Nursing Elites

1. A healthcare professional is preparing to administer ceftriaxone 1 g IM to a client who has a pelvic infection. Which of the following actions should the healthcare professional plan to take?

• A. Administer the medication via IM bolus over 5 minutes.
• B. Reconstitute with 0.9% sodium chloride.
• C. Discard the reconstituted medication if it is cloudy.
• D. Administer the medication in a large muscle.

Correct answer: D

Rationale: Administering ceftriaxone in a large muscle is crucial for proper absorption and to reduce the risk of pain or tissue irritation. Intramuscular administration of ceftriaxone helps achieve optimal therapeutic levels in the bloodstream for the treatment of the pelvic infection. Choices A, B, and C are incorrect. Choice A is not recommended as ceftriaxone should not be administered as a bolus over 5 minutes. Choice B is irrelevant because the question is about the administration route, not the reconstitution process. Choice C is also irrelevant as it does not pertain to the administration but to the quality of the reconstituted medication.

2. A client with heart failure is being discharged with a prescription for digoxin (Lanoxin). The nurse should include which instruction in the discharge teaching?

• A. Take your pulse before each dose and hold the medication if your pulse is below 60 beats per minute
• B. Increase your fluid intake to at least 3 liters per day
• C. Report any weight loss of more than 2 pounds in a week
• D. Take the medication with meals to avoid gastrointestinal upset

Correct answer: A

Rationale: The correct instruction for a client taking digoxin is to monitor the pulse before each dose and hold the medication if the pulse is below 60 beats per minute. Digoxin can cause bradycardia, so it is crucial to assess the pulse rate before administration to prevent potential complications. Choices B, C, and D are incorrect because increasing fluid intake, reporting weight loss, or taking the medication with meals are not specific instructions related to the safe use of digoxin.

3. A healthcare professional is assessing a client who has a new prescription for warfarin. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Frequent urination
• C. Hypokalemia
• D. Bleeding gums

Correct answer: D

Rationale: Bleeding gums are a sign of excessive anticoagulation with warfarin, indicating a potential risk of bleeding complications. It is crucial to report this finding promptly to the provider for further assessment and adjustment of the medication regimen to prevent serious bleeding events. Weight gain, frequent urination, and hypokalemia are not typically associated with warfarin use and are not immediate concerns that require urgent reporting to the provider.

4. When teaching a client about the adverse effects of simvastatin, which of the following findings should be included as an adverse effect?

• A. Tinnitus
• B. Muscle pain
• C. Diarrhea
• D. Facial flushing

Correct answer: B

Rationale: Muscle pain should be included as an adverse effect when teaching a client about simvastatin. It can be a sign of rhabdomyolysis, a severe side effect associated with statins like simvastatin that involves muscle breakdown. Monitoring for muscle pain is crucial to prevent serious complications and ensure timely intervention. Tinnitus, diarrhea, and facial flushing are not typically associated with simvastatin use and are less common adverse effects compared to muscle pain.

5. The healthcare provider assesses a client who has been prescribed furosemide (Lasix) for cardiac disease. Which electrocardiographic change would be a concern for a client taking a diuretic?

• A. Tall, spiked T waves
• B. A prolonged QT interval
• C. A widening QRS complex
• D. Presence of a U wave

Correct answer: D

Rationale: The presence of a U wave is often associated with hypokalemia, a possible side effect of diuretic therapy like furosemide. Hypokalemia can lead to U wave formation on an electrocardiogram, making the presence of U waves a concerning finding in clients taking diuretics. Tall, spiked T waves are typically seen in hyperkalemia, not hypokalemia. A prolonged QT interval is more commonly associated with conditions like Long QT syndrome or certain medications, not specifically with diuretics. A widening QRS complex is usually seen in conditions affecting the conduction system of the heart, such as bundle branch blocks, rather than being directly related to diuretic use.

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