Nursing Elites

1. How should bleeding in a patient on warfarin be monitored?

• A. Monitor INR levels
• B. Monitor hemoglobin levels
• C. Monitor potassium levels
• D. Monitor platelet count

Correct answer: A

Rationale: The correct answer is to monitor INR levels. INR levels are the most critical indicator for monitoring bleeding risk in patients on warfarin. INR stands for International Normalized Ratio and specifically measures the clotting tendency of the blood. Monitoring hemoglobin levels, potassium levels, or platelet count are not as directly relevant to assessing bleeding risk in patients on warfarin.

2. A nurse is providing teaching to a client who has a new prescription for ferrous sulfate. Which of the following instructions should the nurse include?

• A. Take this medication with orange juice to increase absorption.
• B. Take this medication on an empty stomach.
• C. Take this medication with milk if it causes stomach upset.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client prescribed ferrous sulfate is to take the medication with orange juice to enhance absorption. Orange juice is recommended because of its vitamin C content, which aids in the absorption of iron. Choice B, taking the medication on an empty stomach, is incorrect because ferrous sulfate is better absorbed with food. Choice C, taking the medication with milk if it causes stomach upset, is incorrect as calcium in milk can interfere with iron absorption. Choice D, taking the medication at bedtime, is incorrect as it is usually recommended to take iron supplements between meals or with food to enhance absorption.

3. A nurse is assessing a client who has pneumonia. Which of the following findings should the nurse report to the provider?

• A. Crackles in the lung bases
• B. Oxygen saturation of 95%
• C. Heart rate of 88/min
• D. Frequent productive cough

Correct answer: A

Rationale: The correct answer is A: Crackles in the lung bases. In a client with pneumonia, crackles in the lung bases can indicate fluid accumulation, suggesting worsening respiratory status. This finding should be reported to the provider for further evaluation and management. Choice B, an oxygen saturation of 95%, is within the normal range and does not require immediate reporting. Choice C, a heart rate of 88/min, is also within normal limits and does not indicate an urgent need for intervention. Choice D, a frequent productive cough, is a common symptom in pneumonia and may not require immediate reporting unless it is severe or worsening. Therefore, crackles in the lung bases are the most concerning finding that warrants prompt attention.

4. A client has a new prescription for levothyroxine. Which of the following statements should the nurse include?

• A. Take this medication with food to prevent nausea.
• B. Take this medication in the morning to prevent insomnia.
• C. You should store this medication in the refrigerator.
• D. Take this medication with a full glass of water before breakfast.

Correct answer: D

Rationale: The correct statement the nurse should include is to take levothyroxine with a full glass of water before breakfast. This helps improve absorption and prevents gastrointestinal side effects. Choice A is incorrect because levothyroxine should be taken on an empty stomach. Choice B is incorrect as insomnia is not a common side effect of levothyroxine. Choice C is also incorrect as levothyroxine does not need to be refrigerated.

5. A nurse is preparing to administer blood to a client. Which of the following actions should the nurse take first?

• A. Check the client's identification bracelet.
• B. Obtain the client's vital signs.
• C. Initiate the transfusion slowly over the first 15 minutes.
• D. Verify the client's blood type and Rh factor.

Correct answer: D

Rationale: The correct answer is to verify the client's blood type and Rh factor first before administering blood. This is crucial to ensure compatibility and prevent transfusion reactions. Checking the client's identification bracelet (Choice A) is important but should come after verifying blood type. Obtaining vital signs (Choice B) and initiating the transfusion slowly (Choice C) are important steps but verifying blood type is the priority to ensure safe blood administration.

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