Nursing Elites

1. What is one of the therapeutic uses of Valproate?

• A. Suppression of seizure activity
• B. Replacement of hypothyroidism to restore normal hormone balance
• C. Maintenance of blood glucose
• D. Lowering of blood pressure

Correct answer: A

Rationale: Valproate, also known as Valproic acid, is commonly used in medicine for the suppression of seizure activity. It is an anticonvulsant medication that helps manage and prevent seizures in various conditions such as epilepsy. While it is not used for replacing hypothyroidism, maintaining blood glucose levels, or lowering blood pressure, its primary therapeutic use is in managing seizures.

2. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

• A. A second nurse enters the prescription into the client's medical record.
• B. Another nurse should listen to the phone call.
• C. The provider can clarify the prescription when he signs the health record.
• D. I should omit the 'read back' if this is a one-time prescription.

Correct answer: B

Rationale: The correct answer is B: 'Another nurse should listen to the phone call.' When taking a telephone prescription, having another nurse listen to the phone call is essential to prevent errors in communication. This process helps ensure accuracy and reduces the risk of misinterpretation. Choice A is incorrect because entering the prescription into the client's medical record is not related to verifying the accuracy of the telephone prescription. Choice C is incorrect as the provider clarifying the prescription upon signing the health record doesn't address the immediate need for verification during the phone call. Choice D is incorrect because the 'read back' is a crucial step in confirming the accuracy of all prescriptions, regardless of whether they are one-time or recurring.

3. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?

• A. Spironolactone
• B. Furosemide
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: A

Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.

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

• A. Muscle pain
• B. Flushing
• C. Gynecomastia
• D. Hyperglycemia

Correct answer: C

Rationale: The correct answer is gynecomastia (Choice C). Bicalutamide is associated with gynecomastia due to its antiandrogenic properties. Gynecomastia, the development of breast tissue in males, is an important adverse effect to monitor when taking bicalutamide. Choices A, B, and D are incorrect. Muscle pain and flushing are not commonly associated with bicalutamide use. Hyperglycemia is not a typical adverse effect of bicalutamide therapy.

5. The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed?

• A. Atenolol (Tenormin)
• B. Nitroglycerin (Nitrostat)
• C. Sildenafil (Viagra)
• D. Ranolazine (Ranexa)

Correct answer: D

Rationale: In cases of chronic angina where initial treatment has not been successful, Ranolazine (Ranexa) is often prescribed. This medication helps by reducing the frequency of angina episodes. Atenolol, Nitroglycerin, and Sildenafil are also used in angina management but Ranolazine is more specifically indicated in cases of refractory angina where other treatments have failed.

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