Nursing Elites

1. A healthcare professional is reviewing laboratory results for a client who has been taking carbamazepine. Which of the following findings should the healthcare professional report to the provider?

• A. WBC count 3,000/mm3
• B. Platelet count 150,000/mm3
• C. Hemoglobin 14 g/dL
• D. Serum potassium 4.5 mEq/L

Correct answer: A

Rationale: A WBC count of 3,000/mm3 indicates leukopenia, a serious side effect of carbamazepine. Leukopenia can increase the risk of infections due to decreased white blood cell count, which is important to report to the provider for further evaluation and management. Platelet count within normal range (choice B), hemoglobin level within normal range (choice C), and serum potassium level within normal range (choice D) are not directly associated with carbamazepine use and do not require immediate reporting as they do not indicate a serious adverse effect.

2. A client has a new prescription for alendronate. Which of the following instructions should be included in the teaching?

• A. Take the medication with a full glass of water.
• B. Lie down for 30 minutes after taking the medication.
• C. Take the medication at bedtime.
• D. Avoid dairy products while taking the medication.

Correct answer: A

Rationale: The correct instruction for taking alendronate is to take it with a full glass of water to prevent esophageal irritation. This helps ensure proper absorption and reduces the risk of irritation to the esophagus. Choice B is incorrect because patients should remain upright for at least 30 minutes after taking alendronate to prevent esophageal irritation. Choice C is incorrect as alendronate should be taken in the morning on an empty stomach. Choice D is also incorrect as there is no specific requirement to avoid dairy products while taking alendronate.

3. What should be the nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk?

• A. Administer nitroglycerin
• B. Have the client sit down
• C. Obtain an electrocardiogram
• D. Apply oxygen

Correct answer: B

Rationale: The nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk is to have the client sit down. Sitting down reduces the workload on the heart and may alleviate pain by improving oxygen supply. This action aims to reduce the strain on the heart and improve oxygen delivery to the myocardium, which can help relieve the symptoms of angina pectoris. Administering nitroglycerin could be the next step after having the client sit down if the pain persists. Obtaining an electrocardiogram and applying oxygen are not the immediate priority actions when dealing with angina pectoris symptoms.

4. A client is receiving intravenous heparin therapy for the treatment of deep vein thrombosis (DVT). Which laboratory test result should the LPN/LVN monitor to ensure the client is receiving a therapeutic dose?

• A. Prothrombin time (PT)
• B. Activated partial thromboplastin time (aPTT)
• C. International normalized ratio (INR)
• D. Platelet count

Correct answer: B

Rationale: The correct laboratory test result that the LPN/LVN should monitor to ensure the client is receiving a therapeutic dose of heparin therapy is the activated partial thromboplastin time (aPTT). The aPTT test is specifically used to monitor heparin therapy, ensuring that the dose administered is within the therapeutic range. Monitoring aPTT helps to prevent complications such as bleeding or clot formation by maintaining the appropriate anticoagulant effect of heparin. Prothrombin time (PT) and International normalized ratio (INR) are more commonly used to monitor warfarin therapy, not heparin. Platelet count is not a direct indicator of heparin's therapeutic effect and is not used to monitor heparin therapy.

5. The nurse is preparing a client for discharge after a myocardial infarction (MI). Which instruction is most important for the nurse to reinforce with the client?

• A. Avoid engaging in sexual activity for at least 6 weeks.
• B. Engage in moderate physical activity daily.
• C. Take prescribed medications even if you feel well.
• D. Return to work only when medically cleared.

Correct answer: C

Rationale: The most critical instruction for a client after a myocardial infarction is to continue taking prescribed medications even if they feel well. This is essential in preventing another myocardial infarction or other complications. Discontinuing medications prematurely can be detrimental to the client's recovery and may increase the risk of further cardiovascular events. Choices A, B, and D are incorrect because engaging in sexual activity, physical activity, or returning to work are important aspects of the client's recovery, but not as crucial as ensuring medication compliance to prevent further cardiac issues.

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