Nokea
A client is taking furosemide. Which of the following findings should the nurse report to the provider?
- A. Weight gain
- B. Dry cough
- C. Hypokalemia
- D. Increased appetite
Correct Answer: C
Rationale: Furosemide is a loop diuretic that can lead to potassium loss, resulting in hypokalemia. Hypokalemia is a serious electrolyte imbalance that can cause various cardiac and muscular issues. Therefore, the nurse should promptly report hypokalemia to the healthcare provider for appropriate management. Choices A, B, and D are incorrect because weight gain, dry cough, and increased appetite are not typically associated with furosemide use and are not immediate concerns that require urgent reporting.
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The healthcare provider is reinforcing instructions to a client with heart failure who is prescribed a low-sodium diet. The provider should advise the client to choose which food item?
- A. Canned soup
- B. Fresh vegetables
- C. Processed cheese
- D. Pickled vegetables
Correct Answer: B
Rationale: Fresh vegetables are a suitable choice for clients on a low-sodium diet as they are naturally low in sodium and provide essential nutrients. In contrast, canned soup, processed cheese, and pickled vegetables tend to be high in sodium, which is not recommended for individuals with heart failure and on a low-sodium diet. Fresh vegetables are also rich in fiber, vitamins, and minerals, making them a healthier option compared to the other choices provided.
The client with a new prescription for warfarin (Coumadin) is receiving teaching from the LPN/LVN. Which statement by the client indicates an understanding of the medication?
- A. I will avoid eating foods high in vitamin K, like spinach and broccoli.
- B. I will take aspirin instead of acetaminophen for headaches while on this medication.
- C. I can stop taking the medication once my symptoms improve.
- D. I will double my dose if I miss a dose to catch up.
Correct Answer: A
Rationale: Clients prescribed with warfarin (Coumadin) need to maintain a consistent intake of vitamin K and avoid sudden increases in foods rich in vitamin K as it can interfere with the effectiveness of the medication. Choice A, 'I will avoid eating foods high in vitamin K, like spinach and broccoli,' is the correct statement indicating an understanding of the medication. This choice demonstrates knowledge of the importance of consistent vitamin K intake to prevent fluctuations in warfarin's effectiveness. Choices B, C, and D are incorrect. Choice B suggests a substitution that is not advised without consulting a healthcare provider. Choice C is incorrect as stopping warfarin suddenly can lead to serious health risks. Choice D is unsafe and incorrect since doubling the dose is not the correct action if a dose is missed.
The nurse is assisting with the care of a client who is on a continuous heparin infusion for deep vein thrombosis (DVT). Which laboratory test should the nurse monitor to evaluate the effectiveness of the therapy?
- A. Prothrombin time (PT)
- B. Activated partial thromboplastin time (aPTT)
- C. International normalized ratio (INR)
- D. Platelet count
Correct Answer: B
Rationale: To evaluate the effectiveness of heparin therapy in a client with DVT, the nurse should monitor the activated partial thromboplastin time (aPTT). The aPTT test helps ensure that the dose of heparin is within the therapeutic range, which is essential for preventing clot formation or excessive bleeding. Monitoring aPTT is crucial in managing patients on heparin therapy to maintain the delicate balance between preventing thrombosis and avoiding hemorrhage. Prothrombin time (PT) and International normalized ratio (INR) are more indicative of warfarin therapy effectiveness, not heparin. Platelet count assesses platelet levels and function, not the effectiveness of heparin therapy for DVT.
A client with a diagnosis of deep vein thrombosis (DVT) has been placed on bed rest. The LPN/LVN should reinforce which instruction to the client to prevent complications?
- A. Perform ankle pumps and circles every 1 to 2 hours.
- B. Use a heating pad to relieve pain in the affected leg.
- C. Keep the affected leg flat and avoid elevation.
- D. Wear tight compression stockings to prevent swelling.
Correct Answer: A
Rationale: Performing ankle pumps and circles every 1 to 2 hours is crucial for a client with DVT on bed rest. These exercises promote venous return, preventing stasis and reducing the risk of complications such as pulmonary embolism. Ankle pumps help activate the calf muscle pump, assisting in propelling blood back to the heart and preventing blood clots from forming or worsening. Choice B is incorrect because using a heating pad can increase blood flow to the area, potentially dislodging a clot. Choice C is incorrect because elevation helps reduce swelling and improve venous return. Choice D is incorrect because although compression stockings can be beneficial, they are not the most important instruction for preventing complications in this scenario.
A client has a new prescription for metformin. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Monitor for signs of hypoglycemia.
- C. Increase fluid intake.
- D. Expect a metallic taste in the mouth.
Correct Answer: C
Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration can also help reduce the risk of kidney problems associated with metformin use. Choices A, B, and D are incorrect. While it's generally recommended to take metformin with food to reduce stomach upset, monitoring for signs of hypoglycemia is more relevant for other antidiabetic medications, and a metallic taste in the mouth is not a common side effect of metformin.