Nursing Elites

1. A client has a prescription for Timolol eye drops for the treatment of glaucoma. Which of the following instructions should the nurse include?

• A. Apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application.
• B. Avoid blinking immediately after instilling the drops.
• C. Keep your eyes closed for 5 minutes after application.
• D. Administer the drops directly onto the cornea.

Correct answer: A

Rationale: The correct instruction for the nurse to include is to apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application. This technique helps prevent systemic absorption of the medication, reducing the risk of systemic side effects. By applying pressure, the drainage of the medication into the bloodstream through the nasolacrimal duct is minimized, enhancing the drug's local ocular effects. Choices B, C, and D are incorrect because blinking immediately after instilling the drops, keeping eyes closed for 5 minutes, and administering the drops directly onto the cornea are not recommended practices for administering Timolol eye drops.

2. A healthcare professional working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the healthcare professional's priority?

• A. Administer flumazenil.
• B. Identify the client's level of orientation.
• C. Infuse IV fluids.
• D. Prepare the client for gastric lavage.

Correct answer: B

Rationale: When managing a client with Benzodiazepine toxicity, the priority action for the healthcare professional is to assess the client. Identifying the client's level of orientation allows the healthcare professional to understand the client's cognitive status, which is crucial for further interventions and decision-making in the care plan. Administering flumazenil (Choice A) may precipitate withdrawal symptoms and should be done cautiously. Infusing IV fluids (Choice C) can be important but is not the priority over assessing the client. Gastric lavage (Choice D) is not typically recommended due to the risk of complications and its limited effectiveness in cases of Benzodiazepine overdose.

3. A healthcare professional is preparing to administer furosemide 80 mg PO daily. The available furosemide oral solution is 10 mg/1 mL. How many mL should the healthcare professional administer?

• A. 8 mL
• B. 10 mL
• C. 6 mL
• D. 12 mL

Correct answer: A

Rationale: To determine the volume to administer, divide the desired dose by the available concentration. In this case, (80 mg / 10 mg/mL) = 8 mL. Therefore, the healthcare professional should administer 8 mL of furosemide oral solution. Choice B (10 mL), C (6 mL), and D (12 mL) are incorrect as they do not accurately calculate the volume needed based on the provided concentration of the solution.

4. A client has a new prescription for Alendronate. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Remain upright for 30 minutes after taking the medication.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to remain upright for 30 minutes after taking Alendronate. Alendronate can cause esophageal irritation and even ulceration if it remains in contact with the esophagus. By staying upright, the medication is more likely to pass through the esophagus and into the stomach, reducing the risk of irritation and complications. Choice A is incorrect because Alendronate should be taken in the morning, not at bedtime, and the client should remain upright after taking it. Choice C is incorrect because Alendronate should be taken on an empty stomach, usually in the morning, to enhance absorption. Choice D is incorrect because while calcium intake is important, it is not directly related to the administration of Alendronate.

5. A healthcare provider is preparing to administer metoprolol to a client. Which of the following findings should the provider identify as a contraindication to receiving this medication?

• A. Bradycardia
• B. Hypertension
• C. Fever
• D. Rash

Correct answer: A

Rationale: Metoprolol, a beta-blocker, is contraindicated in clients with bradycardia as it can further lower the heart rate, potentially leading to more serious complications. Bradycardia is defined as a heart rate below 60 beats per minute, and administering metoprolol in such cases can exacerbate this condition, causing adverse effects on cardiac output. Hypertension, fever, and rash are not contraindications for metoprolol administration.

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