Nursing Elites

1. A healthcare provider is reviewing the laboratory report of a client who is receiving heparin therapy for a deep vein thrombosis. Which of the following lab values indicates a therapeutic response to the therapy?

• A. PT of 12 seconds
• B. aPTT of 70 seconds
• C. Platelets of 150,000/mm3
• D. INR of 1.5

Correct answer: B

Rationale: An aPTT of 70 seconds is within the therapeutic range for a client receiving heparin therapy. The activated partial thromboplastin time (aPTT) is the most sensitive test to monitor heparin therapy. A therapeutic aPTT range for a client receiving heparin is usually 1.5 to 2.5 times the control value. Choices A, C, and D are not indicators of a therapeutic response to heparin therapy. PT measures the extrinsic pathway of coagulation and is not specific to monitoring heparin therapy. Platelet count is important to monitor for heparin-induced thrombocytopenia, but it does not indicate the therapeutic response to heparin therapy. INR is used to monitor warfarin therapy, not heparin therapy.

2. A patient is prescribed a diuretic for hypertension. What is the most important assessment the nurse should perform?

• A. Monitor the patient's respiratory rate.
• B. Check the patient's blood pressure regularly.
• C. Monitor the patient's potassium levels.
• D. Monitor the patient's sodium levels.

Correct answer: D

Rationale: Corrected Rationale: When a patient is prescribed a diuretic for hypertension, monitoring the patient's sodium levels is crucial. Diuretics can lead to alterations in sodium levels, potentially causing complications like hyponatremia. While monitoring other parameters like respiratory rate, blood pressure, and potassium levels may also be important, the primary concern with diuretic therapy is the risk of sodium imbalance, making the monitoring of sodium levels the most critical assessment.

3. A nurse is providing teaching to a client who has schizophrenia about thioridazine. Which of the following instructions should the nurse include?

• A. Report any sign of infection to the provider immediately
• B. Expect your blood pressure to increase
• C. Easy bruising may occur while taking this medication
• D. Muscle rigidity is an expected adverse effect during the first few days of therapy

Correct answer: A

Rationale: The correct answer is A: 'Report any sign of infection to the provider immediately.' This instruction is essential for clients taking thioridazine or other antipsychotic medications. Thioridazine does not typically affect blood pressure or cause easy bruising. Muscle rigidity is more commonly associated with other antipsychotic medications. Reporting signs of infection promptly is crucial as antipsychotic medications can affect the immune system, making individuals more susceptible to infections. Early detection and treatment of infections help prevent complications and ensure proper medication management.

4. While reviewing a client's chart, a nurse notices a discrepancy in the medication record. What should the nurse do?

• A. Correct the discrepancy and document the correction.
• B. Report the discrepancy to the nurse manager.
• C. Ignore the discrepancy assuming it is a clerical error.
• D. Discuss the discrepancy with the client and adjust the records.

Correct answer: B

Rationale: Reporting medication discrepancies to the nurse manager is crucial to ensure patient safety and proper follow-up. The nurse manager is responsible for addressing medication errors and implementing necessary corrective actions. Choice A is incorrect because simply correcting the discrepancy without reporting it may lead to potential harm to the patient and violates professional standards. Choice C is incorrect as ignoring the discrepancy increases the risk of medication errors going unresolved. Choice D is incorrect because discussing the discrepancy with the client before verifying the accuracy of the record can cause confusion and compromise patient safety.

5. A nurse is assessing a client who is receiving a continuous IV infusion of heparin. Which of the following findings should the nurse report to the provider?

• A. Report any urine output greater than 30 mL/hr.
• B. Bruising on the arms and legs.
• C. Positive Trousseau's sign.
• D. Urine output of 60 mL/hr.

Correct answer: B

Rationale: The correct answer is B. Bruising on the arms and legs is a sign of bleeding, which is a serious complication of heparin therapy and should be reported immediately to the provider. Option A is incorrect as urine output greater than 30 mL/hr is a normal finding. Option C, positive Trousseau's sign, is associated with hypocalcemia, not heparin therapy. Option D, urine output of 60 mL/hr, is within the normal range and does not indicate a complication of heparin therapy.

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