Nursing Elites

1. What is the primary purpose of administering anticoagulants to a patient with atrial fibrillation?

• A. To reduce blood pressure.
• B. To prevent clot formation.
• C. To prevent arrhythmias.
• D. To reduce inflammation.

Correct answer: B

Rationale: The primary purpose of administering anticoagulants to a patient with atrial fibrillation is to prevent clot formation. Patients with atrial fibrillation are at an increased risk of forming blood clots in the heart, which can lead to stroke if they travel to the brain. Anticoagulants help to reduce this risk by inhibiting the clotting process. Therefore, choices A, C, and D are incorrect because anticoagulants do not primarily aim to reduce blood pressure, prevent arrhythmias, or reduce inflammation in patients with atrial fibrillation.

2. The patient is taking low-dose erythromycin prophylactically and will start cefaclor for treating an acute infection. The nurse should discuss this with the provider because taking both medications simultaneously can cause which effect?

• A. Decreased effectiveness of cefaclor.
• B. Increased effectiveness of cefaclor.
• C. Decreased effectiveness of erythromycin.
• D. Increased effectiveness of erythromycin.

Correct answer: A

Rationale: When erythromycin and cefaclor are taken together, erythromycin can inhibit the metabolism of cefaclor, leading to elevated cefaclor levels and potentially causing adverse effects. This results in a decrease in the effectiveness of cefaclor. Therefore, the nurse should discuss this potential drug interaction with the provider to consider an alternative treatment or adjust the dosages to prevent complications. Choices B, C, and D are incorrect because the concern lies with the effect on cefaclor when combined with erythromycin, not the effect on erythromycin itself.

3. Following the diagnosis of angina pectoris, a client reports being unable to walk up two flights of stairs without pain. Which of the following measures would most likely help the client prevent this problem?

• A. Climb the stairs early in the day.
• B. Rest for at least an hour before climbing the stairs.
• C. Take a nitroglycerin tablet before climbing the stairs.
• D. Lie down after climbing the stairs.

Correct answer: C

Rationale: The correct answer is to take a nitroglycerin tablet before climbing the stairs. Nitroglycerin helps prevent angina by dilating the coronary arteries, which increases blood flow to the heart. This medication can help reduce the chest pain and discomfort experienced during physical exertion. Climing the stairs early in the day (Choice A) does not address the underlying issue of inadequate blood flow to the heart. Resting for at least an hour before climbing the stairs (Choice B) may not be as effective in preventing angina as taking nitroglycerin. Lying down after climbing the stairs (Choice D) does not offer a preventive measure for angina; it is more focused on post-activity rest rather than prevention.

4. A client is to have a transsphenoidal hypophysectomy to remove a large, invasive pituitary tumor. The nurse should instruct the client that the surgery will be performed through an incision in the:

• A. Back of the mouth.
• B. Nose.
• C. Sinus channel below the right eye.
• D. Upper gingival mucosa in the space between the upper gums and lip.

Correct answer: D

Rationale: The correct answer is D: Upper gingival mucosa in the space between the upper gums and lip. A transsphenoidal hypophysectomy involves accessing the pituitary gland through an incision in the upper gingival mucosa, providing direct access to the pituitary gland without external scars. Choices A, B, and C are incorrect because the surgery is not performed through the back of the mouth, the nose, or the sinus channel below the right eye. It is crucial for the client to understand the specific location of the incision to ensure accurate preoperative education and expectations.

5. The nurse is caring for a patient who has had severe vomiting. The patient’s serum sodium level is 130 mEq/L. The nurse will expect the patient’s provider to order which treatment?

• A. Diuretic therapy
• B. Intravenous hypertonic 5% saline
• C. Intravenous normal saline 0.9%
• D. Oral sodium supplements

Correct answer: C

Rationale: In this scenario, the patient has hyponatremia with a serum sodium level of 130 mEq/L. For a serum sodium level between 125 and 135 mEq/L, the appropriate treatment is intravenous normal saline 0.9%. Normal saline helps to increase the sodium content in the vascular fluid. Diuretic therapy would exacerbate sodium and fluid depletion, which is not suitable for a patient already dehydrated from severe vomiting. Intravenous hypertonic 5% saline is typically reserved for severe hyponatremia with a serum sodium level below 120 mEq/L. Oral sodium supplements are not feasible in this case as the patient is vomiting and may not be able to tolerate oral intake easily.

Similar Questions