Nursing Elites

1. A client is prescribed Clopidogrel. Which of the following laboratory values should be monitored to assess for potential adverse effects?

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

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication, so monitoring the client's platelet count is crucial to assess for potential bleeding complications. Changes in platelet count can indicate an increased risk of bleeding, a known adverse effect of Clopidogrel. Monitoring white blood cell count, hemoglobin, or blood glucose is not directly related to the potential adverse effects of Clopidogrel and would not provide relevant information regarding the medication's impact on platelet function.

2. A client is being educated by a healthcare provider about a new prescription for Digoxin. Which of the following client statements indicates an understanding of the teaching?

• A. I will take the medication with a high-fiber meal.
• B. I should report any vision changes to my healthcare provider.
• C. I will take the medication if my heart rate is below 60 bpm.
• D. I should avoid dairy products while taking this medication.

Correct answer: B

Rationale: The correct answer is B. Visual disturbances, such as blurred vision or seeing halos, can be a sign of digoxin toxicity. It is crucial for the client to report any changes in vision to their healthcare provider promptly to prevent serious complications. Choice A is incorrect because taking Digoxin with a high-fiber meal can affect its absorption. Choice C is incorrect because taking Digoxin based on heart rate alone is not recommended without healthcare provider supervision. Choice D is incorrect because there is no specific interaction between Digoxin and dairy products.

3. A healthcare professional is preparing to administer a transfusion of 300 mL of pooled platelets for a client who has severe Thrombocytopenia. How long should the healthcare professional plan to administer the transfusion over?

• A. Within 30 min/unit
• B. Within 60 min/unit
• C. Within 2 hr/unit
• D. Within 4 hr/unit

Correct answer: A

Rationale: Platelets are fragile components that must be administered quickly to maintain their effectiveness and minimize the risk of clumping. The recommended administration time for platelets is within 15 to 30 minutes per unit. This rapid administration helps ensure the platelets remain viable and functional for the client receiving the transfusion. Therefore, the correct answer is to administer the transfusion within 30 minutes per unit. Choices B, C, and D are incorrect as they exceed the recommended administration time for platelets, which could compromise their efficacy and pose risks to the client.

4. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in clients with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is characterized by inflammation of a vein with the formation of a clot, and estrogen can further exacerbate this condition, leading to serious complications. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and osteoporosis are conditions where estrogen therapy may actually be indicated. Dysfunctional uterine bleeding is another condition where estrogen therapy can be used to help regulate menstrual bleeding.

5. A client with Graves' disease is being taught about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?

• A. Propranolol helps increase blood flow to my thyroid gland.
• B. Propranolol is used to prevent excess glucose in my blood.
• C. Propranolol will decrease my tremors and fast heart rate.
• D. Propranolol promotes a decrease in thyroid hormone in my body.

Correct answer: C

Rationale: The correct answer is C. Propranolol is a beta-adrenergic antagonist that helps decrease heart rate and control tremors in individuals with Graves' disease. It does not increase blood flow to the thyroid gland (choice A), prevent excess glucose in the blood (choice B), or directly decrease thyroid hormone levels in the body (choice D). Propranolol's primary role in Graves' disease is to alleviate symptoms like tremors and fast heart rate by blocking the effects of excessive thyroid hormone, rather than reducing the actual levels of thyroid hormone in the body.

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