Nursing Elites

1. Which laboratory test should be monitored to evaluate the effectiveness of anticoagulant therapy in a client with deep vein thrombosis (DVT)?

• A. Complete blood count (CBC)
• B. Activated partial thromboplastin time (aPTT)
• C. Serum electrolytes
• D. Liver function tests

Correct answer: B

Rationale: Activated partial thromboplastin time (aPTT) is the laboratory test monitored to evaluate the effectiveness of anticoagulant therapy, particularly with heparin. It measures the time it takes for blood to clot, and monitoring aPTT helps ensure the therapeutic range is maintained to prevent clot formation and excessive bleeding. Choices A, C, and D are incorrect because a complete blood count (CBC) assesses overall health, serum electrolytes evaluate the body's electrolyte balance, and liver function tests assess liver health, none of which directly evaluate the effectiveness of anticoagulant therapy for DVT.

2. The healthcare professional is reinforcing teaching for a client with peripheral artery disease (PAD). Which statement by the client indicates a need for further teaching?

• A. I will keep my legs elevated on pillows while resting.
• B. I will avoid crossing my legs when sitting.
• C. I will wear loose-fitting, comfortable shoes.
• D. I will avoid exposure to cold temperatures.

Correct answer: A

Rationale: The correct answer is A. Elevating the legs can decrease blood flow in clients with PAD, worsening symptoms. Therefore, advising the client to keep the legs elevated on pillows while resting is incorrect and can exacerbate the condition. Choice B is correct as avoiding crossing legs helps prevent circulation restriction. Choice C is correct as wearing loose-fitting shoes promotes circulation. Choice D is correct as avoiding exposure to cold temperatures helps prevent vasoconstriction, which can worsen PAD symptoms.

3. A client has a new prescription for enalapril. Which of the following instructions should the nurse include?

• A. Monitor for a dry cough.
• B. Take the medication at bedtime.
• C. Avoid consuming grapefruit juice.
• D. Take the medication with food.

Correct answer: A

Rationale: The correct answer is A: Monitor for a dry cough. When a client is prescribed enalapril, it is important to monitor for a dry cough because it can be a side effect that indicates a potential issue like angioedema. This side effect needs close attention as it may require discontinuation of the medication to prevent further complications. Choices B, C, and D are incorrect because enalapril does not need to be taken at bedtime, does not interact with grapefruit juice, and can be taken without regard to meals.

4. A client has a history of left-sided heart failure. The nurse should look for the presence of which finding to determine whether the problem is currently active?

• A. Presence of ascites
• B. Bilateral lung crackles
• C. Jugular vein distention
• D. Pedal edema bilaterally

Correct answer: B

Rationale: When assessing a client with a history of left-sided heart failure, the presence of bilateral lung crackles is a key finding to determine if the condition is currently active. Crackles in the lungs indicate fluid accumulation, a common sign of left-sided heart failure due to pulmonary congestion. Choices A, C, and D are incorrect because ascites, jugular vein distention, and pedal edema are more commonly associated with right-sided heart failure.

5. A client with a diagnosis of angina pectoris is prescribed nitroglycerin. The nurse should teach the client to take the medication in which way?

• A. Take one tablet daily with breakfast
• B. Take one tablet every 5 minutes as needed, up to three times
• C. Take one tablet every hour until pain subsides
• D. Take one tablet only if pain does not subside after 30 minutes

Correct answer: B

Rationale: Nitroglycerin is a rapid-acting medication used to relieve angina pain by dilating blood vessels. The correct administration is to take one tablet every 5 minutes as needed, up to three doses. This dosing regimen helps in managing acute angina episodes effectively. Choice A is incorrect because nitroglycerin is not taken once daily. Choice C is incorrect because waiting for an hour between doses may not provide timely relief during angina attacks. Choice D is incorrect as it suggests waiting for 30 minutes before taking another dose, which could delay symptom relief in acute situations.

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