Nursing Elites

1. A healthcare professional is reviewing the medication list of a client scheduled for surgery. Which of the following medications places the client at risk for increased bleeding during surgery?

• A. Warfarin
• B. Acetaminophen
• C. Ibuprofen
• D. Aspirin

Correct answer: D

Rationale: Aspirin is an anticoagulant that inhibits platelet function, increasing the risk of bleeding during surgery. It is important for the healthcare professional to identify this medication, inform the surgical team, and consider withholding it prior to surgery to reduce the risk of excessive bleeding. Warfarin is also an anticoagulant but can be managed by adjusting the dosage or monitoring INR levels. Acetaminophen and ibuprofen are not associated with increased bleeding risk as they do not affect platelet function like aspirin.

2. A client has a prescription for Heparin. Which of the following laboratory tests should be monitored while the client is receiving Heparin?

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

Correct answer: D

Rationale: Activated partial thromboplastin time (aPTT) is the correct laboratory test to monitor while a client is receiving Heparin. This test is used to assess the therapeutic levels of heparin in the blood, ensuring that the dose is within the safe and effective range. Monitoring aPTT helps healthcare providers adjust the dosage of Heparin to prevent complications such as bleeding or clotting.

3. A client has a new prescription for Metformin. Which of the following instructions should be included?

• A. Take this medication with food.
• B. Avoid eating foods high in potassium.
• C. Take this medication at bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: The correct instruction for taking Metformin is to take it with food. This helps reduce gastrointestinal side effects and ensures better absorption of the medication. Choice B is incorrect as there is no specific need to avoid foods high in potassium when taking Metformin. Choice C is incorrect because Metformin is usually taken with meals, not at bedtime. Choice D is incorrect as Metformin is typically taken daily, not every other day.

4. A client who has been taking prednisone to treat asthma is advised to discontinue the medication. The client should be instructed to reduce the dose gradually to prevent which of the following adverse effects?

• A. Hyperglycemia
• B. Adrenocortical insufficiency
• C. Severe dehydration
• D. Rebound pulmonary congestion

Correct answer: B

Rationale: Abruptly stopping prednisone can result in adrenocortical insufficiency due to suppression of the adrenal glands. Gradually tapering the dose helps the body adjust and resume its natural cortisol production, preventing adrenal insufficiency. Choice A, hyperglycemia, is a possible adverse effect of prednisone, but it is not the primary reason for gradual tapering. Severe dehydration (Choice C) and rebound pulmonary congestion (Choice D) are not typically associated with discontinuing prednisone.

5. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take the albuterol at the same time each day.
• B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
• C. Use beclomethasone if experiencing an acute episode.
• D. Avoid shaking the beclomethasone before use.

Correct answer: B

Rationale: When a client is prescribed an inhaled beta2-agonist, such as albuterol, and an inhaled glucocorticoid, such as beclomethasone, for asthma control, the beta2-agonist should be administered first. This sequence is important because the beta2-agonist promotes bronchodilation, which enhances the absorption and effectiveness of the glucocorticoid. Instructing the client to administer the albuterol inhaler before using the beclomethasone inhaler ensures optimal therapeutic benefit. Therefore, option B is the correct choice. Option A is incorrect because the timing of albuterol administration may vary based on the prescribed regimen. Option C is incorrect because beclomethasone is a controller medication, not a rescue medication, and should not be used during acute episodes. Option D is incorrect because beclomethasone should be shaken before use to ensure proper dispersion of the medication.

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