Nursing Elites

1. A healthcare provider is providing discharge instructions to a client who has a new prescription for warfarin. Which of the following statements should the healthcare provider include?

• A. Avoid using a soft toothbrush.
• B. Report any signs of bleeding.
• C. Increase your intake of leafy green vegetables.
• D. Take the medication with food.

Correct answer: B

Rationale: The correct answer is to instruct the client to report any signs of bleeding when taking warfarin. Warfarin is an anticoagulant medication that increases the risk of bleeding, so it is essential to monitor for any signs of abnormal bleeding and report them promptly for appropriate management. Choices A, C, and D are incorrect. Instructing the client to avoid using a soft toothbrush is not directly related to warfarin therapy. Increasing the intake of leafy green vegetables is not recommended as they contain vitamin K, which can interfere with warfarin's anticoagulant effects. Taking warfarin with food can be inconsistent and may not result in optimal absorption.

2. When assessing a client receiving total parenteral nutrition (TPN), which laboratory value is most important for the nurse to monitor regularly?

• A. Albumin
• B. Calcium
• C. Glucose
• D. Alkaline phosphatase

Correct answer: C

Rationale: The most important laboratory value to monitor regularly in clients receiving total parenteral nutrition (TPN) is glucose. TPN solutions contain high concentrations of glucose, which can lead to hyperglycemia. Monitoring glucose levels is crucial to detect and prevent hyperglycemia, a common complication associated with TPN administration. Albumin (Choice A) levels are not typically affected by TPN administration. Calcium (Choice B) and alkaline phosphatase (Choice D) are not directly impacted by TPN and are not the primary values to monitor in TPN therapy.

3. A nurse is assessing a client who has been taking levothyroxine for hypothyroidism. Which of the following findings should the nurse report to the provider?

• A. Weight loss
• B. Insomnia
• C. Heat intolerance
• D. Dry skin

Correct answer: C

Rationale: The correct answer is C: Heat intolerance. Heat intolerance is a sign of levothyroxine toxicity and requires immediate attention. Weight loss may actually be an expected outcome of levothyroxine therapy as it can help regulate metabolism in hypothyroidism. Insomnia can occur as a side effect of levothyroxine but is not as concerning as heat intolerance. Dry skin is a common symptom of hypothyroidism and may improve with levothyroxine therapy, so it is not a priority finding to report to the provider.

4. A nurse is assessing a client who is taking hydrocodone. Which of the following findings should the nurse report to the provider?

• A. Constipation
• B. Sedation
• C. Dry mouth
• D. Respiratory depression

Correct answer: D

Rationale: The correct answer is D: Respiratory depression. Hydrocodone is an opioid medication that can cause respiratory depression, a serious side effect that should be reported immediately to the healthcare provider. Constipation, sedation, and dry mouth are common side effects of hydrocodone but are not as concerning as respiratory depression. Constipation can be managed with lifestyle modifications and medications, sedation may improve with time or dosage adjustments, and dry mouth is a common and usually benign side effect.

5. The client is being taught about the use of sublingual nitroglycerin for chest pain. Which instruction should be provided?

• A. Swallow the tablet whole with water.
• B. Place the tablet under the tongue and let it dissolve.
• C. Chew the tablet and then swallow.
• D. Place the tablet between the cheek and gum.

Correct answer: B

Rationale: The correct method for administering sublingual nitroglycerin is to place the tablet under the tongue and allow it to dissolve. This route of administration facilitates rapid absorption of the medication into the bloodstream, enabling quick relief of chest pain associated with angina or heart conditions. Choice A is incorrect because sublingual nitroglycerin should not be swallowed whole. Choice C is wrong as chewing the tablet can lead to the rapid release of the drug, causing adverse effects like headaches or dizziness. Choice D is also incorrect as the tablet should not be placed between the cheek and gum, but under the tongue for proper absorption.

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