A nurse is providing discharge teaching to a client who has a new prescription for Warfarin. Which of the following statements should the nurse include?
- A. You should avoid taking aspirin for headaches while on this medication.
- B. You should use a soft toothbrush to brush your teeth.
- C. You should avoid foods that are rich in vitamin K.
- D. You should avoid prolonged exposure to sunlight.
Correct Answer: B
Rationale: The correct statement to include in discharge teaching for a client prescribed Warfarin is to use a soft toothbrush to prevent gum bleeding. Warfarin is an anticoagulant that increases the risk of bleeding, so using a soft toothbrush can help prevent gum injury and bleeding. Choice A is incorrect because aspirin, another blood-thinning medication, should generally be avoided while on Warfarin to reduce the risk of bleeding. Choice C is incorrect because clients on Warfarin should maintain a consistent intake of vitamin K-rich foods rather than avoid them completely. Choice D is unrelated to the medication and not a priority teaching point for a client prescribed Warfarin.
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What is pharmacodynamics?
- A. The medical reference summarizing standards of drug purity, strength, and directions for synthesis
- B. The drug's actions at receptor sites and the physiological, chemical, and behavioral effects produced by these actions
- C. The maximum response that a drug can produce
- D. Movements of the drugs throughout the body
Correct Answer: B
Rationale: Pharmacodynamics refers to the drug's actions at receptor sites and the physiological, chemical, and behavioral effects produced by these actions. It involves understanding how drugs interact with the body at the molecular level to produce their effects, including mechanisms of action, receptor binding, and downstream physiological responses. Choice A is incorrect because it describes pharmacopeia, which is a reference book containing standards for drugs. Choice C refers to efficacy, which is the maximum effect a drug can produce. Choice D describes pharmacokinetics, which focuses on the movement of drugs within the body.
To which pharmacologic classification does the drug propranolol belong?
- A. Beta Blockers
- B. Cholinergics
- C. Immune globulins
- D. Barbiturates
Correct Answer: A
Rationale: Propranolol belongs to the pharmacologic classification of Beta Blockers. Beta blockers work by blocking the action of adrenaline and other stress hormones on beta-adrenergic receptors. They are commonly used to manage conditions like high blood pressure, angina, and arrhythmias. Choice B, Cholinergics, is incorrect because cholinergics work by stimulating the parasympathetic nervous system, unlike beta blockers that block adrenergic receptors. Choice C, Immune globulins, is incorrect as it refers to antibodies used to boost the immune system, not the mechanism of action of propranolol. Choice D, Barbiturates, is incorrect as barbiturates are a different class of drugs that act as central nervous system depressants, primarily used as sedatives and anesthetics.
A client calls the clinic and tells the nurse that she has missed taking several of her contraceptive pills during the current cycle. What is the best instruction for the nurse to give the client?
- A. Please come into the clinic immediately to have a pregnancy test done.'
- B. You might consider another form of birth control if you keep missing your pills.'
- C. If you have missed fewer than three of your pills, you do not need to worry.'
- D. You should use an alternative form of birth control for the rest of this cycle.'
Correct Answer: D
Rationale: Missing several contraceptive pills compromises efficacy, requiring an alternative method for the cycle to prevent pregnancy. Testing assesses outcome, not prevention. Future methods don't address now. Fewer than three still risks failure. D ensures immediate protection, making it the best instruction.
When administering the drug senna to a patient, what must a health care provider inform the patient of?
- A. This drug is intended to lower blood pressure and is best used in combination with other antihypertensives
- B. This drug is not intended for long-term use
- C. The patient must limit his/her fiber intake
- D. Advise the patient to change positions slowly to limit the risk of orthostatic hypotension
Correct Answer: B
Rationale: The correct answer is B. Senna is a laxative used for short-term relief of constipation, not for long-term use. Choice A is incorrect because senna does not lower blood pressure or require combination with antihypertensives. Choice C is unrelated as there is no need to limit fiber intake with senna. Choice D is incorrect as orthostatic hypotension is not a common concern with senna use.
A client with cancer and a prescription for methotrexate PO reports bleeding gums while being assessed by a nurse in a provider's clinic. Which of the following actions should the nurse take?
- A. Explain to the client that this is an expected adverse effect.
- B. Check the value of the client's current platelet count.
- C. Instruct the client to use an electric toothbrush.
- D. Have the client make an appointment to see the dentist.
Correct Answer: B
Rationale: The correct action for the nurse to take when a client on methotrexate reports bleeding gums is to check the client's current platelet count. Bleeding gums may indicate thrombocytopenia, a decreased platelet count which can be a severe side effect of methotrexate therapy. Monitoring the platelet count is crucial for early detection and management of this potentially life-threatening complication. Choice A is incorrect as bleeding gums in this context may not be an expected adverse effect of methotrexate. Choice C is irrelevant and does not address the potential underlying issue of thrombocytopenia. Choice D is not the primary action needed at this point; checking the platelet count is more urgent to assess the severity of the situation.