Nursing Elites

1. A client has a new prescription for sertraline. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should take this medication at bedtime.
• B. I may experience sexual dysfunction.
• C. I should avoid drinking grapefruit juice.
• D. I may experience weight loss while taking this medication.

Correct answer: B

Rationale: The correct answer is B. Sexual dysfunction is a common side effect of sertraline. When the client mentions this potential side effect, it indicates an understanding of the teaching about the medication's effects. This response shows awareness of a significant adverse effect that the client should be informed about when starting sertraline. Choices A, C, and D are incorrect because taking sertraline at bedtime, avoiding grapefruit juice, or experiencing weight loss are not key teaching points associated with this medication.

2. A client is admitted with an arterial ischemic leg ulcer. The nurse expects to note that this ulcer has which typical characteristic?

• A. Dark pink base
• B. Deep and painful
• C. Accompanied by very slight pain
• D. Brown pigmentation of surrounding skin

Correct answer: B

Rationale: Arterial ischemic ulcers are typically characterized by being deep and painful, often with a pale or necrotic base. The lack of adequate blood flow leads to tissue damage, resulting in these ulcers having a deep appearance and causing significant pain to the individual. The other options are not commonly associated with arterial ischemic ulcers; a dark pink base, very slight pain, or brown pigmentation of surrounding skin are not typical features of this type of ulcer.

3. Which laboratory test should be monitored to evaluate the effectiveness of anticoagulant therapy in a client with deep vein thrombosis (DVT)?

• A. Complete blood count (CBC)
• B. Activated partial thromboplastin time (aPTT)
• C. Serum electrolytes
• D. Liver function tests

Correct answer: B

Rationale: Activated partial thromboplastin time (aPTT) is the laboratory test monitored to evaluate the effectiveness of anticoagulant therapy, particularly with heparin. It measures the time it takes for blood to clot, and monitoring aPTT helps ensure the therapeutic range is maintained to prevent clot formation and excessive bleeding. Choices A, C, and D are incorrect because a complete blood count (CBC) assesses overall health, serum electrolytes evaluate the body's electrolyte balance, and liver function tests assess liver health, none of which directly evaluate the effectiveness of anticoagulant therapy for DVT.

4. The client with a history of coronary artery disease (CAD) is scheduled for a stress test. What instruction should the nurse provide to the client before the test?

• A. Continue taking your usual dose of beta-blockers
• B. Refrain from eating or drinking anything for 4 hours before the test
• C. Wear loose, comfortable clothing and walking shoes
• D. Avoid any physical activity for 24 hours before the test

Correct answer: C

Rationale: Before a stress test, the nurse should instruct the client to wear loose, comfortable clothing and walking shoes. This is essential as the stress test involves physical exercise, and the client should be ready for the activity involved. Continuing beta-blockers should be based on healthcare provider's instructions; adjustments may be needed. Fasting before the test is usually not necessary. Avoiding physical activity for 24 hours before the test is not recommended as it may affect the accuracy of the test results by not providing a true reflection of the client's exercise capacity.

5. What predisposing factor most likely contributed to the proximal end of the femur fracture in a 62-year-old woman who lives alone and tripped on a rug in her home?

• A. Failing eyesight leading to an unsafe environment
• B. Renal osteodystrophy from chronic kidney disease (CKD)
• C. Osteoporosis from declining hormone levels
• D. Cerebral vessel changes causing transient ischemic attacks

Correct answer: C

Rationale: The most likely predisposing factor contributing to the proximal end of the femur fracture in a 62-year-old woman is osteoporosis resulting from declining hormone levels. Osteoporosis weakens the bones, making them more susceptible to fractures, especially in older adults, particularly women. In this case, the fracture can be attributed to the bone density loss associated with osteoporosis, which is a common concern in postmenopausal women. Choices A, B, and D are less likely to have directly contributed to the femur fracture in this scenario. Failing eyesight may increase the risk of falls but does not directly weaken the bones. Renal osteodystrophy affects bone health but is less common in this age group. Cerebral vessel changes causing transient ischemic attacks are related to vascular issues, not bone strength.

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