Nursing Elites

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

• A. Expect muscle pain.
• B. Monitor your weight daily.
• C. Avoid consuming grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: D

Rationale: When a client is prescribed furosemide, an important consideration is preventing hypokalemia, a potential side effect of the medication. Furosemide can lead to potassium depletion, so increasing the intake of potassium-rich foods is crucial to maintain adequate potassium levels in the body. Choices A, B, and C are incorrect because muscle pain is not a common side effect of furosemide, monitoring weight daily may not be directly related to the medication, and avoiding grapefruit juice is more relevant for certain medications that interact with grapefruit juice, not furosemide.

2. A client is receiving intravenous heparin therapy for the treatment of deep vein thrombosis (DVT). Which laboratory test result should the LPN/LVN monitor to ensure the client is receiving a therapeutic dose?

• A. Prothrombin time (PT)
• B. Activated partial thromboplastin time (aPTT)
• C. International normalized ratio (INR)
• D. Platelet count

Correct answer: B

Rationale: The correct laboratory test result that the LPN/LVN should monitor to ensure the client is receiving a therapeutic dose of heparin therapy is the activated partial thromboplastin time (aPTT). The aPTT test is specifically used to monitor heparin therapy, ensuring that the dose administered is within the therapeutic range. Monitoring aPTT helps to prevent complications such as bleeding or clot formation by maintaining the appropriate anticoagulant effect of heparin. Prothrombin time (PT) and International normalized ratio (INR) are more commonly used to monitor warfarin therapy, not heparin. Platelet count is not a direct indicator of heparin's therapeutic effect and is not used to monitor heparin therapy.

3. A client is admitted to the hospital with a diagnosis of myocardial infarction (MI). Which diagnostic test is most likely to be ordered to confirm this diagnosis?

• A. Echocardiogram
• B. Electrocardiogram (ECG)
• C. Chest X-ray
• D. Complete blood count (CBC)

Correct answer: B

Rationale: An Electrocardiogram (ECG) is the primary diagnostic tool used to confirm a myocardial infarction. An ECG provides immediate information on cardiac function and can show characteristic changes indicative of a myocardial infarction, such as ST-segment elevation or depression. An echocardiogram (Choice A) is useful for assessing heart structure and function but is not typically used as the primary test for confirming an acute myocardial infarction. Chest X-ray (Choice C) may show certain changes in heart size or pulmonary congestion but is not the primary diagnostic test for MI. A Complete Blood Count (CBC) (Choice D) provides information about the cellular components of blood and is not specific to confirming a myocardial infarction.

4. A client with atrial fibrillation is receiving warfarin (Coumadin). The nurse should monitor which laboratory test to determine the effectiveness of the therapy?

• A. Prothrombin time (PT) and international normalized ratio (INR)
• B. Activated partial thromboplastin time (aPTT)
• C. Complete blood count (CBC)
• D. Fibrinogen level

Correct answer: A

Rationale: To monitor the effectiveness of warfarin therapy in a client with atrial fibrillation, the nurse should assess the Prothrombin time (PT) and international normalized ratio (INR) levels. These tests help determine the clotting ability of the blood and ensure that the client's anticoagulation levels are within the therapeutic range, reducing the risk of bleeding or clotting complications. Activated partial thromboplastin time (aPTT) (Choice B) is more commonly used to monitor heparin therapy. Complete blood count (CBC) (Choice C) provides information about the cellular components of blood but does not directly assess the effectiveness of warfarin therapy. Fibrinogen level (Choice D) is not typically used to monitor warfarin therapy; it reflects the level of fibrinogen in the blood, which is involved in the clotting process.

5. When assisting a hospitalized client newly diagnosed with coronary artery disease (CAD) to make appropriate selections from the dietary menu, which meal should the nurse encourage the client to select?

• A. Sausage, pancakes, and toast
• B. Broccoli, buttered rice, and grilled chicken
• C. Hamburger, baked apples, and avocado salad
• D. Fresh strawberries, steamed vegetables, and baked fish

Correct answer: D

Rationale: The correct choice is D: Fresh strawberries, steamed vegetables, and baked fish. This meal is low in saturated fats and cholesterol, which is suitable for a client with CAD. It aligns with dietary recommendations to support heart health and manage CAD. Choices A, B, and C are less appropriate as they contain higher levels of saturated fats and cholesterol, which are not ideal for individuals with CAD.

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