Nursing Elites

1. What is the primary action of warfarin as an anticoagulant?

• A. Prevents the formation of blood clots
• B. Dissolves existing blood clots
• C. Dilates coronary arteries
• D. Treats rhythm disturbances

Correct answer: A

Rationale: The correct answer is A: "Prevents the formation of blood clots." Warfarin acts as an anticoagulant by inhibiting the synthesis of certain clotting factors in the liver. This action reduces the blood's ability to clot, making it effective in preventing the formation of blood clots. Choice B is incorrect because warfarin does not dissolve existing blood clots; it prevents their formation. Choice C is incorrect because warfarin's primary action is not to dilate coronary arteries. Choice D is incorrect as warfarin is not used to treat rhythm disturbances, but rather to prevent clot formation.

2. A healthcare professional in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings is indicative of this condition?

• A. Insidious onset of painless loss of vision
• B. Gradual reduction in peripheral vision
• C. Severe pain around the eyes
• D. Intraocular pressure 12 mm Hg

Correct answer: C

Rationale: Severe pain around the eyes that radiates over the face is a classic symptom of acute angle-closure glaucoma. This intense pain is often associated with other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. Immediate medical attention is required to prevent permanent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more indicative of conditions like macular degeneration. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12 mm Hg is within the normal range and is not typical of angle-closure glaucoma.

3. A client's serum Calcium is 8.8 mg/dL. Which of the following medications should the nurse anticipate administering to this client?

• A. Calcitonin-salmon
• B. Calcium carbonate
• C. Zoledronic acid
• D. Ibandronate

Correct answer: B

Rationale: The client's serum calcium level is below the expected reference range. In this case, the appropriate medication to anticipate administering is Calcium carbonate, an oral form of calcium used to increase serum calcium levels to the expected reference range.

4. A client has a new prescription for Efavirenz, an NNRTI. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime to prevent drowsiness.
• B. Take this medication with a glass of milk.
• C. Take this medication with a glass of juice.
• D. Take this medication at the same time every day.

Correct answer: A

Rationale: The correct instruction is to take Efavirenz at bedtime to prevent drowsiness and manage central nervous system side effects like dizziness and vivid dreams. While it is important to take the medication at the same time daily for consistent blood levels, the emphasis should be on bedtime to minimize the impact of these side effects. Choices B and C suggesting taking the medication with milk or juice are incorrect and not relevant to optimizing Efavirenz therapy.

5. The client with angina is being discharged to home. The nurse is instructing the client on dietary changes. What should be included in this teaching?

• A. Decrease salt and fat intake and limit alcohol intake.
• B. There are no dietary restrictions for a person diagnosed with angina.
• C. Limit smoking and increase protein and sugar intake.
• D. Increase fruits, vegetables, and foods high in cholesterol.

Correct answer: A

Rationale: The correct answer is to decrease salt and fat intake and limit alcohol intake. These dietary changes can help manage angina by reducing the workload on the heart and preventing further plaque buildup in the arteries. Choices B, C, and D are incorrect as dietary restrictions for angina typically involve reducing salt, fat, and alcohol intake, rather than increasing sugar or cholesterol intake.

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