Nursing Elites

1. A healthcare professional is educating a client who has a new prescription for warfarin. Which of the following statements should the healthcare professional include?

• A. Avoid foods high in vitamin K.
• B. Report any signs of bleeding to your healthcare provider.
• C. Use a soft toothbrush to prevent gum bleeding.
• D. Use an electric razor to prevent cuts.

Correct answer: B

Rationale: The correct statement that the healthcare professional should include when educating a client prescribed warfarin is to report any signs of bleeding to their healthcare provider. Bleeding can indicate excessive anticoagulation, which is a serious side effect of warfarin. Prompt reporting of bleeding symptoms is crucial to prevent complications. Choices A, C, and D are incorrect. While avoiding foods high in vitamin K may be important when taking warfarin due to its interaction with the medication, it is not the priority over reporting signs of bleeding. Using a soft toothbrush and electric razor are general precautions for individuals on anticoagulants but are not as critical as reporting bleeding symptoms.

2. A healthcare professional is preparing to administer IV Vancomycin to a client who has a systemic infection. Which of the following actions should the healthcare professional take?

• A. Administer the medication rapidly over 15 minutes.
• B. Monitor the client for hypertension during infusion.
• C. Administer a test dose before the full dose.
• D. Monitor the client for Red Man Syndrome.

Correct answer: D

Rationale: The correct action for the healthcare professional is to monitor the client for Red Man Syndrome. Red Man Syndrome is a common adverse reaction to Vancomycin characterized by flushing, rash, and hypotension. It is important to monitor the client for these symptoms to intervene promptly if they occur.

3. A client is taking atorvastatin for hyperlipidemia. Which of the following findings should the nurse report to the provider immediately?

• A. Headache
• B. Nausea
• C. Muscle pain
• D. Diarrhea

Correct answer: C

Rationale: Muscle pain should be reported immediately as it can indicate rhabdomyolysis, a severe adverse effect of atorvastatin. Rhabdomyolysis is characterized by muscle pain, weakness, and can lead to serious complications such as kidney damage, making it crucial for the nurse to notify the provider promptly. Headache, nausea, and diarrhea are common side effects of atorvastatin and do not require immediate reporting unless severe or persistent.

4. A client in the operating room received a dose of Succinylcholine. During the operation, the client suddenly develops rigidity, and their body temperature begins to rise. The healthcare provider should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: C

Rationale: Muscle rigidity and a sudden rise in temperature are manifestations of malignant hyperthermia. Dantrolene acts on skeletal muscles to reduce metabolic activity and treat malignant hyperthermia effectively. Neostigmine (choice A) is used to reverse the effects of non-depolarizing neuromuscular blockers, not to treat malignant hyperthermia. Naloxone (choice B) is an opioid antagonist used for opioid overdose. Vecuronium (choice D) is a non-depolarizing neuromuscular blocker and is not used to treat malignant hyperthermia.

5. 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. The healthcare professional should set the IV pump to deliver how many mL/hr?

• 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. The correct calculation is: 100 mL (volume) / 0.5 hr (time) = 200 mL/hr. Therefore, the correct answer is 200 mL/hr. Choice B (150 mL/hr), C (100 mL/hr), and D (250 mL/hr) are incorrect as they do not match the calculated flow rate needed for the administration of clindamycin.

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