Nursing Elites

1. While caring for a client receiving Heparin therapy, which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?

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

Correct answer: C

Rationale: The nurse should monitor the aPTT (activated partial thromboplastin time) when caring for a client receiving Heparin therapy. The aPTT reflects the intrinsic pathway of the clotting cascade and is used to monitor the effectiveness of heparin, which primarily affects this pathway by potentiating antithrombin III. Monitoring the aPTT helps ensure that the client's blood is within the therapeutic range to prevent thrombus formation. Choices A, B, and D are incorrect. PT (Prothrombin Time) and INR (International Normalized Ratio) are used to monitor Warfarin therapy, not Heparin. Platelet count is important in assessing for thrombocytopenia but is not a specific indicator of Heparin therapy effectiveness.

2. A client has a new prescription for Etravirine, an NNRTI. Which of the following statements should the nurse include in teaching the client?

• A. Take this medication with food.
• B. Take this medication on an empty stomach.
• C. Take this medication at the same time every day.
• D. Take this medication at bedtime to prevent drowsiness.

Correct answer: C

Rationale: The correct statement the nurse should include in teaching the client is to take Etravirine at the same time every day. This ensures consistent blood levels and effectiveness of the medication. Consistent timing is essential to achieve optimal therapeutic effects and avoid missing doses. Choices A and B are incorrect because Etravirine should not necessarily be taken with or without food; it is more important to take it consistently. Choice D is incorrect as there is no need to take Etravirine at bedtime to prevent drowsiness.

3. A client has a new prescription for Tetracycline. Which of the following instructions should be included?

• A. Take the medication with milk.
• B. Avoid prolonged sun exposure.
• C. Take the medication at bedtime.
• D. Expect urine to turn dark yellow.

Correct answer: B

Rationale: The correct instruction to include for a client prescribed Tetracycline is to 'Avoid prolonged sun exposure.' Tetracycline can cause photosensitivity, making the client more sensitive to the sun's rays. This can lead to adverse reactions like sunburn or skin rashes. Therefore, it is crucial for the client to minimize sun exposure and wear protective clothing when outdoors. Choice A is incorrect because taking Tetracycline with milk can reduce its absorption. Choice C is incorrect as there is no specific requirement to take Tetracycline at bedtime. Choice D is also incorrect as Tetracycline does not typically cause dark yellow urine.

4. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV Nitroprusside is infused at high dosages, it can lead to thiocyanate toxicity, causing mental status changes such as delirium. It is crucial to monitor the thiocyanate levels to ensure they remain below 10 mg/dL during therapy to prevent adverse effects. Choices A, B, and D are incorrect because IV Nitroprusside is not commonly associated with intestinal ileus, neutropenia, or hyperthermia. Monitoring for delirium is crucial due to the risk of thiocyanate toxicity.

5. What is levothyroxine's pharmacologic classification?

• A. Thyroid Preparations
• B. Metabolic Inhibitors
• C. Analgesic
• D. Loop Diuretic

Correct answer: A

Rationale: Levothyroxine is classified as a thyroid preparation because it is a synthetic form of the thyroid hormone thyroxine. It is primarily used to treat hypothyroidism by supplementing or replacing the natural thyroid hormones in the body, helping to regulate metabolism and energy levels. Choice B, Metabolic Inhibitors, is incorrect because levothyroxine does not inhibit metabolism but rather helps regulate it. Choice C, Analgesic, is incorrect as levothyroxine is not used for pain relief but for thyroid hormone replacement therapy. Choice D, Loop Diuretic, is also incorrect as loop diuretics are medications that act on the kidneys to increase urine production and are not related to thyroid hormone replacement therapy.

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