Nursing Elites

1. The patient with a history of myocardial infarction (MI) is prescribed aspirin. What instruction should the nurse include in the discharge teaching?

• A. Take the aspirin with food to prevent gastrointestinal upset
• B. Discontinue the aspirin if experiencing ringing in the ears
• C. Take the aspirin at bedtime to minimize side effects
• D. Avoid taking aspirin if also taking other NSAIDs

Correct answer: A

Rationale: Taking aspirin with food is recommended to prevent gastrointestinal irritation and upset, which are common side effects of aspirin. It helps protect the stomach lining and reduce the risk of developing ulcers. This instruction is crucial in promoting medication adherence and minimizing discomfort for the patient. Choices B, C, and D are incorrect because discontinuing aspirin without consulting a healthcare provider, taking it at bedtime, or avoiding it if taking other NSAIDs can have negative consequences on the patient's health and treatment plan.

2. When assessing a client receiving total parenteral nutrition (TPN), which laboratory value is most important for the nurse to monitor regularly?

• A. Albumin
• B. Calcium
• C. Glucose
• D. Alkaline phosphatase

Correct answer: C

Rationale: The most important laboratory value to monitor regularly in clients receiving total parenteral nutrition (TPN) is glucose. TPN solutions contain high concentrations of glucose, which can lead to hyperglycemia. Monitoring glucose levels is crucial to detect and prevent hyperglycemia, a common complication associated with TPN administration. Albumin (Choice A) levels are not typically affected by TPN administration. Calcium (Choice B) and alkaline phosphatase (Choice D) are not directly impacted by TPN and are not the primary values to monitor in TPN therapy.

3. A client is being taught about the use of an albuterol inhaler. Which of the following instructions should be included?

• A. Use the inhaler every 4 hours around the clock.
• B. Shake the inhaler well before use.
• C. Rinse your mouth with water after each use.
• D. Use the inhaler while lying down.

Correct answer: B

Rationale: Shaking the inhaler well before use is a crucial step in ensuring proper medication delivery. This action helps disperse the medication evenly within the device, optimizing the effectiveness of each dose. It ensures that the client receives the intended amount of medication. The other options are incorrect: Option A suggests a fixed time interval for inhaler use, which may not be suitable for all clients and can lead to overuse. Option C, rinsing the mouth, is more relevant for corticosteroid inhalers to prevent oral thrush. Option D, using the inhaler while lying down, is not recommended as it may lead to improper drug delivery and is not the correct position for inhaler use.

4. The client with atrial fibrillation is receiving warfarin (Coumadin). Which laboratory test should be monitored to determine the effectiveness of the therapy?

• A. Prothrombin time (PT) and international normalized ratio (INR)
• B. Activated partial thromboplastin time (aPTT)
• C. Complete blood count (CBC)
• D. Fibrinogen level

Correct answer: A

Rationale: Monitoring Prothrombin time (PT) and international normalized ratio (INR) is crucial when a client is on warfarin therapy. These tests assess the clotting ability of the blood and help determine the appropriate dosage of warfarin to prevent complications such as bleeding or clotting events. PT and INR values within the therapeutic range indicate the effectiveness of warfarin in managing atrial fibrillation. Choice B, activated partial thromboplastin time (aPTT), is not typically used to monitor warfarin therapy; it is more commonly used to assess the effectiveness of heparin therapy. Choice C, complete blood count (CBC), does not directly assess the anticoagulant effect of warfarin. Choice D, fibrinogen level, is not a primary test for monitoring warfarin therapy; it is more relevant in assessing conditions like disseminated intravascular coagulation.

5. When teaching a client about the use of lisinopril, which of the following instructions should the nurse include?

• A. Monitor your blood pressure regularly.
• B. Take the medication with food.
• C. Increase your intake of potassium-rich foods.
• D. Avoid grapefruit juice.

Correct answer: A

Rationale: The correct answer is to instruct the client to monitor their blood pressure regularly when taking lisinopril. Lisinopril is known to cause hypotension, so monitoring blood pressure is crucial to ensure it stays within a safe range. This monitoring helps in early detection of any potential issues related to low blood pressure, allowing for timely intervention. Choices B, C, and D are incorrect because taking lisinopril with food, increasing potassium-rich foods intake, and avoiding grapefruit juice are not specific instructions related to the safe and effective use of lisinopril.

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