Nursing Elites

1. A client is receiving heparin therapy. Which of the following laboratory results indicates the client is receiving an effective dose of heparin?

• A. INR 1.5
• B. aPTT 60 seconds
• C. Platelets 150,000/mm³
• D. Potassium 4.0 mEq/L

Correct answer: B

Rationale: An aPTT of 60 seconds indicates the client is receiving an effective dose of heparin. The activated partial thromboplastin time (aPTT) measures the time it takes for a clot to form, and a therapeutic range for heparin therapy is usually 1.5 to 2 times the control value, which is around 60-80 seconds. An INR of 1.5 is not related to heparin therapy, as it is commonly used to monitor warfarin therapy. Platelet count and potassium levels are not direct indicators of the effectiveness of heparin therapy.

2. A nurse is caring for an infant who has coarctation of the aorta. Which of the following should the nurse identify as an expected finding?

• A. Weak femoral pulses.
• B. Frequent nosebleeds.
• C. Upper extremity hypotension.
• D. Increased intracranial pressure.

Correct answer: A

Rationale: Corrected Rationale: Weak femoral pulses are an expected finding in an infant with coarctation of the aorta. The narrowing of the aorta leads to decreased blood flow to the lower extremities, resulting in weak or absent femoral pulses. Frequent nosebleeds (Choice B) are not typically associated with coarctation of the aorta. Upper extremity hypotension (Choice C) is not a common finding in coarctation of the aorta; instead, blood pressure is usually elevated in the upper extremities. Increased intracranial pressure (Choice D) is not directly related to coarctation of the aorta.

3. A nurse is caring for a client who has a new prescription for levothyroxine. Which of the following laboratory values should the nurse monitor to determine the effectiveness of the medication?

• A. Calcium
• B. Sodium
• C. Thyroid-stimulating hormone (TSH)
• D. Magnesium

Correct answer: C

Rationale: The correct answer is C: Thyroid-stimulating hormone (TSH). Monitoring TSH levels is crucial to assess the effectiveness of levothyroxine in clients with hypothyroidism. TSH is produced by the pituitary gland and stimulates the thyroid gland to produce thyroid hormones. In hypothyroidism, where the thyroid gland is underactive, administering levothyroxine helps to normalize thyroid hormone levels. Monitoring TSH levels allows the healthcare provider to adjust the levothyroxine dosage to ensure that thyroid hormone levels are within the therapeutic range. Choices A, B, and D (Calcium, Sodium, and Magnesium) are not directly related to assessing the effectiveness of levothyroxine therapy in hypothyroidism and would not provide relevant information regarding the medication's efficacy.

4. How should a healthcare professional manage a patient with non-compliance to hypertension medication?

• A. Provide education on medication
• B. Refer the patient to a specialist
• C. Discontinue the medication
• D. Reassess the patient in 6 months

Correct answer: A

Rationale: Providing education on medication is crucial when managing a patient with non-compliance to hypertension medication. By educating the patient on the importance of adherence, potential side effects, and the impact of uncontrolled hypertension, healthcare professionals can help improve the patient's understanding and compliance. Referring the patient to a specialist (Choice B) may be necessary in some cases but should not be the first step. Discontinuing the medication (Choice C) without exploring reasons for non-compliance and providing education can worsen the patient's condition. Reassessing the patient in 6 months (Choice D) is important but should be accompanied by interventions to address non-compliance in the interim.

5. A client with heart failure at risk for pulmonary edema should receive which intervention to improve oxygenation?

• A. Place the client in a supine position.
• B. Encourage the client to increase fluid intake.
• C. Elevate the client's legs when in bed.
• D. Administer oxygen via non-rebreather mask.

Correct answer: D

Rationale: Administering oxygen via a non-rebreather mask is the appropriate intervention for a client at risk for pulmonary edema as it helps improve oxygenation by delivering a high concentration of oxygen. Placing the client in a supine position can exacerbate pulmonary edema by increasing venous return to the heart, leading to fluid overload. Encouraging increased fluid intake is contraindicated in clients with heart failure and at risk for pulmonary edema, as it can worsen fluid accumulation. Elevating the client's legs when in bed is more appropriate for clients with conditions such as venous insufficiency or edema in the lower extremities, not for pulmonary edema.

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