Nursing Elites

1. A client is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication?

• A. Decreased blood pressure
• B. Increase in HDL cholesterol
• C. Prevention of bipolar manic episodes
• D. Improved sexual function

Correct answer: A

Rationale: The therapeutic effect of lisinopril, an ACE inhibitor, is indicated by a decrease in blood pressure. Lisinopril works by relaxing blood vessels, leading to a reduction in blood pressure. Monitoring and achieving a decrease in blood pressure is a key outcome when managing hypertension with lisinopril. Choices B, C, and D are incorrect because lisinopril is not intended to increase HDL cholesterol, prevent bipolar manic episodes, or improve sexual function. Therefore, the correct outcome indicating the therapeutic effect of lisinopril is a decrease in blood pressure.

2. Which of the following drugs is associated with Stevens-Johnson syndrome?

• A. Valproic acid
• B. Quinidine
• C. Isoniazid
• D. Ethosuximide

Correct answer: D

Rationale: Stevens-Johnson syndrome is a severe skin reaction that can be associated with Ethosuximide.

3. What is the therapeutic class of Valproate?

• A. Anticoagulant
• B. Antianxiety, benzodiazepines
• C. Anticonvulsant, vascular headache suppressant
• D. Mood stabilizer

Correct answer: C

Rationale: Valproate belongs to the therapeutic class of anticonvulsants. It is primarily used to manage seizures but is also effective in treating vascular headaches. Therefore, it is not classified as an anticoagulant, antianxiety medication, or mood stabilizer. Option A, anticoagulant, is incorrect as valproate does not have anticoagulant properties. Option B, antianxiety benzodiazepines, is incorrect as valproate is not primarily used to treat anxiety disorders with benzodiazepines. Option D, mood stabilizer, is incorrect as valproate is not classified as a mood stabilizer, although it can be used in some cases for mood disorders, its primary therapeutic class is anticonvulsant.

4. How do ACE inhibitors work?

• A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
• B. Block stimulation of beta 1 and beta 2 at the receptor sites
• C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
• D. None of the above

Correct answer: C

Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.

5. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a different site each day.
• B. Remove the patch at bedtime each day.
• C. Apply the patch over an area with little or no hair.
• D. Keep the patch on for 24 hours at a time.

Correct answer: B

Rationale: The correct instruction for a Nitroglycerin transdermal patch is to remove it each day, usually at bedtime, to prevent tolerance. Keeping the patch on for 24 hours at a time can lead to tolerance development. Applying the patch to a different site each day is not necessary, as long as the area is rotated to prevent skin irritation. Applying the patch over an area with little or no hair is not a critical instruction for the Nitroglycerin patch.

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