Nursing Elites

1. A client has been prescribed an anticoagulant for atrial fibrillation. Which of the following instructions should the nurse include?

• A. Take the medication with food to prevent nausea.
• B. Avoid activities that may cause injury.
• C. Monitor your heart rate daily before taking the medication.
• D. Avoid alcohol while taking this medication.

Correct answer: B

Rationale: The correct instruction for a client prescribed an anticoagulant for atrial fibrillation is to avoid activities that may cause injury. Anticoagulants increase the risk of bleeding, so it is important to prevent situations that could lead to injury or trauma. Choice A is incorrect because anticoagulants are not typically affected by food intake. Choice C is not necessary for all anticoagulant medications, and heart rate monitoring is more relevant for other conditions. Choice D is not directly related to the action of anticoagulants and is not a priority instruction for this medication.

2. A healthcare professional is preparing to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication over 5 minutes.
• B. Administer a dose of Naloxone prior to giving the Hydromorphone.
• C. Assess the client's blood pressure prior to administration.
• D. Inject the medication into the client's subcutaneous tissue.

Correct answer: A

Rationale: The healthcare professional should administer IV Hydromorphone slowly over 5 minutes to reduce the risk of hypotension and respiratory depression. Rapid administration can lead to adverse effects due to its potency. Choice B is incorrect because Naloxone is used as an antidote for opioid overdose, not routinely administered with Hydromorphone. Choice C is important but not specific to the administration of Hydromorphone. Choice D is incorrect as Hydromorphone is intended for intravenous use, not subcutaneous injection.

3. A client with increased liver enzymes is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?

• A. Glucosamine
• B. Saw palmetto
• C. Kava
• D. St. John's wort

Correct answer: C

Rationale: The nurse should report kava to the provider because chronic use or high doses of kava can lead to liver damage, including severe liver failure. It is crucial for the nurse to be vigilant about any herbal supplement that could potentially worsen the client's liver condition.

4. A client is receiving IV Dopamine for the treatment of shock. Which of the following findings indicates that the medication is effective?

• A. Increased heart rate
• B. Decreased blood pressure
• C. Increased urine output
• D. Decreased respiratory rate

Correct answer: C

Rationale: Dopamine is a medication used in shock to increase cardiac output and improve renal perfusion. An increase in urine output indicates that the medication is effective as it shows improved renal perfusion and kidney function, which are essential for managing shock effectively. Choices A, B, and D are incorrect as an increased heart rate, decreased blood pressure, and decreased respiratory rate are not direct indicators of the effectiveness of IV Dopamine in treating shock.

5. How do ACE inhibitors work?

• A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
• B. Block stimulation of beta 1 and beta 2 at the receptor sites
• C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
• D. None of the above

Correct answer: C

Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.

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