Nursing Elites

1. Which of the following is NOT an opioid or NSAID?

• A. Morphine
• B. Ibuprofen
• C. Hydromorphone
• D. Acetaminophen

Correct answer: D

Rationale: Acetaminophen is the correct answer as it is not classified as an opioid or NSAID. Acetaminophen is considered a non-opioid analgesic, which means it works by a different mechanism than opioids and NSAIDs to relieve pain and reduce fever. Morphine, hydromorphone, and ibuprofen, on the other hand, are classified as opioids or NSAIDs. Morphine and hydromorphone are opioids, while ibuprofen is an NSAID (Nonsteroidal Anti-Inflammatory Drug), all of which work through different mechanisms compared to acetaminophen.

2. A client has a new prescription for Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include in the discharge teaching?

• 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 Nitroglycerin sublingual tablets is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. This regimen helps in relieving angina symptoms effectively. Option A of taking one tablet every 15 minutes is too infrequent and may delay symptom relief. Option C of taking one tablet at bedtime is not appropriate as Nitroglycerin is used for immediate relief of angina. Option D of taking one tablet on an empty stomach is irrelevant since Nitroglycerin is not affected by food intake.

3. A healthcare professional is preparing to administer verapamil by IV bolus to a client who is experiencing cardiac dysrhythmias. For which of the following adverse effects should the healthcare professional monitor when giving this medication?

• A. Hyperthermia
• B. Hypotension
• C. Ototoxicity
• D. Muscle pain

Correct answer: B

Rationale: Verapamil is known to cause hypotension as one of its adverse effects due to its vasodilatory properties. Therefore, it is essential for the healthcare professional to monitor the client's blood pressure closely during and after administration to prevent complications such as severe hypotension. Hyperthermia, ototoxicity, and muscle pain are not commonly associated with verapamil administration, making choices A, C, and D incorrect.

4. A healthcare professional is preparing to administer vancomycin to a client. The professional should monitor for which of the following adverse effects?

• A. Nephrotoxicity
• B. Hepatotoxicity
• C. Red Man Syndrome
• D. Diarrhea

Correct answer: C

Rationale: Red Man Syndrome is a common adverse effect of vancomycin characterized by flushing and rash. It is not related to nephrotoxicity, hepatotoxicity, or diarrhea. Monitoring for this reaction allows for prompt intervention to prevent severe complications.

5. A client has a prescription for Timolol eye drops for the treatment of glaucoma. Which of the following instructions should the nurse include?

• A. Apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application.
• B. Avoid blinking immediately after instilling the drops.
• C. Keep your eyes closed for 5 minutes after application.
• D. Administer the drops directly onto the cornea.

Correct answer: A

Rationale: The correct instruction for the nurse to include is to apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application. This technique helps prevent systemic absorption of the medication, reducing the risk of systemic side effects. By applying pressure, the drainage of the medication into the bloodstream through the nasolacrimal duct is minimized, enhancing the drug's local ocular effects. Choices B, C, and D are incorrect because blinking immediately after instilling the drops, keeping eyes closed for 5 minutes, and administering the drops directly onto the cornea are not recommended practices for administering Timolol eye drops.

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