While preparing an infusion of mannitol (Osmitrol), the nurse notices small crystals in the IV tubing. What is the most appropriate action by the nurse?

Correct Answer: B

Rationale: The most appropriate action by the nurse when small crystals are observed in the IV tubing while preparing an infusion of mannitol (Osmitrol) is to discard the solution and obtain another bag of medication. Small crystals in the IV tubing can indicate that the medication may be contaminated or that it has precipitated out of solution, which can potentially lead to complications if infused into the patient. It is crucial to ensure that the medication is in proper form before administration to prevent any harm to the patient. Therefore, discarding the solution and obtaining a new bag of medication is the safest and most appropriate course of action in this situation.

Correct Answer: D

Rationale: In general, the maximum recommended dose of simvastatin is 40 mg daily due to an increased risk of myopathy, including rhabdomyolysis, at higher doses. However, in certain cases, especially for patients who have been tolerating and responding well to simvastatin 40 mg for an extended period without experiencing myopathy, increasing the dose to 80 mg may be considered. Patients who have been taking simvastatin for 12 months with no evidence of myopathy are likely to benefit from the higher dose in terms of better lipid control. It is important to monitor closely for any signs or symptoms of myopathy even with the 80 mg dose.

Correct Answer: B

Rationale: Ginkgo is known to have anticoagulant properties that can interact with and enhance the effects of anticoagulant medications, such as warfarin. Therefore, patients taking anticoagulant therapy should avoid herbal products containing ginkgo to prevent excessive anticoagulation and the risk of bleeding complications. It is essential for healthcare providers to educate patients on potential herb-drug interactions to ensure their safety and optimal therapeutic outcomes.

Correct Answer: C

Rationale: Lithium is commonly used as a mood stabilizer in the treatment of bipolar disorder. It helps reduce the intensity of manic episodes, thereby stabilizing the patient's mood and preventing extreme mood swings. While lithium is primarily known for its mood-stabilizing effects, it is not used to lower blood glucose, slow the heart, or heal ulcers.

Correct Answer: A

Rationale: Premature infants, especially those born very premature or with health complications, often require blood transfusions due to their underdeveloped organs and medical conditions. Their small size and medical fragility make them the age group that typically uses the most units of blood and blood products. This high demand for blood products is necessary to support their growth, development, and overall health. Conversely, while individuals in other age groups may also require blood transfusions, premature infants have specific and ongoing needs that often result in a greater overall use of blood and blood products in this age group.