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A client is receiving dietary instructions from a nurse regarding warfarin sodium (Coumadin) therapy. The nurse advises the client to avoid which food item?
- A. Grapes
- B. Spinach
- C. Watermelon
- D. Cottage cheese
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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During an admission assessment, a client informs the nurse that they take propylthiouracil (PTU) daily. Based on this information, the nurse suspects that the client has a history of:
- A. Myxedema
- B. Graves' disease
- C. Addison's disease
- D. Cushing's syndrome
Correct Answer: B
Rationale: Propylthiouracil (PTU) is a medication commonly used to treat hyperthyroidism, including Graves' disease, which is characterized by an overactive thyroid gland. The client mentioning the daily use of PTU indicates that they likely have a history of Graves' disease, as this medication helps manage the condition by reducing the production of thyroid hormones. Therefore, the correct answer is B: Graves' disease.
Heparin sodium is prescribed for the client. The nurse expects that the healthcare provider will prescribe which of the following to monitor for a therapeutic effect of the medication?
- A. Hematocrit level
- B. Hemoglobin level
- C. Prothrombin time (PT)
- D. Activated partial thromboplastin time (aPTT)
Correct Answer: D
Rationale: The activated partial thromboplastin time (aPTT) is used to monitor the therapeutic effect of heparin sodium. Heparin affects the intrinsic pathway of coagulation, and monitoring aPTT helps ensure the medication is within the therapeutic range to prevent clot formation. Hematocrit and hemoglobin levels assess red blood cell concentrations, while prothrombin time (PT) is used to monitor the therapeutic effect of warfarin sodium, a different anticoagulant that affects the extrinsic pathway of coagulation.
A client is learning how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching?
- A. Withdraws the NPH insulin first
- B. Withdraws the regular insulin first
- C. Injects air into the NPH insulin vial first
- D. Injects an amount of air equal to the desired dose of insulin into the vial
Correct Answer: A
Rationale: When mixing regular insulin with another insulin preparation, it is crucial to withdraw the regular insulin first to prevent contamination. NPH insulin should be drawn after the regular insulin to maintain the integrity of each insulin type. Therefore, if the client withdraws the NPH insulin first, it indicates the need for further teaching.
When reviewing laboratory results for a client receiving tacrolimus (Prograf), which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?
- A. Blood glucose of 200 mg/dL
- B. Potassium level of 3.8 mEq/L
- C. Platelet count of 300,000 cells/mm³
- D. White blood cell count of 6000 cells/mm³
Correct Answer: A
Rationale: An elevated blood glucose level of 200 mg/dL indicates an adverse effect of tacrolimus. This finding suggests hyperglycemia, which is a known adverse effect of the medication. Other potential adverse effects of tacrolimus include neurotoxicity and hypertension. Monitoring blood glucose levels is crucial to detect and manage this adverse effect promptly.
A client with severe acne is seen in the clinic, and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the HCP if the client is taking which medication?
- A. Vitamin A
- B. Digoxin (Lanoxin)
- C. Furosemide (Lasix)
- D. Phenytoin (Dilantin)
Correct Answer: A
Rationale: Isotretinoin is a metabolite of vitamin A, which can lead to toxicity when taken together. Therefore, it is crucial to avoid concurrent use of vitamin A supplements with isotretinoin. Contacting the HCP to discuss discontinuing vitamin A supplements is important to prevent potential adverse effects.