Nursing Elites

1. The client is on nitroglycerin patches. What should the nurse include in the client’s education?

• A. Rotate the application site with each new patch.
• B. Apply the patch at the same time each day.
• C. Leave the patch on for 24 hours, then remove it for 12 hours before applying a new one.
• D. Apply the patch to the same site each time.

Correct answer: A

Rationale: The correct answer is A: 'Rotate the application site with each new patch.' When educating a client using nitroglycerin patches, it is essential to rotate the application site to prevent skin irritation. Choice B is incorrect because applying the patch at the same time each day is not a critical aspect of patch application. Choice C is incorrect as nitroglycerin patches are usually left on for a specific period, typically 12 to 14 hours, before being replaced. Choice D is incorrect because applying the patch to the same site each time can lead to skin irritation and tolerance development.

2. The nurse is caring for a client on amiodarone who develops a cough. What is the most appropriate action?

• A. Notify the healthcare provider immediately.
• B. Reassure the client that this is a common side effect.
• C. Continue the amiodarone and monitor the client’s symptoms.
• D. Discontinue the amiodarone immediately.

Correct answer: A

Rationale: The correct action when a client on amiodarone develops a cough, which can be a sign of pulmonary toxicity, a serious side effect of amiodarone, is to notify the healthcare provider immediately. This is crucial because pulmonary toxicity can lead to severe complications if not addressed promptly. Choices B and C are incorrect as they do not address the potential severity of the situation and may delay necessary intervention. Choice D of discontinuing amiodarone immediately without consulting the healthcare provider can be risky, as sudden discontinuation of the medication may have adverse effects on the client's condition.

3. What is a condition where the airways become swollen and produce extra mucus, making it difficult to breathe, often associated with COPD?

• A. Chronic bronchitis
• B. Pneumonia
• C. Emphysema
• D. Tuberculosis

Correct answer: A

Rationale: Chronic bronchitis is the correct answer. It is a long-term inflammation of the bronchi, leading to persistent cough and mucus production, commonly associated with chronic obstructive pulmonary disease (COPD). Pneumonia (Choice B) is an infection that inflames the air sacs in one or both lungs. Emphysema (Choice C) is a lung condition where the air sacs in the lungs are damaged, making it difficult to breathe. Tuberculosis (Choice D) is a bacterial infection that primarily affects the lungs.

4. What is a condition characterized by the presence of air or gas in the pleural space, leading to the collapse of the lung?

• A. Pneumothorax
• B. Pulmonary embolism
• C. Pleural effusion
• D. Atelectasis

Correct answer: A

Rationale: The correct answer is Pneumothorax. Pneumothorax occurs when air or gas accumulates in the pleural space, causing the lung to collapse. This condition can result in symptoms such as chest pain and difficulty breathing. Pulmonary embolism (choice B) is a blockage in one of the pulmonary arteries in the lungs, usually caused by a blood clot. Pleural effusion (choice C) is the accumulation of excess fluid in the pleural space, not air or gas. Atelectasis (choice D) refers to the collapse or closure of a lung resulting in reduced or absent gas exchange.

5. The healthcare provider is preparing to administer heparin to a client. What lab value should be monitored?

• A. PT/INR
• B. aPTT
• C. Platelet count
• D. Hemoglobin

Correct answer: B

Rationale: The correct lab value that should be monitored when administering heparin is the aPTT (activated partial thromboplastin time). Heparin affects the intrinsic pathway of the coagulation cascade, and aPTT is a sensitive measure to assess the effectiveness of heparin therapy. Monitoring aPTT helps in adjusting the heparin dose to maintain the desired anticoagulant effect. PT/INR is more specific to monitor warfarin therapy, not heparin. Platelet count and hemoglobin levels are important parameters to assess bleeding tendencies and oxygen-carrying capacity but are not directly related to monitoring heparin therapy.

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