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 healthcare provider is educating a client with type 2 diabetes mellitus about managing blood glucose levels. Which of the following statements by the client indicates a need for further teaching?

• A. I will monitor my blood glucose levels every morning.
• B. I will stop taking my insulin if my blood glucose level is below 200 mg/dL.
• C. I will take my insulin as prescribed, even if I am feeling well.
• D. I will eat more simple carbohydrates if my blood glucose level is low.

Correct answer: D

Rationale: The correct answer is D because consuming more simple carbohydrates when blood glucose levels are low can cause a rapid spike in blood sugar levels, leading to potential complications. Clients with type 2 diabetes should eat complex carbohydrates or foods that help stabilize blood sugar levels when experiencing hypoglycemia. Choices A, B, and C demonstrate understanding of monitoring blood glucose levels regularly, not stopping insulin without consulting a healthcare provider, and adhering to insulin therapy even when feeling well, which are all appropriate actions for managing diabetes.

3. How should a healthcare provider handle a patient with non-compliance to hypertension medication?

• A. Provide education about medication
• B. Refer the patient to a specialist
• C. Explore alternative treatments
• D. Reassess the patient in 6 months

Correct answer: A

Rationale: Providing education about the importance of medication adherence is crucial in managing hypertension. By educating the patient about the significance of taking their medication as prescribed, the healthcare provider can help improve compliance and control the patient's blood pressure. Referring the patient to a specialist (Choice B) may be necessary in some cases but addressing non-compliance should start with education. Exploring alternative treatments (Choice C) could be considered if the current medication is not suitable, but initial steps should focus on improving adherence. Reassessing the patient in 6 months (Choice D) may be too delayed if non-compliance is an issue that needs immediate attention.

4. A client with cancer is about to receive low-dose brachytherapy via a vaginal implant. What intervention should be included in the care plan?

• A. Remove vaginal packing.
• B. Insert an indwelling urinary catheter.
• C. Ambulate the client four times daily.
• D. Keep the client NPO until therapy is complete.

Correct answer: B

Rationale: The correct intervention that should be included in the care plan for a client about to receive low-dose brachytherapy via a vaginal implant is to insert an indwelling urinary catheter. This is crucial to prevent bladder distention during brachytherapy, ensuring the treatment's effectiveness and the client's comfort. Removing vaginal packing (Choice A) may not be necessary or appropriate in this situation. Ambulating the client four times daily (Choice C) is a good nursing intervention for general patient care but is not specifically related to brachytherapy via a vaginal implant. Keeping the client NPO until therapy is complete (Choice D) is not necessary unless specifically indicated due to the treatment's nature or the client's condition.

5. Which lab value is critical to monitor in patients receiving warfarin therapy?

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

Correct answer: A

Rationale: The correct answer is A: Monitor INR. INR (International Normalized Ratio) is crucial to monitor in patients receiving warfarin therapy. INR measures the blood's ability to clot and is used to ensure that patients are within the therapeutic range for warfarin therapy. This is important to prevent both clotting disorders and bleeding complications. Monitoring potassium levels (choice B) is not directly related to warfarin therapy. Platelet count (choice C) and sodium levels (choice D) are important parameters but are not as critical to monitor specifically for patients on warfarin therapy.

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