Nursing Elites

1. A nurse is caring for a client who is receiving a continuous heparin infusion. Which of the following laboratory values should the nurse monitor?

• A. Hemoglobin
• B. aPTT
• C. INR
• D. Platelet count

Correct answer: B

Rationale: The correct answer is B: aPTT. The activated partial thromboplastin time (aPTT) is monitored to assess the therapeutic effect of heparin and to adjust the infusion rate if needed. Monitoring hemoglobin levels (choice A) is important for assessing anemia but is not specific to heparin therapy. INR (choice C) is used to monitor the effects of warfarin, not heparin. Platelet count (choice D) is important to monitor for heparin-induced thrombocytopenia, but aPTT is the primary laboratory value used to monitor heparin therapy.

2. A client with heart failure at risk for pulmonary edema should receive which intervention to improve oxygenation?

• A. Place the client in a supine position.
• B. Encourage the client to increase fluid intake.
• C. Elevate the client's legs when in bed.
• D. Administer oxygen via non-rebreather mask.

Correct answer: D

Rationale: Administering oxygen via a non-rebreather mask is the appropriate intervention for a client at risk for pulmonary edema as it helps improve oxygenation by delivering a high concentration of oxygen. Placing the client in a supine position can exacerbate pulmonary edema by increasing venous return to the heart, leading to fluid overload. Encouraging increased fluid intake is contraindicated in clients with heart failure and at risk for pulmonary edema, as it can worsen fluid accumulation. Elevating the client's legs when in bed is more appropriate for clients with conditions such as venous insufficiency or edema in the lower extremities, not for pulmonary edema.

3. A nurse is teaching a client about the physiological changes that occur with aging. Which of the following findings should the nurse expect?

• A. Decreased sense of taste
• B. Decreased blood pressure
• C. Increased gastric secretions
• D. Increased accommodation to near vision

Correct answer: A

Rationale: The correct answer is A: Decreased sense of taste. As individuals age, they may experience a decrease in their sense of taste due to changes in taste buds and a decrease in saliva production. This can lead to a reduced ability to taste flavors or distinguish between different tastes. Choices B, C, and D are incorrect. Decreased blood pressure is not a consistent physiological change with aging; instead, blood pressure may increase or remain stable. Gastric secretions tend to decrease with age, leading to issues like decreased absorption of certain nutrients. Accommodation to near vision typically decreases with age, causing a condition known as presbyopia, where individuals have difficulty focusing on close objects.

4. A nurse is providing teaching to a client about the adverse effects of sertraline. Which of the following adverse effects should the nurse include?

• A. Excessive sweating.
• B. Increased urinary frequency.
• C. Dry cough.
• D. Metallic taste in the mouth.

Correct answer: A

Rationale: The correct adverse effect of sertraline that the nurse should include in the teaching is excessive sweating. Sertraline is known to cause this side effect in some individuals. Increased urinary frequency (choice B) is not a commonly reported adverse effect of sertraline. Dry cough (choice C) and metallic taste in the mouth (choice D) are also not typically associated with sertraline use. Therefore, the nurse should focus on educating the client about the potential adverse effect of excessive sweating.

5. A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings should the nurse expect?

• A. Increased urine output
• B. Increased serum sodium
• C. Hyponatremia
• D. Hypercalcemia

Correct answer: C

Rationale: In clients with Syndrome of Inappropriate Antidiuretic Hormone (SIADH), the nurse should expect hyponatremia. SIADH leads to excess water retention, diluting the sodium levels in the blood, resulting in low serum sodium levels. Choice A, increased urine output, is incorrect as SIADH causes water retention, leading to decreased urine output. Choice B, increased serum sodium, is incorrect because SIADH causes a dilutional effect due to water retention, resulting in decreased serum sodium levels. Choice D, hypercalcemia, is unrelated to SIADH and not a typical finding.

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