Nursing Elites

1. A client is prescribed clopidogrel. What laboratory result should be monitored by the nurse?

• A. White blood cell count
• B. Creatinine
• C. Blood glucose
• D. Platelet count

Correct answer: D

Rationale: When a client is prescribed clopidogrel, monitoring the platelet count is essential. Clopidogrel is an antiplatelet medication that works by preventing blood clots. Monitoring the platelet count is crucial in assessing the risk of thrombocytopenia, a potential side effect of clopidogrel. Monitoring white blood cell count, creatinine, or blood glucose is not directly related to the action or side effects of clopidogrel, making choices A, B, and C incorrect.

2. A client with a history of angina is scheduled for an exercise electrocardiography (ECG) test. The nurse should explain that the purpose of this test is to evaluate which factor?

• A. The heart's response to physical stress
• B. The client's overall physical fitness
• C. The presence of electrolyte imbalances
• D. The effectiveness of anti-anginal medications

Correct answer: A

Rationale: An exercise electrocardiography (ECG) test is used to evaluate the heart's response to physical stress. During the test, the heart's electrical activity is monitored while the client exercises, helping to identify any areas of ischemia or abnormal rhythms. This test helps healthcare providers assess the heart's function and detect any potential issues related to angina or other cardiac conditions. Choice B, the client's overall physical fitness, is incorrect because the test primarily focuses on the heart's response to stress rather than the client's general physical fitness. Choice C, the presence of electrolyte imbalances, is incorrect as this test is not specifically designed to evaluate electrolyte levels. Choice D, the effectiveness of anti-anginal medications, is incorrect as the main purpose of the test is to assess the heart's response to physical stress, not medication effectiveness.

3. An ambulatory clinic nurse is interviewing a client who is complaining of flu-like symptoms. The client suddenly develops chest pain. Which question best assists the nurse in discriminating pain caused by a non-cardiac problem?

• A. Can you describe the pain to me?
• B. Have you ever experienced this pain before?
• C. Does the pain get worse when you breathe in?
• D. Can you rate the pain on a scale of 1 to 10, with 10 being the worst?

Correct answer: C

Rationale: The correct answer is C. Pain that worsens with breathing in can indicate pleuritic chest pain, which is non-cardiac in nature. This specific question helps in differentiating non-cardiac causes from cardiac causes of chest pain, as cardiac pain typically does not worsen with breathing. Choices A, B, and D are less specific in discriminating between cardiac and non-cardiac chest pain.

4. A client has a new prescription for heparin. Which of the following laboratory results should be monitored to evaluate the effectiveness of the medication?

• A. Prothrombin time (PT)
• B. International normalized ratio (INR)
• C. Activated partial thromboplastin time (aPTT)
• D. Platelet count

Correct answer: C

Rationale: Activated partial thromboplastin time (aPTT) is the laboratory result that should be monitored to evaluate the effectiveness of heparin. Heparin works by prolonging the aPTT, and monitoring this parameter helps ensure the medication's effectiveness and safety in preventing clot formation. Prothrombin time (PT) and International normalized ratio (INR) are used to monitor the effectiveness of warfarin, another anticoagulant. Platelet count is essential to assess platelet function and clotting disorders, but it is not specifically used to monitor heparin therapy.

5. A client with a diagnosis of deep vein thrombosis (DVT) has been placed on bed rest. The LPN/LVN should reinforce which instruction to the client to prevent complications?

• A. Perform ankle pumps and circles every 1 to 2 hours.
• B. Use a heating pad to relieve pain in the affected leg.
• C. Keep the affected leg flat and avoid elevation.
• D. Wear tight compression stockings to prevent swelling.

Correct answer: A

Rationale: Performing ankle pumps and circles every 1 to 2 hours is crucial for a client with DVT on bed rest. These exercises promote venous return, preventing stasis and reducing the risk of complications such as pulmonary embolism. Ankle pumps help activate the calf muscle pump, assisting in propelling blood back to the heart and preventing blood clots from forming or worsening. Choice B is incorrect because using a heating pad can increase blood flow to the area, potentially dislodging a clot. Choice C is incorrect because elevation helps reduce swelling and improve venous return. Choice D is incorrect because although compression stockings can be beneficial, they are not the most important instruction for preventing complications in this scenario.

Similar Questions