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 client has a new prescription for Maraviroc to treat HIV infection. The healthcare provider should monitor the client for which of the following adverse reactions?

• A. Liver failure
• B. Kidney failure
• C. Pancreatitis
• D. Severe allergic reactions

Correct answer: D

Rationale: The correct answer is D: Severe allergic reactions. Maraviroc, used to treat HIV infection, can lead to severe allergic reactions, including hepatotoxicity. While liver failure is a potential adverse effect, it is often preceded by hepatotoxicity manifestations like jaundice or right upper quadrant pain. Kidney failure and pancreatitis are not typically associated with Maraviroc use. Therefore, monitoring for signs of severe allergic reactions and hepatotoxicity is crucial for early detection and intervention.

3. A client in the post-anesthesia recovery unit received a nondepolarizing neuromuscular blocking agent and is experiencing muscle weakness. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: A

Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers by increasing acetylcholine levels at the neuromuscular junction, thereby helping to restore muscle strength. Naloxone is an opioid antagonist used to reverse opioid effects, not neuromuscular blockade. Dantrolene is a skeletal muscle relaxant used to treat malignant hyperthermia or neuroleptic malignant syndrome, not to reverse neuromuscular blockade. Vecuronium is a nondepolarizing neuromuscular blocking agent, like the one the client received, and is not used to reverse its effects.

4. A client has a new prescription for Furosemide to treat heart failure. Which of the following laboratory results should the nurse monitor?

• A. Potassium level
• B. Sodium level
• C. Hemoglobin A1C
• D. BUN

Correct answer: A

Rationale: The nurse should monitor the client's potassium levels when taking Furosemide because the medication can lead to hypokalemia. Hypokalemia is a potential side effect of Furosemide, a loop diuretic, due to increased potassium excretion in the urine. Monitoring potassium levels is crucial to prevent complications such as cardiac dysrhythmias associated with low potassium levels. Therefore, choices B (Sodium level), C (Hemoglobin A1C), and D (BUN) are incorrect as they are not directly influenced by Furosemide therapy for heart failure.

5. A client with asthma has new prescriptions for cromolyn and albuterol by nebulizer. Which statement by the client indicates an understanding of the teaching?

• A. If my breathing begins to feel tight, I will use the cromolyn immediately.
• B. I will be sure to take the albuterol before taking the cromolyn.
• C. I will use both medications immediately after exercising.
• D. I will administer the medications 10 minutes apart.

Correct answer: B

Rationale: The correct answer is B. Taking albuterol before cromolyn ensures that the airways are open, allowing the cromolyn to reach the lungs effectively. Choice A is incorrect because cromolyn is a preventive medication and should be used regularly, not just when symptoms worsen. Choice C is incorrect because medications should be used as prescribed, not based on a specific event like exercising. Choice D is incorrect because there is no need to wait 10 minutes between administering these two medications when using a nebulizer.

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