Nursing Elites

1. The nurse is caring for a client with atrial fibrillation on dabigatran (Pradaxa). What is the most important instruction to give to the client?

• A. Take the medication with food to prevent stomach upset.
• B. Do not miss a dose and take it at the same time each day.
• C. Avoid consuming alcohol while on this medication.
• D. Monitor for signs of bleeding.

Correct answer: B

Rationale: The most important instruction to give to a client on dabigatran (Pradaxa) is not to miss a dose and take it at the same time each day. This is crucial for maintaining the anticoagulant effect of the medication. Choice A is not necessary as dabigatran does not need to be taken with food. Choice C is important but not as crucial as ensuring proper dosing. Choice D is also important but falls behind in priority compared to maintaining consistent dosing.

2. What procedure involves using a balloon to open a narrowed or blocked blood vessel, often followed by the placement of a stent?

• A. Angioplasty
• B. Valve replacement
• C. Coronary artery bypass graft (CABG)
• D. Endarterectomy

Correct answer: A

Rationale: The correct answer is A, Angioplasty. Angioplasty is a procedure that uses a balloon to open a narrowed or blocked blood vessel, often followed by the placement of a stent to maintain vessel patency. Choice B, Valve replacement, involves replacing damaged heart valves, not treating narrowed blood vessels. Choice C, Coronary artery bypass graft (CABG), is a procedure to bypass blocked coronary arteries, not directly open them using a balloon. Choice D, Endarterectomy, is a surgical procedure to remove plaque from the inner lining of an artery, not involving the use of a balloon and stent to open a vessel.

3. The nurse is administering enoxaparin (Lovenox) to a client. What is the most important lab value to monitor?

• A. Platelet count
• B. Hemoglobin
• C. White blood cell count
• D. aPTT

Correct answer: A

Rationale: The correct answer is A: Platelet count. When administering enoxaparin, it is crucial to monitor the platelet count because enoxaparin can lead to a rare but serious side effect known as thrombocytopenia, which is a decrease in platelet levels. Monitoring the platelet count helps in detecting this adverse effect early. Choices B, C, and D are incorrect because hemoglobin, white blood cell count, and aPTT are not the most important lab values to monitor specifically for enoxaparin administration.

4. What is a condition where the airways become inflamed and narrow, making breathing difficult?

• A. Asthma
• B. Bronchitis
• C. Pleurisy
• D. Tuberculosis

Correct answer: A

Rationale: Asthma is the correct answer. It is a condition characterized by inflammation, narrowing, and swelling of the airways, leading to symptoms like wheezing, shortness of breath, and coughing. Bronchitis is the inflammation of the bronchial tubes; Pleurisy is inflammation of the tissues that line the lungs and chest cavity; Tuberculosis is a bacterial infection that mainly affects the lungs.

5. What is a type of pneumonia that is contracted by inhaling contaminated water droplets?

• A. Legionnaires' disease
• B. Tuberculosis
• C. Asbestosis
• D. Histoplasmosis

Correct answer: A

Rationale: The correct answer is Legionnaires' disease. Legionnaires' disease is a severe form of pneumonia caused by inhaling water droplets contaminated with Legionella bacteria. This bacterium thrives in water systems such as air conditioning units, hot tubs, and water fountains. Choices B, C, and D are incorrect because Tuberculosis is caused by Mycobacterium tuberculosis, Asbestosis is caused by asbestos fibers, and Histoplasmosis is caused by a fungus found in bird and bat droppings.

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