Nursing Elites

1. A client is prescribed Omeprazole for managing heartburn. What information should the nurse include in the teaching?

• A. Take this medication at bedtime.
• B. This medication decreases the production of gastric acid.
• C. Take this medication 2 hours after eating.
• D. This medication can cause hyperkalemia.

Correct answer: B

Rationale: The correct answer is B. The nurse should educate the client that Omeprazole works by reducing the production of gastric acid through inhibiting the enzyme responsible for its production. This action helps in managing heartburn and related symptoms effectively. Choice A is incorrect because Omeprazole is usually taken before eating. Choice C is incorrect as Omeprazole is typically taken before a meal. Choice D is unrelated to Omeprazole, as it is not associated with causing hyperkalemia.

2. Which of the following drugs is associated with hepatitis as a reaction?

• A. Valproic acid
• B. Quinidine
• C. Isoniazid
• D. Ethosuximide

Correct answer: C

Rationale: Hepatitis is a known side effect of isoniazid. It is important to monitor patients on isoniazid for signs of liver damage, including hepatitis, as part of their treatment regimen for tuberculosis.

3. 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 determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect as it results from a miscalculation. Choices C and D, 20 gtt/min and 18 gtt/min respectively, are also incorrect calculations based on the given parameters.

4. When a client reports urticaria and dyspnea after receiving amoxicillin/clavulanic acid, which medication should be administered first?

• A. Administer epinephrine
• B. Administer albuterol
• C. Administer diphenhydramine
• D. Administer prednisone

Correct answer: A

Rationale: In the scenario described, the client is experiencing symptoms of a severe allergic reaction. The priority intervention is to administer epinephrine. Epinephrine acts quickly to reverse the effects of the allergic reaction and can be life-saving in cases of anaphylaxis. Albuterol is used for bronchodilation and may help with respiratory symptoms but is not the first-line treatment for anaphylaxis. Diphenhydramine and prednisone are used for allergic reactions but are not as rapid-acting as epinephrine and should be considered after administering epinephrine in this situation.

5. When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor?

• A. Decreased appetite
• B. Explosive diarrhea
• C. Decreased pulse rate
• D. Orthostatic hypotension

Correct answer: D

Rationale: The correct answer is 'Orthostatic hypotension.' When administering Amitriptyline, the nurse should monitor for orthostatic hypotension. This condition can occur due to the drug's anticholinergic effects, leading to a sudden drop in blood pressure when standing up. Symptoms may include dizziness, lightheadedness, and an increased risk of falls. Monitoring for signs of orthostatic hypotension is crucial to prevent complications. Choices A, B, and C are incorrect as decreased appetite, explosive diarrhea, and decreased pulse rate are not typically associated with the administration of Amitriptyline.

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