Nokea
A nurse is evaluating the laboratory results of four clients. The nurse should report which of the following laboratory results to the provider?
- A. A client who has a prescription for heparin and an aPTT of 90 seconds (30-40 seconds).
- B. A client who has a prescription for warfarin and an INR of 2.0 (0.8 to 1.1).
- C. A client who has a prescription for heparin and an aPTT of 65 seconds (30-40 seconds).
- D. A client who has a prescription for warfarin and an INR of 3.0 (0.8 to 1.1).
Correct Answer: A
Rationale: The correct answer is A. A client who has a prescription for heparin and an aPTT of 90 seconds (30-40 seconds) should be reported to the provider because the aPTT result is significantly above the therapeutic range, indicating a potential risk of bleeding due to excessive anticoagulation. Heparin therapy requires close monitoring of aPTT levels to ensure the medication's efficacy and safety. Reporting this result promptly to the provider allows for timely adjustment of the heparin dosage to prevent complications.
Choices B, C, and D are incorrect because they fall within or close to the desired therapeutic ranges for the respective medications. Therefore, they do not require immediate reporting to the provider as they suggest appropriate anticoagulation levels.
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A nurse is collecting data from a client who states she recently started taking garlic as an herbal supplement. The nurse should advise the client to stop taking garlic due to a potential reaction with which of the following client medications?
- A. Dicloxacillin
- B. Warfarin
- C. Esomeprazole
- D. Hydrochlorothiazide
Correct Answer: B
Rationale: The correct answer is B: Warfarin. Garlic can interact with warfarin, an anticoagulant, potentially increasing the risk of bleeding due to its antiplatelet effects. Garlic can enhance the effects of warfarin, leading to an increased risk of bleeding complications. Dicloxacillin (A) is an antibiotic, Esomeprazole (C) is a proton pump inhibitor, and Hydrochlorothiazide (D) is a diuretic, none of which have significant interactions with garlic.
A nurse is reinforcing teaching with a client who has a new prescription for nitroglycerin transdermal patches to treat angina. The nurse should inform the client that which of the following manifestations is an adverse effect of the medication?
- A. Headache
- B. Polyuria
- C. Ringing in the ears
- D. Increased blood pressure
Correct Answer: A
Rationale: The correct answer is A: Headache. Nitroglycerin transdermal patches can cause headaches as an adverse effect due to vasodilation leading to increased blood flow to the brain. This is a common side effect that may occur in patients using nitroglycerin. Polyuria (B) and ringing in the ears (C) are not common side effects of nitroglycerin. Increased blood pressure (D) is not an adverse effect of nitroglycerin; in fact, nitroglycerin decreases blood pressure by dilating blood vessels.
A nurse is reinforcing teaching about cyclosporine with a client who is postoperative following a kidney transplant. Which of the following statements indicates an understanding of the information?
- A. I can take ibuprofen to treat headaches.
- B. I will get out of bed slowly in the morning.
- C. I can expect hair loss when taking this medication.
- D. I will call my doctor if I have a sore throat.
Correct Answer: D
Rationale: The correct answer is D: "I will call my doctor if I have a sore throat." This statement indicates an understanding of the potential side effects of cyclosporine, one of which is immunosuppression leading to increased susceptibility to infections. By recognizing the importance of reporting a sore throat promptly, the client demonstrates awareness of the need for close monitoring and early intervention to prevent serious complications.
Incorrect choices:
A: Taking ibuprofen can interact with cyclosporine and is not recommended.
B: Getting out of bed slowly is a general precaution but not specific to cyclosporine.
C: Hair loss is not a common side effect of cyclosporine.
E, F, G: No information is provided for these choices.
A nurse is preparing to administer regular and NPH insulin to a client. Which of the following actions should the nurse take?
- A. Withdraw the NPH insulin last.
- B. Mix the medications in a 3-mL syringe.
- C. Administer the medications in two separate syringes.
- D. Inject air into the regular vial first.
Correct Answer: A
Rationale: The correct answer is A: Withdraw the NPH insulin last. This is because regular insulin is a clear solution and should be withdrawn first to prevent contamination with the cloudy NPH insulin. Mixing the medications in a 3-mL syringe (B) is not recommended as it may alter the effectiveness of the insulin. Administering the medications in two separate syringes (C) is important to avoid mixing them prior to administration. Injecting air into the regular vial first (D) is unnecessary and not a standard practice.
A nurse is reinforcing teaching with a client who has a new prescription for prednisone to treat rheumatoid arthritis. Which of the following statements should indicate to the nurse that the client understands the teaching?
- A. I should watch for weight loss.
- B. I should increase the sodium in my diet.
- C. I will take this medication on an empty stomach.
- D. I will report a sore throat to my provider.
Correct Answer: D
Rationale: The correct answer is D: "I will report a sore throat to my provider." This is the correct answer because prednisone can suppress the immune system, increasing the risk of infections like thrush or sore throat. Reporting these symptoms promptly is crucial to prevent complications.
Choice A is incorrect because prednisone can actually cause weight gain. Choice B is incorrect because prednisone can lead to fluid retention, so increasing sodium intake is not recommended. Choice C is incorrect because prednisone should be taken with food to reduce stomach upset.