Nursing Elites

1. A client is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication?

• A. Decreased blood pressure
• B. Increase in HDL cholesterol
• C. Prevention of bipolar manic episodes
• D. Improved sexual function

Correct answer: A

Rationale: The therapeutic effect of lisinopril, an ACE inhibitor, is indicated by a decrease in blood pressure. Lisinopril works by relaxing blood vessels, leading to a reduction in blood pressure. Monitoring and achieving a decrease in blood pressure is a key outcome when managing hypertension with lisinopril. Choices B, C, and D are incorrect because lisinopril is not intended to increase HDL cholesterol, prevent bipolar manic episodes, or improve sexual function. Therefore, the correct outcome indicating the therapeutic effect of lisinopril is a decrease in blood pressure.

2. Which of the following is classified as a class IA Sodium Channel blocker?

• A. Quinidine
• B. Disopyramide
• C. Aminodarone
• D. Propafenone

Correct answer: A

Rationale: Quinidine is classified as a class IA sodium channel blocker. Class IA antiarrhythmics, like quinidine, work by blocking sodium channels and delaying repolarization. Propafenone, mentioned in the original rationale, is actually a class IC antiarrhythmic agent, not a class IA sodium channel blocker.

3. A client has a new prescription for Verapamil to treat angina. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Muscle pain
• B. Dry cough
• C. Peripheral edema
• D. Increased urination

Correct answer: C

Rationale: Verapamil, a calcium channel blocker, can cause peripheral edema due to vasodilation. Clients should monitor for this adverse effect characterized by swelling in the extremities. Muscle pain (choice A) is not a common adverse effect of Verapamil. Dry cough (choice B) is more commonly associated with ACE inhibitors. Increased urination (choice D) is not a typical adverse effect of Verapamil. Therefore, the correct answer is monitoring for peripheral edema.

4. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

• A. 1-year-old who has no health problems
• B. 17-year-old who has a hypersensitivity to Penicillin
• C. 25-year-old who is pregnant
• D. 52-year-old who takes a multivitamin supplement

Correct answer: B

Rationale: The correct answer is B. A 17-year-old can receive the influenza vaccine via nasal spray even if they have a hypersensitivity to penicillin, as this is not a contraindication for the influenza immunization. The nasal spray vaccine (LAIV) is a live attenuated vaccine that is suitable for healthy individuals aged 2-49 years. Pregnancy (choice C) is a contraindication for the nasal spray influenza vaccine. Children under 2 years of age (choice A) are also not candidates for the nasal spray. Taking a multivitamin supplement (choice D) is not a determining factor for the type of influenza vaccine a person should receive.

5. A healthcare professional is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare professional should recognize that the medication affected which of the following systems in the client?

• A. Cardiovascular
• B. Immune
• C. Central nervous
• D. Gastrointestinal

Correct answer: C

Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders caused by certain medications affecting the central nervous system. These effects can include symptoms like tremors, rigidity, and bradykinesia. Medications like typical antipsychotics induce extrapyramidal effects by interfering with dopamine transmission in the central nervous system. Choices A, B, and D are incorrect as extrapyramidal effects are specifically related to the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.

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