Nursing Elites

1. A client is receiving warfarin therapy. Which of the following findings should the nurse identify as an adverse effect of warfarin?

• A. Nausea
• B. Epistaxis
• C. Diarrhea
• D. Dyspepsia

Correct answer: B

Rationale: Epistaxis, or nosebleeds, can be an indication of excessive anticoagulation while on warfarin therapy. Warfarin is a blood thinner that helps prevent blood clots. Epistaxis can occur as a result of the blood-thinning effects of warfarin, leading to increased bleeding tendencies, including nosebleeds. Nausea, diarrhea, and dyspepsia are not typically associated with warfarin therapy; therefore, they are not the adverse effects the nurse should identify in a client receiving warfarin.

2. A healthcare professional is preparing to administer heparin 15,000 units subcutaneously every 12 hours. The available heparin injection is 20,000 units/mL. How many milliliters should the healthcare professional administer per dose?

• A. 0.8 mL
• B. 0.75 mL
• C. 0.5 mL
• D. 1 mL

Correct answer: A

Rationale: To calculate the volume to administer, use the formula: Desired dose / Concentration = Volume to administer. In this case, (15,000 units / 20,000 units/mL) = 0.75 mL. Since the volume needs to be rounded up to the nearest tenth, the correct answer is 0.8 mL. Choice B (0.75 mL) is incorrect because it does not account for rounding up the volume. Choices C (0.5 mL) and D (1 mL) are incorrect as they do not reflect the precise calculation based on the given concentration and desired dose.

3. A client is being discharged with a new prescription for Atenolol. Which of the following instructions should the nurse include?

• A. Take this medication in the morning.
• B. Monitor your heart rate regularly.
• C. Avoid consuming foods high in potassium.
• D. Increase your fluid intake.

Correct answer: B

Rationale: The correct answer is B: 'Monitor your heart rate regularly.' Atenolol is a beta-blocker that can cause bradycardia (slow heart rate). Monitoring the heart rate regularly is crucial to promptly detect any significant decreases. This allows for timely intervention and adjustment of the medication regimen if needed, helping to prevent adverse effects associated with bradycardia. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning does not address the need for heart rate monitoring. Avoiding foods high in potassium is more relevant for medications like ACE inhibitors or potassium-sparing diuretics. Increasing fluid intake is not directly related to the use of Atenolol.

4. A client has a new prescription for Warfarin. Which of the following statements by the client indicates a need for further teaching?

• A. I will avoid eating large amounts of green leafy vegetables.
• B. I will take my medication at the same time every day.
• C. I will increase my intake of foods high in potassium.
• D. I will report any signs of bleeding to my provider.

Correct answer: C

Rationale: The correct answer is C because Warfarin interacts with vitamin K, not potassium. Therefore, the client needs to be cautious with foods high in vitamin K, such as green leafy vegetables, rather than foods high in potassium. Choices A, B, and D are correct statements regarding Warfarin therapy and do not indicate a need for further teaching.

5. While teaching a client starting therapy with rituximab, which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The correct answer is B: Fever. The nurse should instruct the client to report fever as it can be an indication of an infection, which is a potential complication of rituximab therapy. Monitoring for fever is crucial to promptly address any signs of infection and ensure the client's safety during treatment. Choices A, C, and D are not typically associated with rituximab therapy and are less likely to be directly related to a serious complication requiring immediate attention.

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