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. Prior to a cardiac catheterization, what instruction should the client be reminded of?

• A. You will need to be NPO for 6 to 8 hours before the procedure.
• B. You will not be able to move around during the procedure.
• C. You will be required to lie still for several hours after the test.
• D. You will not have to drink any fluids immediately before the test.

Correct answer: A

Rationale: Being NPO (nothing by mouth) for 6 to 8 hours before a cardiac catheterization is crucial to prevent complications such as aspiration during the procedure. This helps ensure the safety and accuracy of the test results by minimizing the risk of food or liquid in the stomach interfering with the procedure. Choice B is incorrect because the client will need to lie still during the procedure to ensure its accuracy. Choice C is incorrect as the client is typically required to lie flat for a few hours after the test, not several hours. Choice D is incorrect as the client is usually not allowed to drink fluids immediately before the test to prevent complications.

3. The client is receiving anticoagulant therapy for atrial fibrillation. Which laboratory test should be monitored to determine the effectiveness of the therapy?

• A. Prothrombin time (PT) and international normalized ratio (INR)
• B. Activated partial thromboplastin time (aPTT)
• C. Platelet count
• D. Erythrocyte sedimentation rate (ESR)

Correct answer: A

Rationale: Prothrombin time (PT) and international normalized ratio (INR) are essential laboratory tests to monitor the effectiveness of anticoagulant therapy in clients with atrial fibrillation. These tests help ensure that the client is within the therapeutic range and are commonly used to assess the clotting ability of the blood. Monitoring PT and INR levels allows healthcare providers to adjust anticoagulant dosages as needed to prevent complications such as bleeding or thrombosis. Activated partial thromboplastin time (aPTT) is more commonly used to monitor heparin therapy, not anticoagulant therapy for atrial fibrillation. Platelet count assesses the number of platelets in the blood and is not a direct indicator of anticoagulant therapy effectiveness. Erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation and is not used to monitor anticoagulant therapy.

4. The healthcare provider is reinforcing dietary instructions to a client with coronary artery disease who has been prescribed a low-cholesterol diet. The healthcare provider should advise the client to choose which food item?

• A. Whole milk
• B. Oatmeal with fresh fruit
• C. Fried chicken
• D. Bacon and eggs

Correct answer: B

Rationale: Oatmeal with fresh fruit is the correct choice for a client with coronary artery disease on a low-cholesterol diet. Oatmeal is a heart-healthy option that is low in cholesterol and saturated fats. Fresh fruits are also a good source of essential nutrients and fiber. Choices A, C, and D are not suitable for a low-cholesterol diet. Whole milk, fried chicken, bacon, and eggs are high in cholesterol and saturated fats, which can be detrimental to individuals with coronary artery disease.

5. When reinforcing dietary instructions to a client with coronary artery disease prescribed a low-fat, low-cholesterol diet, which food item should the nurse advise the client to choose?

• A. Whole milk
• B. Grilled salmon
• C. Fried chicken
• D. Bacon and eggs

Correct answer: B

Rationale: Grilled salmon is the correct choice for a client with coronary artery disease on a low-fat, low-cholesterol diet because it is low in saturated fat and high in omega-3 fatty acids, which are beneficial for heart health. Whole milk, fried chicken, and bacon and eggs are higher in saturated fats and cholesterol, making them less suitable choices for this client. Whole milk is high in saturated fat, while fried chicken and bacon and eggs are sources of both saturated fat and cholesterol, which can negatively impact heart health in clients with coronary artery disease.

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