Nursing Elites

1. What is the therapeutic class of Valproate?

• A. Anticoagulant
• B. Antianxiety, benzodiazepines
• C. Anticonvulsant, vascular headache suppressant
• D. Mood stabilizer

Correct answer: C

Rationale: Valproate belongs to the therapeutic class of anticonvulsants. It is primarily used to manage seizures but is also effective in treating vascular headaches. Therefore, it is not classified as an anticoagulant, antianxiety medication, or mood stabilizer. Option A, anticoagulant, is incorrect as valproate does not have anticoagulant properties. Option B, antianxiety benzodiazepines, is incorrect as valproate is not primarily used to treat anxiety disorders with benzodiazepines. Option D, mood stabilizer, is incorrect as valproate is not classified as a mood stabilizer, although it can be used in some cases for mood disorders, its primary therapeutic class is anticonvulsant.

2. A client with congestive heart failure taking digoxin refused breakfast and is complaining of nausea and weakness. Which action should the nurse take first?

• A. Check the client's vital signs.
• B. Request a consult with a dietitian.
• C. Suggest that the client rests before eating the meal.
• D. Request an order for an antiemetic.

Correct answer: A

Rationale: The nurse should check the client's vital signs first because nausea and weakness can be signs of digoxin toxicity. Vital signs can provide immediate information on the client's condition and help guide further interventions. Monitoring vital signs will allow the nurse to assess for bradycardia, a common sign of digoxin toxicity. Requesting a dietitian consult (choice B) may be necessary but addressing the immediate concern of toxicity is the priority. Suggesting rest before eating (choice C) may not address the underlying issue of digoxin toxicity. Requesting an antiemetic (choice D) can be considered later but is not the initial action needed in this situation.

3. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following dietary instructions should the nurse include?

• A. Increase your intake of leafy green vegetables.
• B. Avoid foods high in vitamin K.
• C. Increase your intake of dairy products.
• D. Avoid foods high in iron.

Correct answer: B

Rationale: The correct answer is B: 'Avoid foods high in vitamin K.' Vitamin K can interfere with the effectiveness of Warfarin, an anticoagulant medication. Foods high in vitamin K, such as leafy green vegetables, can reduce the medication's anticoagulant effect. Therefore, clients taking Warfarin should be advised to avoid or consume a consistent amount of foods high in vitamin K to maintain the medication's effectiveness. Choices A, C, and D are incorrect because increasing leafy green vegetables, dairy products, or avoiding foods high in iron are not directly related to the interaction with Warfarin.

4. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?

• A. Clopidogrel (Plavix)
• B. Morphine
• C. Aspirin (ASA)
• D. Metoprolol (Lopressor)

Correct answer: A

Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.

5. At what amount does Acetaminophen stop effectively controlling pain?

• A. Over 1,000 mg
• B. 750 mg
• C. Over 1,500 mg
• D. 150 mg

Correct answer: A

Rationale: Acetaminophen is known to lose its effectiveness in controlling pain beyond a dosage of 1,000 mg. Taking more than 1,000 mg will not provide additional pain relief but can increase the risk of adverse effects. Choice B (750 mg) is incorrect because this amount is within the typical recommended dose range for Acetaminophen. Choice C (Over 1,500 mg) is incorrect as it suggests a higher dose than the point at which Acetaminophen starts to lose its effectiveness. Choice D (150 mg) is too low a dose to effectively control pain for most adults.

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