Nursing Elites

1. While caring for a client receiving epoetin alfa to treat anemia, which finding should the nurse monitor for?

• A. Leukocytosis
• B. Hypertension
• C. Hyperkalemia
• D. Fever

Correct answer: B

Rationale: The nurse should monitor the client for hypertension when receiving epoetin alfa. Epoetin alfa stimulates red blood cell production, which can lead to increased blood pressure. Leukocytosis (increased white blood cells) and hyperkalemia (high potassium levels) are not typically associated with epoetin alfa therapy. Fever is also not a common adverse effect of this medication.

2. A client is receiving heparin therapy. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?

• A. PT
• B. aPTT
• C. INR
• D. Platelet count

Correct answer: B

Rationale: The corrected answer is B: aPTT. The activated partial thromboplastin time (aPTT) is the laboratory value used to monitor the effectiveness of heparin therapy. The aPTT should be maintained at 1.5 to 2 times the normal level to ensure therapeutic anticoagulation. Monitoring aPTT helps healthcare providers adjust heparin doses to achieve the desired anticoagulant effects and prevent complications such as bleeding or clotting. Choice A, PT (prothrombin time), is used to monitor warfarin therapy, not heparin. Choice C, INR (international normalized ratio), is also used to monitor warfarin therapy. Choice D, platelet count, is important for assessing the risk of bleeding, but it does not directly monitor the effectiveness of heparin therapy.

3. Which of the following conditions is not treated with Ephedrine?

• A. COPD
• B. Hypotension
• C. Congestion
• D. Incontinence

Correct answer: A

Rationale: Ephedrine is not typically used to treat COPD. While it can help relieve symptoms like congestion and hypotension, it is not a first-line treatment for COPD. Incontinence is not a condition commonly treated with Ephedrine either.

4. When should Montelukast be taken?

• A. At least two hours before exercise
• B. Daily in the evening
• C. Two hours before exercise or daily in the evening
• D. None of the above

Correct answer: B

Rationale: Montelukast should be taken daily in the evening to effectively manage asthma symptoms. Taking it at the same time each day helps maintain a consistent level of the medication in the body, providing optimal control over asthma symptoms and inflammation. Choice A is incorrect because Montelukast should not be taken specifically before exercise, but rather daily. Choice C is incorrect because although taking Montelukast two hours before exercise is not necessary, taking it daily in the evening is essential for its effectiveness. Choice D is incorrect as Montelukast should be taken daily to manage asthma.

5. When administering digoxin (Lanoxin) to a patient, the healthcare provider observes various signs and symptoms of an overdose. Which of the following should the healthcare provider give to reverse digoxin toxicity?

• A. Naloxone
• B. Vitamin K
• C. Digibind
• D. Flumazenil

Correct answer: C

Rationale: Digibind, also known as Digoxin immune Fab, is the specific antidote used to treat digoxin toxicity. It works by binding to digoxin in the body, forming a complex that can be excreted by the kidneys, thereby reversing the toxic effects of digoxin overdose. Naloxone is used for opioid overdoses, not digoxin toxicity. Vitamin K is used to reverse the effects of warfarin overdose. Flumazenil is used to reverse the effects of benzodiazepine overdose, not digoxin toxicity.

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