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. A client has a new prescription for metronidazole. The client should avoid which of the following?

• A. Dairy products
• B. Alcohol
• C. Leafy green vegetables
• D. Grapefruit juice

Correct answer: B

Rationale: The correct answer is B: Alcohol. Clients should avoid alcohol while taking metronidazole to prevent a disulfiram-like reaction, which can cause symptoms such as nausea, vomiting, headache, and flushing. Alcohol can interact with metronidazole and lead to adverse effects. Choices A, C, and D are not typically contraindicated with metronidazole. Dairy products, leafy green vegetables, and grapefruit juice do not have significant interactions with metronidazole, unlike alcohol.

3. A client is starting therapy with cisplatin. The healthcare provider should instruct the client to report which of the following adverse effects?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The correct answer is tinnitus. Cisplatin can cause ototoxicity, which may manifest as tinnitus. Tinnitus should be reported promptly to the healthcare provider to prevent further hearing damage.

4. Which of the following conditions is not treated with epinephrine?

• A. Renal disease
• B. Asthma
• C. Hypotension
• D. Glaucoma

Correct answer: A

Rationale: Epinephrine is not used to treat renal disease. Epinephrine is commonly used to treat conditions like asthma, hypotension, and glaucoma, but it is not an appropriate treatment for renal disease. Renal disease requires specific management strategies that do not involve the use of epinephrine.

5. Which drug is the antidote for Alprazolam?

• A. Physostigmine
• B. Protamine sulfate
• C. Flumazenil
• D. Acetylcysteine

Correct answer: C

Rationale: Flumazenil is the specific antidote used to reverse the effects of Alprazolam. Alprazolam is a benzodiazepine, and Flumazenil is a benzodiazepine receptor antagonist that works by competitively inhibiting the actions of benzodiazepines at the receptor site, effectively reversing their sedative and other effects. Physostigmine is not used as an antidote for benzodiazepine overdose and can have significant side effects. Protamine sulfate is used to reverse the effects of heparin, not benzodiazepines like Alprazolam. Acetylcysteine is used as an antidote for acetaminophen overdose, not benzodiazepines like Alprazolam.

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