Nursing Elites

1. A healthcare professional is obtaining a medication history from a client who is to receive Imipenem-cilastatin IV to treat an infection. Which of the following medications the client also receives puts them at risk for a medication interaction?

• A. Regular insulin
• B. Furosemide
• C. Valproic acid
• D. Ferrous sulfate

Correct answer: C

Rationale: The correct answer is C, Valproic acid. Imipenem-cilastatin decreases the blood levels of valproic acid, an antiseizure medication, which can lead to increased seizure activity. Monitoring and adjusting the dosage of valproic acid may be necessary when co-administered with Imipenem-cilastatin to prevent adverse effects. Choices A, B, and D do not typically interact significantly with Imipenem-cilastatin and are not associated with a high risk of adverse interactions in this scenario.

2. A client is receiving IV Dopamine for the treatment of shock. Which of the following findings indicates that the medication is effective?

• A. Increased heart rate
• B. Decreased blood pressure
• C. Increased urine output
• D. Decreased respiratory rate

Correct answer: C

Rationale: Dopamine is a medication used in shock to increase cardiac output and improve renal perfusion. An increase in urine output indicates that the medication is effective as it shows improved renal perfusion and kidney function, which are essential for managing shock effectively. Choices A, B, and D are incorrect as an increased heart rate, decreased blood pressure, and decreased respiratory rate are not direct indicators of the effectiveness of IV Dopamine in treating shock.

3. A healthcare professional is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The amount available is acetaminophen liquid 500 mg/5 mL. How many mL should the healthcare professional administer per dose?

• A. 6.5 mL
• B. 7 mL
• C. 5 mL
• D. 8 mL

Correct answer: A

Rationale: To calculate the volume to administer: (Desired dose / Concentration) = Volume to administer. In this case, (650 mg / 500 mg) x 5 mL = 6.5 mL. Therefore, the healthcare professional should administer 6.5 mL of acetaminophen per dose to achieve the desired 650 mg dose for pain relief. Choice A is correct because it accurately calculates the volume required based on the concentration of the liquid acetaminophen. Choices B, C, and D are incorrect as they do not reflect the correct calculation based on the concentration of the liquid medication and the desired dose.

4. A client has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should be taken to obtain an accurate gentamicin serum level?

• A. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
• B. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
• C. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
• D. Draw a peak level at 0900 and a trough level at 2100.

Correct answer: C

Rationale: To obtain an accurate gentamicin serum level, the trough should be drawn immediately before administering the medication, and the peak level should be drawn 30 minutes after the dose. This timing allows for the assessment of the lowest and highest drug concentrations in the bloodstream, ensuring therapeutic levels are achieved while minimizing the risk of toxicity. Choice A is correct as it follows this timing protocol. Choices B and D have incorrect timing for peak and trough levels, which would not provide an accurate representation of the drug's concentration in the bloodstream.

5. A client with increased liver enzymes is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?

• A. Glucosamine
• B. Saw palmetto
• C. Kava
• D. St. John's wort

Correct answer: C

Rationale: The nurse should report kava to the provider because chronic use or high doses of kava can lead to liver damage, including severe liver failure. It is crucial for the nurse to be vigilant about any herbal supplement that could potentially worsen the client's liver condition.

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