Nursing Elites

1. A patient with atrial fibrillation is prescribed warfarin. Which laboratory test should the nurse monitor to assess the effectiveness of the medication?

• A. Complete blood count (CBC)
• B. Prothrombin time (PT)/INR
• C. Partial thromboplastin time (PTT)
• D. Serum potassium level

Correct answer: B

Rationale: The correct answer is B: Prothrombin time (PT)/INR. Warfarin affects the clotting ability of the blood by inhibiting vitamin K-dependent clotting factors. Monitoring the prothrombin time (PT) and international normalized ratio (INR) is crucial to assess the effectiveness and safety of warfarin therapy. These tests help determine if the patient is within the desired anticoagulation range to prevent either clotting issues or excessive bleeding.

2. A patient with rheumatoid arthritis is prescribed methotrexate. What should the nurse include in the patient teaching?

• A. Take folic acid supplements as prescribed.
• B. Avoid alcohol completely.
• C. Expect to see immediate results.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: Patients prescribed methotrexate should be advised to take folic acid supplements as prescribed. Methotrexate can deplete folic acid levels, leading to side effects. By taking folic acid supplements as directed, the patient can reduce the risk of experiencing adverse effects associated with methotrexate therapy. It is important to note that the effects of methotrexate may not be immediate, so realistic expectations should be set with the patient. Alcohol should be avoided while taking methotrexate due to potential interactions and increased risk of liver toxicity. There is no specific recommendation to limit fluid intake to 1 liter per day in relation to methotrexate therapy.

3. What instruction should be provided to a client with a history of myocardial infarction (MI) who is prescribed nitroglycerin?

• A. Take nitroglycerin with food to avoid stomach upset.
• B. Store nitroglycerin tablets in a dark, glass container.
• C. Swallow nitroglycerin tablets whole without chewing.
• D. Discontinue the medication if a headache occurs.

Correct answer: B

Rationale: Nitroglycerin is a medication that should be stored in a dark, glass container to protect it from light and moisture. Exposure to light and moisture can reduce its effectiveness. Storing it in a dark, glass container helps maintain the medication's stability and potency, ensuring that it remains safe and effective for use in emergencies, such as angina attacks.

4. What is an important teaching point for a patient prescribed dabigatran for atrial fibrillation?

• A. Take the medication with food to enhance absorption.
• B. Do not crush or chew the capsules.
• C. Increase intake of green leafy vegetables.
• D. Avoid all dairy products.

Correct answer: B

Rationale: The correct teaching point for a patient prescribed dabigatran is not to crush or chew the capsules. Doing so can alter the absorption of the medication, increasing the risk of bleeding. It is important for patients to swallow the capsules whole to ensure proper delivery of the medication.

5. A healthcare professional is educating a group of recent nursing graduates about their risks for contracting hepatitis B. What preventative measure should the professional promote?

• A. Immunization
• B. Chronic tonsillitis
• C. Consumption of a vitamin-rich diet
• D. Annual vitamin K injections

Correct answer: A

Rationale: The correct preventative measure to promote for preventing hepatitis B infection is immunization. Healthcare workers, including nurses, are at risk of exposure to hepatitis B, and vaccination is crucial in preventing infection. Immunization, along with adherence to standard precautions such as using personal protective equipment, proper hand hygiene, and safe needle practices, plays a vital role in protecting healthcare workers from contracting hepatitis B.

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