Nokea
A client with atrial fibrillation is prescribed warfarin (Coumadin). Which instruction should the nurse give to the client regarding lifestyle changes?
- A. Avoid prolonged sitting or standing.
- B. Use an electric razor to prevent cuts.
- C. Take your medication with a full glass of water.
- D. Eat a diet low in protein.
Correct Answer: B
Rationale: The correct answer is B. Using an electric razor is advised to prevent cuts, which is crucial for individuals taking warfarin due to the increased risk of bleeding associated with this medication. Lifestyle changes related to warfarin therapy focus on minimizing the risk of bleeding, and using safety measures such as an electric razor is a practical recommendation to reduce the likelihood of injury. Choices A, C, and D are incorrect. Avoiding prolonged sitting or standing is more related to preventing blood clots than to the bleeding risk of warfarin. Taking warfarin with a full glass of water is not a specific lifestyle change associated with its use. Eating a diet low in protein is not a typical recommendation for individuals on warfarin therapy.
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A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath. The LPN/LVN understands that a life-threatening complication of this condition is which?
- A. Pneumonia
- B. Pulmonary edema
- C. Pulmonary embolism
- D. Myocardial infarction
Correct Answer: C
Rationale: The correct answer is C, Pulmonary embolism. Pulmonary embolism is a critical complication of thrombophlebitis where a blood clot dislodges and travels to the lungs, obstructing blood flow. This obstruction can lead to chest pain, shortness of breath, and potentially fatal consequences, making it a life-threatening emergency that requires prompt intervention. Choices A, B, and D are incorrect because pneumonia, pulmonary edema, and myocardial infarction are not directly associated with thrombophlebitis and would not present with the sudden onset of chest pain and shortness of breath in this context.
The nurse is caring for a client with heart failure who is receiving digoxin (Lanoxin). Which sign of digoxin toxicity should the nurse monitor for?
- A. Hypertension
- B. Bradycardia
- C. Hyperglycemia
- D. Insomnia
Correct Answer: B
Rationale: Corrected Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin can cause bradycardia due to its effects on the heart's electrical conduction system. Monitoring for a slow heart rate is crucial as it indicates potential toxicity. Hypertension, hyperglycemia, and insomnia are not typically associated with digoxin toxicity. Hypertension is more commonly seen in other conditions, hyperglycemia is not a typical sign of digoxin toxicity, and insomnia is not a recognized symptom of digoxin toxicity.
Men may require higher doses of which drug class due to differences in body composition?
- A. Lipid-soluble drugs
- B. Water-soluble drugs
- C. Drugs that are highly protein bound
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because men's greater lean mass dilutes water-soluble drugs, often requiring higher doses for efficacy, unlike others. Choice A is incorrect as lipid-soluble drugs align with fat, lower in men. Choice C is wrong because protein binding isn't sex-specific here. Choice D is incorrect since only water-soluble drugs apply.
Strategies to avoid counterfeit drugs include:
- A. Purchasing from licensed pharmacies
- B. Checking drug packaging
- C. Avoiding online purchases from unverified sources
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because using licensed pharmacies (regulated supply), checking packaging (authenticity cues), and avoiding unverified online sources (high-risk) all prevent counterfeit drug use, per FDA advice. Choice A is incorrect alone as it's one strategy. Choice B is wrong by itself because packaging is just part. Choice C is incorrect solo since online avoidance is only one method.
What predisposing factor most likely contributed to the proximal end of the femur fracture in a 62-year-old woman who lives alone and tripped on a rug in her home?
- A. Failing eyesight leading to an unsafe environment
- B. Renal osteodystrophy from chronic kidney disease (CKD)
- C. Osteoporosis from declining hormone levels
- D. Cerebral vessel changes causing transient ischemic attacks
Correct Answer: C
Rationale: The most likely predisposing factor contributing to the proximal end of the femur fracture in a 62-year-old woman is osteoporosis resulting from declining hormone levels. Osteoporosis weakens the bones, making them more susceptible to fractures, especially in older adults, particularly women. In this case, the fracture can be attributed to the bone density loss associated with osteoporosis, which is a common concern in postmenopausal women. Choices A, B, and D are less likely to have directly contributed to the femur fracture in this scenario. Failing eyesight may increase the risk of falls but does not directly weaken the bones. Renal osteodystrophy affects bone health but is less common in this age group. Cerebral vessel changes causing transient ischemic attacks are related to vascular issues, not bone strength.