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 client has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, what advice should the nurse provide?

• A. Avoid using acetaminophen for headaches.
• B. Restrict intake of foods high in sodium.
• C. Decrease fluid intake to less than 1,500 mL daily.
• D. Limit aerobic activity in hot weather.

Correct answer: D

Rationale: The nurse should advise the client to limit aerobic activity in hot weather to prevent sodium/water depletion, which can increase the risk for Lithium toxicity. Excessive sweating and fluid loss can lead to dehydration and changes in lithium levels, potentially resulting in toxicity. Choices A, B, and C are incorrect. Avoiding acetaminophen for headaches is not directly related to Lithium toxicity. Restricting sodium intake and decreasing fluid intake can lead to increased lithium levels and toxicity, so these are not recommended actions.

3. When preparing to administer IV Acyclovir for Herpes Zoster, what action should the nurse take?

• A. Infuse the medication over 1 hour.
• B. Monitor the client's blood pressure every 15 minutes during infusion.
• C. Administer a stool softener.
• D. Monitor the client's blood glucose level every 4 hours during infusion.

Correct answer: A

Rationale: The correct action for the nurse is to infuse IV Acyclovir over at least 1 hour to prevent nephrotoxicity. Rapid infusion can lead to adverse effects, so a slow infusion rate is crucial for patient safety. Monitoring blood pressure, administering a stool softener, or monitoring blood glucose levels are not directly related to the administration of IV Acyclovir for Herpes Zoster.

4. A healthcare professional is educating a client who has a new prescription for warfarin. Which of the following statements should the healthcare professional include?

• A. Avoid foods high in vitamin K.
• B. Report any signs of bleeding to your healthcare provider.
• C. Use a soft toothbrush to prevent gum bleeding.
• D. Use an electric razor to prevent cuts.

Correct answer: B

Rationale: The correct statement that the healthcare professional should include when educating a client prescribed warfarin is to report any signs of bleeding to their healthcare provider. Bleeding can indicate excessive anticoagulation, which is a serious side effect of warfarin. Prompt reporting of bleeding symptoms is crucial to prevent complications. Choices A, C, and D are incorrect. While avoiding foods high in vitamin K may be important when taking warfarin due to its interaction with the medication, it is not the priority over reporting signs of bleeding. Using a soft toothbrush and electric razor are general precautions for individuals on anticoagulants but are not as critical as reporting bleeding symptoms.

5. A client has a new prescription for Prednisone. Which of the following laboratory values should be monitored by the healthcare provider?

• A. Serum potassium
• B. Serum calcium
• C. Serum sodium
• D. Serum glucose

Correct answer: D

Rationale: When a client is prescribed Prednisone, monitoring serum glucose levels is essential. Prednisone, a corticosteroid, can lead to hyperglycemia. Therefore, regular monitoring of serum glucose helps in detecting and managing any potential hyperglycemic effects of the medication. Monitoring serum potassium, calcium, or sodium is not typically required when a client is on Prednisone unless there are specific risk factors or concerns related to these electrolytes.

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