Nursing Elites

1. A healthcare professional is preparing to administer a dose of warfarin. Which of the following actions should the healthcare professional take?

• A. Verify INR levels
• B. Administer with food
• C. Monitor blood glucose levels
• D. Assess liver function

Correct answer: A

Rationale: Corrected Rationale: When administering warfarin, it is crucial to verify the patient's INR levels. INR monitoring is essential to ensure that the patient is receiving the correct dose of warfarin for their condition and to minimize the risk of bleeding. Choices B, C, and D are incorrect because administering warfarin with food, monitoring blood glucose levels, and assessing liver function are not directly related to the safe administration and monitoring of warfarin therapy.

2. A nurse is planning care for a client who has a chest tube. Which of the following actions should the nurse take to ensure proper functioning of the chest tube?

• A. Clamp the chest tube intermittently.
• B. Keep the drainage system below chest level.
• C. Empty the drainage chamber every 4 hours.
• D. Apply sterile gauze around the insertion site daily.

Correct answer: B

Rationale: To ensure proper functioning of a chest tube, the nurse should keep the drainage system below chest level. This position allows for proper drainage by gravity and prevents backflow into the pleural space. Clamping the chest tube intermittently can lead to a buildup of pressure and should be avoided. Emptying the drainage chamber every 4 hours is important but not directly related to maintaining the chest tube's function. Applying sterile gauze around the insertion site daily is essential for infection prevention but does not specifically ensure the proper functioning of the chest tube.

3. A client with type 1 DM is being taught about hypoglycemia by a nurse. Which statement by the client indicates an understanding of the teaching?

• A. “Exercise decreases the risk of hypoglycemia.”
• B. “I should skip my insulin if I don't eat.”
• C. “I can drink 4 oz of regular soda if my blood sugar is low.”
• D. “Oral diabetic medications do not lead to hypoglycemia; only insulin does.”

Correct answer: C

Rationale: The correct answer is C because the client should have a quick-acting source of 15 g of carbohydrates to treat hypoglycemic episodes, such as 4 oz of regular soda. Choice A is incorrect because while exercise can help manage blood sugar levels, it can also increase the risk of hypoglycemia if not properly managed. Choice B is incorrect as skipping insulin when not eating can lead to hyperglycemia, not prevent hypoglycemia. Choice D is incorrect because certain oral diabetic medications can indeed cause hypoglycemia, not just insulin.

4. A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription?

• A. Asthma
• B. Hypertension
• C. Tachydysrhythmias
• D. Urolithiasis

Correct answer: A

Rationale: Corrected Rationale: Propranolol, a non-selective beta-blocker, should be avoided in clients with asthma as it can cause bronchoconstriction due to its beta2-blocking effects. Therefore, a client history finding of asthma would require the nurse to clarify this medication prescription. Hypertension, tachydysrhythmias, and urolithiasis are not contraindications for propranolol use, making them incorrect choices. For clients with asthma, a beta1 selective blocker would be preferred to avoid exacerbating bronchoconstriction.

5. A nurse is preparing to administer a dose of losartan. Which of the following should the nurse assess first?

• A. Blood pressure
• B. Heart rate
• C. Serum potassium
• D. Liver function

Correct answer: A

Rationale: The correct answer is to assess blood pressure first. Losartan is an angiotensin receptor blocker used to lower blood pressure. Assessing the patient's blood pressure before administering losartan is crucial to ensure it is not already too low, which could lead to hypotension. Assessing heart rate (choice B) is important but not the priority when administering losartan. Serum potassium levels (choice C) and liver function (choice D) are also important assessments, but they are not the primary concern before administering losartan.

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