Nursing Elites

1. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?

• A. 22 gtt/min
• B. 24 gtt/min
• C. 20 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect as it results from a miscalculation. Choices C and D, 20 gtt/min and 18 gtt/min respectively, are also incorrect calculations based on the given parameters.

2. A nurse is providing teaching for a male client who has Schizophrenia and is taking Risperidone. Which of the following instructions should the nurse include in the teaching?

• A. Add extra snacks to your diet to prevent weight loss.
• B. Notify the provider if you develop breast enlargement.
• C. You may begin to have mild seizures while taking this medication.
• D. This medication is likely to increase your libido.

Correct answer: B

Rationale: The correct answer is B: 'Notify the provider if you develop breast enlargement.' Gynecomastia (breast enlargement) and galactorrhea can occur due to an increase in prolactin levels while taking risperidone. The client should inform the provider if these manifestations occur. Choices A, C, and D are incorrect. Adding extra snacks to the diet to prevent weight loss is not a specific instruction related to risperidone. Seizures are not a common side effect of risperidone, so the statement about mild seizures is inaccurate. Risperidone is more likely to cause sexual side effects like erectile dysfunction rather than increasing libido, making choice D incorrect.

3. A client is prescribed Propranolol for a dysrhythmia. Which of the following actions should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Administer Propranolol to decrease the client's blood pressure.
• C. Assist the client with sitting up or standing after taking this medication.
• D. Monitor the client for hypokalemia due to the risk of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol is to assist the client when sitting up or standing after taking the medication. Propranolol can lead to orthostatic hypotension, causing dizziness upon sudden position changes. It is essential to help the client with position changes to prevent falls or injury. Holding Propranolol if the client's apical pulse is greater than 100/min (Choice A) is incorrect because Propranolol is often used to manage dysrhythmias and slowing down the heart rate. Administering Propranolol to decrease the client's blood pressure (Choice B) is not the primary indication for using this medication. Monitoring the client for hypokalemia due to the risk of Propranolol toxicity (Choice D) is not a direct effect of Propranolol; rather, it is more related to other medications like diuretics.

4. A client has a prescription for Furosemide. Which of the following instructions should the nurse include?

• A. Take the medication in the morning.
• B. Increase your intake of potassium-rich foods.
• C. Expect your urine to turn orange.
• D. Avoid prolonged sunlight exposure.

Correct answer: B

Rationale: The correct answer is B: 'Increase your intake of potassium-rich foods.' Furosemide is a loop diuretic that can lead to hypokalemia (low potassium levels) due to increased excretion of potassium in the urine. To counteract this effect and maintain electrolyte balance, the client should be advised to increase their intake of potassium-rich foods. This instruction helps prevent potential complications associated with low potassium levels. Choices A, C, and D are incorrect. Taking Furosemide in the morning does not affect its effectiveness; urine turning orange is not an expected side effect of Furosemide; and avoiding prolonged sunlight exposure is not directly related to Furosemide use.

5. Which of the following is not a side effect of the ACE Inhibitor (Captopril)?

• A. Rash
• B. Angioedema
• C. Cough
• D. Congestion

Correct answer: D

Rationale: Congestion is not a common side effect associated with ACE inhibitors such as Captopril. ACE inhibitors are known to cause a dry, persistent cough due to bradykinin accumulation, rash, and angioedema, but congestion is not typically listed as a side effect.

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