Nursing Elites

1. A healthcare professional is reviewing the medical record of a client who has a new prescription for enoxaparin. Which of the following findings should the healthcare professional report to the provider?

• A. Platelet count 150,000/mm³
• B. aPTT 30 seconds
• C. Sodium 140 mEq/L
• D. Serum creatinine 3.0 mg/dL

Correct answer: D

Rationale: An elevated serum creatinine level indicates impaired kidney function, which can affect the metabolism and excretion of enoxaparin, potentially leading to increased drug levels and risk of bleeding. Therefore, it is crucial to report a high serum creatinine level before administering enoxaparin. Platelet count, aPTT, and sodium levels are not directly related to the administration of enoxaparin and would not impact its use; hence, they do not need to be reported before starting the medication.

2. A nurse is providing teaching to a client who is at 28 weeks of gestation and is scheduled for a glucose tolerance test. Which of the following instructions should the nurse include?

• A. You should avoid consuming any food or drink for 8 hours before the test.
• B. You should drink 8 oz of water 1 hour before the test.
• C. You should take an antacid before the test.
• D. You should drink a glass of milk 1 hour before the test.

Correct answer: A

Rationale: Clients should avoid consuming any food or drink for 8 hours before the glucose tolerance test to ensure accurate results. Choice A is the correct instruction for the client preparing for a glucose tolerance test. Drinking water, taking an antacid, or consuming milk before the test can interfere with the accuracy of the results. Water or any other substance might affect the concentration of glucose in the blood, leading to inaccurate test results. Antacids and milk can also interfere with the test outcome. Therefore, the client should follow the instruction to fast for 8 hours before the test.

3. A nurse is planning care for a client who has a new diagnosis of deep vein thrombosis (DVT). Which of the following interventions should the nurse include?

• A. Massage the affected extremity every 4 hours.
• B. Encourage the client to remain on bed rest.
• C. Apply cold packs to the affected extremity.
• D. Encourage the client to ambulate frequently.

Correct answer: C

Rationale: The correct intervention for a client with deep vein thrombosis (DVT) is to apply cold packs to the affected extremity. Cold packs help reduce swelling and pain by causing vasoconstriction. Massaging the affected extremity could dislodge a clot, leading to serious complications. Encouraging bed rest may increase the risk of clot propagation, while frequent ambulation is contraindicated as it can dislodge clots.

4. Which lab value is critical to monitor in patients receiving warfarin therapy?

• A. Monitor INR
• B. Monitor potassium levels
• C. Monitor platelet count
• D. Monitor sodium levels

Correct answer: A

Rationale: The correct answer is A: Monitor INR. INR (International Normalized Ratio) is crucial to monitor in patients receiving warfarin therapy. INR measures the blood's ability to clot and is used to ensure that patients are within the therapeutic range for warfarin therapy. This is important to prevent both clotting disorders and bleeding complications. Monitoring potassium levels (choice B) is not directly related to warfarin therapy. Platelet count (choice C) and sodium levels (choice D) are important parameters but are not as critical to monitor specifically for patients on warfarin therapy.

5. A nurse is caring for a client who has a prescription for spironolactone. Which of the following foods should the nurse recommend?

• A. Chicken breast
• B. Pasta
• C. Spinach
• D. Yogurt

Correct answer: A

Rationale: Correct Answer: Chicken breast. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium. Foods high in potassium, like spinach and yogurt, should be avoided when taking spironolactone to prevent hyperkalemia. Chicken breast, being a low-potassium protein source, is a suitable recommendation for clients on spironolactone therapy.

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