Nursing Elites

1. What is an important teaching point for a patient prescribed dabigatran for atrial fibrillation?

• A. Take the medication with food to enhance absorption.
• B. Do not crush or chew the capsules.
• C. Increase intake of green leafy vegetables.
• D. Avoid all dairy products.

Correct answer: B

Rationale: The correct teaching point for a patient prescribed dabigatran is not to crush or chew the capsules. Doing so can alter the absorption of the medication, increasing the risk of bleeding. It is important for patients to swallow the capsules whole to ensure proper delivery of the medication.

2. A client admitted with a diagnosis of sepsis has a central venous pressure (CVP) of 15 mm Hg. What should the nurse do first?

• A. Administer a fluid bolus of 500 ml.
• B. Notify the healthcare provider immediately.
• C. Administer a diuretic.
• D. Continue to monitor the CVP.

Correct answer: B

Rationale: A CVP of 15 mm Hg is higher than normal, indicating possible fluid overload or heart failure, which needs immediate attention. Notifying the healthcare provider is crucial as they can evaluate the client's condition, order appropriate interventions, and prevent potential complications.

3. Which regimen is most effective for treating H. pylori infection?

• A. Metronidazole, bismuth subsalicylate, amoxicillin for 14 days
• B. Clarithromycin and omeprazole for 14 days
• C. Metronidazole, lansoprazole, and clarithromycin for 14 days
• D. Metronidazole, clarithromycin, and omeprazole for 7 days

Correct answer: C

Rationale: Regimen C, which consists of metronidazole, lansoprazole, and clarithromycin for 14 days, is recommended by the FDA as an effective treatment for H. pylori infection. This regimen has been shown to have a high eradication rate and is a standard recommendation in clinical practice guidelines for the management of H. pylori-related conditions.

4. An elderly female client comes to the clinic for a regular check-up. The client tells the nurse that she has increased her daily doses of acetaminophen (Tylenol) for the past month to control joint pain. Based on this client's comment, what previous lab values should the nurse compare with today's lab report?

• A. Look at last quarter's hemoglobin and hematocrit to assess for dehydration.
• B. Look for an increase in today's LDH compared to the previous one to assess for possible liver damage.
• C. Expect to find an increase in today's APTT compared to last quarter's due to bleeding.
• D. Determine if there is a decrease in serum potassium due to renal compromise.

Correct answer: B

Rationale: When a client increases their daily doses of acetaminophen for joint pain, it raises concerns about possible liver damage due to acetaminophen overdose. LDH (Lactate Dehydrogenase) levels can indicate liver function, so comparing today's levels with previous ones can help assess for liver damage caused by acetaminophen overuse.

5. When assessing a client with a chest tube connected to suction, which observation indicates that the chest tube is functioning properly?

• A. Continuous bubbling in the water seal chamber.
• B. Intermittent bubbling in the suction control chamber.
• C. No fluctuation in the water seal chamber.
• D. Steady bubbling in the suction control chamber.

Correct answer: D

Rationale: Steady bubbling in the suction control chamber is the correct observation that indicates the chest tube is functioning properly. This steady bubbling signifies that the suction is actively maintaining the desired pressure level within the system, ensuring proper drainage and lung re-expansion. Continuous bubbling in the water seal chamber, intermittent bubbling in the suction control chamber, or no fluctuation in the water seal chamber are not indicative of optimal chest tube function and may require further assessment or intervention.

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