Nursing Elites

1. When teaching a client who has a new prescription for Ciprofloxacin, which of the following instructions should the nurse include?

• A. Take this medication with an antacid.
• B. Avoid direct sunlight.
• C. Increase your intake of dairy products.
• D. Expect urine to turn orange.

Correct answer: B

Rationale: The correct instruction for a client prescribed Ciprofloxacin is to avoid direct sunlight. Ciprofloxacin can cause photosensitivity, increasing the risk of sunburn. Clients should be advised to avoid direct sunlight and wear protective clothing, including hats and sunglasses when going outdoors to prevent skin damage. Choices A, C, and D are incorrect. Taking Ciprofloxacin with an antacid can reduce its absorption, so they should not be taken together. Increasing dairy product intake is not necessary or relevant to taking Ciprofloxacin. While Ciprofloxacin can discolor urine, turning it orange, this is not a critical side effect that requires specific instructions for the client.

2. A child is prescribed Amoxicillin 20 mg/kg/day PO to be administered every 12 hr. The child weighs 44 lb. The available medication is amoxicillin suspension 250 mg/5 mL. How many mL should be given per dose?

• A. 4 mL
• B. 5 mL
• C. 6 mL
• D. 3 mL

Correct answer: A

Rationale: To calculate the dosage per administration: Convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the nurse should administer 4 mL of amoxicillin suspension per dose. Choice B, 5 mL, is incorrect because the calculation shows that 4 mL is the correct dose. Choices C and D are also incorrect as they are not in line with the calculated dosage based on the weight of the child and the concentration of the medication.

3. A client is prescribed Propranolol for a dysrhythmia. Which of the following actions should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Administer Propranolol to decrease the client's blood pressure.
• C. Assist the client with sitting up or standing after taking this medication.
• D. Monitor the client for hypokalemia due to the risk of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol is to assist the client when sitting up or standing after taking the medication. Propranolol can lead to orthostatic hypotension, causing dizziness upon sudden position changes. It is essential to help the client with position changes to prevent falls or injury. Holding Propranolol if the client's apical pulse is greater than 100/min (Choice A) is incorrect because Propranolol is often used to manage dysrhythmias and slowing down the heart rate. Administering Propranolol to decrease the client's blood pressure (Choice B) is not the primary indication for using this medication. Monitoring the client for hypokalemia due to the risk of Propranolol toxicity (Choice D) is not a direct effect of Propranolol; rather, it is more related to other medications like diuretics.

4. A healthcare professional in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil?

• A. Isosorbide
• B. Phenytoin
• C. Metronidazole
• D. Prednisone

Correct answer: A

Rationale: Sildenafil is contraindicated with nitrates like isosorbide due to the risk of severe hypotension. Isosorbide is a nitrate that can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Therefore, it is essential to avoid concurrent use of isosorbide and sildenafil to prevent adverse effects. Phenytoin, metronidazole, and prednisone do not have significant interactions with sildenafil and are not contraindicated when used together.

5. A client with Subacute Bacterial Endocarditis is receiving Streptomycin IM among other antibiotics. For which of the following manifestations should the nurse monitor as an adverse effect of this medication?

• A. Extremity paresthesias
• B. Urinary retention
• C. Severe constipation
• D. Complex partial seizures

Correct answer: A

Rationale: The correct answer is extremity paresthesias. Streptomycin, used to treat infections like Subacute Bacterial Endocarditis, can cause paresthesias in the hands and feet as an adverse effect. Monitoring for this symptom is vital to detect and manage it promptly. Choices B, C, and D are incorrect because urinary retention, severe constipation, and complex partial seizures are not commonly associated adverse effects of Streptomycin.

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