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 Enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the following adverse reactions?

• A. Bone marrow suppression
• B. Pancreatitis
• C. Pancreatitis
• D. Bone marrow suppression

Correct answer: D

Rationale: While bone marrow suppression is not typically associated with Enfuvirtide, a more relevant concern is the risk of severe allergic reactions such as anaphylaxis. Enfuvirtide, an HIV fusion inhibitor, can cause local injection site reactions and systemic allergic responses. Monitoring for signs of allergic reactions, such as rash, fever, and difficulty breathing, is crucial to ensure the client's safety.

3. When teaching a client with schizophrenia strategies to cope with anticholinergic effects of Fluphenazine, which of the following should the nurse suggest to minimize anticholinergic effects?

• A. Take the medication in the morning to prevent insomnia.
• B. Chew sugarless gum to moisten the mouth.
• C. Use cooling measures to decrease fever.
• D. Take an antacid to relieve nausea.

Correct answer: B

Rationale: The correct answer is B: 'Chew sugarless gum to moisten the mouth.' Chewing sugarless gum can help alleviate dry mouth, which is a common anticholinergic effect of Fluphenazine. Dry mouth can be uncomfortable and affect the client's oral health. Options A, C, and D are incorrect because they do not directly address anticholinergic effects. Taking the medication in the morning to prevent insomnia (Option A) is unrelated to anticholinergic effects. Using cooling measures to decrease fever (Option C) is not a common anticholinergic effect of Fluphenazine. Taking an antacid to relieve nausea (Option D) does not specifically target anticholinergic effects.

4. When teaching a client with cancer who has a prescription for methotrexate, which supplement should the nurse instruct the client to take?

• A. Folic acid
• B. Magnesium
• C. Vitamin D
• D. Iron

Correct answer: A

Rationale: The correct answer is folic acid. Methotrexate is a folic acid antagonist, so instructing the client to take folic acid helps reduce the risk of methotrexate toxicity by providing additional folic acid that the medication may deplete. Magnesium (choice B), Vitamin D (choice C), and Iron (choice D) are not the correct supplements to instruct the client to take with methotrexate.

5. Which of the following medications is a bronchodilator?

• A. Albuterol
• B. Omeprazole
• C. Ondansetron
• D. Senna

Correct answer: A

Rationale: Albuterol is classified as a bronchodilator, which is commonly used to treat conditions like asthma by relaxing the muscles in the airways and increasing airflow to the lungs. Omeprazole is a proton pump inhibitor used to reduce stomach acid production, while ondansetron is an anti-nausea medication, and senna is a laxative.

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