The proper way to administer more than one eye medication (drops) scheduled at the same time is to:

Correct Answer: C

Rationale: The correct way to administer more than one eye medication scheduled at the same time is to give the eye drops of the different medications five minutes apart (Option C). This practice is crucial to ensure the effectiveness of each medication and prevent potential interactions between them. Administering eye drops right after one another (Option A) can lead to dilution of the medications and reduce their therapeutic effects. Mixing the eye drops in a dropper and administering them at the same time (Option B) is not recommended as the medications may interact chemically, altering their efficacy. In an educational context, understanding the proper administration of medications is vital for nursing students to provide safe and effective care to patients. Teaching the rationale behind spacing out eye drop administration helps students grasp the importance of medication timing and avoid potential complications. It also emphasizes the significance of following medication administration guidelines to optimize patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Use allowed in moderate renal failure. Propofol is a short-acting intravenous anesthetic agent commonly used for induction of anesthesia due to its rapid onset and offset of action. It is advantageous for patients with renal impairment because it is metabolized by the liver and excreted in the urine, making it suitable for use in moderate renal failure where other agents may accumulate and cause adverse effects. Option A (Administered orally) is incorrect because propofol is administered intravenously, not orally. Option B (Half-life up to 4 h) is incorrect because propofol has a short half-life of about 1-2 hours, not up to 4 hours. Option C (Low perfusion to the brain) is incorrect because propofol is known to have rapid distribution to the brain, contributing to its quick onset of action and sedative effects. Educationally, understanding the pharmacokinetic properties of propofol is crucial for nurses administering anesthesia. Knowing that propofol is suitable for patients with renal impairment can help nurses make informed decisions when selecting anesthetic agents, ensuring patient safety and optimal outcomes.

Correct Answer: D

Rationale: In this scenario, the best course of action for the patient with hypokalemia (serum potassium of 2.9 mEq/L) due to thiazide diuretic use is to supplement potassium by increasing intake of fruits and bananas (Option D). Thiazide diuretics can cause potassium loss through increased urinary excretion, leading to hypokalemia. Potassium supplementation helps correct this imbalance and prevent complications like cardiac arrhythmias. Option A, beginning an exercise regimen, is not appropriate in this case as it does not address the immediate need to correct the low potassium levels. Option B, cardiac enzyme evaluation for possible myocardial infarction, is not indicated based on the information provided. Option C, discontinuing the thiazide diuretic and starting an ACE inhibitor, may exacerbate the potassium deficiency as ACE inhibitors can also increase potassium levels. In an educational context, it is crucial for nursing students to understand the effects of medications on electrolyte balance, especially in older adults who may be more susceptible to adverse effects. Recognizing and managing electrolyte imbalances is a fundamental aspect of nursing pharmacology to ensure patient safety and optimal outcomes.

Correct Answer: D

Rationale: The correct answer is D) Normal gastric epithelium. Rationale: Sucralfate works by forming a protective barrier over ulcers, promoting healing. In this scenario, the patient's history of NSAID-induced ulcers suggests that he may have had gastric mucosal damage prior to starting sucralfate. After 1 year of treatment, the most likely finding on upper endoscopy would be normal gastric epithelium, indicating successful healing and protection provided by sucralfate. Explanation of Incorrect Options: A) Duodenitis: This is less likely as sucralfate primarily acts in the stomach, so duodenitis would not be the expected outcome. B) Duodenal perforation: This is an extreme and unlikely outcome of sucralfate treatment. C) Gastric ulcers that appear unhealed: Given the protective nature of sucralfate, unhealed ulcers would be an unexpected finding after a year of treatment. Educational Context: Understanding the mechanism of action of sucralfate and its role in treating and preventing NSAID-induced ulcers is crucial for nursing pharmacology. This case highlights the importance of monitoring and assessing the effectiveness of pharmacological interventions, as well as recognizing expected outcomes based on drug actions. It also emphasizes the significance of tailoring treatment to individual patient needs and medical history.

Correct Answer: A

Rationale: In this scenario, the most appropriate course of action is to choose option A) Continue infusion; premedicate with antipyretic for next doses. The patient's presentation of fever and chills following amphotericin administration suggests an infusion-related reaction known as "shake and bake" syndrome. This reaction is common with amphotericin and is characterized by flu-like symptoms. Continuing the infusion while premedicating with an antipyretic can help manage these symptoms and allow the patient to receive the necessary treatment. Option B) Discontinuing the infusion is not the best choice as the patient still requires treatment for systemic candidemia, and discontinuing the medication without proper management of symptoms may compromise the effectiveness of the therapy. Options C) Intravenous prednisone and discontinue amphotericin and D) Intravenous tetracycline and discontinue amphotericin are incorrect because prednisone and tetracycline are not indicated for managing infusion-related reactions to amphotericin. Prednisone is a corticosteroid that may not address the immediate symptoms, and tetracycline is an antibiotic with no direct relevance to managing amphotericin-induced fever and chills. From an educational perspective, understanding the common side effects and management strategies for medications like amphotericin is crucial for nursing pharmacology practice. It highlights the importance of recognizing and appropriately managing medication-related adverse events to ensure patient safety and treatment efficacy. Nurses must be equipped with this knowledge to provide prompt and effective care in similar clinical situations.