Nursing Elites

1. 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.

2. A client has a new prescription for Alendronate. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Remain upright for 30 minutes after taking the medication.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to remain upright for 30 minutes after taking Alendronate. Alendronate can cause esophageal irritation and even ulceration if it remains in contact with the esophagus. By staying upright, the medication is more likely to pass through the esophagus and into the stomach, reducing the risk of irritation and complications. Choice A is incorrect because Alendronate should be taken in the morning, not at bedtime, and the client should remain upright after taking it. Choice C is incorrect because Alendronate should be taken on an empty stomach, usually in the morning, to enhance absorption. Choice D is incorrect because while calcium intake is important, it is not directly related to the administration of Alendronate.

3. A healthcare provider is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

• A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
• B. Obtain help from another healthcare provider to confirm the correct client and blood product.
• C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
• D. Stay with the client for the first 15 to 30 minutes of the transfusion.

Correct answer: B

Rationale: The correct answer is to obtain help from another healthcare provider to confirm the correct client and blood product. This action is crucial in preventing an acute hemolytic reaction, which is caused by ABO or Rh incompatibility. Verifying the correct client and blood product before the transfusion ensures that there are no errors in identification, reducing the risk of a potentially life-threatening reaction. Choices A, C, and D are important aspects of transfusion safety but are not directly related to preventing acute hemolytic reactions. Ensuring a patent IV line, monitoring vital signs, and staying with the client are all essential during transfusion but do not specifically address the risk of ABO or Rh incompatibility reactions.

4. A client has a new prescription for Digoxin. Which of the following findings should the nurse identify as a potential sign of Digoxin toxicity?

• A. Nausea
• B. Dry mouth
• C. Hypoglycemia
• D. Tinnitus

Correct answer: A

Rationale: Nausea is a potential sign of Digoxin toxicity. Other signs of Digoxin toxicity include vomiting, visual disturbances, and confusion. Nausea can be an early indicator of toxicity and should be closely monitored by the nurse. Dry mouth and hypoglycemia are not typically associated with Digoxin toxicity. Tinnitus is more commonly associated with medications like aspirin or loop diuretics, not Digoxin.

5. A client reports taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

• A. Sedation
• B. Nasal congestion
• C. Productive cough
• D. Constipation

Correct answer: B

Rationale: The correct answer is B: Nasal congestion. When used for more than 5 days, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion, which is an adverse effect to be assessed in the client. Sedation (choice A) is not a common adverse effect of phenylephrine. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with phenylephrine use.

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