Nursing Elites

1. What is the primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT)?

• A. No need for regular INR monitoring
• B. Lower risk of bleeding
• C. Fewer dietary restrictions
• D. Longer half-life

Correct answer: A

Rationale: The primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT) is that rivaroxaban does not require regular INR monitoring. This eliminates the need for frequent blood tests to adjust the dosage, making it more convenient for patients to manage their anticoagulant therapy.

2. What is the primary action of amlodipine when prescribed to a patient with hypertension?

• A. Increase heart rate
• B. Reduce blood pressure
• C. Lower cholesterol levels
• D. Decrease blood sugar levels

Correct answer: B

Rationale: Amlodipine is a calcium channel blocker that works by relaxing the blood vessels, leading to a reduction in blood pressure. This medication does not increase heart rate, lower cholesterol levels, or decrease blood sugar levels.

3. What action should the nurse take to prevent tracheal tissue damage in a client with a tracheostomy?

• A. Secure the tracheostomy ties firmly.
• B. Change the tracheostomy tube daily.
• C. Use the minimal leak technique when inflating the cuff.
• D. Clean the stoma with hydrogen peroxide.

Correct answer: C

Rationale: To prevent tracheal tissue damage in a client with a tracheostomy, the nurse should use the minimal leak technique when inflating the cuff. This method helps avoid excessive pressure on the tracheal tissue, thereby reducing the risk of damage. Choice A is incorrect because securing the tracheostomy ties too tightly can cause pressure and tissue damage. Choice B is incorrect as changing the tracheostomy tube daily is not necessary unless there is a specific clinical indication. Choice D is incorrect as cleaning the stoma with hydrogen peroxide can irritate the skin and mucous membranes, potentially leading to damage.

4. A client with chronic obstructive pulmonary disease (COPD) is receiving prednisone (Deltasone). Which side effect should the nurse monitor for?

• A. Hypoglycemia
• B. Infection
• C. Hypotension
• D. Weight loss

Correct answer: B

Rationale: The correct answer is B: Infection. Prednisone is an immunosuppressant medication commonly used in COPD to reduce inflammation. Due to its immunosuppressive effects, clients are at an increased risk of developing infections. Therefore, nurses should closely monitor clients receiving prednisone for signs and symptoms of infections to provide timely interventions.

5. A patient with bipolar disorder is prescribed lithium. What dietary advice should the nurse provide?

• A. Increase intake of caffeine.
• B. Maintain a consistent salt intake.
• C. Avoid dairy products.
• D. Increase intake of green leafy vegetables.

Correct answer: B

Rationale: The correct answer is B: Maintain a consistent salt intake. Patients prescribed lithium should maintain a consistent salt intake to help stabilize lithium levels. Fluctuations in salt intake can affect the levels of lithium in the body, potentially leading to toxicity or reduced effectiveness of the medication. It is important for patients to be consistent with their salt intake and to avoid sudden increases or decreases. Choices A, C, and D are incorrect. Increasing intake of caffeine is not recommended as it can interfere with the effects of lithium. Avoiding dairy products is not necessary unless there are specific intolerances or interactions with other medications. While green leafy vegetables are generally healthy, there is no specific recommendation to increase their intake in relation to lithium therapy.

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