For correct answer choice:

1. 42 gtt/min is correct. Using the flow rate formula: Using the flow rate formula, divide the total volume (3,000 mL) by the time in minutes (1,440 min for 24 hours) and then multiply by the drop factor (20 gtt/mL).

(3000 mL/1440) ✕20 = 42 gtt/min

This calculation yields approximately 42 gtt/min.

For correct answer choice:

Peripheral edema is correct. Amlodipine is a calcium channel blocker that can cause peripheral edema due to vasodilation and fluid retention, particularly in the lower extremities.

For incorrect answer choices:

Tinnitus is incorrect. Tinnitus is not a common side effect of amlodipine and is more commonly associated with other medications, such as some antibiotics or salicylates.

Increased appetite is incorrect. While changes in appetite can occur with various medications, increased appetite is not a typical side effect of amlodipine.

Hypoglycemia is incorrect. Amlodipine does not typically cause hypoglycemia. In fact, it may have a neutral or slightly beneficial effect on glucose metabolism in some patients.

For correct answer choice:

Deferoxamine is correct. Deferoxamine is a chelating agent used to treat iron toxicity. It binds to excess iron in the blood, allowing the body to excrete it through urine.

For incorrect answer choices:

Activated charcoal is incorrect. Activated charcoal is used to absorb certain toxins in the gastrointestinal tract, but it is ineffective for iron toxicity because iron is not adsorbed by charcoal.

Dimercaprol is incorrect. Dimercaprol is not used for iron poisoning; it is more commonly used for arsenic, mercury, and lead poisoning.

CaNa2-EDTA is incorrect. CaNa2-EDTA is used to treat lead poisoning, not iron poisoning.

For correct answer choice:

Potassium level of 5.8 mEq/L is correct. Spironolactone is a potassium-sparing diuretic, which can cause hyperkalemia. A potassium level of 5.8 mEq/L is above the normal range (3.5-5.0 mEq/L) and may lead to dangerous cardiac dysrhythmias, so the nurse should hold the medication and notify the healthcare provider.

For incorrect answer choices:

Sodium level of 145 mEq/L is incorrect. This value is within the normal range (135-145 mEq/L), and sodium levels are not typically a primary concern with spironolactone.

Blood urea nitrogen (BUN) of 18 mg/dL is incorrect. It is within the normal range (7-20 mg/dL). BUN levels are more relevant in assessing kidney function but do not directly relate to spironolactone use unless significantly elevated.

Glucose level of 100 mg/dL is incorrect. It is a normal fasting glucose level. Spironolactone does not significantly affect blood glucose levels.

For correct answer choice:

During each meal and snack is correct. Pancreatic enzymes should be taken with food to facilitate digestion, as they help break down fats, proteins, and carbohydrates during the digestive process.

For incorrect answer choices:

At bedtime before sleeping is incorrect. Taking enzymes at this time does not coincide with food intake and may lead to inadequate digestion of any food consumed in the evening.

Before engaging in physical activity is incorrect. Physical activity does not typically require enzyme supplementation unless it coincides with meal intake, which would render this timing ineffective.

In the morning upon waking up is incorrect. This timing does not align with meals, resulting in suboptimal absorption and digestion of nutrients throughout the day.

For correct answer choice:

31 is correct. To calculate the drops per minute, the nurse first determines the total volume to be infused and the time in minutes:

• Total volume: 1,000 mL
• Time: 8 hours × 60 minutes/hour = 480 minutes
• Flow rate (mL/min) = Total volume ÷ Time = 1,000 mL ÷ 480 min ≈ 2.08 mL/min
• To find the drops per minute, multiply the mL/min by the drop factor: 2.08 mL/min × 15 drops/mL = 31.2 drops/min, rounded to 31 drops/min.

For incorrect answer choices:

50 is incorrect. This calculation does not accurately reflect the necessary flow rate based on the given volume and time.

63 is incorrect. It overestimates the drops per minute, indicating a misunderstanding of the drop factor or the time conversion.

75 is incorrect. This value is significantly higher than calculated and would result in an unsafe infusion rate for the patient.

To calculate the correct dose, use the formula:

• (Desired Dose ÷ Amount on Hand) × Volume
• (90 mg ÷ 100 mg) × 5 mL = 4.5 mL

For correct answer choice:

Alteplase increases the risk of bleeding in hemorrhagic strokes is correct. Alteplase is a clot-dissolving agent used for ischemic strokes, but it is contraindicated in hemorrhagic strokes because it can worsen the bleeding.

For incorrect answer choices:

Alteplase must be administered within 1 hour of stroke symptoms is incorrect. While time is a critical factor in alteplase administration (typically within 3–4.5 hours), the primary reason it’s contraindicated here is due to the hemorrhagic nature of the stroke.

The patient has a history of diabetes, which contraindicates Alteplase is incorrect. A history of diabetes does not contraindicate Alteplase, although blood sugar must be monitored carefully.

Alteplase is primarily used for treating myocardial infarction, not stroke is incorrect. Alteplase is commonly used for both ischemic strokes and myocardial infarctions, depending on the clinical scenario.

Nurses, pharmacists, and pharmacy technicians receive education and training on policy and procedures, including the medication reconciliation process. Patients, caregivers, and families may be interviewed to verify all medications the patient takes.

LEARNING OBJECTIVE
To ensure medication safety and continuation of care, it is vital to complete medication reconciliations during the transition of care. Nurses are critical in this process.

For correct answer choice:

Intracranial bleeding is correct. One of the most serious complications of thrombolytic therapy, particularly in the context of a stroke, is intracranial bleeding, which can occur as a result of the drug's effect on clot dissolution and increased bleeding tendency.

For incorrect answer choices:

Allergic reaction is incorrect. While allergic reactions can occur with many medications, they are not a primary concern specific to thrombolytic therapy. The focus should be on monitoring for bleeding complications.

Pulmonary embolism is incorrect. Although thrombolytics are used to treat certain clots, a pulmonary embolism is not a direct complication of thrombolytic therapy itself, especially in the context of stroke treatment.

Hypotension is incorrect. Hypotension may occur in various clinical scenarios, but it is not a specific complication of thrombolytic therapy that requires priority monitoring compared to the risk of bleeding.

For correct answer choice:

Inotropic agents is correct. Inotropic agents such as dobutamine or milrinone increase the contractile strength of the heart, thereby improving cardiac output in patients with heart failure.

For incorrect answer choices:

Diuretics is incorrect. Diuretics help reduce fluid overload in heart failure patients by promoting urine production. While they relieve symptoms, they do not enhance myocardial contractility.

Calcium channel blockers is incorrect. These medications primarily reduce heart rate and can cause vasodilation but do not enhance myocardial contractility. Some calcium channel blockers may even decrease contractility.

Angiotensin II receptor blockers is incorrect. These agents primarily work to lower blood pressure and decrease the afterload on the heart, which helps to manage heart failure but does not directly enhance myocardial contractility.

For correct answer choice:

Activated partial thromboplastin time is correct. Checking aPTT before administering heparin is essential to confirm that the patient is within the therapeutic range. This ensures the patient receives an appropriate dose to prevent further clotting.

For incorrect answer choices:

Fibrinogen level is incorrect. It measures the level of fibrinogen in the blood, which is not routinely used to monitor heparin therapy. While fibrinogen levels can indicate clotting ability, they do not provide information on heparin efficacy.

D-dimer test is incorrect. It is primarily used to rule out thrombotic disorders and does not measure the effectiveness of heparin therapy. Elevated D-dimer levels may indicate clot formation but do not provide dosing information for heparin.

Thrombin time is incorrect. It measures the time it takes for blood to clot in the presence of thrombin, but it is not the primary test for monitoring heparin therapy. Thrombin time is more relevant for assessing the effects of direct thrombin inhibitors.

For correct answer choice:

3% saline is a hypertonic solution with more dissolved particles than blood. Hence, when infused, fluid moves out of the cells and into the intravascular space.

For incorrect answer choices:

Isotonic fluid examples are 0.9% normal saline and lactated ringers(LR). The fluids are similar to the blood concentration; thus, when infused, there is no shift into the intravascular space.

An example of hypotonic fluid is 0.45% saline. Compared to the blood, the concentration of dissolved solutes is less; thus, fluid moves from the intravascular to the intracellular compartment.

There are only three types of intravenous fluids.

LEARNING OBJECTIVE
Optimal cellular functioning requires the maintenance of fluid balance. To correct imbalances, fluids are frequently administered in the hospital setting. Nurses must know the types of fluids and their actions to monitor for potential complications.

For correct answer choice:

Reduce the size and vascularity of the thyroid gland is correct. Lugol’s iodine solution is given preoperatively to patients with hyperthyroidism to decrease the size and vascularity of the thyroid, reducing the risk of hemorrhage during surgery.

For incorrect answer choices:

Prevent postoperative bleeding and bruising is incorrect. While Lugol’s solution helps reduce vascularity, its direct role is not specifically about preventing postoperative bleeding but rather preparing the gland for surgery.

Stimulate the release of thyroid hormones is incorrect. Lugol’s iodine inhibits thyroid hormone synthesis, making it beneficial for reducing the thyroid’s activity before surgery, but it does not stimulate hormone release.

Protect the thyroid from radioactive iodine exposure is incorrect. Although iodine can be used to block radioactive iodine in other situations, Lugol's iodine is specifically used in this context to prepare the gland for surgery.

For correct answer choice:

Nonhazardous pharmaceutical waste is disposed of in the blue container.

For incorrect answer choices:

The yellow containers are designed to contain potentially harmful pathogens such as trace chemotherapy waste. The black containers are designed for hazardous waste, including pharmaceuticals. Red containers are engineered for biohazard, sharps, and pathological waste.

LEARNING OBJECTIVE
Proper handling of medications is crucial to prevent harm to self and others. Knowledge of handling waste is critical to prevent complications.

For correct answer choice:

"It helps relieve the pain and discomfort associated with the infection." is correct. This response accurately describes the primary function of phenazopyridine, which is to provide symptomatic relief from pain and discomfort due to UTIs.

For incorrect answer choices:

"It increases the acidity of your urine to help eliminate the infection." is incorrect. Phenazopyridine does not change urine acidity to treat the infection but rather provides pain relief.

"It acts as an antibiotic to directly fight the bacteria in your urinary tract." is incorrect. This is misleading; phenazopyridine does not possess antibacterial properties nor treat the infection.

"It flushes out the bacteria by increasing your urine output." is incorrect. Phenazopyridine does not increase urine output but alleviates symptoms.

For correct answer choice:

Correct Guillain Barre Syndrome(GBS): Some people with a history of Guillain-Barre Syndrome should not receive the influenza vaccine.

For incorrect answer choices:

The elderly, young, and patients with multiple comorbidities are at higher risk of having complications from the flu. It is recommended that they receive vaccination if there are no contraindications.

LEARNING OBJECTIVE
Nurses need to possess knowledge of all medications and treatments that they provide. Not only do they need to know the patient’s medical history, but they must also review pertinent lab data. They must look for any interactions between new or prior medications and be aware of any allergies the patient has every time they administer a medication.

For correct answer choice:

Zithromax is correct. Zithromax (azithromycin) is a macrolide antibiotic used to treat bacterial infections such as respiratory infections, skin infections, and sexually transmitted diseases.

For incorrect answer choices:

Zetia is incorrect. Zetia (ezetimibe) is a cholesterol-lowering medication, not an antibiotic.

Zoloft is incorrect. Zoloft (sertraline) is an antidepressant, part of the selective serotonin reuptake inhibitor (SSRI) class, not an antibiotic.

Zyprexa is incorrect. Zyprexa (olanzapine) is an antipsychotic medication used to treat mental health conditions such as schizophrenia and bipolar disorder, not a bacterial infection.

For correct answer choice:

Spread a thin layer evenly is correct. This technique allows for better absorption and minimizes irritation to the skin.

For incorrect answer choices:

Apply a thick layer and rub vigorously is incorrect. This can lead to skin irritation and may hinder absorption.

Use long, firm strokes in the opposite direction of hair growth is incorrect. This can cause irritation and discomfort.

Apply only to the edges of the lesions is incorrect. The medication should cover the entire affected area for effective treatment.

For correct answer choice:

Active bleeding from a recent surgical site is correct. tPA is contraindicated in patients with active bleeding due to the risk of significant hemorrhage, which can be exacerbated by thrombolytic therapy.

For incorrect answer choices:

Elevated blood pressure of 150/90 mmHg is incorrect. Elevated blood pressure is a concern and should be managed but, it is not an absolute contraindication for tPA if it is otherwise safe to administer.

Patient's age of 75 years is incorrect. However, age is a risk factor that requires careful consideration during evaluation but it alone is not a contraindication.

History of hyperlipidemia is incorrect. Hyperlipidemia does not contradict the use of tPA. It is more relevant to the long-term management of cardiovascular health but does not affect the immediate administration of thrombolytics.

For correct answer choice:

The DEA provides anonymous online reporting for those suspected of drug diversion, and Nurses have an ethical and professional duty to report impaired colleagues are true: The DEA provides anonymous online reporting for those suspected of drug diversion. Nurses have an ethical and professional duty to report impaired colleagues. Also, in some states and jurisdictions, reporting is mandatory.

For incorrect answer choices:

Impaired nurses will have their licenses revoked, and Benzodiazepines are the most common diverted substance in healthcare facilities. These statements are false: Impaired nurses will have their licenses revoked. Benzodiazepines are the most common diverted substance in healthcare facilities. Impaired nurses can undergo treatment to return to work. With repeated offenses, action may be taken against their license. Opioids are the most common diverted substance.

LEARNING OBJECTIVE
Substance use disorder is a disease that can affect anyone, including healthcare professionals. Nurses must be aware of the warning signs and the rules and regulations of their state.

For correct answer choice:

A patient with a history of liver disease is correct. The liver metabolizes Simvastatin, and patients with liver disease may be at increased risk for statin-related hepatotoxicity. Monitoring liver function tests is essential in these patients.

For incorrect answer choices:

A patient with controlled hypertension is incorrect. Controlled hypertension does not contraindicate the use of simvastatin. Also, this patient can be safely managed with the medication.

A patient who smokes cigarettes is incorrect. While smoking can affect lipid levels, it is not a direct contraindication for simvastatin use. Patients who smoke may still benefit from cholesterol-lowering medications.

A patient with a recent diagnosis of type 2 diabetes is incorrect. While diabetes is a risk factor for cardiovascular disease, it does not prevent the use of simvastatin. In fact, statins are often prescribed to diabetic patients to manage cholesterol levels.

For correct answer choice:

The purpose of propofol is to provide relaxation to the patient, so having a restless patient is unacceptable. An elevated heart rate is a sign of decreased sedation.

For incorrect answer choices:

A patient who is easily arousable and returns to sleep with normal vital signs has an appropriate level of relaxation. A patient who is difficult to arouse may need the propofol decreased as there is too much sedation.

LEARNING OBJECTIVE
Nurses should understand the medication they are infusing and have specific parameters for the level of sedation. Some providers may use the Richmond Agitation Sedation Scale score(RASS).

For correct answer choice:

Severe electrolyte imbalances is correct. Bumetanide is a loop diuretic that can lead to a depletion in electrolytes, particularly potassium and magnesium. IIn case of severe electrolyte imbalance, administering bumetanide could exacerbate these issues. This can lead to serious complications such as arrhythmias.

For incorrect answer choices:

Hypertension is incorrect. Bumetanide is often used to manage fluid overload, which can contribute to hypertension. While the nurse may need to monitor the patient's blood pressure, hypertension alone does not contraindicate the use of this medication.

Heart failure is incorrect. Bumetanide is commonly prescribed to patients with heart failure to manage fluid overload and pulmonary congestion. It is an essential medication for improving symptoms in such patients.

Acute renal failure is incorrect. Although caution is warranted in patients with renal impairment, bumetanide may still be used under close monitoring to promote diuresis. The nurse would assess the patient's renal function but would not automatically withhold the medication without further evaluation.

For correct answer choice:

Diazepam is correct. Diazepam is a benzodiazepine that is classified as an anxiolytic, commonly prescribed to manage anxiety, alcohol withdrawal, and muscle spasms. Like other benzodiazepines, it enhances GABA’s calming effects.

For incorrect answer choices:

Digoxin is incorrect. Digoxin is a cardiac glycoside used to treat heart failure and atrial fibrillation, not anxiety.

Duloxetine is incorrect. Duloxetine is an antidepressant that belongs to the serotonin-norepinephrine reuptake inhibitor (SNRI) class, primarily used to treat depression and neuropathic pain. Although it may have effects on anxiety, it is not considered a first-line anxiolytic.

Diltiazem is incorrect. Diltiazem is a calcium channel blocker used to treat hypertension and angina, not anxiety disorders.

For correct answer choice:

Antiprotozoal is correct. The protozoan Giardia lamblia causes giardiasis, and the appropriate treatment involves the use of antiprotozoal medications, such as metronidazole or tinidazole, which specifically target protozoan infections.

For incorrect answer choices:

Antifungal is incorrect because antifungal medications are designed to treat fungal infections, such as candidiasis or athlete's foot, and are not effective against protozoan pathogens like Giardia.

Antiviral is incorrect as antiviral medications are used to treat viral infections, such as influenza or HIV, and do not have any efficacy against protozoal infections.

Antibiotic is incorrect because while antibiotics can treat bacterial infections, they are not effective against protozoa and could disrupt the normal flora without addressing the underlying issue.

For correct answer choice:

Proper protocol needs to be followed. A second nurse needs to not only witness but cosign the waste of the controlled substance.

For incorrect answer choices:

Not following proper protocols can result in actions against your nursing license.

• Some nurses may have good intentions to utilize medications later rather than waste them. Holding onto controlled substances could be considered drug diversion.
• Nurses can not give extra medications to the patient without an order; it is illegal.
• The medication must be removed from the vial/device and wasted so it may not be diverted.

LEARNING OBJECTIVE
To prevent drug diversion, there is a closed system for record keeping. Records must be kept, including inventory counts frequently.

For correct answer choice:

Respiratory rate is correct. Opioid analgesics, such as morphine or hydromorphone, can depress the respiratory system. The nurse should assess the client’s respiratory rate before administration to ensure it is within a safe range, typically above 12 breaths per minute. If the client’s respiratory rate is too low, the opioid could further depress their breathing, leading to respiratory failure.

For incorrect answer choices:

Blood pressure is incorrect because while opioids can cause hypotension, respiratory rate is the most critical assessment to prevent life-threatening complications such as respiratory depression.

Temperature is incorrect because opioids do not have a direct effect on body temperature, and monitoring temperature is not the priority before administering an opioid analgesic.

Urine output is incorrect because although opioids can cause urinary retention, respiratory status is the most important aspect to assess before giving the medication.

For correct answer choice:

Persistent cough is correct. Lisinopril, an ACE inhibitor, can cause a persistent dry cough due to the accumulation of bradykinin, which can lead to respiratory tract irritation.

For incorrect answer choices:

Increased heart rate is incorrect. While an increased heart rate may occur for various reasons, it is not a common adverse effect specifically associated with lisinopril.

Elevated blood glucose is incorrect. Lisinopril does not typically affect blood glucose levels significantly and may even be protective for diabetic patients.

Weight gain is incorrect. While weight gain can be a concern in heart failure patients, it is not a direct adverse effect of lisinopril. Weight changes may indicate fluid retention but should be monitored as part of overall heart failure management rather than a direct reaction to the medication.