Nursing Elites

1. A nurse is providing discharge teaching to a client who has a new prescription for digoxin. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will take my pulse before taking this medication.
• B. I should take this medication with food to prevent nausea.
• C. I will take this medication if my heart rate is less than 60/min.
• D. I should take this medication with food if I am not feeling well.

Correct answer: A

Rationale: The correct answer is A. Taking the pulse before taking digoxin is crucial as it helps monitor the heart rate, as digoxin can cause bradycardia as a side effect. Option B is incorrect because digoxin should be taken on an empty stomach to enhance absorption. Option C is incorrect because digoxin should be held and the healthcare provider should be contacted if the heart rate is less than 60/min. Option D is incorrect because digoxin should not be taken with food due to decreased absorption.

2. How should a healthcare professional handle a patient who is refusing to take a prescribed medication?

• A. Immediately give the medication
• B. Assess the reasons for refusal
• C. Document refusal
• D. Explore alternative treatment options

Correct answer: B

Rationale: Assessing the reasons for refusal is crucial as it allows the healthcare professional to understand the patient's concerns, which can range from fear of side effects to cost issues. By identifying the underlying reasons, the healthcare professional can tailor their approach to address these specific concerns, potentially improving medication adherence. Giving the medication immediately (Choice A) without understanding the patient's reasons for refusal can lead to further non-compliance. While documenting refusal (Choice C) is important for legal and tracking purposes, it does not directly address the patient's concerns. Exploring alternative treatment options (Choice D) may be considered after understanding the reasons for refusal, but it is not the initial step in managing medication refusal.

3. What is the most critical lab value to monitor for a patient on heparin therapy?

• A. Monitor aPTT levels
• B. Monitor platelet count
• C. Monitor INR levels
• D. Monitor sodium levels

Correct answer: A

Rationale: The correct answer is to monitor aPTT levels. Activated Partial Thromboplastin Time (aPTT) is crucial for assessing the therapeutic effectiveness of heparin, as it reflects the intrinsic pathway of the coagulation cascade. Monitoring aPTT helps ensure that the patient is within the therapeutic range of heparin, minimizing the risk of bleeding complications. Platelet count (choice B) is important to assess for potential heparin-induced thrombocytopenia but is not the primary lab value to monitor during heparin therapy. INR levels (choice C) are monitored in patients on warfarin therapy, not heparin. Sodium levels (choice D) are not directly related to heparin therapy monitoring.

4. A nurse is discussing group treatment and therapy with a client. The nurse should include which of the following as being a characteristic of a therapeutic group?

• A. The group is organized in an autocratic structure
• B. The group encourages members to focus on a particular issue
• C. The group must be led by a licensed psychiatrist
• D. The group encourages clients to form dependent relationships

Correct answer: B

Rationale: The correct answer is B. Therapeutic groups indeed encourage members to focus on particular issues. This focus helps individuals address specific concerns, work through challenges, and support one another in a structured setting. Choice A is incorrect because therapeutic groups typically promote a democratic structure that values input from all members rather than an autocratic one. Choice C is incorrect as therapeutic groups can be led by various mental health professionals, not solely by licensed psychiatrists. Choice D is incorrect; therapeutic groups aim to foster independent growth and self-reliance rather than promoting dependent relationships.

5. A nurse is assessing a client who has acute pancreatitis. Which of the following findings should the nurse expect?

• A. Left upper quadrant pain.
• B. Periumbilical pain.
• C. Rebound tenderness.
• D. Flank pain.

Correct answer: A

Rationale: Corrected Rationale: The correct answer is A, left upper quadrant pain. In acute pancreatitis, inflammation of the pancreas commonly causes pain in the left upper quadrant of the abdomen. This pain can be severe and radiate to the back. Periumbilical pain (choice B) is more indicative of acute appendicitis. Rebound tenderness (choice C) is associated with peritoneal inflammation, not specifically pancreatitis. Flank pain (choice D) is more characteristic of conditions involving the kidneys or ureters, such as renal colic.

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