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. A patient with an anxiety disorder is prescribed alprazolam. What is the primary action of this medication?

• A. Increase energy levels
• B. Induce sedation
• C. Elevate mood
• D. Reduce anxiety

Correct answer: D

Rationale: Alprazolam is a benzodiazepine that primarily works by reducing anxiety. It achieves this by enhancing the inhibitory effects of the neurotransmitter GABA in the brain, which leads to a calming effect on the individual. Therefore, the primary action of alprazolam is to decrease anxiety levels rather than increase energy, induce sedation, or elevate mood.

3. The client has acute kidney injury (AKI). Which assessment finding requires immediate intervention?

• A. Urine output of 50 ml in the last hour.
• B. Serum potassium of 6.2 mEq/L.
• C. Blood pressure of 150/90 mm Hg.
• D. Serum creatinine of 2.5 mg/dL.

Correct answer: B

Rationale: An elevated serum potassium level of 6.2 mEq/L in a client with AKI can lead to life-threatening cardiac arrhythmias, necessitating immediate intervention. Hyperkalemia is a serious complication in AKI as impaired kidney function can result in the accumulation of potassium in the blood, posing a risk of cardiac arrest. Prompt treatment to lower potassium levels is crucial to prevent cardiac complications in this situation.

4. A client with a new diagnosis of diabetes mellitus is learning to self-administer insulin. Which instruction should the nurse include?

• A. Store the insulin in the freezer.
• B. Administer the insulin at the same site each time.
• C. Rotate injection sites within the same region.
• D. Shake the vial vigorously before drawing up the insulin.

Correct answer: C

Rationale: The correct instruction for a client learning to self-administer insulin is to rotate injection sites within the same region. This practice helps prevent lipodystrophy, which is a condition characterized by fat tissue changes due to repeated injections in the same spot, and also ensures consistent absorption of insulin throughout the body. Storing insulin in the freezer is incorrect as it can lead to denaturation of the insulin. Administering the insulin at the same site each time can cause lipodystrophy and inconsistent absorption. Shaking the vial vigorously before drawing up the insulin is also incorrect as it can lead to insulin degradation.

5. A client with a severe head injury is admitted to the intensive care unit (ICU). Which finding should the nurse report to the healthcare provider immediately?

• A. Urine output of 100 mL/hour.
• B. Intracranial pressure (ICP) of 20 mm Hg.
• C. Respiratory rate of 12 breaths/minute.
• D. Mean arterial pressure (MAP) of 70 mm Hg.

Correct answer: B

Rationale: An Intracranial Pressure (ICP) of 20 mm Hg is at the upper limit of normal and may indicate increased intracranial pressure, which is a critical finding in a client with a severe head injury. Elevated ICP can lead to further brain damage and must be addressed promptly to prevent complications such as herniation. Monitoring and managing ICP are crucial in the care of patients with head injuries in the ICU.

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