Nursing Elites

1. What is the therapeutic use of Phenytoin?

• A. Replacement in hypothyroidism to restore normal hormonal balance
• B. Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux
• C. Diminished seizure activity, termination of ventricular arrhythmias
• D. Prevention of thrombus formation, prevention of extension of existing thrombi

Correct answer: C

Rationale: Phenytoin is primarily used to diminish seizure activity and is effective in terminating ventricular arrhythmias. It works by stabilizing neuronal membranes, reducing repetitive neuronal firing, and limiting the spread of seizure activity in the brain. While phenytoin does not have a direct role in preventing thrombus formation or extending existing thrombi, it is crucial in managing seizures and certain arrhythmias.

2. A client has a new prescription for Labetalol. Which of the following instructions should be included?

• A. Take this medication at bedtime.
• B. Avoid sudden discontinuation of the medication.
• C. Increase your intake of sodium-rich foods.
• D. Avoid drinking grapefruit juice.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid sudden discontinuation of Labetalol. Abrupt discontinuation of beta-blockers like Labetalol can lead to rebound hypertension and other cardiac issues. It is important for clients to taper off the medication under healthcare provider guidance to prevent potential complications.

3. A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?

• A. It can take several weeks before you feel like the medication is helping.
• B. Take the medication just before bedtime to promote sleep.
• C. You should take the medication when needed for obsessive urges.
• D. Monitor for weight gain while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Paroxetine, an antidepressant commonly used for OCD, typically takes 1 to 4 weeks before the client experiences the full therapeutic benefit. Therefore, informing the client that it may take several weeks before feeling the medication's effects is crucial to manage expectations and ensure compliance with the treatment plan. Choice B is incorrect because Paroxetine is usually taken in the morning due to its activating effects and may cause insomnia if taken before bedtime. Choice C is incorrect because Paroxetine should be taken regularly as prescribed, not just when experiencing obsessive urges. Choice D is incorrect because although weight gain can be a side effect of Paroxetine, it is not a priority instruction compared to the delayed onset of therapeutic effects.

4. Which medication is contraindicated with Nitroglycerin?

• A. Hydrochloroquine
• B. Methylprednisolone
• C. Phenazopyridine
• D. Erectile dysfunction drugs

Correct answer: D

Rationale: The correct answer is D: Erectile dysfunction drugs. Erectile dysfunction drugs are contraindicated with Nitroglycerin because they can potentiate the hypotensive effects of Nitroglycerin, leading to severe hypotension. Choices A, B, and C are incorrect because they are not known to have significant interactions with Nitroglycerin.

5. What is a common side effect that typically occurs with the initial therapy of Nitroglycerine as a result of increased vasodilation?

• A. Abdominal cramps
• B. Calf pain
• C. Headache
• D. Blurred vision

Correct answer: C

Rationale: Headache is a common side effect associated with the initial therapy of Nitroglycerine due to its vasodilatory properties. The vasodilation caused by Nitroglycerine leads to relaxation of blood vessels, including those in the head, which can result in headaches. This side effect is considered normal and is often transient, diminishing with continued use of the medication.

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