Amoxicillin 20 mg/kg/day PO to be administered every 12 hr. The child weighs 44 lb. The available medication is amoxicillin suspension 250 mg/5 mL. How many mL should be given per dose?

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

Correct answer: A

Rationale: To calculate the dosage per administration: Convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the nurse should administer 4 mL of amoxicillin suspension per dose. Choice B, 5 mL, is incorrect because the calculation shows that 4 mL is the correct dose. Choices C and D are also incorrect as they are not in line with the calculated dosage based on the weight of the child and the concentration of the medication.

3. When teaching the family of a child with Cystic Fibrosis about a new prescription for Acetylcysteine, which information should the nurse include?

• A. Expect this medication to suppress your cough.
• B. Expect this medication to smell like rotten eggs.
• C. Expect this medication to cause euphoria.
• D. Expect this medication to turn your urine orange.

Correct answer: B

Rationale: The correct answer is B: 'Expect this medication to smell like rotten eggs.' Acetylcysteine contains sulfur, which gives it a characteristic rotten-egg odor. This odor is normal and expected when using this medication. Choices A, C, and D are incorrect because Acetylcysteine is not used to suppress cough, cause euphoria, or change urine color. Educating the family on the distinct smell of Acetylcysteine will help them understand its characteristics and alleviate concerns about the odor.

4. A client is to receive Tetracaine prior to a Bronchoscopy. Which of the following actions should the nurse include in the plan of care?

• A. Keep the client NPO until the pharyngeal response returns.
• B. Monitor the insertion site for a hematoma.
• C. Palpate the bladder to detect urinary retention.
• D. Maintain the client on bed rest for 12 hours following the procedure.

Correct answer: A

Rationale: The correct action the nurse should include in the plan of care is to keep the client NPO until the pharyngeal response returns. This is important to prevent aspiration until the client's normal pharyngeal sensation is restored, typically within about 1 hour after the procedure. Monitoring the insertion site for a hematoma, palpating the bladder, and maintaining the client on bed rest are not directly related to the administration of Tetracaine prior to a Bronchoscopy. Therefore, these actions are not necessary in the immediate post-procedure care of a client receiving Tetracaine for a Bronchoscopy.

5. What is the action of Metformin?

• A. Decreasing intestinal glucose absorption
• B. Increasing sensitivity to insulin
• C. Decreasing hepatic glucose production
• D. All of the above

Correct answer: D

Rationale: Metformin exerts its effects by decreasing hepatic glucose production, increasing sensitivity to insulin, and decreasing intestinal glucose absorption. These actions help in lowering blood glucose levels and improving insulin sensitivity in individuals with diabetes.

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