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 type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. To ensure the insulin is available when food is digested, the client should take this medication 30 minutes before each meal. This timing aligns the medication with the expected postprandial rise in blood glucose levels, optimizing its effectiveness in controlling blood sugar levels. Choices A, C, and D are incorrect because taking Repaglinide with meals, just before bed, or as soon as waking up does not align with the medication's mechanism of action and timing needed for optimal effectiveness.

3. A nurse is teaching a client who has breast cancer about the adverse effects of chemotherapy. Which of the following statements should the nurse include?

• A. You should use a soft-bristled toothbrush to prevent bleeding.'
• B. You should take aspirin for minor aches and pains.'
• C. You should avoid contact with individuals who recently received live virus vaccines.'
• D. You should consume a diet low in protein to reduce the risk of renal damage.'

Correct answer: A

Rationale: The nurse should instruct the client to use a soft-bristled toothbrush to prevent bleeding, which can occur due to chemotherapy-induced thrombocytopenia.

4. A client is prescribed Propranolol for dysrhythmia. Which action should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Monitor the client's blood pressure after administering Propranolol.
• C. Assist the client when transitioning to a sitting or standing position after taking Propranolol.
• D. Monitor the client's potassium levels for signs of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol to a client with dysrhythmia is to assist the client when transitioning to a sitting or standing position. Propranolol can cause orthostatic hypotension, leading to dizziness during position changes, so it is essential to help the client move slowly to prevent falls or injuries. Choices A, B, and D are incorrect because holding Propranolol based on pulse rate, monitoring blood pressure after administration, and monitoring potassium levels are not directly related to the common side effect of orthostatic hypotension associated with Propranolol.

5. Which of the following is not a common effect of Midazolam?

• A. Amnesia
• B. Decreased respiratory function
• C. Anesthetic
• D. Dizziness

Correct answer: D

Rationale: Midazolam is a benzodiazepine commonly used for its sedative, anxiolytic, and amnestic effects. While dizziness can be a side effect of Midazolam, it is not a primary or common effect. Therefore, the correct answer is D, as it deviates from the typical effects associated with Midazolam.

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