Nursing Elites

1. A patient with coronary artery disease (CAD) is prescribed a statin medication. What should the nurse include in the patient education?

• A. Take the medication with food.
• B. Report any muscle pain or weakness.
• C. Increase intake of grapefruit juice.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: Patients prescribed statin medications should be educated to report any muscle pain or weakness to their healthcare provider promptly. Muscle pain or weakness could be a sign of rhabdomyolysis, a serious side effect associated with statin use that requires medical attention. Choices A, C, and D are incorrect. Taking statins with food or increasing grapefruit juice intake are not necessary recommendations. Avoiding foods high in potassium is also not directly related to statin use.

2. A 45-year-old obese man arrives at a clinic reporting daytime sleepiness, difficulty falling asleep at night, and snoring. The nurse should recognize the manifestations of what health problem?

• A. Adenoiditis
• B. Chronic tonsillitis
• C. Obstructive sleep apnea
• D. Laryngeal cancer

Correct answer: C

Rationale: The symptoms described, including daytime sleepiness, difficulty falling asleep at night, and snoring, are classic signs of obstructive sleep apnea. This condition is commonly seen in obese individuals due to the relaxation of throat muscles during sleep, leading to airway obstruction. Adenoiditis and chronic tonsillitis are less likely as they don't typically present with the same symptoms mentioned.

3. The healthcare provider is planning care for a non-potty-trained child with nephrotic syndrome. Which intervention provides the best means of determining fluid retention?

• A. Weigh the child daily.
• B. Observe the lower extremities for pitting edema.
• C. Measure the child's abdominal girth weekly.
• D. Weigh the child's wet diapers.

Correct answer: A

Rationale: Daily weighing is the most accurate method to monitor fluid retention in a child with nephrotic syndrome. Changes in weight can indicate fluid retention or loss, which is crucial in managing nephrotic syndrome. Observing for pitting edema and measuring abdominal girth are also important assessments, but daily weighing provides more immediate and precise information about fluid status.

4. The preceptor is orienting a new graduate nurse to the critical care unit. The preceptor asks the new graduate to state symptoms that most likely indicate the beginning of a shock state in a critically ill client. What findings should the new graduate nurse identify?

• A. Warm skin, hypertension, and constricted pupils.
• B. Bradycardia, hypotension, and respiratory acidosis.
• C. Mottled skin, tachypnea, and hyperactive bowel sounds.
• D. Tachycardia, mental status change, and low urine output.

Correct answer: D

Rationale: Tachycardia, mental status change, and low urine output are early indicators of shock. In a critically ill client, these findings suggest a decrease in tissue perfusion. Prompt recognition and intervention are crucial to prevent the progression of shock and its complications.

5. A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory test should the nurse monitor to determine the effectiveness of the medication?

• A. Platelet count.
• B. Prothrombin time (PT) and international normalized ratio (INR).
• C. Activated partial thromboplastin time (aPTT).
• D. Fibrinogen level.

Correct answer: B

Rationale: Prothrombin time (PT) and international normalized ratio (INR) are essential laboratory tests to monitor the effectiveness of warfarin (Coumadin) therapy. These tests help assess the clotting time and the desired anticoagulant effect of the medication. Monitoring PT and INR levels is crucial to ensure that the client is within the therapeutic range, reducing the risk of bleeding or clotting complications associated with warfarin therapy. Platelet count (Choice A) measures the number of platelets in the blood and is not specific for monitoring warfarin therapy. Activated partial thromboplastin time (aPTT) (Choice C) is more commonly used to monitor heparin therapy, not warfarin. Fibrinogen level (Choice D) assesses the amount of fibrinogen in the blood and is not a specific test for monitoring warfarin therapy.

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