Nursing Elites

1. A healthcare professional is caring for a client who is receiving heparin therapy. Which of the following laboratory tests should the healthcare professional monitor to evaluate the therapeutic effect of heparin?

• A. PT/INR
• B. Platelet count
• C. aPTT
• D. WBC count

Correct answer: C

Rationale: The correct test to monitor the therapeutic effect of heparin is the activated partial thromboplastin time (aPTT). Heparin's action is to prolong the clotting time, and aPTT reflects this effect. Monitoring aPTT helps ensure that the client is within the therapeutic range to prevent clot formation while minimizing the risk of bleeding complications. PT/INR is used to monitor warfarin therapy, platelet count assesses for potential thrombocytopenia, and WBC count evaluates for signs of infection or inflammation, not the therapeutic effect of heparin.

2. A client is being educated by a healthcare provider about Terbutaline. Which of the following statements by the client indicates understanding of the teaching?

• A. This medication will stop my contractions.
• B. This medication will prevent vaginal bleeding.
• C. This medication will promote blood flow to my baby.
• D. This medication will increase my prostaglandin production.

Correct answer: A

Rationale: The correct answer is A. Terbutaline works by blocking beta2-adrenergic receptors, leading to uterine smooth muscle relaxation and stopping contractions. It is commonly used to delay preterm labor. Choice B is incorrect because Terbutaline is not used to prevent vaginal bleeding. Choice C is incorrect because Terbutaline's primary action is not related to promoting blood flow to the baby. Choice D is incorrect because Terbutaline does not increase prostaglandin production; instead, it works by blocking beta2-adrenergic receptors.

3. A patient is receiving IV heparin for a deep-vein thrombosis and begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

• A. Vitamin K1
• B. Atropine
• C. Protamine
• D. Calcium gluconate

Correct answer: C

Rationale: Protamine is the antidote for heparin, as it reverses its anticoagulant effects. In cases of heparin overdose or if there is excessive bleeding, administering protamine can quickly neutralize the effects of heparin, helping to prevent further bleeding complications.

4. When using Nitroglycerine (transdermal), how many hours should you be nitrate-free each day?

• A. 1-2 hours
• B. 5-10 hours
• C. 3-4 hours
• D. 10-12 hours

Correct answer: D

Rationale: When using Nitroglycerine (transdermal), it should be applied for 10-12 hours per day to ensure its effectiveness. A nitrate-free period within the day is essential to prevent the development of tolerance to the medication.

5. What is the pharmacological action of metformin?

• A. Blocks stimulation of beta1 and beta2.
• B. Blocks vasoconstriction and aldosterone.
• C. Acts at many levels in the CNS to produce an anxiolytic effect.
• D. Decreases hepatic glucose production.

Correct answer: D

Rationale: The correct answer is D: Decreases hepatic glucose production. Metformin's primary pharmacological action is to decrease hepatic glucose production, leading to lower blood sugar levels and improved insulin sensitivity in the liver. Choices A, B, and C are incorrect because metformin does not block stimulation of beta1 and beta2 receptors, vasoconstriction, aldosterone, or act in the CNS to produce an anxiolytic effect. Therefore, these options are not reflective of metformin's mechanism of action.

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