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 nurse is providing instructions to an adolescent who has a history of seizures and is taking an anticonvulsant medication. Which of the following statements indicates that the client understands the instructions?

• A. I will never be able to drive a car.
• B. My anticonvulsant medication will clear up my skin.
• C. I can't drink alcohol while I am taking my medication.
• D. If I forget my morning medication, I can take two pills at bedtime.

Correct answer: C

Rationale: The correct answer is C: 'I can't drink alcohol while I am taking my medication.' Alcohol can lower the seizure threshold and should be avoided by individuals taking anticonvulsants. Choice A is incorrect because it is an extreme statement and not necessary for someone taking anticonvulsants. Choice B is incorrect as anticonvulsant medications are not used to clear skin conditions. Choice D is incorrect because doubling up medication doses can be harmful and should not be done without healthcare provider approval.

3. A healthcare professional prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The healthcare professional plans to include which of the following in the instructions?

• A. Instruct the client to drink 3000 mL of fluid per day.
• B. Instruct the client to take the medication with food.
• C. Inform the client that the effect of the medication will occur immediately.
• D. Instruct the client that, if swelling of the lips occurs, this is a normal expected response.

Correct answer: A

Rationale: Allopurinol is an antigout medication that works by reducing the production of uric acid in the body. To prevent kidney stones and promote the excretion of uric acid, increased fluid intake is essential. Instructing the client to drink 3000 mL of fluid per day helps to reduce the risk of kidney stones and assists in the elimination of uric acid, thereby enhancing the effectiveness of allopurinol therapy.

4. Which statement by the client indicates a need for further teaching about the use of metoprolol (Lopressor)?

• A. I will not stop taking the medication abruptly.
• B. I will take my pulse before taking the medication.
• C. I will take the medication with food.
• D. I will take the medication at bedtime.

Correct answer: D

Rationale: The correct answer is D because taking metoprolol (Lopressor) at bedtime is not specifically recommended. Metoprolol should be taken with food to enhance absorption. It is crucial for the client not to stop taking the medication abruptly to prevent rebound hypertension or other adverse effects. Additionally, monitoring the pulse before taking metoprolol is important for assessing its effect on heart rate.

5. A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, 'My chest still hurts.' Select the appropriate actions that the nurse should take.

• A. Call a code blue.
• B. Contact the registered nurse.
• C. Contact the client's family.
• D. Assess the client's pain level.

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to contact the registered nurse. When a client with coronary artery disease experiences chest pain and does not achieve relief after the initial administration of nitroglycerin, it is crucial to inform the registered nurse promptly. Following the usual guideline for nitroglycerin administration, the nurse may administer a second tablet after assessing the client's pain level. The nurse should continue to assess the client's pain and monitor vital signs before each dose administration. Calling a code blue is not warranted at this point, as the client's condition does not indicate an immediate life-threatening emergency. Contacting the client's family is not necessary unless requested by the client.

Similar Questions