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 Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin sublingual tablets involves taking one tablet at the onset of chest pain and repeating every 5 minutes for up to three doses. This protocol helps in managing angina episodes effectively. Choice A suggests taking a tablet every 15 minutes until pain relief, which may delay appropriate intervention. Choice C, taking a tablet at bedtime, is not suitable for immediate relief during angina attacks. Choice D, taking a tablet on an empty stomach, is unrelated to the correct administration of Nitroglycerin sublingual tablets.

3. Which of the following conditions is not treated with Methotrexate?

• A. Sarcomas
• B. Leukemias
• C. Ectopic pregnancy
• D. Rheumatic fever

Correct answer: D

Rationale: The correct answer is D. Methotrexate is not typically used to treat rheumatic fever, which is more commonly managed with antibiotics to eradicate the underlying infection. Methotrexate is commonly used in the treatment of conditions like sarcomas, leukemias, and ectopic pregnancies due to its anti-inflammatory and anti-cancer properties.

4. When starting Alfuzosin for the treatment of Benign Prostatic Hyperplasia, a nurse is providing teaching to a client. The nurse should instruct the client that which of the following is an adverse effect of this medication?

• A. Bradycardia
• B. Edema
• C. Hypotension
• D. Tremor

Correct answer: C

Rationale: The correct adverse effect of Alfuzosin is hypotension. Alfuzosin relaxes muscle tone in veins, leading to decreased cardiac output and subsequent hypotension. Patients on this medication should be advised to change positions slowly to prevent a sudden drop in blood pressure. Choice A, Bradycardia, is not a common adverse effect of Alfuzosin. Choice B, Edema, is not typically associated with Alfuzosin use. Choice D, Tremor, is also not a common adverse effect of Alfuzosin.

5. A client has a new prescription for Simvastatin. Which of the following client statements indicates an understanding of the teaching?

• A. I will take this medication at bedtime.
• B. I should avoid eating grapefruit while taking this medication.
• C. I will need to monitor my blood sugar closely while taking this medication.
• D. I will stop taking the medication if I develop muscle pain.

Correct answer: B

Rationale: The correct answer is B. Grapefruit can increase the levels of simvastatin in the blood, leading to an increased risk of serious side effects, including muscle pain or damage. Therefore, it is crucial for the client to avoid consuming grapefruit while taking this medication to prevent potential complications.

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