Nursing Elites

1. Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:

• A. Headaches
• B. Cold remedy
• C. Neuropathic pain
• D. Antianxiety

Correct answer: C

Rationale: Phenytoin, an antiarrhythmic and anticonvulsant medication, is also used off-label for treating neuropathic pain. While its primary indications are for managing heart rhythm disorders and seizures, it has shown efficacy in managing neuropathic pain, expanding its clinical utility. Choices A, B, and D are incorrect as phenytoin is not commonly used for headaches, cold remedies, or antianxiety purposes.

2. A client has a new prescription for Raltegravir. Which of the following statements should the nurse include in teaching the client?

• A. This medication prevents the virus from entering the cell.
• B. This medication prevents the virus from leaving the cell.
• C. This medication blocks the virus from attaching to the cell.
• D. This medication blocks the virus from replicating in the cell.

Correct answer: D

Rationale: The correct answer is D because Raltegravir works by blocking the integrase enzyme, preventing the virus from integrating its genetic material into the host cell's DNA. By inhibiting this process, viral replication within the host cell is halted. Choices A, B, and C are incorrect because Raltegravir's mechanism of action specifically targets viral replication within the cell, not virus entry, exit, or attachment to the cell.

3. A healthcare professional is caring for a client who is prescribed Digoxin. Which of the following findings should the healthcare professional monitor to assess for potential toxicity?

• A. Bradycardia
• B. Hypertension
• C. Hypoglycemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Bradycardia. Bradycardia is a common sign of Digoxin toxicity. Digoxin can cause bradycardia due to its effects on the heart's electrical conduction system. Monitoring the client's heart rate regularly is essential to detect and manage toxicity promptly. Choice B, Hypertension, is incorrect as Digoxin toxicity typically presents with bradycardia and not hypertension. Choices C and D, Hypoglycemia and Hypercalcemia, are also incorrect as they are not typically associated with Digoxin toxicity.

4. A client has a new prescription for Iron supplements. Which of the following instructions should be included in the teaching?

• A. Take the medication with a glass of orange juice.
• B. Avoid taking the medication with milk.
• C. Increase fiber intake to prevent constipation.
• D. Expect stools to be dark.

Correct answer: C

Rationale: The correct answer is to increase fiber intake to prevent constipation when taking iron supplements. Iron supplements can lead to constipation as a common side effect. Increasing fiber intake helps promote healthy bowel movements and counteracts the constipating effects of iron. Choice A is incorrect because iron absorption is hindered by calcium found in milk. Choice B is incorrect as orange juice enhances iron absorption due to its vitamin C content. Choice D is incorrect as iron supplements can cause stools to appear dark, not bright red.

5. When instructing a client with a new prescription for Timolol on how to insert eye drops, which area should the nurse instruct the client to press on to prevent systemic absorption of the medication?

• A. Bony orbit
• B. Nasolacrimal duct
• C. Conjunctival sac
• D. Outer canthus

Correct answer: B

Rationale: Pressing on the nasolacrimal duct, located near the inner corner of the eye, blocks the lacrimal punctum and prevents the medication from entering the systemic circulation. This technique helps to ensure the medication stays localized in the eye, enhancing its therapeutic effect while minimizing systemic side effects. Choices A, C, and D are incorrect. The bony orbit is the eye socket and not a site to press for preventing systemic absorption. The conjunctival sac is where eye drops are instilled, not pressed on. The outer canthus is also not the correct area to press to prevent systemic absorption.

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