Nursing Elites

1. A nurse is reviewing the laboratory results of a client who is receiving warfarin therapy for atrial fibrillation. Which of the following laboratory values should the nurse report to the provider?

• A. INR 1.8
• B. Hemoglobin 14 g/dL
• C. Platelets 175,000/mm³
• D. Potassium 3.8 mEq/L

Correct answer: A

Rationale: The correct answer is A. An INR of 1.8 is below the therapeutic range for a client receiving warfarin, indicating a potential risk of blood clots. This value should be reported to the provider for further evaluation and possible adjustment of the warfarin dosage. Choices B, C, and D are within normal ranges and do not directly relate to the effectiveness or safety of warfarin therapy in this scenario, making them less urgent to report.

2. A nurse is caring for a client who has a pulmonary embolism. The nurse should identify the effectiveness of the treatment by assessing which of the following?

• A. A chest x-ray reveals increased density in all lung fields
• B. The client reports feeling less anxious
• C. Diminished breath sounds are auscultated unilaterally
• D. ABG results include pH 7.48, PaO2 77 mm Hg, and PaCO2 47 mm Hg

Correct answer: B

Rationale: The correct answer is B. Client-reported improvement in anxiety is an indication of effective treatment for pulmonary embolism. Choice A is incorrect as increased density in all lung fields on a chest x-ray may indicate complications or lack of improvement. Choice C is incorrect as diminished breath sounds auscultated unilaterally may suggest a localized lung issue and not necessarily reflect the effectiveness of treatment for a pulmonary embolism. Choice D is incorrect as the ABG results provided do not specifically indicate the effectiveness of treatment for a pulmonary embolism.

3. A client with preeclampsia and postpartum hemorrhage is being cared for by a nurse. The nurse should recognize that which of the following medications is contraindicated?

• A. Methylergonovine
• B. Misoprostol
• C. Dinoprostone
• D. Oxytocin

Correct answer: A

Rationale: The correct answer is A, Methylergonovine. Methylergonovine is contraindicated in clients with preeclampsia due to the risk of hypertension. Misoprostol (choice B), Dinoprostone (choice C), and Oxytocin (choice D) are appropriate medications for managing postpartum hemorrhage and are not contraindicated in clients with preeclampsia.

4. A client at 32 weeks of gestation with preeclampsia is receiving teaching from a nurse. Which statement by the client indicates an understanding of the teaching?

• A. I will take a daily aspirin to prevent blood clots.
• B. I will call my provider if I experience swelling in my hands.
• C. I should increase my calcium intake to prevent seizures.
• D. I will restrict my protein intake to prevent further kidney damage.

Correct answer: B

Rationale: The correct answer is B because swelling in the hands is a potential sign of worsening preeclampsia, and the client should report this to their provider. Choice A is incorrect since aspirin is not recommended in preeclampsia. Choice C is incorrect as calcium intake is not directly related to preventing seizures in preeclampsia. Choice D is incorrect because protein restriction is not the standard management for preventing further kidney damage in preeclampsia.

5. A healthcare professional is providing discharge teaching for a client with type 2 diabetes mellitus. Which resource should be provided?

• A. Personal blogs about managing the adverse effects of diabetes medications.
• B. Food label recommendations from the Institute of Medicine.
• C. Diabetes medication information from the Physicians' Desk Reference.
• D. Food exchange lists for meal planning from the American Diabetes Association.

Correct answer: D

Rationale: Food exchange lists from the American Diabetes Association are a valuable resource for meal planning in diabetes. These lists provide guidelines for portion control and help individuals make healthier food choices. Personal blogs may not always provide accurate and evidence-based information. Food label recommendations are important but may not specifically address meal planning for diabetes. Diabetes medication information is essential but not the primary focus when educating about dietary management for type 2 diabetes.

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