Nursing Elites

1. A client with HIV is beginning therapy with zidovudine. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Fatigue
• B. Blurred vision
• C. Ringing in the ears
• D. Constipation

Correct answer: A

Rationale: Fatigue is a common adverse effect of zidovudine due to its impact on bone marrow, leading to anemia. Zidovudine is known to suppress bone marrow function, resulting in decreased production of red blood cells and subsequently causing fatigue due to anemia. Monitoring for fatigue is essential to ensure early detection and management of this adverse effect.

2. A healthcare professional is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. How many mL should the healthcare professional administer per dose?

• A. 0.8 mL
• B. 0.75 mL
• C. 0.5 mL
• D. 1 mL

Correct answer: A

Rationale: To calculate the volume to administer, use the formula: (Desired dose / Concentration) = Volume to administer. In this case, (15,000 units / 20,000 units/mL) = 0.75 mL, which is rounded up to 0.8 mL. Therefore, the healthcare professional should administer 0.8 mL per dose of heparin. Choice B (0.75 mL) is incorrect as it is the exact calculated volume but needs to be rounded up. Choices C (0.5 mL) and D (1 mL) are incorrect as they do not reflect the correct calculated volume for the desired dose of heparin.

3. A healthcare provider is reviewing the medical history of a client who is scheduled for surgery and takes Warfarin daily. Which of the following laboratory results should the healthcare provider monitor?

• A. Potassium level
• B. INR
• C. BUN
• D. Platelet count

Correct answer: B

Rationale: The INR (International Normalized Ratio) is the most important lab value to monitor in a client taking warfarin. Warfarin is an anticoagulant, and the INR reflects the effectiveness of anticoagulation therapy. Monitoring the INR helps ensure the client is within the therapeutic range to prevent both clotting and bleeding complications.

4. A client has a new prescription for Warfarin. Which of the following instructions should the nurse include?

• A. Monitor for signs of bleeding.
• B. Avoid foods high in vitamin K.
• C. Expect to have increased urination.
• D. Take the medication with an antacid.

Correct answer: A

Rationale: The correct instruction for a client starting Warfarin is to monitor for signs of bleeding. Warfarin is an anticoagulant that increases the risk of bleeding; therefore, it is crucial for the client to watch for any signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stools, or unusual bleeding from gums or nose. If any of these signs occur, the client should promptly report them to their healthcare provider for further evaluation and management. Choices B, C, and D are incorrect because avoiding foods high in vitamin K is related to other medications like Coumadin, increased urination is not a common side effect of Warfarin, and taking Warfarin with an antacid can potentially interfere with its absorption.

5. Why is it important to monitor ins and outs in patients using ACE inhibitors?

• A. To assess for renal impairment
• B. To ensure the patient is receiving adequate fluid intake
• C. To assess the patient for potential heart failure
• D. To assess for NSAID use

Correct answer: A

Rationale: It is crucial to monitor ins and outs in patients using ACE inhibitors to assess for renal impairment. ACE inhibitors can affect renal function, potentially leading to renal impairment. Monitoring the patient's fluid balance helps in early recognition of any renal issues and allows for timely interventions to prevent complications.

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