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. When starting amitriptyline, a client should be instructed to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Urinary retention
• C. Bradycardia
• D. Dry cough

Correct answer: B

Rationale: When a client starts taking amitriptyline, an important adverse effect to monitor for is urinary retention. Amitriptyline is a tricyclic antidepressant that can cause anticholinergic effects, including urinary retention. It is crucial to educate the client on recognizing and reporting this adverse effect to their healthcare provider. Diarrhea is not a common adverse effect of amitriptyline and is more associated with other medications. Bradycardia is a possible adverse effect of amitriptyline, but urinary retention is a more common and significant concern. Dry cough is not a typical adverse effect of amitriptyline.

3. A client with Graves' disease is being taught about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?

• A. Propranolol helps increase blood flow to my thyroid gland.
• B. Propranolol is used to prevent excess glucose in my blood.
• C. Propranolol will decrease my tremors and fast heart rate.
• D. Propranolol promotes a decrease in thyroid hormone in my body.

Correct answer: C

Rationale: The correct answer is C. Propranolol is a beta-adrenergic antagonist that helps decrease heart rate and control tremors in individuals with Graves' disease. It does not increase blood flow to the thyroid gland (choice A), prevent excess glucose in the blood (choice B), or directly decrease thyroid hormone levels in the body (choice D). Propranolol's primary role in Graves' disease is to alleviate symptoms like tremors and fast heart rate by blocking the effects of excessive thyroid hormone, rather than reducing the actual levels of thyroid hormone in the body.

4. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital has a long half-life of 4 days, meaning it remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should expect to administer phenobarbital once a day to maintain therapeutic levels and effectiveness. Administering it more than once a day would lead to unnecessary dosing and potential adverse effects as the medication remains active in the body for an extended period.

5. A client has a prescription for Timolol eye drops for the treatment of glaucoma. Which of the following instructions should the nurse include?

• A. Apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application.
• B. Avoid blinking immediately after instilling the drops.
• C. Keep your eyes closed for 5 minutes after application.
• D. Administer the drops directly onto the cornea.

Correct answer: A

Rationale: The correct instruction for the nurse to include is to apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application. This technique helps prevent systemic absorption of the medication, reducing the risk of systemic side effects. By applying pressure, the drainage of the medication into the bloodstream through the nasolacrimal duct is minimized, enhancing the drug's local ocular effects. Choices B, C, and D are incorrect because blinking immediately after instilling the drops, keeping eyes closed for 5 minutes, and administering the drops directly onto the cornea are not recommended practices for administering Timolol eye drops.

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