Nursing Elites

1. A healthcare provider is reviewing the medical record of a client who is requesting combination oral contraceptives. Which of the following conditions in the client's history is a contraindication to the use of oral contraceptives?

• A. Hyperthyroidism.
• B. Thrombophlebitis.
• C. Diverticulosis.
• D. Hypocalcemia.

Correct answer: B

Rationale: Thrombophlebitis is a contraindication for the use of oral contraceptives due to the increased risk of complications such as thromboembolism. Hyperthyroidism, diverticulosis, and hypocalcemia are not contraindications for oral contraceptives. Hyperthyroidism may affect the metabolism of contraceptives but does not contraindicate their use. Diverticulosis and hypocalcemia do not directly impact the safety or effectiveness of oral contraceptives.

2. A healthcare provider is reviewing laboratory results for a client who is receiving heparin therapy. Which of the following results indicates that the medication is effective?

• A. Platelets 250,000/mm³
• B. aPTT 60 seconds
• C. Hemoglobin 15 g/dL
• D. INR 1.5

Correct answer: B

Rationale: An aPTT of 60 seconds indicates that the client is receiving an effective dose of heparin. The activated partial thromboplastin time (aPTT) measures the time it takes for blood to clot and is used to monitor heparin therapy. A therapeutic range for aPTT during heparin therapy is usually 1.5 to 2 times the control value, which is around 25-35 seconds. Platelets, hemoglobin, and INR values are not direct indicators of the effectiveness of heparin therapy.

3. A nurse is caring for a client who is newly diagnosed with pancreatic cancer and has questions about the disease. To research, the nurse should identify which of the following electronic databases has the most comprehensive collection of nursing articles?

• A. MEDLINE
• B. CINAHL
• C. ProQuest
• D. Health Source

Correct answer: B

Rationale: The correct answer is B, CINAHL. CINAHL is specifically dedicated to nursing and allied health literature, making it the most appropriate database for nursing articles and research. It provides a comprehensive collection of nursing-related articles, journals, and research studies, which are essential for evidence-based practice. MEDLINE, on the other hand, is a valuable resource for medical literature but is not as nursing-focused as CINAHL. ProQuest and Health Source cover a wider range of subjects beyond nursing, so they are not as comprehensive when it comes to nursing-specific articles and research. Therefore, for the nurse looking to access a database with a vast collection of nursing articles, CINAHL is the most suitable option.

4. A client reports that the medication appears different than what they take at home. Which of the following responses should the nurse take?

• A. Did the healthcare provider discuss with you that there was a change in this medication?
• B. I recommend that you take this medication as prescribed.
• C. Do you know why this medication is being prescribed to you?
• D. I will call the pharmacist now to check on this medication.

Correct answer: D

Rationale: Contacting the pharmacist is the most appropriate action to ensure the correct medication is being administered. This response addresses the client's concern directly and prioritizes patient safety. The other options do not directly address the issue of the medication discrepancy. Option A focuses on the healthcare provider's discussion, not the medication itself. Option B assumes that the current medication is correct without verification. Option C addresses the reason for the prescription but does not verify the medication's correctness.

5. A nurse is caring for a client who is experiencing acute alcohol withdrawal. Which of the following actions should the nurse take?

• A. Administer haloperidol as prescribed.
• B. Keep the client in a supine position.
• C. Administer lorazepam as prescribed.
• D. Encourage the client to drink fluids with meals.

Correct answer: C

Rationale: The correct action the nurse should take when caring for a client experiencing acute alcohol withdrawal is to administer lorazepam as prescribed. Lorazepam is a benzodiazepine used to prevent seizures and manage agitation in clients undergoing alcohol withdrawal. Administering haloperidol (Choice A) is not recommended in alcohol withdrawal as it may lower the seizure threshold. Keeping the client in a supine position (Choice B) is not specifically indicated in managing alcohol withdrawal. Encouraging the client to drink fluids with meals (Choice D) is important for hydration but does not address the acute symptoms of alcohol withdrawal.

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