Nursing Elites

1. When caring for a client prescribed warfarin, which laboratory test should the nurse monitor to evaluate the therapeutic effect of the medication?

• A. aPTT
• B. Platelet count
• C. BUN
• D. PT/INR

Correct answer: D

Rationale: The correct laboratory test to monitor the therapeutic effect of warfarin is the PT/INR. Warfarin affects blood clotting, and the PT/INR levels indicate the effectiveness of the medication in preventing clot formation. Therefore, monitoring PT/INR levels helps ensure that the client is within the therapeutic range and is protected from potential complications related to clotting. Choice A (aPTT) is incorrect because while it measures the clotting time, it is not the preferred test for monitoring warfarin therapy. Choice B (Platelet count) is incorrect as it assesses the number of platelets and not the medication's therapeutic effect. Choice C (BUN) is unrelated to monitoring the effects of warfarin therapy and is primarily used to assess kidney function.

2. The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?

• A. “I will check my weight regularly for any gain or loss.”
• B. “I’ll make sure to take my high blood pressure medications.”
• C. “I am attending a smoking cessation class.”
• D. “As long as I exercise, stress at my job will not bother me.”

Correct answer: D

Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.

3. A client with heart failure is prescribed digoxin. Which of the following findings should the nurse identify as an adverse effect of digoxin?

• A. Constipation
• B. Blurred vision
• C. Nausea
• D. Headache

Correct answer: B

Rationale: Blurred vision is a common adverse effect of digoxin and can indicate toxicity. Monitoring for visual changes is essential to prevent serious complications in clients taking digoxin.

4. A healthcare provider is providing discharge instructions to a client who is prescribed Enalapril. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Dry cough. A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. Enalapril can cause a non-productive cough due to its effect on bradykinin levels. The client should be advised to report this symptom to their healthcare provider to consider alternative treatments. Choices B, C, and D are incorrect because weight gain, diarrhea, and nausea are not typically associated with Enalapril use.

5. A healthcare provider is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare provider should recognize that the medication affected which of the following systems in the client?

• A. Cardiovascular
• B. Immune
• C. Central nervous
• D. Gastrointestinal

Correct answer: C

Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders that can be caused by certain medications affecting the central nervous system, such as typical antipsychotic medications. These effects can lead to symptoms like tremors, muscle rigidity, and involuntary movements, which are all related to disruptions in the central nervous system. Choices A, B, and D are incorrect because extrapyramidal effects are specifically associated with the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.

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