Nokea
A client has been prescribed Warfarin for atrial fibrillation. Which of the following instructions should the nurse include in the discharge teaching?
- A. Avoid foods high in vitamin K.
- B. Take this medication with food to prevent nausea.
- C. Monitor your heart rate daily before taking the medication.
- D. Limit your fluid intake to 1 liter per day.
Correct Answer: A
Rationale: The correct instruction for the nurse to include in the discharge teaching for a client prescribed Warfarin is to 'Avoid foods high in vitamin K.' Foods high in vitamin K can decrease the effectiveness of Warfarin by interfering with its anticoagulant effects, potentially leading to blood clotting issues. It is crucial for clients on Warfarin therapy to maintain a consistent intake of vitamin K-containing foods to ensure the stability of the medication's effects. Choices B, C, and D are incorrect because taking Warfarin with food, monitoring heart rate daily, or limiting fluid intake are not directly related to optimizing the effectiveness of Warfarin therapy.
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A client with heart failure is prescribed digoxin. Which statement by the client indicates an adverse effect of the medication?
- A. I can walk a mile a day.
- B. I've had a backache for several days.
- C. I am urinating more frequently.
- D. I feel nauseated and have no appetite.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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.
The following are true for adrenaline EXCEPT:
- A. it acts via G-proteins
- B. alpha receptor stimulation results in decreased cAMP production
- C. it may be administered via inhalation, orally and parentally
- D. it has no active metabolites
Correct Answer: C
Rationale: Adrenaline, or epinephrine, is a catecholamine that exerts its effects through adrenergic receptors, which are G-protein-coupled, making its action via G-proteins a true statement. Alpha receptor stimulation typically inhibits adenylate cyclase, reducing cyclic AMP (cAMP) production, which aligns with its known pharmacology and is also true. Adrenaline can indeed be administered via inhalation (e.g., for asthma), orally (though less common), and parenterally (e.g., intramuscularly in anaphylaxis), confirming this as true. However, adrenaline does have active metabolites, such as metanephrine and normetanephrine, produced via catechol-O-methyltransferase (COMT) metabolism, making the statement about having no active metabolites false. In cardiac arrest, it facilitates CPR by causing peripheral vasoconstriction, increasing coronary perfusion pressure, which is true. The false statement here is about the absence of active metabolites, as adrenaline's breakdown products retain some activity, a key point in understanding its pharmacokinetics and duration of effect.
A healthcare professional is reviewing the medical history of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following findings should the healthcare professional report to the provider?
- A. Hemoglobin A1C of 7.5%
- B. Creatinine level of 1.2 mg/dL
- C. BUN level of 18 mg/dL
- D. Liver function tests showing AST of 50 units/L
Correct Answer: D
Rationale: The correct answer is D. Elevated AST levels in liver function tests should be reported to the provider when a client is prescribed Metformin due to the potential risk of hepatotoxicity associated with the medication. Elevated Hemoglobin A1C (choice A), Creatinine level within normal range (choice B), and BUN level within normal range (choice C) are not directly concerning when initiating Metformin therapy.
What nursing interventions should you perform when a patient is on Albuterol? (Select all that apply)
- A. Assess lung sounds, pulse, and blood pressure before administering
- B. Monitor for changes in behavior
- C. Observe for paradoxical bronchospasms
- D. Both A and C
Correct Answer: D
Rationale: The correct nursing interventions to perform when a patient is on Albuterol include assessing the patient's lung sounds, pulse, and blood pressure before administering the medication to monitor for cardiovascular side effects like increased heart rate. Additionally, it is crucial to observe for paradoxical bronchospasms, a rare but serious adverse reaction where the medication causes a worsening of bronchospasm instead of relief. Monitoring for changes in behavior is not directly related to Albuterol administration and is not a standard nursing intervention for patients receiving this medication, making choice B incorrect. Therefore, the correct answer is D as it includes the essential nursing actions for patients on Albuterol.