Nursing Elites

1. A healthcare professional is caring for a client who is receiving heparin therapy. Which of the following laboratory tests should the healthcare professional monitor to evaluate the therapeutic effect of heparin?

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

Correct answer: C

Rationale: The correct test to monitor the therapeutic effect of heparin is the activated partial thromboplastin time (aPTT). Heparin's action is to prolong the clotting time, and aPTT reflects this effect. Monitoring aPTT helps ensure that the client is within the therapeutic range to prevent clot formation while minimizing the risk of bleeding complications. PT/INR is used to monitor warfarin therapy, platelet count assesses for potential thrombocytopenia, and WBC count evaluates for signs of infection or inflammation, not the therapeutic effect of heparin.

2. A client with Angina Pectoris asks the nurse about the next step if they take one tablet, wait 5 minutes, but still have Anginal pain. Which response should the nurse provide?

• A. Take two more sublingual tablets at the same time.
• B. Call emergency services.
• C. Take a sustained-release nitroglycerin capsule.
• D. Wait another 5 minutes then take a second sublingual tablet.

Correct answer: B

Rationale: If anginal pain persists after taking the first tablet and waiting 5 minutes, the priority step is to call emergency services (911) and then take a second sublingual tablet. Persistent pain could indicate a myocardial infarction, and immediate medical attention is crucial. Taking two more tablets at the same time (Choice A) can lead to excessive vasodilation and hypotension. Taking a sustained-release nitroglycerin capsule (Choice C) is not appropriate for immediate relief during an acute episode. Waiting another 5 minutes and then taking a second tablet (Choice D) is not advisable in this emergency situation where prompt action is necessary.

3. A client has a prescription for Hydralazine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Monitor your blood pressure regularly.
• C. Expect to have increased energy levels.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is to monitor blood pressure regularly. Hydralazine is an antihypertensive medication that helps lower blood pressure. Monitoring blood pressure regularly is essential to ensure it remains within the target range and to assess the effectiveness of the medication. Choice A is incorrect because the timing of taking Hydralazine is usually not specified as bedtime. Choice C is incorrect because increased energy levels are not an expected effect of Hydralazine. Choice D is incorrect because Hydralazine does not interact with potassium in the same way as other medications like potassium-sparing diuretics.

4. A client is being taught about Terbutaline. Which statement by the client indicates understanding of the teaching?

• A. This medication will stop my contractions.
• B. This medication will prevent vaginal bleeding.
• C. This medication will promote blood flow to my baby.
• D. This medication will increase my prostaglandin production.

Correct answer: A

Rationale: The correct answer is A. Terbutaline works by blocking beta2-adrenergic receptors, leading to uterine smooth muscle relaxation and stopping contractions. Therefore, the client demonstrating understanding by recognizing that the medication will stop contractions is the most accurate response. Choices B, C, and D are incorrect because Terbutaline is primarily used to inhibit contractions in preterm labor, not prevent vaginal bleeding, promote blood flow to the baby, or increase prostaglandin production.

5. A healthcare professional reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the professional take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication, and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify trough levels of a medication, the healthcare professional should obtain a blood specimen immediately before administering the next dose of medication. This timing ensures an accurate representation of the medication's lowest concentration in the bloodstream, which is crucial for therapeutic monitoring and dose adjustments. Choice B is incorrect because waiting 24 hours after taking the medication would not provide an accurate trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect because obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level, as it is the lowest concentration before the next dose.

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