Nursing Elites

1. A patient with a diagnosis of deep vein thrombosis (DVT) is receiving heparin therapy. Which laboratory test should the nurse monitor to evaluate the effectiveness of the heparin therapy?

• A. Prothrombin time (PT)
• B. Partial thromboplastin time (PTT)
• C. Bleeding time
• D. Platelet count

Correct answer: B

Rationale: The correct answer is B: Partial thromboplastin time (PTT). Heparin affects the intrinsic pathway of the coagulation cascade, which is reflected by changes in the PTT. Monitoring the PTT helps ensure that the patient's blood is within the desired therapeutic range and prevents complications related to clotting or bleeding. Prothrombin time (PT) primarily assesses the extrinsic pathway and is not as sensitive to heparin therapy. Bleeding time and platelet count are not specific tests for monitoring the effectiveness of heparin therapy in DVT.

2. A client with a cold is taking the antitussive benzonatate (Tessalon). Which assessment data indicates to the nurse that the medication is effective?

• A. Reports reduced nasal discharge.
• B. Denies having coughing spells.
• C. Able to sleep through the night.
• D. Expectorating bronchial secretions.

Correct answer: B

Rationale: The correct answer is B. Denying having coughing spells indicates the effectiveness of benzonatate, an antitussive that suppresses coughing. The goal of antitussive medications like benzonatate is to reduce or eliminate coughing, so the absence of coughing spells signifies the drug's efficacy. The other options do not directly reflect the medication's intended effect and are not specific indicators of benzonatate's effectiveness.

3. A 28-year-old woman presents with abdominal pain, diarrhea, and rectal bleeding. She has a history of similar episodes in the past. What is the most likely diagnosis?

• A. Ulcerative colitis
• B. Irritable bowel syndrome
• C. Celiac disease
• D. Diverticulitis

Correct answer: A

Rationale: The constellation of symptoms including abdominal pain, diarrhea, and rectal bleeding in a young woman with a history of similar episodes is highly suggestive of ulcerative colitis. This chronic inflammatory condition primarily affects the colon and rectum, leading to symptoms such as bloody diarrhea, abdominal pain, and urgency. The recurrent nature of her symptoms and the presence of rectal bleeding further support this diagnosis over other conditions listed, such as irritable bowel syndrome, celiac disease, or diverticulitis, which typically do not present with the same combination of symptoms and history.

4. A male infant born at 30-weeks gestation at an outlying hospital is being prepared for transport to a Level IV neonatal facility. His respirations are 90/min, and his heart rate is 150 beats per minute. Which drug is the transport team most likely to administer to this infant?

• A. Ampicillin (Omnipen) 25 mg/kg slow IV push.
• B. Gentamicin sulfate (Garamycin) 2.5 mg/kg IV.
• C. Digoxin (Lanoxin) 20 micrograms/kg IV.
• D. Beractant (Survanta) 100 mg/kg per endotracheal tube.

Correct answer: D

Rationale: In this scenario, the infant is a preterm neonate with respiratory distress and is being transported to a Level IV neonatal facility. The drug most likely to be administered by the transport team is Beractant (Survanta) via endotracheal tube. Beractant is a surfactant used to treat respiratory distress syndrome in preterm infants by improving lung compliance and reducing the need for mechanical ventilation.

5. A patient with schizophrenia is prescribed olanzapine. What is an important side effect for the healthcare provider to monitor?

• A. Hypertension
• B. Weight gain
• C. Hypoglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Weight gain. Olanzapine, an atypical antipsychotic, is known to cause significant weight gain and metabolic syndrome. It is crucial for healthcare providers to closely monitor patients for these side effects to prevent complications and provide appropriate interventions.

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