Nursing Elites

1. A client has been diagnosed with open-angle glaucoma. The healthcare provider prescribes pilocarpine 1% eye drops. The nurse explains that which action of this drug makes it a useful treatment for the client's condition?

• A. The ciliary muscle contracts, increasing the outflow of aqueous humor in the eye.
• B. Ciliary muscles are paralyzed to decrease accommodation.
• C. Bilateral mydriasis with cycloplegia is accomplished.
• D. The production of aqueous humor in the eyes is decreased.

Correct answer: A

Rationale: Pilocarpine, a cholinergic agent, stimulates the ciliary muscle to contract, which opens the trabecular meshwork and facilitates the outflow of aqueous humor, reducing intraocular pressure. This mechanism helps in managing open-angle glaucoma by improving drainage and lowering pressure within the eye. Choice A is correct because the contraction of the ciliary muscle increases the outflow of aqueous humor, aiding in the treatment of open-angle glaucoma. Choices B, C, and D are incorrect because they do not describe the mechanism of action of pilocarpine in treating glaucoma.

2. A client who is recovering from an appendectomy is receiving narcotics. Earlier, the nurse witnessed the client's family pushing the pain pump. What should the nurse implement?

• A. Check the client's level of consciousness
• B. Instruct the family not to push the button
• C. Stop the client's basal infusion
• D. Administer a narcotic reversal medication

Correct answer: B

Rationale: Instructing the family not to push the button is necessary to prevent the client from receiving an excessive amount of narcotics, ensuring the safe and appropriate use of the pain pump. Checking the client's level of consciousness may not address the issue of family members pushing the button. Stopping the client's basal infusion is not indicated unless there are specific medical reasons for doing so. Administering a narcotic reversal medication is not necessary at this point as the issue lies with inappropriate use rather than an overdose.

3. A client with a diagnosis of bipolar disorder is prescribed oxcarbazepine. The nurse should monitor for which potential adverse effect?

• A. Hyponatremia
• B. Agranulocytosis
• C. Liver toxicity
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A, Hyponatremia. Oxcarbazepine, an anticonvulsant used in bipolar disorder, can lead to hyponatremia. This is because it can cause the body to retain water, leading to a dilution of sodium levels in the blood. Monitoring sodium levels is crucial to prevent complications such as confusion, seizures, and even coma. Choices B, C, and D are incorrect. Agranulocytosis is not typically associated with oxcarbazepine use. Liver toxicity is a potential adverse effect of some medications but not commonly seen with oxcarbazepine. While weight gain can be a side effect of certain medications used in bipolar disorder treatment, it is not a common adverse effect of oxcarbazepine.

4. A client is admitted to a long-term care facility, and the nurse and a new employee are conducting medication reconciliation. The nurse notes that oxybutynin has been prescribed. The nurse realizes the new employee understands the drug's effect if the new employee explains that this medication is prescribed to treat which condition?

• A. Pain
• B. Depression
• C. Overactive bladder
• D. Chronic anxiety

Correct answer: C

Rationale: The correct answer is C: Overactive bladder. Oxybutynin is prescribed to treat overactive bladder by reducing muscle spasms of the bladder. It is classified as an anticholinergic medication. Choices A, B, and D are incorrect. Oxycodone is an opioid used for pain management. Bupropion is an antidepressant used to treat depression. Buspirone is an anxiolytic used to manage anxiety disorders.

5. A client with chronic kidney disease is prescribed erythropoietin. The nurse should monitor for which potential adverse effect?

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

Correct answer: A

Rationale: Erythropoietin is a medication commonly used to stimulate red blood cell production in individuals with chronic kidney disease. One of the potential adverse effects of erythropoietin therapy is hypertension. The increased production of red blood cells can lead to elevated blood pressure levels. Therefore, monitoring for hypertension is essential to ensure the client's safety and well-being while on this medication. Choices B, C, and D are incorrect because hypotension, tachycardia, and bradycardia are not typically associated with erythropoietin therapy. Hypertension is the primary adverse effect to monitor in this case.

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