Nursing Elites

1. What is a severe adverse effect of warfarin?

• A. Bleeding
• B. Arrhythmias
• C. Blurred vision
• D. Bradycardia

Correct answer: A

Rationale: A severe adverse effect of warfarin is bleeding. Warfarin is an anticoagulant medication that works by inhibiting blood clotting factors, which can lead to an increased risk of bleeding. Excessive bleeding can occur internally or externally, and it is crucial for individuals taking warfarin to be aware of this potential complication and seek medical attention if they experience any signs of bleeding. Arrhythmias, blurred vision, and bradycardia are not typically associated with warfarin use, making them incorrect choices.

2. A client is receiving long-term aspirin therapy. The healthcare provider should monitor the client for which of the following complications?

• A. Hemorrhagic stroke
• B. Thromboembolic stroke
• C. Iron deficiency anemia
• D. Neutropenia

Correct answer: A

Rationale: The correct answer is A: Hemorrhagic stroke. Long-term aspirin therapy can lead to hemorrhagic stroke due to its antiplatelet effects, which increase the risk of bleeding. Aspirin inhibits platelet aggregation, which can predispose the individual to bleeding complications, including hemorrhagic stroke. Choices B, C, and D are incorrect because aspirin therapy is more likely to cause bleeding complications rather than thromboembolic events, iron deficiency anemia, or neutropenia.

3. A client has a new prescription for Warfarin. Which of the following statements by the client indicates a need for further teaching?

• A. I will avoid eating large amounts of green leafy vegetables.
• B. I will take my medication at the same time every day.
• C. I will increase my intake of foods high in potassium.
• D. I will report any signs of bleeding to my provider.

Correct answer: C

Rationale: The correct answer is C because Warfarin interacts with vitamin K, not potassium. Therefore, the client needs to be cautious with foods high in vitamin K, such as green leafy vegetables, rather than foods high in potassium. Choices A, B, and D are correct statements regarding Warfarin therapy and do not indicate a need for further teaching.

4. When administering subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty, what action should the nurse plan to take?

• A. Expel any air bubbles from the prefilled syringe before injecting.
• B. Insert the needle completely into the client's tissue.
• C. Administer the injection in the client's thigh.
• D. Aspirate carefully after inserting the needle into the client's skin.

Correct answer: B

Rationale: When administering enoxaparin via a prefilled syringe for deep subcutaneous injection, the nurse should insert the needle completely into the client's tissue. This action ensures proper delivery of the medication into the subcutaneous layer, promoting optimal therapeutic effects. Choice A is incorrect because there is no need to expel air bubbles from a prefilled syringe. Choice C is incorrect as enoxaparin is typically administered in the abdomen for subcutaneous injections. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or damage to tissues.

5. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?

• A. 22 gtt/min
• B. 24 gtt/min
• C. 20 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To calculate the flow rate, use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Thus, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect because it miscalculates the flow rate. Choices C and D, 20 gtt/min and 18 gtt/min, are also incorrect as they do not accurately calculate the flow rate based on the given information.

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