Nokea
A patient is receiving a secondary infusion of azithromycin 500 mg in 500 mL of normal saline (NS) to be infused over 2 hours. The intravenous (IV) administration set delivers 10 gtt/mL. How many gtt/min should the nurse regulate the infusion?
Correct Answer: 42
Rationale: Infusion rate: 500 mL / 2 hr = 250 mL/hr. Drops per minute: (250 mL/hr × 10 gtt/mL) / 60 min = 41.67, rounded to 42 gtt/min. This ensures accurate delivery of azithromycin.
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An adult patient at an outpatient clinic has been prescribed the antibiotic tetracycline HCI. What should the nurse include in the patient’s teaching plan?
- A. Consume with milk or antacids to prevent gastrointestinal irritation.
- B. Protect your skin from sunlight while on this medication.
- C. Enhance gastrointestinal absorption by taking with orange juice.
- D. Return to the clinic weekly for serum drug level checks.
Correct Answer: B
Rationale: Tetracycline causes photosensitivity, increasing sunburn risk, so sun protection (B) is essential. Milk/antacids (A) reduce absorption by chelating tetracycline. Orange juice (C) contains calcium, impairing absorption. Weekly drug level checks (D) are not required for tetracycline.
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.
A client with a history of chronic obstructive pulmonary disease (COPD) has been prescribed a new ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
- A. The client primes the inhaler with 7 pumps.
- B. The client stores the medication at room temperature.
- C. The client rinses their mouth after each use.
- D. The client attaches a spacer device to the inhaler.
Correct Answer: A
Rationale: Ipratropium inhalers require 2-3 priming sprays for new devices, not 7 (A), indicating a need for teaching. Room temperature storage (B), mouth rinsing (C), and spacer use (D) are correct.
After taking orlistat for one week, a female patient tells the home health nurse that she is experiencing increasingly frequent oily stools and gas. What action should the nurse take?
- A. Ask the patient to describe her dietary intake history for the last several days.
- B. Advise the patient to stop taking the drug and contact her healthcare provider.
- C. Instruct the patient to increase her intake of saturated fats over the next week.
- D. Obtain a stool specimen to evaluate for occult blood and fat content.
Correct Answer: A
Rationale: Orlistat inhibits fat absorption, causing oily stools and gas if dietary fat is high. Assessing dietary intake (A) identifies the cause. Stopping the drug (B) is premature. Increasing fats (C) worsens symptoms. Stool testing (D) is unnecessary for known side effects.
The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. What action should the nurse take?
- A. Instruct the client that it is necessary to take nothing but water with the medication.
- B. Withhold the medication until the client’s breakfast tray is available on the unit.
- C. Consult with a pharmacist about scheduling the dose one hour after the client eats.
- D. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk.
Correct Answer: A
Rationale: Risedronate, a bisphosphonate, must be taken with plain water on an empty stomach, 30 minutes before food or other beverages, to ensure optimal absorption. Milk (B) contains calcium, reducing absorption. Delaying until breakfast (C) violates timing requirements. Consulting a pharmacist (D) is unnecessary, as administration guidelines are clear.