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. How should a client prevent systemic absorption of Timolol eye drops according to the nurse's instructions?

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

Correct answer: B

Rationale: The correct technique to prevent systemic absorption of eye drops is to press on the nasolacrimal duct while instilling them. By doing so, the lacrimal punctum gets temporarily blocked, reducing drainage into the nasolacrimal duct and systemic circulation. This method helps enhance the localized effect of the medication and decreases the risk of systemic side effects. Choices A, C, and D are incorrect as they do not play a direct role in preventing systemic absorption of the eye drops.

3. A client is being taught about taking Tetracycline to treat a GI infection caused by Helicobacter pylori. Which of the following statements should indicate to the nurse that the client understands the instructions?

• A. I will take this medication with 8 ounces of milk.
• B. I will inform my doctor if I experience diarrhea.
• C. I can discontinue this medication when I feel completely well.
• D. I can take this medication just before bedtime.

Correct answer: B

Rationale: The correct answer is B. Diarrhea can indicate the development of a suprainfection, which can be serious. Therefore, it is essential for the client to notify the healthcare provider if they experience diarrhea while taking Tetracycline to treat a GI infection caused by Helicobacter pylori. Choices A, C, and D are incorrect because taking Tetracycline with milk can reduce its absorption, discontinuing the medication prematurely can lead to treatment failure, and taking it just before bedtime may increase the risk of esophageal irritation due to the potential reflux of the medication.

4. A client has a new prescription for Clonidine. What instruction should the nurse include during teaching?

• A. Take the medication with food.
• B. Expect to feel drowsy or lightheaded.
• C. Increase your fluid intake.
• D. Avoid foods high in fat.

Correct answer: B

Rationale: The correct instruction when teaching a client about Clonidine is to expect to feel drowsy or lightheaded. Clonidine can cause these side effects, especially when starting the medication. The nurse should advise the client to avoid activities that require alertness until they understand how the medication affects them. Choices A, C, and D are incorrect because taking Clonidine with food, increasing fluid intake, or avoiding foods high in fat are not specific instructions related to managing the side effects of Clonidine.

5. When a nurse assesses a client's IV catheter insertion site and notes a hematoma, which of the following actions should the nurse take? (Select all that apply.)

• A. Stop the infusion.
• B. Apply alcohol to the insertion site.
• C. Apply warm compresses to the insertion site.
• D. Elevate the client's arm.

Correct answer: C

Rationale: When a nurse detects a hematoma at the IV catheter insertion site, applying warm compresses is beneficial as it can promote healing by enhancing circulation and reducing swelling. Elevating the client's arm helps in reducing edema, which can relieve pressure, pain, and further bleeding in the hematoma area. Stopping the infusion may be necessary in certain situations, but it is not a standard action for all hematoma cases. Applying alcohol to the insertion site is discouraged as it can cause irritation and may not aid in resolving the hematoma.

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