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. How should a healthcare provider respond to a patient with a history of hypertension who is non-compliant with medication?

• A. Encourage compliance through education
• B. Contact the healthcare provider
• C. Document the refusal
• D. Explore alternative treatment options

Correct answer: A

Rationale: Encouraging compliance through education is crucial in helping patients understand the importance of consistent medication use. By providing education, the patient can make informed decisions about their health and better manage their condition. Contacting the healthcare provider (choice B) may be necessary in some cases, but the initial approach should focus on patient education. Documenting the refusal (choice C) is important for legal and medical records but does not address the root cause of non-compliance. Exploring alternative treatment options (choice D) should come after efforts to educate and encourage compliance with the current medication regimen.

3. A nurse is completing an incident report after a client fall. Which of the following competencies of Quality and Safety Education for Nurses is the nurse demonstrating?

• A. Quality improvement
• B. Patient safety
• C. Evidence-based practice
• D. Informatics

Correct answer: A

Rationale: The correct answer is A: Quality improvement. Completing an incident report after a client fall aligns with the quality improvement competency of QSEN, as it involves identifying a system issue (fall incident) that needs to be addressed to enhance the quality of care. Choice B, patient safety, focuses more on preventing harm to patients rather than the systematic improvement process. Choice C, evidence-based practice, pertains to integrating research evidence with clinical expertise and patient values in decision-making, which is not directly related to incident reporting. Choice D, informatics, involves using technology and data to support decision-making and improve patient care, which is not the primary focus when completing an incident report.

4. A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following statements indicates a need for further teaching?

• A. I will take warfarin every other day.
• B. I will eat more leafy green vegetables while taking warfarin.
• C. I will use a soft toothbrush while taking warfarin.
• D. I will have my INR checked regularly while taking warfarin.

Correct answer: B

Rationale: The correct answer is B. Eating more leafy green vegetables can increase vitamin K intake, which may reduce the effectiveness of warfarin. This can lead to fluctuations in the International Normalized Ratio (INR) levels, affecting the medication's efficacy. Choices A, C, and D are correct statements. Taking warfarin every other day, using a soft toothbrush to prevent gum bleeding, and having regular INR checks are all appropriate and important actions when taking warfarin.

5. A client is prescribed albuterol. Which of the following instructions should the nurse include?

• A. Take this medication before meals.
• B. You might experience tremors while taking this medication.
• C. Limit your caffeine intake while taking this medication.
• D. Take this medication at bedtime.

Correct answer: B

Rationale: The correct answer is B. Albuterol can cause tremors as a common side effect. Instructing the client about this potential side effect is crucial for their awareness and preparedness. Choices A, C, and D are incorrect because taking albuterol before meals, limiting caffeine intake, or taking it at bedtime are not specific instructions related to managing the side effects of albuterol like tremors.

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