Nokea
A nurse is teaching a client who has a new prescription for warfarin about foods that affect the INR. The nurse should include in the teaching that which of the following foods interact with this medication?
- A. Orange juice.
- B. Kale.
- C. Beef stew.
- D. Yogurt.
Correct Answer: B
Rationale: The correct answer is B: Kale. Kale is high in vitamin K, which can interfere with the anticoagulant effects of warfarin by increasing the clotting factors in the blood, leading to a decreased INR. It is important for patients on warfarin to maintain a consistent intake of vitamin K-rich foods to ensure their INR remains within the therapeutic range. Orange juice (A), beef stew (C), and yogurt (D) do not significantly interact with warfarin. A summary of why they are incorrect: Orange juice does not have a direct interaction with warfarin. Beef stew does not contain significant amounts of vitamin K. Yogurt is not a high vitamin K food.
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A nurse is preparing to receive a client from surgery following a transverse colon resection with colostomy placement. The nurse should expect to assess the stoma at which of the following locations? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)
- A. A
- B. B
- C. C
Correct Answer:
Rationale: Correct Answer: B
Rationale: The correct location to assess the stoma following a transverse colon resection with colostomy placement is at location B, which is in the left lower quadrant. This is because the transverse colon is typically located in the upper abdomen, and the stoma would be brought out at the most dependent portion of the colon, which is in the left lower quadrant. Assessing the stoma in this location allows the nurse to monitor for proper stoma function and potential complications.
Summary:
A: Incorrect - Location A is in the right upper quadrant, which is not the typical site for a stoma following a transverse colon resection.
C: Incorrect - Location C is in the left upper quadrant, which is also not the typical site for a stoma after this surgery.
D, E, F, G: Not applicable as they are not relevant to the question.
A nurse is caring for a client who has left-sided heart failure. Which of the following findings should indicate to the nurse that the client is experiencing a decrease in cardiac output?
- A. Weight gain
- B. Distended abdomen
- C. Confusion
- D. Dyspnea
Correct Answer: D
Rationale: The correct answer is D: Dyspnea. In left-sided heart failure, the heart is unable to pump efficiently, leading to a decrease in cardiac output. Dyspnea (shortness of breath) occurs due to the accumulation of fluid in the lungs (pulmonary congestion), indicating decreased cardiac output. Weight gain (A) and distended abdomen (B) are more indicative of right-sided heart failure. Confusion (C) can be a sign of decreased cerebral perfusion, but dyspnea is a more direct indicator of decreased cardiac output in left-sided heart failure.
A nurse on an intensive care unit is planning care for a client who has increased intracranial pressure following a head injury. Which of the following IV medications should the nurse plan to administer?
- A. Propranolol
- B. Dobutamine
- C. Mannitol
- D. Chlorpromazine
Correct Answer: C
Rationale: The correct answer is C: Mannitol. Mannitol is an osmotic diuretic that helps reduce intracranial pressure by drawing fluid out of brain tissues. It is commonly used in the management of increased intracranial pressure in clients with head injuries. Propranolol (A) is a beta-blocker used for hypertension and anxiety, not for reducing intracranial pressure. Dobutamine (B) is a beta-1 agonist used for cardiac support, not for managing intracranial pressure. Chlorpromazine (D) is an antipsychotic medication and is not indicated for reducing intracranial pressure.
A nurse is providing discharge teaching to a client who had a bilateral architectomy. The nurse should instruct the client to expect which of the following symptoms?
- A. Hypoglycemia
- B. Increased libido
- C. Hot flashes
- D. Increased muscle mass
Correct Answer: A
Rationale: The correct answer is A: Hypoglycemia. After a bilateral adrenalectomy, the client will have decreased cortisol production, leading to adrenal insufficiency. This can result in hypoglycemia due to decreased glucose regulation. Increased libido (B) and increased muscle mass (D) are not typical symptoms following this procedure. Hot flashes (C) are more commonly associated with menopause.
A nurse is caring for a client who has gastroenteritis. Which of the following assessment findings should the nurse recognize as an indication that the client is experiencing dehydration?
- A. Distended jugular veins.
- B. Increased blood pressure.
- C. Decreased blood pressure.
- D. Pitting, dependent edema.
Correct Answer: C
Rationale: The correct answer is C: Decreased blood pressure. Dehydration leads to a decrease in blood volume, causing a drop in blood pressure. As a result, the body tries to conserve fluids, leading to decreased urine output and concentrated urine. Distended jugular veins (A) are more indicative of heart failure. Increased blood pressure (B) is not typically associated with dehydration. Pitting, dependent edema (D) is a sign of fluid overload, not dehydration.