Nokea
A nurse is caring for a client who has a new prescription for warfarin. Which of the following laboratory tests should the nurse use to monitor the client's therapeutic response to the medication?
- A. INR
- B. aPTT
- C. Platelet count
- D. Hemoglobin A1C
Correct Answer: A
Rationale: The correct answer is A: INR. The INR (International Normalized Ratio) is the laboratory test used to monitor the therapeutic response of warfarin. It helps ensure that the client's clotting time is within the desired range to prevent complications such as excessive bleeding or clotting. Choice B, aPTT (Activated Partial Thromboplastin Time), is not typically used to monitor warfarin therapy but rather for assessing heparin therapy. Choice C, Platelet count, assesses the number of platelets in the blood and is not specifically used to monitor warfarin therapy. Choice D, Hemoglobin A1C, is a test used to monitor long-term blood sugar control in diabetic patients and is not relevant to monitoring warfarin therapy.
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A nurse is caring for a client who is postoperative following a thyroidectomy. The nurse should identify that which of the following client reports is an indication of hypocalcemia?
- A. Constipation
- B. Frequent urination
- C. Numbness and tingling of the fingers
- D. Increased thirst
Correct Answer: C
Rationale: The correct answer is C: 'Numbness and tingling of the fingers.' Post-thyroidectomy, hypocalcemia is a concern due to potential damage to the parathyroid glands that regulate calcium levels. Numbness and tingling of the fingers are classic signs of hypocalcemia. Constipation (Choice A) is not typically associated with hypocalcemia. Frequent urination (Choice B) is more indicative of conditions like diabetes or a urinary tract infection. Increased thirst (Choice D) is commonly seen in conditions such as diabetes insipidus or uncontrolled diabetes mellitus, not specifically related to hypocalcemia.
A nurse is reviewing the laboratory report of a client who has been receiving lithium carbonate for the past 12 months. The nurse notes a lithium level of 0.8 mEq/L. Which of the following orders from the provider should the nurse expect?
- A. Withhold the next dose.
- B. Increase the dosage.
- C. Discontinue the medication.
- D. Administer the medication.
Correct Answer: D
Rationale: Administering the medication is appropriate for a stable lithium level of 0.8 mEq/L. A level of 0.8 mEq/L falls within the therapeutic range for lithium, indicating that the client is receiving an adequate dose to maintain therapeutic effects. Withholding the next dose, increasing the dosage, or discontinuing the medication would not be indicated at this lithium level as it is within the desired range for therapeutic benefit. Therefore, the correct action would be to continue administering the medication to ensure the client maintains the therapeutic level of lithium.
A client is being taught about a new prescription for furosemide. Which of the following statements by the client indicates an understanding of the teaching?
- A. This medication will decrease my potassium levels.
- B. I should eat a banana every day to increase my potassium intake.
- C. I will stop taking this medication if I experience a cough.
- D. I should avoid drinking alcohol while taking this medication.
Correct Answer: D
Rationale: The correct answer is D. Clients taking furosemide should avoid alcohol because it can lead to dehydration and potential interactions with the medication. Choices A and B are incorrect because furosemide is a diuretic that can actually lower potassium levels, so the client should not expect an increase in potassium levels or solely rely on bananas for potassium intake. Choice C is incorrect because a cough is not a common side effect of furosemide and should not be a reason to stop taking the medication.
A client with acute diverticulitis should have which intervention included in the care plan?
- A. Administer a cleansing enema.
- B. Initiate a low-fiber diet.
- C. Apply moist heat to the abdomen.
- D. Provide a clear liquid diet.
Correct Answer: B
Rationale: The correct intervention for a client with acute diverticulitis is to initiate a low-fiber diet. A low-fiber diet helps manage acute diverticulitis by reducing irritation to the colon, allowing it to heal. Administering a cleansing enema (Choice A) can worsen diverticulitis by increasing pressure within the colon. Applying moist heat to the abdomen (Choice C) may provide comfort but does not address the underlying cause. Providing a clear liquid diet (Choice D) is not ideal for diverticulitis management as it lacks the necessary nutrients for healing and may not provide enough bulk to prevent further irritation.
A nurse in an emergency department is assessing a client who reports ingesting thirty diazepam tablets. After securing the client's airway and initiating an IV, which of the following actions should the nurse take next?
- A. Monitor the client's IV site for thrombophlebitis
- B. Administer flumazenil to the client
- C. Evaluate the client for further suicidal behavior
- D. Initiate seizure precautions for the client
Correct Answer: B
Rationale: In cases of benzodiazepine overdose, such as diazepam ingestion, flumazenil is the antidote. Therefore, the priority action for the nurse is to administer flumazenil to the client. Monitoring the IV site for thrombophlebitis (Choice A) is important but not the immediate priority. Evaluating the client for further suicidal behavior (Choice C) is important but not the next immediate action. Initiating seizure precautions (Choice D) is not the priority as the client's airway has already been secured.