Nokea
A nurse is reviewing a client's medication regimen. Which of the following medications places the client at increased risk for digoxin toxicity?
- A. Calcium channel blockers
- B. Potassium-sparing diuretics
- C. Beta blockers
- D. Loop diuretics
Correct Answer: D
Rationale: The correct answer is D, Loop diuretics. Loop diuretics can lead to hypokalemia, which increases the risk for digoxin toxicity. Loop diuretics cause potassium loss, and hypokalemia can potentiate the toxic effects of digoxin. Choices A, B, and C are incorrect because calcium channel blockers, potassium-sparing diuretics, and beta blockers do not directly increase the risk of digoxin toxicity.
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A client receiving epoetin alfa therapy for anemia is being monitored for therapeutic effects. Which of the following laboratory values indicates the medication is effective?
- A. White blood cell count
- B. Hematocrit
- C. Platelet count
- D. Red blood cell count
Correct Answer: B
Rationale: The correct answer is B: Hematocrit. An increase in hematocrit levels indicates the effectiveness of epoetin alfa in treating anemia. Hematocrit reflects the percentage of red blood cells in the blood, so an increase in hematocrit signifies an improvement in the patient's red blood cell count and oxygen-carrying capacity. Choices A, C, and D are incorrect because white blood cell count, platelet count, and red blood cell count do not directly reflect the therapeutic effects of epoetin alfa in treating anemia.
A client with an artificial heart valve is prescribed warfarin therapy. Which of the following laboratory values should the nurse monitor to assess the therapeutic effect of warfarin?
- A. Hemoglobin (Hgb)
- B. Prothrombin time (PT)
- C. Bleeding time
- D. Activated partial thromboplastin time (aPTT)
Correct Answer: B
Rationale: The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting the clotting factors dependent on vitamin K, such as factors II, VII, IX, and X. The prothrombin time (PT) measures the extrinsic pathway and is used to monitor the therapeutic effects of warfarin therapy. Monitoring PT helps assess the time it takes for the blood to clot, ensuring that the anticoagulant effect is within the desired range. Choices A, C, and D are incorrect because hemoglobin (Hgb) measures the amount of hemoglobin in the blood, bleeding time assesses the time it takes for bleeding to stop, and activated partial thromboplastin time (aPTT) is used to monitor heparin therapy, not warfarin therapy.
A healthcare provider is preparing to administer heparin sodium to a client with deep vein thrombosis (DVT). Which of the following laboratory values should the provider monitor during therapy?
- A. INR
- B. Serum creatinine
- C. aPTT
- D. Bilirubin
Correct Answer: C
Rationale: The correct answer is C: aPTT. The healthcare provider should monitor the activated partial thromboplastin time (aPTT) value during heparin therapy to assess the client's coagulation status. Heparin affects the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps ensure that the client is within the therapeutic range to prevent bleeding or clotting issues. INR (Choice A) is used to monitor warfarin therapy, not heparin. Serum creatinine (Choice B) is not directly related to monitoring heparin therapy. Bilirubin (Choice D) is related to liver function, not heparin therapy.
A client is prescribed HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed?
- A. Liver function tests
- B. Renal function tests
- C. Visual acuity screening
- D. Hearing screenings
Correct Answer: A
Rationale: The correct answer is A: Liver function tests. Atorvastatin, an HMG CoA reductase inhibitor, can lead to hepatotoxicity, making it essential to monitor liver function tests regularly. Choices B, C, and D are incorrect because atorvastatin primarily affects the liver, not the kidneys, vision, or hearing.
A nurse is caring for a client who has been prescribed amoxicillin. Which of the following client history findings requires the nurse to clarify the medication prescription?
- A. Hypertension
- B. Peptic ulcer disease
- C. Asthma
- D. Gastroesophageal reflux disease
Correct Answer: C
Rationale: The correct answer is C. Clients with a history of asthma should avoid amoxicillin due to potential hypersensitivity reactions. Amoxicillin can trigger asthma exacerbations in some individuals. Hypertension (choice A), peptic ulcer disease (choice B), and gastroesophageal reflux disease (choice D) are not contraindications for amoxicillin use, so they do not require the nurse to clarify the medication prescription in this case.