Nursing Elites

1. A healthcare provider is reviewing laboratory results for a client who is receiving heparin therapy. Which of the following results indicates that the medication is effective?

• A. Platelets 250,000/mm³
• B. aPTT 60 seconds
• C. Hemoglobin 15 g/dL
• D. INR 1.5

Correct answer: B

Rationale: An aPTT of 60 seconds indicates that the client is receiving an effective dose of heparin. The activated partial thromboplastin time (aPTT) measures the time it takes for blood to clot and is used to monitor heparin therapy. A therapeutic range for aPTT during heparin therapy is usually 1.5 to 2 times the control value, which is around 25-35 seconds. Platelets, hemoglobin, and INR values are not direct indicators of the effectiveness of heparin therapy.

2. A nurse is planning care for a client who is postoperative following abdominal surgery. Which of the following interventions should the nurse implement to prevent respiratory complications?

• A. Encourage the client to ambulate twice daily.
• B. Encourage the client to deep breathe and cough every hour.
• C. Encourage the client to use an incentive spirometer every hour.
• D. Instruct the client to avoid coughing to prevent pain.

Correct answer: C

Rationale: The correct answer is C. Encouraging the client to use an incentive spirometer every hour is crucial to prevent respiratory complications postoperatively. Incentive spirometry helps in lung expansion and prevents atelectasis, which is common after abdominal surgery. Choice A, encouraging ambulation, is important for preventing complications but does not directly address respiratory issues. Choice B, deep breathing and coughing every hour, is also beneficial but not as effective in preventing atelectasis as using an incentive spirometer. Choice D, instructing the client to avoid coughing, is incorrect as coughing helps clear secretions and prevent respiratory complications.

3. A nurse is caring for a client who has a prescription for furosemide. The nurse should monitor the client for which of the following electrolyte imbalances?

• A. Hypernatremia
• B. Hypokalemia
• C. Hypercalcemia
• D. Hypomagnesemia

Correct answer: B

Rationale: The correct answer is B: Hypokalemia. Furosemide, a loop diuretic, can cause potassium loss leading to hypokalemia. Monitoring potassium levels is crucial as low potassium can result in various complications like cardiac dysrhythmias. Choices A, C, and D are incorrect. Hypernatremia is high sodium levels, which are not typically associated with furosemide use. Hypercalcemia is elevated calcium levels and hypomagnesemia is low magnesium levels, which are not the primary electrolyte imbalances associated with furosemide.

4. A nurse is providing teaching about folic acid to a client who is primigravida. Which of the following information should the nurse include in the teaching?

• A. You should take folic acid to prevent neural tube defects in your baby.
• B. You should consume at least 400 micrograms of folic acid daily.
• C. You can increase your dietary intake of folic acid by consuming cereals and citrus fruits.
• D. You should expect improved energy levels when taking folic acid supplements.

Correct answer: C

Rationale: The correct answer is C. Folic acid helps prevent neural tube defects, and dietary sources like cereals and citrus fruits are good options to increase folic acid intake. Choice A is incorrect because folic acid is primarily recommended to prevent neural tube defects, not to prevent infections. Choice B is incorrect because the recommended daily intake of folic acid for pregnant women is at least 400 micrograms, not 300. Choice D is incorrect because folic acid is not typically associated with improving energy levels.

5. What is the priority intervention for a patient with suspected pulmonary embolism?

• A. Administer oxygen
• B. Administer anticoagulants
• C. Administer bronchodilators
• D. Reposition the patient

Correct answer: A

Rationale: Administering oxygen is the priority intervention for a patient with suspected pulmonary embolism. Maintaining adequate oxygenation is crucial in these patients to prevent hypoxemia and support oxygen delivery to tissues. Administering anticoagulants may be necessary but is not the initial priority. Administering bronchodilators is not indicated for pulmonary embolism. Repositioning the patient does not address the immediate need for oxygenation.

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