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A client has been diagnosed with atrial fibrillation. The physician ordered warfarin (Coumadin) to be taken on a daily basis. The nurse instructs the client to avoid using which of the following over-the-counter medications while taking warfarin?
- A. Aspirin
- B. Diphenhydramine (Benadryl)
- C. Digoxin (Lanoxin)
- D. Pseudoephedrine (Sudafed)
Correct Answer: A
Rationale: Aspirin increases bleeding risk when taken with warfarin, a blood thinner, and should be avoided. Other listed medications have less significant interactions with warfarin.
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An obese diabetic client complains of bilateral leg aching. His physician has referred him to cardiac rehabilitation to start an exercise program. Which of the following activities is most helpful for the client?
- A. Interval training on the stationary bicycle.
- B. Interval training on the treadmill.
- C. Interval training on a commercial ski machine.
- D. Interval training on the stair climber.
Correct Answer: A
Rationale: Stationary cycling is low-impact, suitable for an obese diabetic client, minimizing joint stress while improving cardiovascular health.
A client with a urinary tract infection is prescribed ciprofloxacin. What should the nurse include in the teaching?
- A. Take the medication with dairy products.
- B. Report tendon pain or swelling.
- C. Increase fluid intake to 1 L/day.
- D. Avoid sunlight exposure completely.
Correct Answer: B
Rationale: Ciprofloxacin can cause tendonitis or tendon rupture, so reporting tendon pain or swelling is critical.
The clinic nurse is reviewing the laboratory reports for a client who is taking allopurinol (Zyloprim). Which of the following laboratory findings indicates that the allopurinol is having the desired effect?
- A. Decreased serum uric acid level.
- B. Decreased serum potassium level.
- C. Increased serum calcium level.
- D. Increased hemoglobin level.
Correct Answer: A
Rationale: Allopurinol reduces serum uric acid levels by inhibiting xanthine oxidase, which is its therapeutic effect in treating gout.
The nurse is teaching a client with a new diagnosis of osteoporosis about dietary management. Which of the following foods should the nurse recommend?
- A. Yogurt.
- B. Bananas.
- C. White bread.
- D. Red meat.
Correct Answer: A
Rationale: Yogurt is high in calcium, essential for bone health in osteoporosis.
A client has been scheduled for a barium swallow (esophagography). The nurse determines that the client understands preprocedure instructions when the client states the intention to take which action before the test?
- A. Take all oral medications as scheduled.
- B. Eat a regular breakfast on the day of the test.
- C. Monitor own bowel movement pattern for constipation.
- D. Remove metal objects and jewelry, especially from the neck and chest area.
Correct Answer: D
Rationale: A barium swallow, or esophagography, is a radiograph that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal (GI) tract. The client is told to remove metal objects such as medals and jewelry before the test so that they will not interfere with radiographic visualization of the field. Some oral medications are withheld before the test, and the client should follow the primary health care provider's instructions regarding medication administration. The client should fast for a minimum of 8 hours before the test, depending on primary health care provider's instructions. It is important after the procedure to monitor for constipation, which can occur as a result of the presence of barium in the GI tract.