Nursing Elites

1. A 43-year-old man has tested positive for systemic candidiasis, and the care team has decided on IV fluconazole as a first-line treatment. When administering this medication, the nurse should

• A. administer the drug with lactated Ringer's.
• B. infuse the drug no faster than 200 mg/h.
• C. avoid administering the drug through a peripheral IV.
• D. administer prophylactic heparin prior to the fluconazole.

Correct answer: C

Rationale: When administering IV fluconazole, the nurse should avoid administering the drug through a peripheral IV. Fluconazole is known to cause phlebitis and tissue irritation if infused through a peripheral IV line. It is recommended to administer fluconazole through a central venous catheter to reduce the risk of complications. Choices A, B, and D are incorrect as there is no specific recommendation to administer the drug with lactated Ringer's, infuse it at a particular rate, or administer prophylactic heparin prior to fluconazole in this scenario.

2. Cellular swelling is:

• A. Irreversible
• B. Evident early in all types of cellular injury
• C. Manifested by decreased intracellular sodium
• D. None of the above is correct

Correct answer: B

Rationale: Cellular swelling is indeed evident early in all types of cellular injury. This occurs due to the influx of water into the cell, leading to swelling. Choice A is incorrect because cellular swelling is reversible if the injury is not severe. Choice C is incorrect because cellular swelling is not manifested by decreased intracellular sodium; in fact, it is associated with increased intracellular sodium due to water influx. Choice D is incorrect as option B is the correct statement.

3. A patient is being educated on the administration of tinidazole (Tindamax). Which of the following indicates that the patient understands the administration of tinidazole?

• A. “I will report to the doctor if I have a slow heart rate.”
• B. “The medicine will leave a bitter or metallic taste in my mouth.”
• C. “I will report urinary urgency and incontinence.”
• D. “The medication is given in two doses every day.”

Correct answer: B

Rationale: The correct answer is B. Tinidazole (Tindamax) is known to cause a bitter or metallic taste in the mouth. This side effect is common and indicates that the patient understands the medication they are taking. Choices A, C, and D are incorrect because they do not specifically relate to the common side effects or administration details of tinidazole.

4. A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What critical instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain and other side effects.
• B. Avoid consuming grapefruit juice while taking this medication.
• C. Take the medication in the morning with breakfast to improve absorption.
• D. Take the medication with a high-fat meal to increase its effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at night to reduce the risk of muscle pain and other side effects. Atorvastatin, like other statins, is more effective when taken in the evening as the body produces more cholesterol at night. Taking it with a high-fat meal (choice D) is not recommended as it may reduce the drug's absorption. Grapefruit juice (choice B) should be avoided with atorvastatin as it can increase the risk of side effects. Taking the medication in the morning with breakfast (choice C) is not as effective as taking it at night.

5. A 22-year-old was recently diagnosed with acquired immunodeficiency syndrome (AIDS). Which decreased lab finding would be expected to accompany this virus?

• A. CD4 helper T cells
• B. CD8 helper T cells
• C. CDC cells
• D. CDC10 cells

Correct answer: A

Rationale: In a person diagnosed with AIDS, a decrease in CD4 helper T cells is expected. These cells are critical for the immune system's proper functioning, and their reduction weakens the body's ability to fight infections. CD8 helper T cells (Choice B) are not typically decreased in AIDS. CDC cells (Choice C) and CDC10 cells (Choice D) are not relevant terms in this context, making them incorrect choices.

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