Nursing Elites

1. A healthcare professional is educating a client who is starting therapy with gemcitabine. Which of the following findings should the healthcare professional instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The healthcare professional should instruct the client to report dyspnea since it can indicate pulmonary toxicity, a severe adverse effect associated with gemcitabine therapy. Monitoring and reporting dyspnea promptly can help in early detection and management of potential serious complications. Constipation, tinnitus, and dry mouth are not typically associated with gemcitabine therapy and are not urgent findings requiring immediate reporting.

2. 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.

3. Which of the following conditions is not treated with Lansoprazole?

• A. Zollinger-Ellison syndrome
• B. Gastritis
• C. Hypertension
• D. Reflux

Correct answer: C

Rationale: Lansoprazole is a proton pump inhibitor used to treat conditions related to excessive stomach acid production, such as Zollinger-Ellison syndrome, gastritis, and reflux. However, it is not indicated for the treatment of hypertension, which is managed using antihypertensive medications. Therefore, the correct answer is C: Hypertension.

4. A healthcare provider is reviewing a client's medication history and notes a new prescription for Enalapril. The healthcare provider should monitor the client for which of the following as an adverse effect of this medication?

• A. Bradycardia
• B. Hyperkalemia
• C. Hypoglycemia
• D. Hypocalcemia

Correct answer: B

Rationale: Enalapril, an ACE inhibitor, can cause hyperkalemia as an adverse effect due to decreased aldosterone levels, leading to potassium retention. Monitoring potassium levels is essential to prevent complications associated with hyperkalemia. Bradycardia (Choice A) is not a common adverse effect of Enalapril. Enalapril does not typically affect glucose levels, so hypoglycemia (Choice C) is not a common concern with this medication. Enalapril does not directly impact calcium levels, so hypocalcemia (Choice D) is not a typical adverse effect.

5. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?

• A. Clopidogrel (Plavix)
• B. Morphine
• C. Aspirin (ASA)
• D. Metoprolol (Lopressor)

Correct answer: A

Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.

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