Nursing Elites

1. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Take off the nitroglycerin patch if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction is to remove the nitroglycerin patch each evening to prevent tolerance. This allows for a 10- to 12-hour nitrate-free period daily, reducing the risk of developing tolerance to nitroglycerin. Cutting the patch in half is not recommended because it can alter the dosing and absorption rate, leading to inadequate symptom control. Taking off the patch for a headache is not necessary as headaches are a common side effect that may improve with continued use. Applying a new patch every 48 hours is not correct as it may not provide continuous symptom relief for angina.

2. A client with deep vein thrombosis has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?

• A. Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
• B. I will call the provider to get a prescription for discontinuing the IV heparin today.
• C. Both heparin and warfarin work together to dissolve the clots.
• D. The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.

Correct answer: A

Rationale: The correct answer is A because warfarin takes several days to reach a therapeutic level and exert its full anticoagulant effect. During this time, the IV heparin is continued to prevent clotting until the warfarin is effective. Both medications are used together temporarily for this reason. Discontinuing heparin prematurely can increase the risk of clot formation. Therefore, the nurse should explain to the client that the IV heparin will be continued until the warfarin reaches a therapeutic level.

3. A client is receiving discharge instructions for a new prescription of Prednisone. Which of the following dietary instructions should be included?

• A. Increase your intake of potassium-rich foods.
• B. Increase your intake of dairy products.
• C. Avoid foods high in vitamin K.
• D. Decrease your intake of protein.

Correct answer: A

Rationale: When a client is prescribed Prednisone, there is a risk of potassium depletion due to the medication. Therefore, it is essential to increase the intake of potassium-rich foods such as bananas, oranges, and spinach to help maintain adequate potassium levels in the body and prevent complications associated with low potassium levels. Choice B and D are incorrect as there is no specific need to increase dairy products or decrease protein intake with Prednisone. Choice C is also incorrect as avoiding foods high in vitamin K is more relevant for clients taking anticoagulants like warfarin.

4. A nurse is teaching a client who has breast cancer about the adverse effects of chemotherapy. Which of the following statements should the nurse include?

• A. You should use a soft-bristled toothbrush to prevent bleeding.'
• B. You should take aspirin for minor aches and pains.'
• C. You should avoid contact with individuals who recently received live virus vaccines.'
• D. You should consume a diet low in protein to reduce the risk of renal damage.'

Correct answer: A

Rationale: The nurse should instruct the client to use a soft-bristled toothbrush to prevent bleeding, which can occur due to chemotherapy-induced thrombocytopenia.

5. Which of the following drugs has a therapeutic effect that prevents thromboembolic events?

• A. Warfarin
• B. Amlodipine
• C. Nitroglycerin
• D. Clopidogrel

Correct answer: A

Rationale: The correct answer is Warfarin. Warfarin is an anticoagulant medication that helps prevent thromboembolic events by inhibiting the formation of blood clots. It is commonly used to reduce the risk of strokes or heart attacks in patients at risk for thrombosis.

Similar Questions