Nursing Elites

1. A healthcare professional is caring for a hospitalized client who has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should the healthcare professional prepare to transfuse?

• A. Whole blood
• B. Platelets
• C. Fresh frozen plasma
• D. Packed red blood cells

Correct answer: C

Rationale: Fresh frozen plasma is the correct choice for a client with an elevated aPTT because it contains essential coagulation factors that can help correct coagulopathy and prevent bleeding. It is rich in clotting factors like fibrinogen, factors V and VIII, which are crucial in maintaining proper blood clotting function. Whole blood (Choice A) is not typically used to correct coagulopathy and is more suitable for situations requiring both volume and oxygen-carrying capacity. Platelets (Choice B) are indicated for thrombocytopenia, not for correcting coagulation factors. Packed red blood cells (Choice D) are used to increase oxygen-carrying capacity in cases of anemia, not for correcting coagulopathy.

2. A client is receiving treatment with etoposide. Which of the following findings should the nurse monitor?

• A. Hypotension
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypertension

Correct answer: A

Rationale: Etoposide, a chemotherapeutic agent, commonly causes hypotension as an adverse effect. It is crucial for the nurse to monitor the client for signs of hypotension, such as dizziness, lightheadedness, or a drop in blood pressure, to promptly intervene and prevent complications.

3. A client has a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to report to the provider?

• A. Somnolence
• B. Constipation
• C. Fluid retention
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Somnolence. Somnolence can indicate lactic acidosis, a rare but serious adverse effect of Metformin. Lactic acidosis is manifested by extreme drowsiness, hyperventilation, and muscle pain. Clients should be instructed to report these symptoms to their healthcare provider promptly to prevent further complications.

4. A client is starting therapy with topotecan. Which of the following findings should the nurse instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The nurse should instruct the client to report a sore throat because it can indicate an infection due to the immunosuppressive effects of topotecan. Monitoring for signs of infection is crucial to prevent complications during therapy. Choices A, B, and D are less critical findings compared to a sore throat. Hair loss is a common side effect of chemotherapy, fatigue is expected with cancer treatment, and red urine is a known harmless effect of topotecan.

5. A client has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

• A. Bruising
• B. Fever
• C. Abdominal pain
• D. Rash

Correct answer: B

Rationale: Fever is a key symptom of serotonin syndrome, a potentially serious condition that can occur with the use of SSRIs like Sertraline. Serotonin syndrome is characterized by excessive levels of serotonin in the body, leading to symptoms such as fever, agitation, confusion, tremors, and sweating. If a client on Sertraline presents with fever, the nurse should consider the possibility of serotonin syndrome and take appropriate actions such as notifying the healthcare provider and monitoring the client closely. Bruising, abdominal pain, and rash are not typically associated with serotonin syndrome and are more likely to be indicative of other conditions or side effects.

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