Nursing Elites

1. You have a patient with achalasia (incomplete muscle relaxation of the GI tract, especially sphincter muscles). Which medications do you anticipate to administer?

• A. Isosorbide dinitrate (Isordil)
• B. Digoxin (Lanoxin)
• C. Captopril (Capoten)
• D. Propanolol (Inderal)

Correct answer: A

Rationale: Isosorbide dinitrate (Isordil) is a medication used to relax the muscles of the GI tract in patients with achalasia.

2. Britney, a 20 y.o. student is admitted with acute pancreatitis. Which laboratory findings do you expect to be abnormal for this patient?

• A. Serum creatinine and BUN
• B. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
• C. Serum amylase and lipase
• D. Cardiac enzymes

Correct answer: C

Rationale: Serum amylase and lipase levels are typically elevated in patients with acute pancreatitis.

3. Cholestyramine resin (Questran Light) is prescribed for the client with an elevated serum cholesterol level. The nurse would instruct the client to take the medication

• A. After meals.
• B. Mixed with fruit juice.
• C. Via rectal suppository.
• D. At least 3 hours before meals.

Correct answer: B

Rationale: Cholestyramine resin binds with bile salts in the intestines to form a compound that is excreted in the feces. The client should be instructed to mix the medication with 3 to 6 oz of water, milk, fruit juice, or soup. The medication should be administered before meals. The medication is not administered via rectal suppository.

4. The nurse is reviewing the medication record of a client with acute gastritis. Which medication if noted on the client’s record, would the nurse question?

• A. Digoxin (Lanoxin)
• B. Indomethacin (Indocin)
• C. Furosemide (Lasix)
• D. Propranolol hydrochloride (Inderal)

Correct answer: B

Rationale: Indomethacin (Indocin) is a Nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus, stomach, duodenum, or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is an antidysrhythmic. Propranolol (Inderal) is a B- adrenergic blocker. Furosemide, digoxin, and propranolol are not contraindicated in clients with gastric disorders.

5. Glenda has cholelithiasis (gallstones). You expect her to complain of:

• A. Pain in the right upper quadrant, radiating to the shoulder.
• B. Pain in the right lower quadrant, with rebound tenderness.
• C. Pain in the left upper quadrant, with shortness of breath.
• D. Pain in the left lower quadrant, with mild cramping.

Correct answer: A

Rationale: Patients with cholelithiasis often complain of pain in the right upper quadrant, radiating to the shoulder.

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