Nursing Elites

1. A patient is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin?

• A. Hemoglobin
• B. Prothrombin time (PT)
• C. Bleeding time
• D. Activated partial thromboplastin time (aPTT)

Correct answer: B

Rationale: The correct answer is to monitor Prothrombin time (PT) when a patient is on warfarin therapy. Warfarin affects blood clotting, and PT is used to assess the therapeutic effect of this medication. Hemoglobin (Choice A) is not directly affected by warfarin therapy and does not reflect its therapeutic effect. Bleeding time (Choice C) measures the time it takes for bleeding to stop after a standardized cut and is not specific to warfarin therapy. Activated partial thromboplastin time (aPTT) (Choice D) is more commonly used to monitor heparin therapy, not warfarin.

2. A nurse is teaching a client who has a new prescription for Hydralazine. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hyperglycemia
• C. Hyponatremia
• D. Constipation

Correct answer: A

Rationale: Corrected Rationale: Hydralazine is a vasodilator that can cause reflex tachycardia as an adverse effect. The client should monitor their pulse and report any significant increases. Choice B, Hyperglycemia, is not a common adverse effect of Hydralazine. Choice C, Hyponatremia, and Choice D, Constipation, are also not typically associated with Hydralazine use.

3. What symptom would alert the healthcare professional to hold Albuterol and notify a healthcare professional immediately?

• A. Insomnia
• B. Paradoxical bronchospasm
• C. Nausea
• D. Headache

Correct answer: B

Rationale: If a patient experiences paradoxical bronchospasm after taking Albuterol, the medication should be withheld, and a healthcare professional should be notified immediately. Paradoxical bronchospasm is a serious adverse reaction where the airways constrict instead of dilating, leading to breathing difficulties. This condition requires prompt medical attention to assess and manage the patient's respiratory status. The other options, insomnia, nausea, and headache, are not typically associated with the need to hold Albuterol and notify a healthcare professional immediately.

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

• A. Monitor for signs of bleeding.
• B. Avoid taking the medication with food.
• C. Expect to have increased urination.
• D. Take the medication with an antacid.

Correct answer: A

Rationale: Corrected Rationale: Clopidogrel is an antiplatelet medication that increases the risk of bleeding. The client should monitor for any signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stool, and report them promptly to their healthcare provider for further evaluation and management. Choice B is incorrect because Clopidogrel can be taken with or without food. Choice C is incorrect as increased urination is not a common side effect of Clopidogrel. Choice D is incorrect as taking Clopidogrel with an antacid may reduce its effectiveness.

5. A healthcare provider is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

• A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
• B. Obtain help from another healthcare provider to confirm the correct client and blood product.
• C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
• D. Stay with the client for the first 15 to 30 minutes of the transfusion.

Correct answer: B

Rationale: The correct answer is to obtain help from another healthcare provider to confirm the correct client and blood product. This action is crucial in preventing an acute hemolytic reaction, which is caused by ABO or Rh incompatibility. Verifying the correct client and blood product before the transfusion ensures that there are no errors in identification, reducing the risk of a potentially life-threatening reaction. Choices A, C, and D are important aspects of transfusion safety but are not directly related to preventing acute hemolytic reactions. Ensuring a patent IV line, monitoring vital signs, and staying with the client are all essential during transfusion but do not specifically address the risk of ABO or Rh incompatibility reactions.

Similar Questions