Nursing Elites

1. A healthcare professional is reviewing the laboratory results of a client taking Warfarin for atrial fibrillation. Which of the following findings should the professional report to the provider immediately?

• A. INR of 4.0
• B. Potassium level of 4.5 mEq/L
• C. Creatinine level of 1.0 mg/dL
• D. BUN of 18 mg/dL

Correct answer: A

Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications. The other laboratory values are within normal limits and do not pose an immediate risk to the client's health while on Warfarin therapy.

2. When educating a client who has a prescription for Levothyroxine, which instruction should the nurse include?

• A. Take this medication on an empty stomach.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct instruction for taking Levothyroxine is on an empty stomach. This helps to enhance the absorption and effectiveness of the medication. Consuming it with food or antacids can impede its absorption, leading to decreased efficacy.

3. A client has a new prescription for Verapamil to control hypertension. Which of the following instructions should the nurse include?

• A. Increase the amount of dietary fiber in the diet.
• B. Drink grapefruit juice daily to increase vitamin C intake.
• C. Decrease the amount of calcium in the diet.
• D. Withhold food for 1 hr after taking the medication.

Correct answer: A

Rationale: Increasing dietary fiber intake is essential when taking Verapamil to prevent constipation, a common adverse effect of this medication. Verapamil is a calcium channel blocker used to treat hypertension, and dietary fiber helps maintain bowel regularity and prevent constipation that may occur as a side effect of the medication.

4. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: Regular insulin typically exhibits a peak effect approximately 1 to 5 hours after administration. It is important for clients to be aware of this timing to ensure optimal management of their blood glucose levels. Insulin glargine, NPH insulin, and Insulin lispro have different onset and peak times compared to Regular insulin. Insulin glargine has a slow, steady release with no pronounced peak, NPH insulin peaks around 4 to 12 hours after administration, and Insulin lispro has a rapid onset and a peak effect around 0.5 to 2.5 hours after administration. Therefore, Regular insulin is the correct choice for a peak effect within the specified time frame.

5. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.

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