Nursing Elites

1. A healthcare professional in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings is indicative of this condition?

• A. Insidious onset of painless loss of vision
• B. Gradual reduction in peripheral vision
• C. Severe pain around the eyes
• D. Intraocular pressure 12 mm Hg

Correct answer: C

Rationale: Severe pain around the eyes that radiates over the face is a classic symptom of acute angle-closure glaucoma. This intense pain is often associated with other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. Immediate medical attention is required to prevent permanent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more indicative of conditions like macular degeneration. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12 mm Hg is within the normal range and is not typical of angle-closure glaucoma.

2. A healthcare provider is caring for a client who has a new prescription for Digoxin. Which of the following findings should the healthcare provider identify as a potential sign of Digoxin toxicity?

• A. Nausea
• B. Dry mouth
• C. Hypoglycemia
• D. Tinnitus

Correct answer: A

Rationale: Nausea is a potential sign of Digoxin toxicity. Along with vomiting, visual disturbances, and confusion, it can be an early indication of an overdose. Dry mouth is not typically associated with Digoxin toxicity. Hypoglycemia is a low blood sugar level and is not directly related to Digoxin toxicity. Tinnitus, a ringing in the ears, is not a common sign of Digoxin toxicity. Healthcare providers should closely monitor clients on Digoxin for symptoms like nausea to prevent serious complications.

3. A nurse is providing teaching for a male client who has Schizophrenia and is taking Risperidone. Which of the following instructions should the nurse include in the teaching?

• A. Add extra snacks to your diet to prevent weight loss.
• B. Notify the provider if you develop breast enlargement.
• C. You may begin to have mild seizures while taking this medication.
• D. This medication is likely to increase your libido.

Correct answer: B

Rationale: The correct answer is B: 'Notify the provider if you develop breast enlargement.' Gynecomastia (breast enlargement) and galactorrhea can occur due to an increase in prolactin levels while taking risperidone. The client should inform the provider if these manifestations occur. Choices A, C, and D are incorrect. Adding extra snacks to the diet to prevent weight loss is not a specific instruction related to risperidone. Seizures are not a common side effect of risperidone, so the statement about mild seizures is inaccurate. Risperidone is more likely to cause sexual side effects like erectile dysfunction rather than increasing libido, making choice D incorrect.

4. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital, with a long half-life of 4 days, remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should administer phenobarbital once a day to maintain a consistent therapeutic effect without the need for multiple daily doses. Administering the medication more than once a day would not be necessary and could increase the risk of side effects or toxicity. Therefore, the correct answer is to administer phenobarbital once a day.

5. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

• A. Administer subcutaneously in a large muscle mass to prevent injury.
• B. Ensure that the medication is kept at room temperature until just prior to administration.
• C. Invert vial gently to mix well before withdrawing dose.
• D. Discard vial after removing one dose of the medication.

Correct answer: D

Rationale: The correct intervention when preparing to administer Filgrastim is to discard the vial after removing one dose of the medication. This practice helps prevent contamination and ensures the medication's effectiveness. Reusing the vial can lead to contamination and compromise the sterility of the medication, putting the client at risk. Therefore, it is crucial to follow proper aseptic technique and discard the vial after withdrawing the prescribed dose.

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