Nursing Elites

1. A patient with chronic kidney disease (CKD) is prescribed erythropoietin. What is the primary action of this medication?

• A. Stimulate white blood cell production
• B. Increase platelet count
• C. Promote red blood cell production
• D. Enhance clotting factor production

Correct answer: C

Rationale: Erythropoietin primarily stimulates the bone marrow to produce more red blood cells, which helps to improve oxygen delivery to tissues. In chronic kidney disease, patients often develop anemia due to reduced erythropoietin production by the kidneys. By administering exogenous erythropoietin, the deficient hormone is replaced, leading to an increase in red blood cell production and subsequently improving the oxygen-carrying capacity of the blood.

2. A client with a diagnosis of rheumatoid arthritis is experiencing severe pain. Which medication is likely to be prescribed?

• A. Acetaminophen (Tylenol)
• B. Ibuprofen (Advil)
• C. Methotrexate (Rheumatrex)
• D. Prednisone (Deltasone)

Correct answer: C

Rationale: Methotrexate is commonly prescribed for rheumatoid arthritis to reduce inflammation and slow disease progression. It is a disease-modifying antirheumatic drug (DMARD) that helps control symptoms and prevent joint damage in individuals with rheumatoid arthritis. While acetaminophen and ibuprofen are used for pain relief, they are not typically prescribed to address the underlying inflammation and disease progression associated with rheumatoid arthritis. Prednisone may be used for short-term symptom relief or during disease flares, but it is not a first-line treatment for rheumatoid arthritis.

3. When a client expresses, 'I don't know how I will go on' while discussing feelings related to a recent loss, the nurse remains silent. What is the most likely reason for the nurse's behavior?

• A. The nurse is indicating disapproval of the statement.
• B. The nurse is showing respect for the client's loss.
• C. Silence is mirroring the client's sadness.
• D. Silence enables the client to contemplate what was expressed.

Correct answer: D

Rationale: In therapeutic communication, silence can offer the client an opportunity to process their emotions and thoughts. By remaining silent, the nurse provides a space for the client to reflect on their own words, facilitating deeper exploration and understanding of their feelings.

4. A client with a history of gout is experiencing an acute attack. Which medication should the nurse expect the healthcare provider to prescribe?

• A. Aspirin.
• B. Allopurinol (Zyloprim).
• C. Colchicine.
• D. Probenecid (Benemid).

Correct answer: C

Rationale: During an acute gout attack, the healthcare provider is likely to prescribe colchicine. Colchicine is commonly used to treat acute gout attacks because it works by reducing inflammation and alleviating pain associated with the condition. It is important to note that aspirin is not recommended for gout treatment and may even exacerbate the symptoms. Allopurinol and probenecid are medications used for long-term management of gout by reducing uric acid levels in the blood, but they are not typically prescribed during an acute attack. Therefore, colchicine is the most appropriate medication for managing an acute gout attack.

5. A client with deep vein thrombosis (DVT) is receiving heparin therapy. Which laboratory test should the nurse monitor to assess the effectiveness of the therapy?

• A. Prothrombin time (PT)
• B. Platelet count
• C. Activated partial thromboplastin time (aPTT)
• D. International normalized ratio (INR)

Correct answer: C

Rationale: Activated partial thromboplastin time (aPTT) is the appropriate laboratory test to monitor the effectiveness of heparin therapy. Heparin works by prolonging the clotting time, which is reflected in the aPTT results. Monitoring aPTT helps ensure the patient is within the therapeutic range and not at risk of bleeding or clotting complications. Prothrombin time (PT) (Choice A) primarily measures the extrinsic pathway of coagulation and is used to monitor warfarin therapy, not heparin. Platelet count (Choice B) assesses the number of platelets present in the blood and is not specific to monitoring heparin therapy. International normalized ratio (INR) (Choice D) is used to monitor warfarin therapy, not heparin.

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