Nursing Elites

1. A hospitalized client has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should be prepared for transfusion?

• A. Whole blood
• B. Platelets
• C. Fresh frozen plasma
• D. Packed red blood cells

Correct answer: C

Rationale: Fresh frozen plasma is the appropriate blood product for a client with an elevated aPTT as it contains various coagulation factors that can help correct coagulopathies and prevent bleeding. Elevated aPTT indicates a deficiency in specific clotting factors, and fresh frozen plasma is rich in these factors. Whole blood, platelets, and packed red blood cells do not contain the necessary coagulation factors to correct an elevated aPTT, so they are not indicated in this situation.

2. Which of the following drugs has a therapeutic effect that prevents thromboembolic events?

• A. Warfarin
• B. Amlodipine
• C. Nitroglycerin
• D. Clopidogrel

Correct answer: A

Rationale: The correct answer is Warfarin. Warfarin is an anticoagulant medication that helps prevent thromboembolic events by inhibiting the formation of blood clots. It is commonly used to reduce the risk of strokes or heart attacks in patients at risk for thrombosis.

3. When teaching a client with a new prescription for nitroglycerin patches, which of the following instructions should the nurse include?

• A. Apply the patch at the same time every day.
• B. Rotate the application site daily.
• C. Remove the patch for 12 hours each day.
• D. Cut the patch in half if needed.

Correct answer: B

Rationale: The correct instruction for a client with a new prescription for nitroglycerin patches is to rotate the application site daily. This is important to prevent skin irritation and ensure optimal absorption of the medication. Applying the patch at the same time every day (Choice A) is not necessary for nitroglycerin patches. Removing the patch for 12 hours each day (Choice C) would disrupt the continuous delivery of medication. Cutting the patch in half (Choice D) can alter the dose and is not recommended unless directed by a healthcare provider.

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

• A. Brush and floss your teeth regularly.
• B. Avoid drinking grapefruit juice.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: A

Rationale: The correct answer is to instruct the client to brush and floss their teeth regularly. Phenytoin can lead to gingival hyperplasia, making oral hygiene crucial to prevent complications. Encouraging good oral care practices helps reduce the risk of adverse effects on the gums and teeth. Avoiding grapefruit juice is not specifically related to Phenytoin. While some medications require intake with food, Phenytoin is usually taken on an empty stomach for better absorption. Increasing calcium-rich foods is not directly associated with Phenytoin therapy.

5. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?

• A. Vitamin K
• B. Calcium carbonate
• C. Acetaminophen
• D. Ranitidine

Correct answer: C

Rationale: The correct answer is Acetaminophen. Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking warfarin. Warfarin works by inhibiting the clotting factors dependent on vitamin K, so Vitamin K intake should be consistent but not excessive. Calcium carbonate and ranitidine do not significantly increase the risk of bleeding when used concurrently with Warfarin.

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