Nokea
A client is receiving heparin therapy. Which of the following laboratory tests should be monitored to evaluate the effectiveness of the therapy?
- A. Prothrombin time (PT)
- B. International normalized ratio (INR)
- C. Activated partial thromboplastin time (aPTT)
- D. Complete blood count (CBC)
Correct Answer: C
Rationale: Activated partial thromboplastin time (aPTT) is the most appropriate laboratory test to monitor the effectiveness of heparin therapy. Heparin works on the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps assess its anticoagulant effect. Therapeutic levels of aPTT for clients on heparin therapy are typically 1.5 to 2.5 times the control value. Prothrombin time (PT) and International normalized ratio (INR) are used to monitor warfarin therapy, which acts on the extrinsic pathway of the coagulation cascade. Complete blood count (CBC) is not specific for monitoring the effectiveness of heparin therapy.
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A healthcare professional is assessing a client who has been taking isoniazid to treat tuberculosis. The healthcare professional should monitor the client for which of the following findings as an adverse effect of the medication?
- A. Diarrhea
- B. Blurred vision
- C. Hearing loss
- D. Jaundice
Correct Answer: D
Rationale: Correct. Jaundice is a serious adverse effect of isoniazid due to liver damage. It is essential to monitor for signs of liver toxicity, such as jaundice, while the client is on this medication. Diarrhea is a common side effect of isoniazid, but it is not as serious as liver damage. Blurred vision and hearing loss are not typically associated with isoniazid use.
A client has a new prescription for amitriptyline. Which of the following instructions should the nurse include?
- A. Take the medication in the morning.
- B. Avoid consuming grapefruit juice.
- C. Take the medication with a full glass of water.
- D. Monitor for signs of weight gain.
Correct Answer: C
Rationale: When a client is prescribed amitriptyline, it is important to instruct them to take the medication with a full glass of water. This instruction helps prevent esophageal irritation, as amitriptyline can be harsh on the esophagus. Option C is the correct choice. Option A, taking the medication in the morning, is not specific to amitriptyline and can vary depending on the individual's condition. Option B, avoiding grapefruit juice, is a general precaution for many medications but not specifically related to amitriptyline. Option D, monitoring for signs of weight gain, is not a direct instruction for taking the medication itself and may not be a common side effect of amitriptyline.
A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following statements should the nurse include?
- A. Avoid using a soft toothbrush.
- B. Report any signs of bleeding.
- C. Increase your intake of leafy green vegetables.
- D. Take the medication with food.
Correct Answer: B
Rationale: The correct answer is B: 'Report any signs of bleeding.' When a patient is prescribed warfarin, it is essential to monitor for signs of bleeding as warfarin is an anticoagulant that increases the risk of bleeding. Choices A, C, and D are incorrect. Avoid using a soft toothbrush is not directly related to warfarin therapy, increasing the intake of leafy green vegetables can interfere with warfarin's effectiveness due to its vitamin K content, and taking warfarin with food is unnecessary as it can be taken with or without food.
A healthcare provider is assessing a client who has been taking lisinopril. Which of the following findings should the provider report?
- A. Dry cough
- B. Hyperkalemia
- C. Elevated blood pressure
- D. Increased appetite
Correct Answer: A
Rationale: The correct answer is A: Dry cough. A dry cough is a common side effect of lisinopril. It is essential to report this to the healthcare provider as it may indicate the need to discontinue the medication to prevent further complications such as angioedema or cough that can persist for weeks to months after stopping the medication. Choice B, hyperkalemia, is not typically associated with lisinopril use; instead, it is a possible side effect of medications like potassium-sparing diuretics. Choice C, elevated blood pressure, would not be a concerning finding as lisinopril is often prescribed to lower blood pressure. Choice D, increased appetite, is not a common side effect of lisinopril and would not typically warrant immediate reporting.
A client with a new prescription for simvastatin is receiving teaching from a healthcare provider. Which of the following statements by the client indicates an understanding of the teaching?
- A. 'I should take this medication in the evening.'
- B. 'I should avoid drinking grapefruit juice.'
- C. 'I should expect my urine to be red-orange while taking this medication.'
- D. 'I will need to take this medication for the rest of my life.'
Correct Answer: A
Rationale: The correct answer is A. Taking simvastatin in the evening is recommended because cholesterol synthesis increases at night. This timing maximizes the effectiveness of the medication in lowering cholesterol levels. Choice B is incorrect because grapefruit juice should be avoided with certain statins, but simvastatin is not significantly affected by grapefruit juice. Choice C is incorrect as red-orange urine is not an expected side effect of simvastatin. Choice D is incorrect because simvastatin is typically prescribed for managing cholesterol levels and may not need to be taken for the rest of the client's life.