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A client has a new prescription for Warfarin. Which of the following instructions should the nurse include?
- A. Monitor for signs of bleeding.
- B. Avoid foods high in vitamin K.
- C. Expect to have increased urination.
- D. Take the medication with an antacid.
Correct Answer: A
Rationale: The correct instruction for a client starting Warfarin is to monitor for signs of bleeding. Warfarin is an anticoagulant that increases the risk of bleeding; therefore, it is crucial for the client to watch for any signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stools, or unusual bleeding from gums or nose. If any of these signs occur, the client should promptly report them to their healthcare provider for further evaluation and management. Choices B, C, and D are incorrect because avoiding foods high in vitamin K is related to other medications like Coumadin, increased urination is not a common side effect of Warfarin, and taking Warfarin with an antacid can potentially interfere with its absorption.
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Which drug is the antidote for Alprazolam?
- A. Physostigmine
- B. Protamine sulfate
- C. Flumazenil
- D. Acetylcysteine
Correct Answer: C
Rationale: Flumazenil is the specific antidote used to reverse the effects of Alprazolam. Alprazolam is a benzodiazepine, and Flumazenil is a benzodiazepine receptor antagonist that works by competitively inhibiting the actions of benzodiazepines at the receptor site, effectively reversing their sedative and other effects. Physostigmine is not used as an antidote for benzodiazepine overdose and can have significant side effects. Protamine sulfate is used to reverse the effects of heparin, not benzodiazepines like Alprazolam. Acetylcysteine is used as an antidote for acetaminophen overdose, not benzodiazepines like Alprazolam.
The adolescent is supposed to go to the school nurse at 12:00 to receive his medication for attention-deficit hyperactivity disorder (ADHD). He often does not go for the medication. What best describes the nurse's understanding of this situation?
- A. The adolescent is embarrassed in front of his peers
- B. The adolescent does not understand the need for the medication
- C. The adolescent forgets that he is supposed to take the medication
- D. The adolescent has made a conscious decision not to take the medication
Correct Answer: A
Rationale: Adolescents prioritize peer image-skipping ADHD meds (e.g., Ritalin) at school likely stems from embarrassment, a developmental trait. Lack of understanding or forgetting is possible but less likely with routine. Conscious refusal needs evidence (e.g., verbal rejection). Embarrassment fits social sensitivity, guiding intervention.
A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
- A. "I will clean the site with an alcohol swab before I apply the patch."
- B. "I will rotate the application sites weekly."
- C. "I will apply the patch to an area of skin with no hair."
- D. "I will place the new patch on the site of the old patch.
Correct Answer: B
Rationale: Rotating the application sites of transdermal patches is important to prevent skin irritation and enhance absorption efficiency. This practice helps to minimize skin irritation and allows the skin to recover between applications. By rotating the sites weekly, the client can ensure optimal medication delivery and reduce the risk of skin reactions at any specific application site. This indicates that the client understands the importance of proper patch placement and skin care.
A client with cirrhosis is about to receive a dose of lactulose. The client questions the need for the medication, stating they are not constipated. The nurse should explain that lactulose is used in cirrhosis to reduce levels of which component in the bloodstream?
- A. Glucose
- B. Ammonia
- C. Potassium
- D. Bicarbonate
Correct Answer: B
Rationale: Lactulose is administered to clients with cirrhosis to lower blood ammonia levels, thus aiding in the prevention of hepatic encephalopathy. Elevated ammonia levels in cirrhosis can lead to cognitive impairment and hepatic encephalopathy. Therefore, the correct answer is B (Ammonia). Glucose (Choice A) is not the component targeted by lactulose in cirrhosis. Potassium (Choice C) and Bicarbonate (Choice D) are not directly affected by lactulose administration in cirrhosis.
A client has a new prescription for Alendronate to treat osteoporosis. Which of the following instructions should the nurse include?
- A. Take the medication with a full glass of water after rising in the morning.
- B. Lie down for at least 30 minutes after taking the medication.
- C. Take the medication before bedtime to reduce the risk of esophageal irritation.
- D. Crush the tablet and mix it with applesauce if having difficulty swallowing.
Correct Answer: A
Rationale: The correct instruction is to take Alendronate with a full glass of water after rising in the morning. This helps reduce the risk of esophageal irritation, as the medication can cause irritation if not taken correctly. Taking it before bedtime (choice C) can increase the risk of irritation as the individual lies down. Lying down after taking the medication (choice B) can also lead to esophageal irritation. Crushing the tablet (choice D) is not recommended as Alendronate should be taken whole with a full glass of water.