Nursing Elites

1. How does omeprazole work in treating a peptic ulcer?

• A. Increasing the production of gastric acid
• B. Neutralizing stomach acid
• C. Coating the stomach lining
• D. Reducing gastric acid secretion

Correct answer: D

Rationale: Omeprazole is a proton pump inhibitor that works by reducing gastric acid secretion. By inhibiting the enzyme responsible for pumping acid into the stomach, omeprazole helps decrease the acidity level in the stomach, providing relief from peptic ulcers. Option A is incorrect because omeprazole does not increase gastric acid production; instead, it decreases it. Option B is incorrect as omeprazole does not neutralize existing stomach acid but rather reduces its secretion. Option C is incorrect as omeprazole does not coat the stomach lining but acts on reducing acid secretion.

2. A client with chronic kidney disease is prescribed sevelamer. The nurse should monitor for which potential side effect?

• A. Hypercalcemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: B

Rationale: When a client with chronic kidney disease is prescribed sevelamer, the nurse should monitor for hypocalcemia. Sevelamer works by binding dietary phosphorus in the gastrointestinal tract, which can lead to decreased calcium absorption and potentially cause hypocalcemia.

3. 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.

4. A client with rheumatoid arthritis is prescribed tofacitinib. What should the nurse include in the client's teaching plan?

• A. Avoid live vaccines while taking this medication.
• B. Take this medication with food to decrease gastrointestinal upset.
• C. Report any signs of infection to the healthcare provider.
• D. Avoid sunlight while taking this medication.

Correct answer: A

Rationale: Tofacitinib is an immunosuppressive medication used in rheumatoid arthritis. Patients taking tofacitinib should avoid live vaccines because the medication can weaken the immune system, making live vaccines potentially harmful. It is essential to educate the client on this to prevent any complications related to live vaccines during their treatment.

5. A client with a diagnosis of generalized anxiety disorder is prescribed citalopram. The nurse should instruct the client that this medication may have which potential side effect?

• A. Nausea
• B. Drowsiness
• C. Insomnia
• D. Headache

Correct answer: A

Rationale: The correct potential side effect of citalopram is nausea. Citalopram can cause gastrointestinal disturbances such as nausea, so clients should be advised to take the medication with food if nausea occurs to help minimize this side effect. While other side effects like drowsiness, insomnia, and headache may also occur with citalopram, nausea is a common side effect that clients should be informed about. Drowsiness and insomnia are more commonly associated with other medications used to treat anxiety or depression, such as benzodiazepines or certain antidepressants. Headache is a less common side effect of citalopram compared to nausea.

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