Nursing Elites

1. A healthcare provider 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 are 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 of 12mm Hg

Correct answer: C

Rationale: Severe pain around the eyes that radiates over the face is a characteristic symptom of acute angle-closure glaucoma. This intense pain is typically accompanied by other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. The acute rise in intraocular pressure leads to these symptoms, indicating a medical emergency that requires immediate attention to prevent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more suggestive of conditions like age-related macular degeneration or diabetic retinopathy. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12mm Hg is within the normal range and not indicative of the acute rise seen in angle-closure glaucoma.

2. A client has a new prescription for Filgrastim. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication with food.
• B. Avoid taking this medication with orange juice.
• C. Report bone pain to your healthcare provider.
• D. Expect a persistent cough while taking this medication.

Correct answer: C

Rationale: The correct answer is C: 'Report bone pain to your healthcare provider.' Filgrastim is known to cause bone pain as a common side effect. Therefore, it is crucial for clients to report any bone pain to their healthcare provider to monitor for potential complications or the need for further management. Choices A, B, and D are incorrect because taking Filgrastim with food, avoiding it with orange juice, and expecting a persistent cough are not relevant instructions associated with this medication.

3. A client has a prescription for Nitroglycerin, and a nurse is providing teaching. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct instruction for taking Nitroglycerin is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. Option A is incorrect because taking a tablet every 15 minutes until pain is relieved may lead to delayed intervention. Option C is incorrect as taking Nitroglycerin at bedtime is not indicated for chest pain. Option D is incorrect as Nitroglycerin should be taken sublingually at the onset of chest pain, not on an empty stomach.

4. A nurse is providing discharge instructions for a client who has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication before bed.
• B. Monitor for increased blood pressure.
• C. Take the medication on an empty stomach.
• D. Monitor for leg cramps.

Correct answer: D

Rationale: The correct answer is D: 'Monitor for leg cramps.' Leg cramps may indicate hypokalemia, an adverse effect of hydrochlorothiazide, and should be reported to the provider. Choice A is incorrect because hydrochlorothiazide is usually taken in the morning to avoid nocturia. Choice B is incorrect as hydrochlorothiazide is a diuretic that helps lower blood pressure. Choice C is incorrect as hydrochlorothiazide can be taken with or without food.

5. A client has a prescription for Hydralazine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Monitor your blood pressure regularly.
• C. Expect to have increased energy levels.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is to monitor blood pressure regularly. Hydralazine is an antihypertensive medication that helps lower blood pressure. Monitoring blood pressure regularly is essential to ensure it remains within the target range and to assess the effectiveness of the medication. Choice A is incorrect because the timing of taking Hydralazine is usually not specified as bedtime. Choice C is incorrect because increased energy levels are not an expected effect of Hydralazine. Choice D is incorrect because Hydralazine does not interact with potassium in the same way as other medications like potassium-sparing diuretics.

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