Nursing Elites

1. Following a stroke, a client has been started on clopidogrel (Plavix). Why is this medication being administered?

• A. To prevent stroke in high-risk patients, such as those with prosthetic heart valves
• B. To decrease blood pressure
• C. To increase heart rate
• D. To provide antiplatelet activity in patients who cannot tolerate aspirin

Correct answer: D

Rationale: Clopidogrel (Plavix) is an antiplatelet medication that inhibits platelet aggregation, reducing the risk of blood clots. It is commonly used in patients who have had a stroke and cannot tolerate aspirin due to allergies or intolerances. Choosing clopidogrel in these cases helps prevent further clot formation and reduces the risk of recurrent strokes.

2. A client is starting therapy with raloxifene. Which adverse effect should the client monitor for as instructed by the nurse?

• A. Leg cramps
• B. Hot flashes
• C. Urinary frequency
• D. Hair loss

Correct answer: B

Rationale: Hot flashes are a common adverse effect associated with raloxifene therapy. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent and treat osteoporosis in postmenopausal women. Hot flashes are a well-known side effect of SERMs due to their estrogen-like effects on the body. Leg cramps, urinary frequency, and hair loss are not typically associated with raloxifene therapy. Therefore, the nurse should instruct the client to monitor for hot flashes as part of the medication education.

3. A client is receiving treatment with etoposide. Which of the following findings should the nurse monitor?

• A. Hypotension
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypertension

Correct answer: A

Rationale: Etoposide, a chemotherapeutic agent, commonly causes hypotension as an adverse effect. It is crucial for the nurse to monitor the client for signs of hypotension, such as dizziness, lightheadedness, or a drop in blood pressure, to promptly intervene and prevent complications.

4. A client has a prescription for Nitroglycerin. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin involves taking one tablet at the onset of chest pain, then another tablet every 5 minutes for up to three doses. This protocol aims to relieve angina symptoms. Choice A is incorrect because waiting 15 minutes between doses may delay symptom relief. Choice C is incorrect as Nitroglycerin is not typically taken at bedtime but rather during angina episodes. Choice D is incorrect because Nitroglycerin is usually taken sublingually, so it doesn't need to be taken on an empty stomach.

5. A healthcare professional is reviewing the laboratory results of a client taking Warfarin for atrial fibrillation. Which of the following findings should the professional report to the provider immediately?

• A. INR of 4.0
• B. Potassium level of 4.5 mEq/L
• C. Creatinine level of 1.0 mg/dL
• D. BUN of 18 mg/dL

Correct answer: A

Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications. The other laboratory values are within normal limits and do not pose an immediate risk to the client's health while on Warfarin therapy.

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