Nokea
A client has been prescribed ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (D5W) 200 mL. How many mL/hour should the nurse program the infusion pump to deliver? (Enter numerical value only.)
Correct Answer: 200
Rationale: Infusion rate: 200 mL / 1 hr = 200 mL/hr. The pump should be set to deliver 200 mL/hr to administer ciprofloxacin correctly.
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A female patient with multiple sclerosis reports less fatigue and improved memory since she started using the herbal supplement, ginkgo biloba. What is the most important information for the nurse to include in the teaching plan for this patient?
- A. Nausea and diarrhea can occur when using this supplement.
- B. Ginkgo biloba use should be limited and not taken during pregnancy.
- C. Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo.
- D. Anxiety and headaches increase with the use of ginkgo biloba.
Correct Answer: C
Rationale: This question is identical to Question 39. Ginkgo biloba’s interaction with aspirin/NSAIDs (C) increases bleeding risk, a critical teaching point. Other side effects (A, D) and pregnancy limits (B) are less urgent. Note: Duplicate question; consider removing.
A patient with chemotherapy-induced nausea has been prescribed metoclopramide. What adverse effect should the nurse report?
- A. Diarrhea.
- B. Unusual irritability.
- C. Nausea.
- D. Involuntary movements.
Correct Answer: D
Rationale: This question is identical to Question 5. Involuntary movements (D), such as tardive dyskinesia, are a serious metoclopramide side effect, requiring immediate reporting. Diarrhea (A) and irritability (B) are less severe. Nausea (C) is the treated condition. Note: Duplicate question; consider removing.
After administering five doses of filgrastim, the nurse observes that the patient’s white blood cell count has increased from 2,500/mm^3 to 5,000/mm^3. What action should the nurse take?
- A. Inform the patient that the medication has been effective.
- B. Review the patient’s culture and sensitivity reports.
- C. Implement neutropenic precautions.
- D. Assess the patient’s vital signs.
Correct Answer: A
Rationale: Filgrastim stimulates white blood cell production. An increase from 2,500/mm^3 to 5,000/mm^3 (A) indicates effectiveness, and the patient should be informed. Culture reports (B) are unrelated to filgrastim’s action. Neutropenic precautions (C) are unnecessary with improved counts. Vital signs (D) don’t directly assess filgrastim’s efficacy.
Rivastigmine, a cholinesterase inhibitor, is prescribed for a female patient with early-stage Alzheimer’s Disease. The patient’s daughter tells the nurse that she plans to start administering the drug when her mother’s symptoms worsen, hoping to avoid nursing home placement. How should the nurse respond?
- A. Affirm the decision to use the medication when the symptoms start to worsen.
- B. Explain that the drug should be used early in the disease process.
- C. Assess the patient’s current mental status before deciding to support the decision.
- D. Confirm that the daughter is aware of the progressive nature of the disease.
Correct Answer: B
Rationale: Rivastigmine is most effective early in Alzheimer’s (B) to slow symptom progression. Delaying until worsening (A) reduces benefits. Mental status assessment (C) informs but doesn’t guide timing. Discussing disease progression (D) is secondary to medication timing.
A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client’s plan of care?
- A. Replace salt with a salt substitute.
- B. Cover your skin before going outside.
- C. Limit intake of high-potassium foods.
- D. Monitor skin for excessive bruising.
Correct Answer: C
Rationale: Spironolactone, a potassium-sparing diuretic, can cause hyperkalemia. Limiting high-potassium foods (C) prevents this risk. Salt substitutes (A) often contain potassium, worsening hyperkalemia. Sun protection (B) and bruising (D) are unrelated to spironolactone’s primary risks.