Nursing Elites

1. A healthcare professional in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings is indicative of this condition?

• A. Insidious onset of painless loss of vision
• B. Gradual reduction in peripheral vision
• C. Severe pain around the eyes
• D. Intraocular pressure 12 mm Hg

Correct answer: C

Rationale: Severe pain around the eyes that radiates over the face is a classic symptom of acute angle-closure glaucoma. This intense pain is often associated with other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. Immediate medical attention is required to prevent permanent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more indicative of conditions like macular degeneration. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12 mm Hg is within the normal range and is not typical of angle-closure glaucoma.

2. Which of the following is not a side effect of the vasodilator Nifedipine?

• A. Nausea
• B. Flushed appearance
• C. Vertigo
• D. Sexual dysfunction

Correct answer: D

Rationale: Sexual dysfunction is not a common side effect of vasodilators such as Nifedipine. Nausea, flushed appearance, and vertigo are more commonly reported side effects associated with this medication. It's essential for healthcare providers to be aware of the potential side effects to monitor and manage them effectively in patients prescribed with Nifedipine.

3. A client has a new prescription for Prednisone. Which of the following laboratory values should the nurse monitor?

• A. Serum potassium
• B. Serum calcium
• C. Serum sodium
• D. Serum glucose

Correct answer: D

Rationale: The correct answer is D, Serum glucose. Prednisone is a corticosteroid that can lead to hyperglycemia. Monitoring serum glucose levels is essential to assess for elevated blood sugar levels. Choices A, B, and C are incorrect as Prednisone does not directly affect potassium, calcium, or sodium levels.

4. 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.

5. A healthcare professional is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. How many mL should the healthcare professional administer per dose?

• A. 0.8 mL
• B. 0.75 mL
• C. 0.5 mL
• D. 1 mL

Correct answer: A

Rationale: To calculate the volume to administer, use the formula: (Desired dose / Concentration) = Volume to administer. In this case, (15,000 units / 20,000 units/mL) = 0.75 mL, which is rounded up to 0.8 mL. Therefore, the healthcare professional should administer 0.8 mL per dose of heparin. Choice B (0.75 mL) is incorrect as it is the exact calculated volume but needs to be rounded up. Choices C (0.5 mL) and D (1 mL) are incorrect as they do not reflect the correct calculated volume for the desired dose of heparin.

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