Nursing Elites

1. A healthcare provider is caring for four clients who have Peptic Ulcer Disease. The healthcare provider should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy due to its potential to induce labor. It is used to prevent ulcers in patients taking nonsteroidal anti-inflammatory drugs and is not indicated for osteoarthritis, kidney stones, or urinary tract infections. Therefore, the correct answer is A. Misoprostol should not be used in pregnant individuals as it can cause uterine contractions and potentially harm the fetus. Choices B, C, and D are incorrect as Misoprostol is not contraindicated for clients with osteoarthritis, kidney stones, or urinary tract infections.

2. A client is taking atorvastatin for hyperlipidemia. Which of the following findings should the nurse report to the provider immediately?

• A. Headache
• B. Nausea
• C. Muscle pain
• D. Diarrhea

Correct answer: C

Rationale: Muscle pain should be reported immediately as it can indicate rhabdomyolysis, a severe adverse effect of atorvastatin. Rhabdomyolysis is characterized by muscle pain, weakness, and can lead to serious complications such as kidney damage, making it crucial for the nurse to notify the provider promptly. Headache, nausea, and diarrhea are common side effects of atorvastatin and do not require immediate reporting unless severe or persistent.

3. When teaching a client with a prescription for Vancomycin, which instruction should the nurse include?

• A. Expect red man syndrome during treatment.
• B. Take the medication with a full glass of water.
• C. Increase your intake of potassium-rich foods.
• D. Monitor for hearing loss while taking this medication.

Correct answer: D

Rationale: The correct answer is D. Vancomycin is known to cause ototoxicity, which can result in hearing loss. Therefore, it is important for clients to monitor for any changes in their hearing while taking this medication and promptly report any issues to their healthcare provider for further evaluation and management. Choices A, B, and C are incorrect because red man syndrome is associated with rapid infusion of Vancomycin, not a common side effect during treatment; taking the medication with a full glass of water is a general instruction for many medications but not specific to Vancomycin; and increasing potassium-rich foods is not directly related to Vancomycin therapy.

4. A client is being educated about Fluticasone for treating Perennial Rhinitis. Which statement by the client indicates an understanding of the teaching?

• A. I should use the spray every 4 hours while I am awake.
• B. It can take as long as 3 weeks before the medication takes maximum effect.
• C. This medication can also be used to treat motion sickness.
• D. I can use this medication when my nasal passages are blocked.

Correct answer: B

Rationale: Correct! While the client may experience some benefits of Fluticasone within a few hours, the maximum effects may not be seen until up to 3 weeks of consistent use. This understanding is important to manage expectations and ensure the client uses the medication effectively for the treatment of Perennial Rhinitis.

5. A healthcare professional is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. How many mL/hr should the IV pump be set to deliver?

• A. 200 mL/hr
• B. 150 mL/hr
• C. 100 mL/hr
• D. 250 mL/hr

Correct answer: A

Rationale: To calculate the flow rate in mL/hr: (Volume in mL / Time in hours) = Flow rate in mL/hr. In this case, (100 mL / 0.5 hr) = 200 mL/hr. Therefore, the IV pump should be set to deliver 200 mL/hr to administer clindamycin 200 mg over 30 minutes. Choice A is correct because it provides the accurate flow rate needed for the administration of the medication. Choices B, C, and D are incorrect as they do not calculate the flow rate correctly based on the volume and time specified in the question.

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