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. How should rifampin most likely be administered to a patient diagnosed with tuberculosis?

• A. Orally, with food
• B. Orally, on an empty stomach
• C. Intramuscularly
• D. Intravenously, as a bolus

Correct answer: A

Rationale: Rifampin is typically administered orally, and it is recommended to be taken with food to enhance its absorption and reduce gastrointestinal side effects. Administering rifampin intramuscularly or intravenously is not the standard route of administration for this medication used in tuberculosis treatment.

3. A patient is starting on alendronate (Fosamax) for the treatment of osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with alendronate absorption. Taking it at bedtime (choice C) is not necessary and may increase the risk of esophageal irritation. Taking the medication with food (choice D) can reduce its absorption and effectiveness.

4. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse include in the patient teaching?

• A. Take the medication with food to prevent nausea.
• B. Take the medication at the same time each day to maintain consistent hormone levels.
• C. Avoid prolonged sun exposure while taking this medication.
• D. Discontinue the medication if side effects occur.

Correct answer: B

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This is crucial for the drug to work optimally. Choice A is incorrect because medroxyprogesterone acetate does not necessarily need to be taken with food to prevent nausea. Choice C is not directly related to the medication's administration and is not a common teaching point for this drug. Choice D is incorrect as discontinuing the medication abruptly can lead to adverse effects and is not recommended without consulting a healthcare provider.

5. Which of the following outcome criteria is appropriate for a client with dementia?

• A. The client will return to an established schedule for activities of daily living.
• B. The client will learn new coping mechanisms to handle anxiety.
• C. The client will seek out resources in the community for support.
• D. The client will follow an established schedule for activities of daily living.

Correct answer: D

Rationale: The correct answer is D. For clients with dementia, following an established schedule for activities of daily living is appropriate as it helps maintain routine and structure, which can be beneficial for their condition. Choice A has been rephrased to align better with the context of dementia care. Choice A is incorrect as expecting a return to a previous level of self-functioning may not be realistic for clients with dementia. Choice B is not the most appropriate outcome criteria as handling anxiety, while important, may not be the primary focus when working with clients with dementia. Choice C, seeking out resources in the community for support, is also important but may not be as directly related to the day-to-day care and management of activities for a client with dementia.

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