Nursing Elites

1. 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.

2. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.

3. A client has a new prescription for Nevirapine, an NNRTI. Which of the following statements should the nurse include in teaching the client?

• A. Take this medication on an empty stomach.
• B. Take this medication with food to increase absorption.
• C. Avoid alcohol while taking this medication.
• D. Take this medication at the same time every day.

Correct answer: B

Rationale: The correct statement that the nurse should include in teaching the client about Nevirapine, an NNRTI, is to take the medication with food to improve gastrointestinal tolerance and prevent nausea. While absorption is not significantly affected by food, taking it with meals can help reduce adverse gastrointestinal effects. Choice A is incorrect because Nevirapine should not be taken on an empty stomach. Choice C is generally true for most medications but is not specific to Nevirapine. Choice D is a good practice for medication adherence but is not specific to the administration requirements of Nevirapine.

4. A healthcare professional is reviewing the laboratory results of a client taking Warfarin for atrial fibrillation. Which of the following findings should the professional report to the provider immediately?

• A. INR of 4.0
• B. Potassium level of 4.5 mEq/L
• C. Creatinine level of 1.0 mg/dL
• D. BUN of 18 mg/dL

Correct answer: A

Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications. The other laboratory values are within normal limits and do not pose an immediate risk to the client's health while on Warfarin therapy.

5. What is the therapeutic class of Valproate?

• A. Anticoagulant
• B. Antianxiety, benzodiazepines
• C. Anticonvulsant, vascular headache suppressant
• D. Mood stabilizer

Correct answer: C

Rationale: Valproate belongs to the therapeutic class of anticonvulsants. It is primarily used to manage seizures but is also effective in treating vascular headaches. Therefore, it is not classified as an anticoagulant, antianxiety medication, or mood stabilizer. Option A, anticoagulant, is incorrect as valproate does not have anticoagulant properties. Option B, antianxiety benzodiazepines, is incorrect as valproate is not primarily used to treat anxiety disorders with benzodiazepines. Option D, mood stabilizer, is incorrect as valproate is not classified as a mood stabilizer, although it can be used in some cases for mood disorders, its primary therapeutic class is anticonvulsant.

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