Nursing Elites

1. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?

• A. Take hydrochlorothiazide as needed for edema.
• B. Check your weight once weekly.
• C. Take the hydrochlorothiazide on an empty stomach.
• D. Take the hydrochlorothiazide in the morning.

Correct answer: D

Rationale: The correct answer is to take hydrochlorothiazide in the morning. This medication is usually advised to be taken in the morning to prevent nocturia, which is excessive urination at night. Option A is incorrect because hydrochlorothiazide should be taken daily as prescribed, not as needed for edema. Option B is incorrect as monitoring weight weekly may not be specifically related to hydrochlorothiazide therapy. Option C is incorrect as hydrochlorothiazide does not need to be taken on an empty stomach.

2. A nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth)

• A. 0.5 mL
• B. 0.005 mL
• C. 0.05 mL
• D. 5 mL

Correct answer: A

Rationale: To calculate the mL needed, set up a proportion: 5 mg / 1 mL = 2.5 mg / X mL. Cross multiply to find X: 5 * X = 2.5 * 1, X = 2.5 / 5 = 0.5 mL. Therefore, the nurse should administer 0.5 mL. Choice B, 0.005 mL, is incorrect as it doesn't match the calculated result. Choice C, 0.05 mL, is incorrect as it is ten times the correct value. Choice D, 5 mL, is incorrect as it represents the total volume of the entire vial, not the amount needed for the specific dose.

3. A nurse is planning to administer chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. The amount available is chlorothiazide oral suspension 250 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest tenth)

• A. 2.6 mL
• B. 2.63 mL
• C. 2.7 mL
• D. 2.2 mL

Correct answer: A

Rationale: To find the dose per administration, first convert the toddler's weight to kg: 28.6 lb ÷ 2.2 = 13 kg. Then calculate the total daily dose: 20 mg/kg × 13 kg = 260 mg/day. Since it is divided into two doses, each dose is 130 mg. The concentration of the oral suspension is 250 mg/5 mL = 50 mg/mL. Therefore, to find the volume needed per dose, divide the dose by the concentration: 130 mg ÷ 50 mg/mL = 2.6 mL per dose. Hence, the nurse should administer 2.6 mL per dose. Choices B, C, and D are incorrect as they do not accurately calculate the dosage of chlorothiazide needed per dose based on the toddler's weight and the concentration of the oral suspension.

4. A nurse is providing teaching to a client who has a urinary tract infection and new prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching?

• A. If the phenazopyridine upsets my stomach, I can take it with meals.
• B. The phenazopyridine will relieve my discomfort, but the ciprofloxacin will get rid of the infection.
• C. I need to drink 2 liters of fluid per day while I am taking the ciprofloxacin.
• D. I should notify my provider immediately if my urine turns an orange color.

Correct answer: D

Rationale: Phenazopyridine can turn the urine orange, which is a normal side effect and not a cause for alarm. The client's statement about notifying the provider immediately if their urine turns orange indicates a need for further teaching because it shows a misunderstanding of the medication's side effects. Choices A, B, and C demonstrate a good understanding of the prescribed medications and their effects, indicating the client has grasped the teaching provided on those aspects.

5. A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests?

• A. Platelet count
• B. Electrolyte levels
• C. Thyroid function
• D. Liver function

Correct answer: D

Rationale: The correct answer is D: Liver function. Gemfibrozil can lead to hepatotoxicity, making it crucial to monitor liver function tests. Monitoring platelet count (choice A) is not specifically indicated for gemfibrozil. Electrolyte levels (choice B) and thyroid function (choice C) are not directly affected by gemfibrozil, so they are not the primary laboratory tests to monitor in this case.

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