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. The nurse is caring for a client with heart failure who is receiving digoxin (Lanoxin). Which sign of digoxin toxicity should the nurse monitor for?

• A. Hypertension
• B. Bradycardia
• C. Hyperglycemia
• D. Insomnia

Correct answer: B

Rationale: Corrected Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin can cause bradycardia due to its effects on the heart's electrical conduction system. Monitoring for a slow heart rate is crucial as it indicates potential toxicity. Hypertension, hyperglycemia, and insomnia are not typically associated with digoxin toxicity. Hypertension is more commonly seen in other conditions, hyperglycemia is not a typical sign of digoxin toxicity, and insomnia is not a recognized symptom of digoxin toxicity.

3. The healthcare professional is assisting in the care of a client diagnosed with deep vein thrombosis (DVT). Which instruction should be reinforced to prevent complications?

• A. Elevate the affected leg using pillows.
• B. Perform leg exercises while sitting.
• C. Wear snug compression stockings.
• D. Avoid applying ice packs to injuries.

Correct answer: A

Rationale: Elevating the affected leg using pillows is crucial in managing deep vein thrombosis (DVT) as it helps reduce swelling and promote venous return, thereby decreasing the risk of complications such as pulmonary embolism. This position aids in improving blood circulation and preventing blood clots from forming or worsening in the affected leg. Performing leg exercises while sitting might increase the risk of dislodging a blood clot. While snug compression stockings are beneficial, the primary focus should be on elevation. Avoiding ice packs on injuries is unrelated to DVT management.

4. When educating a client with a new prescription for nitroglycerin, which of the following instructions should the nurse include?

• A. Store the medication in a cool, dark place.
• B. Take the medication before bedtime.
• C. Take the medication with food.
• D. Take the medication at the first sign of chest pain.

Correct answer: D

Rationale: The correct instruction for a client with a new prescription for nitroglycerin is to take the medication at the first sign of chest pain. Nitroglycerin is a vasodilator used to relieve chest pain associated with angina. Taking it at the onset of chest pain ensures prompt relief by dilating blood vessels and increasing blood flow to the heart muscle. Storing nitroglycerin in a cool, dark place helps maintain its potency, while taking it with food can alter its absorption. Timing the medication with bedtime is not necessary, but prompt administration at the first sign of chest pain is crucial for effective management of angina. Choices A, B, and C are incorrect because storing the medication in a cool, dark place, taking it before bedtime, and taking it with food are not essential instructions for nitroglycerin use. The priority is to administer it promptly when chest pain occurs to achieve optimal therapeutic effects.

5. The client is being taught about the use of sublingual nitroglycerin for chest pain. Which instruction should be provided?

• A. Swallow the tablet whole with water.
• B. Place the tablet under the tongue and let it dissolve.
• C. Chew the tablet and then swallow.
• D. Place the tablet between the cheek and gum.

Correct answer: B

Rationale: The correct method for administering sublingual nitroglycerin is to place the tablet under the tongue and allow it to dissolve. This route of administration facilitates rapid absorption of the medication into the bloodstream, enabling quick relief of chest pain associated with angina or heart conditions. Choice A is incorrect because sublingual nitroglycerin should not be swallowed whole. Choice C is wrong as chewing the tablet can lead to the rapid release of the drug, causing adverse effects like headaches or dizziness. Choice D is also incorrect as the tablet should not be placed between the cheek and gum, but under the tongue for proper absorption.

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