Nursing Elites

1. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?

• A. 22 gtt/min
• B. 24 gtt/min
• C. 20 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To calculate the flow rate, use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Thus, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect because it miscalculates the flow rate. Choices C and D, 20 gtt/min and 18 gtt/min, are also incorrect as they do not accurately calculate the flow rate based on the given information.

2. A patient is prescribed acetaminophen 650 mg PO every 6 hr PRN for pain. The available acetaminophen liquid is 500 mg/5 mL. How many mL should the nurse 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 nurse should administer 6.5 mL of acetaminophen liquid per dose to provide the prescribed 650 mg of acetaminophen. Choice B, 7 mL, is incorrect because the correct calculation results in 6.5 mL. Choice C, 5 mL, is incorrect as it is the concentration of the acetaminophen liquid, not the final volume needed. Choice D, 8 mL, is incorrect because it does not reflect the accurate calculation based on the prescription and concentration.

3. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following foods should the provider instruct the client to avoid?

• A. Broccoli
• B. Bananas
• C. Chicken
• D. Potatoes

Correct answer: A

Rationale: Clients taking Warfarin should avoid foods high in vitamin K, such as broccoli, as they can interfere with the effectiveness of the medication. Vitamin K can counteract the anticoagulant effects of Warfarin, potentially leading to blood clotting issues. Broccoli is rich in vitamin K, so its consumption should be consistent to avoid fluctuations in the medication's effectiveness. Bananas, chicken, and potatoes are not known to significantly interact with Warfarin and do not pose a risk of affecting its anticoagulant properties.

4. When assessing a client with chronic Neutropenia receiving Filgrastim, what action should the nurse take to evaluate for an adverse effect of the medication?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: The correct action when assessing a client receiving Filgrastim for chronic Neutropenia is to assess for bone pain. Bone pain is a known dose-related adverse effect of Filgrastim. Acetaminophen or opioid analgesics can be used to manage bone pain if necessary. Assessing for other types of pain, lung crackles, or heart murmurs would not be specific to the adverse effects of Filgrastim.

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

• A. Avoid drinking grapefruit juice.
• B. Take the medication with your evening meal.
• C. Increase your intake of leafy green vegetables.
• D. Stop taking the medication if you experience muscle pain.

Correct answer: A

Rationale: The correct answer is A: 'Avoid drinking grapefruit juice.' Grapefruit juice should be avoided when taking Atorvastatin because it can increase the blood levels of the medication, potentially leading to a higher risk of adverse effects like muscle pain and liver damage. It is important to follow this instruction to ensure the safe and effective use of Atorvastatin. Choices B, C, and D are incorrect. Taking Atorvastatin with food, specifically a low-fat meal, is recommended, but it is not necessary to specify the evening meal. While increasing intake of leafy green vegetables is generally beneficial for health, it is not a specific instruction for Atorvastatin. Lastly, stopping the medication if one experiences muscle pain is not advisable without consulting a healthcare provider, as muscle pain can be a symptom of a serious side effect of Atorvastatin that requires medical attention.

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