Nursing Elites

1. A healthcare provider is providing discharge teaching to a client who has a new prescription for furosemide. Which of the following statements should the provider include?

• A. Expect muscle pain.
• B. Monitor your weight daily.
• C. Avoid consuming grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: D

Rationale: When a client is prescribed furosemide, an important consideration is preventing hypokalemia, a potential side effect of the medication. Furosemide can lead to potassium depletion, so increasing the intake of potassium-rich foods is crucial to maintain adequate potassium levels in the body. Choices A, B, and C are incorrect because muscle pain is not a common side effect of furosemide, monitoring weight daily may not be directly related to the medication, and avoiding grapefruit juice is more relevant for certain medications that interact with grapefruit juice, not furosemide.

2. A client is admitted to the hospital with a diagnosis of pericarditis. The nurse reviews the client's record for which sign or symptom that differentiates pericarditis from other cardiopulmonary problems?

• A. Anterior chest pain
• B. Pericardial friction rub
• C. Weakness and irritability
• D. Chest pain that worsens with inspiration

Correct answer: B

Rationale: Pericardial friction rub is a distinctive sign of pericarditis, characterized by a scraping or grating sound heard on auscultation, which helps differentiate pericarditis from other cardiopulmonary conditions. While anterior chest pain may be present in various cardiopulmonary issues, it is not specific to pericarditis. Weakness and irritability are nonspecific symptoms that can be seen in many conditions. Chest pain worsening with inspiration is more indicative of pleuritic conditions such as pleurisy or pneumonia, rather than pericarditis.

3. Which laboratory test should be monitored to evaluate the effectiveness of anticoagulant therapy in a client with deep vein thrombosis (DVT)?

• A. Complete blood count (CBC)
• B. Activated partial thromboplastin time (aPTT)
• C. Serum electrolytes
• D. Liver function tests

Correct answer: B

Rationale: Activated partial thromboplastin time (aPTT) is the laboratory test monitored to evaluate the effectiveness of anticoagulant therapy, particularly with heparin. It measures the time it takes for blood to clot, and monitoring aPTT helps ensure the therapeutic range is maintained to prevent clot formation and excessive bleeding. Choices A, C, and D are incorrect because a complete blood count (CBC) assesses overall health, serum electrolytes evaluate the body's electrolyte balance, and liver function tests assess liver health, none of which directly evaluate the effectiveness of anticoagulant therapy for DVT.

4. A client who has a new prescription for warfarin is being educated by a healthcare professional about monitoring for adverse effects. Which of the following statements by the client indicates an understanding of the teaching?

• A. 'I should use a soft toothbrush to brush my teeth.'
• B. 'I will double my dose if I miss one.'
• C. 'I should increase my intake of leafy green vegetables.'
• D. 'I will contact my doctor if I notice any unusual bleeding or bruising.'

Correct answer: D

Rationale: The correct answer is D: 'I will contact my doctor if I notice any unusual bleeding or bruising.' This statement indicates a good understanding of the teaching regarding warfarin. Warfarin is an anticoagulant medication that increases the risk of bleeding. Contacting the doctor if unusual bleeding or bruising is noticed is essential as it can help prevent serious complications. Choices A, B, and C are incorrect. Using a soft toothbrush is generally recommended for oral hygiene but is not directly related to monitoring for adverse effects of warfarin. Doubling the dose of warfarin if a dose is missed is dangerous and can increase the risk of bleeding. Increasing the intake of leafy green vegetables can interfere with warfarin's effectiveness as they contain vitamin K, which antagonizes warfarin's anticoagulant effects.

5. A client is being taught about the use of an albuterol inhaler. Which of the following instructions should be included?

• A. Use the inhaler every 4 hours around the clock.
• B. Shake the inhaler well before use.
• C. Rinse your mouth with water after each use.
• D. Use the inhaler while lying down.

Correct answer: B

Rationale: Shaking the inhaler well before use is a crucial step in ensuring proper medication delivery. This action helps disperse the medication evenly within the device, optimizing the effectiveness of each dose. It ensures that the client receives the intended amount of medication. The other options are incorrect: Option A suggests a fixed time interval for inhaler use, which may not be suitable for all clients and can lead to overuse. Option C, rinsing the mouth, is more relevant for corticosteroid inhalers to prevent oral thrush. Option D, using the inhaler while lying down, is not recommended as it may lead to improper drug delivery and is not the correct position for inhaler use.

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