Nursing Elites

1. The client is being taught about the use of warfarin. What is the most important dietary instruction?

• A. Avoid foods high in vitamin K.
• B. Increase the intake of vitamin K-rich foods.
• C. Avoid foods high in protein.
• D. Increase the intake of foods high in calcium.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is a medication that works by decreasing the activity of vitamin K in the body to prevent blood clotting. Therefore, consuming foods high in vitamin K like green leafy vegetables can interfere with the medication's effectiveness. Choices B, C, and D are incorrect. Increasing the intake of vitamin K-rich foods would counteract the effects of warfarin. Avoiding foods high in protein or increasing the intake of foods high in calcium are not specifically related to the use of warfarin.

2. The client on clopidogrel (Plavix) should be monitored for which adverse effect?

• A. Bleeding
• B. Hypertension
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Correct! Clopidogrel (Plavix) is an antiplatelet medication that helps prevent blood clots. As a side effect, it can increase the risk of bleeding. Monitoring for signs of bleeding, such as easy bruising, blood in urine or stools, or prolonged bleeding from cuts, is crucial. Choices B, C, and D are incorrect as hypertension, tachycardia, and bradycardia are not typically associated with clopidogrel use.

3. What is a surgical procedure to create an opening in the windpipe to assist with breathing?

• A. Tracheostomy
• B. Lobectomy
• C. Thoracotomy
• D. Pleurodesis

Correct answer: A

Rationale: Tracheostomy is the correct answer. It is a surgical procedure to create an opening in the windpipe (trachea) to assist with breathing. This procedure is commonly used for patients who require long-term ventilation support. Choice B, Lobectomy, involves the removal of a lobe of the lung and is not related to creating an opening in the windpipe. Choice C, Thoracotomy, is a surgical incision into the chest wall and is not specifically related to creating an opening in the windpipe. Choice D, Pleurodesis, is a procedure to treat recurrent pleural effusions by causing the pleural layers to stick together, and it is not related to creating an opening in the windpipe.

4. What procedure involves inserting a needle into the pleural space to remove excess fluid and help the patient breathe more easily?

• A. Thoracentesis
• B. Bronchoscopy
• C. Spirometry
• D. Arterial blood gas (ABG)

Correct answer: A

Rationale: Thoracentesis is the correct answer. It is a procedure where a needle is inserted into the pleural space to remove excess fluid, aiding in easier breathing. Bronchoscopy (Choice B) is a procedure to visualize the airways and diagnose lung problems, not specifically for fluid drainage. Spirometry (Choice C) is a test to measure lung function, not a procedure for fluid removal. Arterial blood gas (ABG) (Choice D) is a blood test to assess oxygen and carbon dioxide levels in the blood, not a procedure for draining fluid from the pleural space.

5. What procedure is used to remove fluid from the pleural space to help a patient breathe more easily?

• A. Thoracentesis
• B. Bronchoscopy
• C. Echocardiogram
• D. CT scan

Correct answer: A

Rationale: Thoracentesis is the correct answer. It is a procedure where a needle is inserted into the pleural space to drain fluid, relieving pressure and helping the patient breathe more easily. Bronchoscopy (choice B) is a procedure used to examine the airways, not to drain fluid. An echocardiogram (choice C) is an imaging test to assess the heart's structure and function, not related to draining pleural fluid. A CT scan (choice D) is a cross-sectional imaging test that provides detailed pictures of the inside of the body, not used for draining pleural fluid.

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