Nursing Elites

1. A healthcare provider is preparing to administer heparin sodium to a client with deep vein thrombosis (DVT). Which of the following laboratory values should the provider monitor during therapy?

• A. INR
• B. Serum creatinine
• C. aPTT
• D. Bilirubin

Correct answer: C

Rationale: The correct answer is C: aPTT. The healthcare provider should monitor the activated partial thromboplastin time (aPTT) value during heparin therapy to assess the client's coagulation status. Heparin affects the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps ensure that the client is within the therapeutic range to prevent bleeding or clotting issues. INR (Choice A) is used to monitor warfarin therapy, not heparin. Serum creatinine (Choice B) is not directly related to monitoring heparin therapy. Bilirubin (Choice D) is related to liver function, not heparin therapy.

2. A nurse is caring for a client receiving IV vancomycin. The nurse notes flushing of the client's neck and chest. Which of the following actions should the nurse take?

• A. Stop the infusion
• B. Document the findings as a harmless reaction
• C. Slow the infusion rate
• D. Administer diphenhydramine

Correct answer: C

Rationale: The correct action for the nurse to take when a client receiving IV vancomycin shows flushing of the neck and chest is to slow the infusion rate. Flushing is a common sign of Red Man Syndrome, which is associated with rapid infusions of vancomycin. Slowing down the infusion rate can help prevent further flushing and the development of Red Man Syndrome. Stopping the infusion (Choice A) may be too drastic if the symptoms are mild and can be managed by slowing the rate. Documenting the findings as a harmless reaction (Choice B) is incorrect because flushing should be addressed promptly to prevent complications. Administering diphenhydramine (Choice D) is not the initial or best intervention for flushing associated with vancomycin; slowing the infusion rate is the priority.

3. A nurse is caring for a client with diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?

• A. 14 units
• B. 28 units
• C. 32 units
• D. 42 units

Correct answer: D

Rationale: The nurse should combine both orders of insulin in the same syringe. To prepare the correct dose, the nurse should withdraw the regular insulin first (14 units) and then the NPH insulin (28 units), totaling 42 units. This combination ensures the client receives the prescribed doses of both types of insulin. Choices A, B, and C are incorrect because the nurse needs to prepare and administer both types of insulin as prescribed, resulting in a total of 42 units in the syringe.

4. A client prescribed lisinopril for hypertension may experience which of the following side effects that the nurse should monitor for?

• A. Cough
• B. Weight gain
• C. Dry mouth
• D. Hyperglycemia

Correct answer: A

Rationale: A persistent dry cough is a common side effect of lisinopril. Lisinopril is an ACE inhibitor that can cause a cough due to the accumulation of bradykinin. Weight gain, dry mouth, and hyperglycemia are not typically associated with lisinopril use, making them incorrect choices in this scenario.

5. A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?

• A. I should take my medication as needed to alleviate symptoms
• B. I should take the medication in divided doses to ensure therapeutic drug levels
• C. I should take the medication in the morning to prevent insomnia
• D. I should take the medication on a full stomach

Correct answer: C

Rationale: Levothyroxine should be taken once in the morning to prevent insomnia and maintain therapeutic levels.

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