Nursing Elites

1. A client has a prescription for Heparin. Which of the following laboratory tests should be monitored while the client is receiving Heparin?

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

Correct answer: D

Rationale: Activated partial thromboplastin time (aPTT) is the correct laboratory test to monitor while a client is receiving Heparin. This test is used to assess the therapeutic levels of heparin in the blood, ensuring that the dose is within the safe and effective range. Monitoring aPTT helps healthcare providers adjust the dosage of Heparin to prevent complications such as bleeding or clotting.

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

• A. Rinse your mouth after each use of this medication.
• B. Limit fluid intake while taking this medication.
• C. Increase your intake of vitamin B12 while taking this medication.
• D. You can take the medication as needed.

Correct answer: A

Rationale: The correct instruction for a client prescribed Beclomethasone is to rinse the mouth after each use to reduce the risk of oral fungal infection. Beclomethasone is a corticosteroid inhaler that can increase the risk of oral thrush, so rinsing the mouth helps minimize this side effect. Choice B is incorrect because there is no need to limit fluid intake while taking Beclomethasone. Choice C is incorrect as there is no specific need to increase vitamin B12 intake with this medication. Choice D is incorrect because Beclomethasone should be taken as prescribed, not as needed.

3. A client is prescribed Atorvastatin. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin
• D. Sodium

Correct answer: B

Rationale: Creatine kinase should be monitored in clients taking Atorvastatin as it can indicate muscle damage, a serious adverse effect of statins. Elevated creatine kinase levels may suggest myopathy or rhabdomyolysis, which are potential complications of statin therapy.

4. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?

• A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
• B. I will take this medication on an empty stomach.
• C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
• D. I should stop taking oral contraceptives while I'm taking methotrexate.

Correct answer: C

Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.

5. A healthcare provider is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The provider should recognize which of the following conditions is a contraindication for taking propranolol?

• A. Asthma
• B. Glaucoma
• C. Hypertension
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Asthma. Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, making it contraindicated in clients with asthma. Using propranolol in asthma can exacerbate bronchoconstriction and potentially lead to respiratory distress or exacerbation of asthma symptoms. Choices B, C, and D are incorrect. Glaucoma, hypertension, and tachycardia are not contraindications for taking propranolol. In fact, propranolol is commonly used to treat hypertension and tachycardia.

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