Nursing Elites

1. A client is prescribed clopidogrel. What laboratory result should be monitored by the nurse?

• A. White blood cell count
• B. Creatinine
• C. Blood glucose
• D. Platelet count

Correct answer: D

Rationale: When a client is prescribed clopidogrel, monitoring the platelet count is essential. Clopidogrel is an antiplatelet medication that works by preventing blood clots. Monitoring the platelet count is crucial in assessing the risk of thrombocytopenia, a potential side effect of clopidogrel. Monitoring white blood cell count, creatinine, or blood glucose is not directly related to the action or side effects of clopidogrel, making choices A, B, and C incorrect.

2. A client with chronic obstructive pulmonary disease (COPD) is prescribed a metered-dose inhaler (MDI) with a spacer. Which instruction should the nurse reinforce to ensure correct use?

• A. Inhale deeply and slowly after activating the MDI.
• B. Hold the breath for 5 seconds after inhaling the medication.
• C. Rinse the mouth immediately after using the MDI.
• D. Exhale fully before placing the mouthpiece in the mouth.

Correct answer: A

Rationale: Inhaling deeply and slowly after activating the MDI is the correct instruction to ensure effective delivery of the medication to the lungs. This technique helps the medication reach the lower airways where it can be most beneficial in managing COPD symptoms. Inhaling too quickly or not deeply enough may result in improper drug delivery and reduce the effectiveness of the treatment. Holding the breath for 5 seconds after inhaling the medication (Choice B) may not be necessary and could cause discomfort without additional benefits. Rinsing the mouth immediately after using the MDI (Choice C) is not necessary unless specified by the healthcare provider. Exhaling fully before placing the mouthpiece in the mouth (Choice D) is not ideal as it may result in inadequate medication delivery to the lungs.

3. A client with a history of angina is scheduled for an exercise electrocardiography (ECG) test. The nurse should explain that the purpose of this test is to evaluate which factor?

• A. The heart's response to physical stress
• B. The client's overall physical fitness
• C. The presence of electrolyte imbalances
• D. The effectiveness of anti-anginal medications

Correct answer: A

Rationale: An exercise electrocardiography (ECG) test is used to evaluate the heart's response to physical stress. During the test, the heart's electrical activity is monitored while the client exercises, helping to identify any areas of ischemia or abnormal rhythms. This test helps healthcare providers assess the heart's function and detect any potential issues related to angina or other cardiac conditions. Choice B, the client's overall physical fitness, is incorrect because the test primarily focuses on the heart's response to stress rather than the client's general physical fitness. Choice C, the presence of electrolyte imbalances, is incorrect as this test is not specifically designed to evaluate electrolyte levels. Choice D, the effectiveness of anti-anginal medications, is incorrect as the main purpose of the test is to assess the heart's response to physical stress, not medication effectiveness.

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

• A. Take the medication with a full glass of water.
• B. Avoid consuming dairy products.
• C. Take the medication on an empty stomach.
• D. Expect a metallic taste in your mouth.

Correct answer: B

Rationale: The correct instruction for a client prescribed phenytoin is to avoid consuming dairy products. Dairy products can reduce the absorption of phenytoin. Taking the medication with a full glass of water (Choice A) is generally a good practice for oral medications but is not specifically required for phenytoin. Taking the medication on an empty stomach (Choice C) can lead to gastrointestinal upset, so it is not recommended for phenytoin. Expecting a metallic taste in the mouth (Choice D) is a possible side effect of phenytoin but is not a crucial instruction for the client to follow.

5. The healthcare professional is caring for a client who has just returned from a cardiac catheterization. The healthcare professional should prioritize which assessment?

• A. Monitoring the client's vital signs every 4 hours
• B. Assessing the puncture site for bleeding
• C. Encouraging the client to ambulate early to prevent complications
• D. Providing the client with fluids to flush out the contrast dye

Correct answer: B

Rationale: Assessing the puncture site for bleeding is a critical assessment after a cardiac catheterization procedure. This is essential to detect and address any potential complications promptly, such as hemorrhage or hematoma formation. Monitoring vital signs, encouraging early ambulation, and providing fluids to flush out contrast dye are important aspects of post-cardiac catheterization care, but assessing the puncture site for bleeding takes precedence due to the immediate risk of complications such as severe bleeding that require immediate intervention.

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