Nursing Elites

1. Which laboratory test should the nurse monitor to determine the effectiveness of heparin therapy for a client with deep vein thrombosis?

• A. Platelet count
• B. Prothrombin time (PT)
• C. Activated partial thromboplastin time (aPTT)
• D. Hemoglobin and hematocrit

Correct answer: C

Rationale: The activated partial thromboplastin time (aPTT) is the specific laboratory test used to monitor the effectiveness of heparin therapy in patients with deep vein thrombosis. It measures the time it takes for blood to clot and is crucial in assessing the therapeutic range of heparin. Platelet count, prothrombin time (PT), and hemoglobin and hematocrit levels are important parameters in assessing coagulation and blood status but do not directly indicate the effectiveness of heparin therapy.

2. A client is receiving morphine sulfate for pain management. Which assessment finding requires immediate action?

• A. Constipation
• B. Drowsiness
• C. Respiratory rate of 10 breaths per minute
• D. Nausea

Correct answer: C

Rationale: A respiratory rate of 10 breaths per minute indicates respiratory depression, a serious side effect of morphine sulfate that can lead to respiratory compromise and requires immediate intervention. Constipation, drowsiness, and nausea are common side effects of morphine but are not immediately life-threatening compared to respiratory depression. Monitoring and addressing a low respiratory rate are crucial in preventing further respiratory distress or failure.

3. A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen?

• A. My ulcer will heal because these medications will kill the bacteria.
• B. These medications are only taken when I have pain from my ulcer.
• C. The medications will kill the bacteria and stop the acid production.
• D. These medications will coat the ulcer and decrease the acid production in my stomach.

Correct answer: C

Rationale: Triple therapy for Helicobacter pylori infection usually includes two antibacterial drugs and a proton pump inhibitor. These medications will kill the bacteria and decrease acid production.

4. The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed?

• A. Echocardiography
• B. Electrocardiography
• C. Cervical radiography
• D. Pulmonary function studies

Correct answer: D

Rationale: Bleomycin, when administered intravenously, can lead to interstitial pneumonitis and potentially progress to pulmonary fibrosis. Therefore, pulmonary function studies are essential to monitor lung function and detect any early signs of pulmonary toxicity. Other tests, such as regular pulmonary assessments, should also be conducted to ensure the safety and well-being of the client.

5. A client is instructed to take levothyroxine (Synthroid). The medication should be taken:

• A. With food
• B. At lunchtime
• C. On an empty stomach
• D. At bedtime with a snack

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach to enhance absorption. Taking it with food or at bedtime can interfere with its absorption, reducing its effectiveness. Therefore, it is essential for the client to take levothyroxine on an empty stomach to ensure optimal therapeutic outcomes.

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