Nursing Elites

1. After a thoracentesis on a client with a pleural effusion, which nursing intervention is most important post-procedure?

• A. Monitor for signs of infection.
• B. Assess for signs of bleeding or hematoma.
• C. Monitor vital signs and respiratory status.
• D. Instruct the client to rest and limit physical activity.

Correct answer: B

Rationale: The correct answer is to assess for signs of bleeding or hematoma. After a thoracentesis, it is crucial to monitor for any bleeding or hematoma formation at the puncture site, as this can lead to complications. Monitoring for signs of infection (Choice A) is essential but is usually a delayed concern compared to the immediate risk of bleeding post-procedure. While monitoring vital signs and respiratory status (Choice C) is important, assessing for bleeding takes precedence to address any immediate complications. Instructing the client to rest and limit physical activity (Choice D) is relevant for general post-procedure care but is not the most critical intervention in this scenario.

2. What important instruction should the nurse provide about taking medroxyprogesterone acetate (Provera) for a patient with endometriosis?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken with food to reduce gastrointestinal upset.
• C. Discontinue medroxyprogesterone if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This consistency is crucial for achieving therapeutic outcomes. Choice B is incorrect because medroxyprogesterone should be taken at the same time each day, regardless of food intake. Choice C is incorrect because side effects should be reported to the healthcare provider for further evaluation rather than discontinuing the medication abruptly. Choice D is incorrect as medroxyprogesterone is usually taken daily for the prescribed duration.

3. What are the characteristics of the inflammatory process?

• A. Loss of function, coolness
• B. Pain, redness
• C. Heat, pallor
• D. Swelling, pallor

Correct answer: B

Rationale: The correct answer is B: Pain, redness. Inflammation is characterized by pain and redness as part of the body's response to tissue injury. Choice A, loss of function and coolness, are not primary characteristics of inflammation. Choice C, heat and pallor, may be present in some cases but are not as consistently associated with inflammation as pain and redness. Choice D, swelling and pallor, includes swelling which is common in inflammation but pallor is not a typical characteristic.

4. Which of the following organs are primarily affected by poorly managed hypertension?

• A. The bladder and urethra
• B. The brain and skin
• C. The heart and kidneys
• D. The stomach and intestines

Correct answer: C

Rationale: Poorly managed hypertension primarily affects the heart and kidneys. The heart is at risk of conditions like heart failure due to the increased workload from elevated blood pressure. The kidneys can suffer damage from longstanding hypertension, leading to kidney disease. Choices A, B, and D are incorrect because the bladder, urethra, brain, skin, stomach, and intestines are not the primary organs affected by poorly managed hypertension.

5. A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What critical instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain and other side effects.
• B. Avoid consuming grapefruit juice while taking this medication.
• C. Take the medication in the morning with breakfast to improve absorption.
• D. Take the medication with a high-fat meal to increase its effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at night to reduce the risk of muscle pain and other side effects. Atorvastatin, like other statins, is more effective when taken in the evening as the body produces more cholesterol at night. Taking it with a high-fat meal (choice D) is not recommended as it may reduce the drug's absorption. Grapefruit juice (choice B) should be avoided with atorvastatin as it can increase the risk of side effects. Taking the medication in the morning with breakfast (choice C) is not as effective as taking it at night.

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