Nursing Elites

1. What is the most critical lab value to monitor for a patient on heparin therapy?

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

Correct answer: A

Rationale: The correct answer is to monitor aPTT levels. Activated Partial Thromboplastin Time (aPTT) is crucial for assessing the therapeutic effectiveness of heparin, as it reflects the intrinsic pathway of the coagulation cascade. Monitoring aPTT helps ensure that the patient is within the therapeutic range of heparin, minimizing the risk of bleeding complications. Platelet count (choice B) is important to assess for potential heparin-induced thrombocytopenia but is not the primary lab value to monitor during heparin therapy. INR levels (choice C) are monitored in patients on warfarin therapy, not heparin. Sodium levels (choice D) are not directly related to heparin therapy monitoring.

2. A client is 24 hr postoperative following an abdominal aortic aneurysm resection. Which of the following findings is a priority to report?

• A. Serosanguineous drainage on dressing
• B. Abdominal distention
• C. Absent bowel sounds
• D. Urine output of 20 mL/hr

Correct answer: D

Rationale: Urine output less than 30 mL/hr is indicative of decreased kidney function, potentially due to inadequate perfusion or other complications post-aneurysm resection. This finding requires immediate reporting to prevent further complications such as acute kidney injury. Serosanguineous drainage on the dressing, abdominal distention, and absent bowel sounds are also important postoperative assessments but are not as critical as impaired kidney function in this scenario.

3. A nurse is caring for an adult client who has prescriptions for multiple medications. Which of the following is an age-related change that increases the risk for adverse effects from these medications?

• A. Rapid gastric emptying
• B. Prolonged medication half-life
• C. Increased medication elimination
• D. Decreased medication sensitivity

Correct answer: B

Rationale: The correct answer is B: Prolonged medication half-life. As clients age, their metabolism tends to slow down, leading to a prolonged half-life of medications in the body. This extended presence of drugs can increase the risk for adverse effects as the substances accumulate. Choice A, rapid gastric emptying, is not an age-related change and actually decreases the time medications spend in the stomach, potentially reducing their effectiveness. Choice C, increased medication elimination, is not an age-related change either; in fact, aging can lead to decreased renal function, affecting drug elimination. Choice D, decreased medication sensitivity, is not an age-related change that directly increases the risk for adverse effects; rather, it may lead to requiring higher doses for effectiveness but does not inherently increase the risk of adverse effects.

4. A healthcare provider is reviewing the medical records of a client with a prescription for combination oral contraceptives. Which of the following conditions is a contraindication?

• A. Hyperthyroidism
• B. Thrombophlebitis
• C. Diverticulosis
• D. Hypocalcemia

Correct answer: B

Rationale: Thrombophlebitis is a contraindication to combination oral contraceptives due to the increased risk of thromboembolic events. Hyperthyroidism, diverticulosis, and hypocalcemia are not contraindications to combination oral contraceptives. Hyperthyroidism may affect thyroid hormone levels but does not directly contraindicate oral contraceptives. Diverticulosis is a condition related to the digestive system and does not impact the use of oral contraceptives. Hypocalcemia, a low calcium level in the blood, is not a contraindication for oral contraceptives.

5. A client with bipolar disorder and experiencing mania is under the care of a nurse. Which intervention should the nurse include in the plan?

• A. Encourage the client to spend time in the day room.
• B. Withdraw the client's TV privileges if they do not attend group therapy.
• C. Encourage the client to take frequent rest periods.
• D. Place the client in seclusion when they exhibit signs of anxiety.

Correct answer: C

Rationale: Encouraging the client to take frequent rest periods is an appropriate intervention for managing mania in a client with bipolar disorder. During a manic episode, individuals often have increased energy levels, decreased need for sleep, and may engage in high-risk behaviors. Encouraging regular rest periods can help reduce stimulation and promote relaxation, which may assist in stabilizing mood. Choices A and B are not as effective in managing manic symptoms, as they do not directly address the client's need for rest and relaxation. Choice D is inappropriate because placing the client in seclusion can increase feelings of anxiety and agitation, worsening the manic episode.

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