Nursing Elites

1. A healthcare provider is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare provider should recognize that the medication affected which of the following systems in the client?

• A. Cardiovascular
• B. Immune
• C. Central nervous
• D. Gastrointestinal

Correct answer: C

Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders that can be caused by certain medications affecting the central nervous system, such as typical antipsychotic medications. These effects can lead to symptoms like tremors, muscle rigidity, and involuntary movements, which are all related to disruptions in the central nervous system. Choices A, B, and D are incorrect because extrapyramidal effects are specifically associated with the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.

2. When instructing a client with a new prescription for Timolol on how to insert eye drops, which area should the nurse instruct the client to press on to prevent systemic absorption of the medication?

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

Correct answer: B

Rationale: Pressing on the nasolacrimal duct, located near the inner corner of the eye, blocks the lacrimal punctum and prevents the medication from entering the systemic circulation. This technique helps to ensure the medication stays localized in the eye, enhancing its therapeutic effect while minimizing systemic side effects. Choices A, C, and D are incorrect. The bony orbit is the eye socket and not a site to press for preventing systemic absorption. The conjunctival sac is where eye drops are instilled, not pressed on. The outer canthus is also not the correct area to press to prevent systemic absorption.

3. What is the classification of Ondansetron?

• A. Antihypertensive
• B. Antiarrhythmic
• C. Antiemetic
• D. Antiulcer agent

Correct answer: C

Rationale: Ondansetron is classified as an antiemetic. It is commonly used to prevent nausea and vomiting, especially in patients undergoing chemotherapy or surgery. Choice A, Antihypertensive, is incorrect as Ondansetron is not used to treat high blood pressure. Choice B, Antiarrhythmic, is incorrect as Ondansetron is not used to manage heart rhythm abnormalities. Choice D, Antiulcer agent, is incorrect as Ondansetron is not primarily indicated for treating ulcers.

4. A client with angina is seeking a prescription for sildenafil to manage erectile dysfunction. Which of the following medications is contraindicated with Sildenafil?

• A. Aspirin
• B. Isosorbide
• C. Clopidogrel
• D. Atorvastatin

Correct answer: B

Rationale: Isosorbide, an organic nitrate used for angina, is contraindicated with sildenafil due to the risk of fatal hypotension. Concurrent use of these medications can lead to severe hypotension. Patients are advised to avoid taking nitrate medications for 24 hours after using isosorbide to prevent this dangerous interaction.

5. A client is starting therapy with Atenolol. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypertension

Correct answer: C

Rationale: Atenolol is a beta-blocker that can cause bradycardia as an adverse effect due to its mechanism of action in slowing down the heart rate. The nurse should instruct the client to monitor their pulse regularly and report any significant decreases to prevent complications related to bradycardia.

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