Nursing Elites

1. A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include that a severe allergy to which of the following medications is a contraindication to ceftriaxone?

• A. Gentamicin
• B. Clindamycin
• C. Piperacillin
• D. Sulfamethoxazole-trimethoprim

Correct answer: C

Rationale: The correct answer is C. Ceftriaxone, a cephalosporin antibiotic, has a cross-sensitivity with penicillin antibiotics like piperacillin. Therefore, a severe allergy to penicillin or penicillin-related antibiotics would be a contraindication to ceftriaxone. Choices A, B, and D are incorrect because they are not associated with a known cross-sensitivity with ceftriaxone.

2. A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects?

• A. Ecchymosis
• B. Decreased urine output
• C. Increased blood pressure
• D. Dizziness

Correct answer: D

Rationale: The correct answer is D: Dizziness. Zolpidem is known to cause dizziness, especially in older adults. This adverse effect can increase the risk of falls and injuries in the elderly population. Monitoring for dizziness is crucial to ensure patient safety. Choice A, Ecchymosis, is the development of bruising and is not a common adverse effect of zolpidem. Choices B and C, Decreased urine output and Increased blood pressure, are not typically associated with zolpidem use. Therefore, they are incorrect choices in this scenario.

3. A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take?

• A. Administer a small test dose before giving the full dose
• B. Infuse the medication over 30 seconds
• C. Monitor client closely for hypertension
• D. Administer cyanocobalamin as an antidote if toxicity occurs

Correct answer: A

Rationale: The correct action the nurse should plan to take when preparing to administer iron dextran IV is to administer a small test dose before giving the full dose. This is done to assess for any allergic reactions that the client may have to the medication. Choice B is incorrect because iron dextran should be infused slowly over a longer period, typically over 1-2 hours to reduce the risk of adverse reactions. Choice C is incorrect because iron dextran administration is more commonly associated with hypotension rather than hypertension. Choice D is incorrect because cyanocobalamin is not used as an antidote for iron dextran toxicity; instead, treatment for iron toxicity may involve supportive care, chelation therapy, or in severe cases, iron antidotes like deferoxamine.

4. A nurse is preparing to administer lactated Ringer's (LR) 1,000 mL IV to infuse over 8 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number).

• A. 21 gtt/min
• B. 20 gtt/min
• C. 25 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To calculate the IV infusion rate in gtt/min: 1000 mL / 480 min × 10 gtt/mL = 20.83 ≈ 21 gtt/min. Therefore, the correct answer is A. Choice B (20 gtt/min) is incorrect because the calculation results in 20.83 gtt/min, rounded to 21. Choices C (25 gtt/min) and D (18 gtt/min) are incorrect as they are not the closest whole number approximation to the calculated value.

5. A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering?

• A. Amantadine
• B. Bupropion
• C. Phenelzine
• D. Hydroxyzine

Correct answer: A

Rationale: The correct answer is Amantadine. Amantadine is used to treat extrapyramidal symptoms, such as mask-like facial expressions, involuntary movements, and tremors, which are common side effects of antipsychotic medications like chlorpromazine. Bupropion is an antidepressant and not indicated for treating these symptoms. Phenelzine is a monoamine oxidase inhibitor used for depression and anxiety disorders, not for extrapyramidal symptoms. Hydroxyzine is an antihistamine used for anxiety and allergic conditions, not for the side effects described in the client.

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