Nursing Elites

1. A client has a new prescription for Alteplase. Which of the following actions should the nurse plan to take?

• A. Administer the medication within 4 hours of the onset of symptoms.
• B. Reconstitute the medication with sterile saline.
• C. Administer heparin concurrently with the Alteplase infusion.
• D. Monitor for changes in level of consciousness.

Correct answer: D

Rationale: Alteplase is a thrombolytic agent used to dissolve blood clots. Patients receiving Alteplase are at risk for bleeding complications, including intracranial bleeding. Monitoring for changes in the level of consciousness is crucial as it can indicate early signs of bleeding, such as increased intracranial pressure. This rapid assessment allows for timely intervention and prevention of further complications. Choices A, B, and C are incorrect. Administering Alteplase within 4 hours of symptom onset is related to the time-sensitive nature of thrombolytic therapy for conditions like acute myocardial infarction or ischemic stroke. Reconstituting Alteplase with sterile saline is a correct step in preparing the medication for administration. Administering heparin concurrently with Alteplase is generally avoided due to the increased risk of bleeding.

2. A client is starting a new prescription for enalapril. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Rise slowly from a sitting position.
• C. Avoid salt substitutes.
• D. Avoid exposure to sunlight.

Correct answer: C

Rationale: The correct instruction for a client starting enalapril is to avoid salt substitutes. Salt substitutes may contain potassium, which could lead to elevated potassium levels when combined with enalapril, increasing the risk of hyperkalemia. Choices A, B, and D are incorrect because there is no specific need to take enalapril with food, rise slowly from a sitting position, or avoid exposure to sunlight when taking this medication.

3. A client has a new prescription for Digoxin. Which of the following instructions should the nurse include?

• A. Increase your intake of bran fiber.
• B. Monitor your heart rate before taking the medication.
• C. Take the medication with antacids.
• D. Avoid drinking orange juice.

Correct answer: B

Rationale: When a client is prescribed Digoxin, it is essential to monitor their heart rate before each dose. Changes such as a heart rate below 60 bpm should be reported to the healthcare provider promptly. This is crucial because Digoxin can affect heart rhythm, and monitoring the heart rate helps in identifying any potential issues early on.

4. A client is receiving long-term aspirin therapy. The healthcare provider should monitor the client for which of the following complications?

• A. Hemorrhagic stroke
• B. Thromboembolic stroke
• C. Iron deficiency anemia
• D. Neutropenia

Correct answer: A

Rationale: The correct answer is A: Hemorrhagic stroke. Long-term aspirin therapy can lead to hemorrhagic stroke due to its antiplatelet effects, which increase the risk of bleeding. Aspirin inhibits platelet aggregation, which can predispose the individual to bleeding complications, including hemorrhagic stroke. Choices B, C, and D are incorrect because aspirin therapy is more likely to cause bleeding complications rather than thromboembolic events, iron deficiency anemia, or neutropenia.

5. Which medication is used as a bronchodilator?

• A. Warfarin
• B. Lovastatin
• C. Albuterol
• D. Valproate

Correct answer: C

Rationale: Albuterol is the correct answer. It is a medication commonly used as a bronchodilator to treat conditions such as asthma. Albuterol works by relaxing the muscles in the airways, allowing better airflow and making breathing easier for individuals with respiratory conditions. Warfarin (Choice A) is an anticoagulant used to prevent blood clots, Lovastatin (Choice B) is a medication used to lower cholesterol levels, and Valproate (Choice D) is used to treat seizures and bipolar disorder. These medications are not bronchodilators and are used for different medical conditions.

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