Nursing Elites

1. Which of the following is a key symptom of myocardial infarction (MI)?

• A. Chest pain.
• B. Shortness of breath.
• C. Nausea.
• D. Fatigue.

Correct answer: A

Rationale: The correct answer is A: Chest pain. Chest pain is a hallmark symptom of myocardial infarction (MI) due to inadequate blood flow to the heart muscle. This pain can be severe, crushing, or squeezing, and may radiate to the left arm, jaw, or back. Shortness of breath (choice B), nausea (choice C), and fatigue (choice D) can accompany MI but are not as specific or characteristic as chest pain in diagnosing this condition. Therefore, chest pain is the primary symptom to recognize for suspected MI.

2. The healthcare professional is preparing to give a dose of trimethoprim-sulfamethoxazole (TMP-SMX) and learns that the patient takes warfarin (Coumadin). The healthcare professional will request an order for

• A. a decreased dose of TMP-SMX.
• B. a different antibiotic.
• C. an increased dose of warfarin.
• D. coagulation studies.

Correct answer: D

Rationale: Sulfonamides, like trimethoprim-sulfamethoxazole (TMP-SMX), can potentiate the anticoagulant effects of warfarin (Coumadin). To monitor the patient's response and prevent adverse effects, the healthcare professional should request coagulation studies, such as International Normalized Ratio (INR) levels. Choosing a decreased dose of TMP-SMX would not address the potential drug interaction between TMP-SMX and warfarin. Opting for a different antibiotic is not necessary if the interaction can be managed by monitoring. Increasing the dose of warfarin without monitoring could lead to excessive anticoagulation and adverse events, so it's not the appropriate action in this scenario.

3. What information will the nurse provide when counseling a patient starting a sulfonamide drug for a urinary tract infection?

• A. Drink several quarts of water daily.
• B. If stomach upset occurs, avoid taking antacids.
• C. Limit sun exposure to avoid skin reactions.
• D. Report any sore throat promptly.

Correct answer: A

Rationale: The correct answer is A: Drink several quarts of water daily. This advice aims to prevent crystalluria, a potential side effect of sulfonamide drugs. Option B is incorrect because antacids should not be taken with sulfonamides as they can decrease drug absorption. Option C is incorrect as sulfonamides can increase sensitivity to sunlight, not requiring sun exposure limitations but sun protection measures. Option D is incorrect because a sore throat could indicate a more serious adverse effect and should be promptly reported for evaluation.

4. The nurse is caring for a patient who develops marked edema and a low urine output as a result of heart failure. Which medication will the nurse expect the provider to order for this patient?

• A. Digoxin (Lanoxin)
• B. Furosemide (Lasix)
• C. Hydrochlorothiazide (HydroDIURIL)
• D. Spironolactone (Aldactone)

Correct answer: B

Rationale: In heart failure with marked edema and low urine output, the nurse can expect the provider to order Furosemide (Lasix). Furosemide is a loop diuretic that acts quickly to remove excess fluid from the body, making it an appropriate choice for this patient's condition. Digoxin is used to improve heart function but does not directly address fluid overload. Hydrochlorothiazide is a thiazide diuretic that is not as potent as Furosemide in managing acute fluid retention. Spironolactone is a potassium-sparing diuretic that is typically used in heart failure for its aldosterone-blocking effects and not for immediate fluid removal.

5. Which of the following lab values would be most concerning in a patient receiving heparin therapy?

• A. Elevated hemoglobin levels.
• B. Low platelet count.
• C. High potassium levels.
• D. Low sodium levels.

Correct answer: B

Rationale: A low platelet count is most concerning in patients receiving heparin therapy due to the risk of heparin-induced thrombocytopenia. Heparin can sometimes cause a drop in platelet count, leading to a potentially serious condition where blood does not clot as it should. This can result in excessive bleeding or clot formation in blood vessels. Elevated hemoglobin levels, high potassium levels, and low sodium levels are not typically associated with heparin therapy and are less likely to cause immediate concerns or complications in this context.

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