Nokea
A patient is prescribed Warfarin (Coumadin) for the treatment of a blood clot. What is the therapeutic INR range for this medication?
- A. 2--3
- B. 3--1
- C. 8--4
- D. 0.5-2.5
Correct Answer: A
Rationale: The therapeutic INR range is 2-3. It may be slightly higher if a patient is at a high risk for clot formation (ex: up to 4.5)
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A 25 year-old female patient with pneumonia is prescribed Doxycycline. What question is important to ask the patient prior to administration of this medication?
- A. Do you take birth control pills?'
- B. Are you allergic to Penicillin?'
- C. Are you allergic to eggs?'
- D. Do you have a history of diabetes?'
Correct Answer: A
Rationale: Doxycycline can reduce the effectiveness of oral contraceptives, so asking about birth control use is critical. Penicillin allergy is unrelated, egg allergy is relevant for vaccines, and diabetes is not a primary concern.
The influenza vaccine is in short supply. Which group of clients would the public health nurse consider priority when administering the vaccine?
- A. Elderly and chronically ill clients.
- B. Child-care workers and children less than four (4) years of age.
- C. Hospital chaplains and health-care workers.
- D. Schoolteachers and students living in a dormitory.
Correct Answer: A
Rationale: Elderly and chronically ill (A) are at highest risk for flu complications, prioritizing them. Child-care workers/children (B), chaplains/HCWs (C), and teachers/students (D) are secondary.
Select all the correct options that represent the pathophysiology of an asthma attack.
- A. The smooth muscle surrounding the alveoli constricts, limiting oxygenation.
- B. The mucosa lining experiences severe inflammation.
- C. The goblet cells within the mucosa lining produce excessive amounts of mucous.
- D. Too much carbon dioxide is exhaled due to hyperventilation and the patient experiences respiratory alkalosis.
Correct Answer: B,C
Rationale: Asthma involves inflammation of the airway mucosa and excessive mucus production by goblet cells. Smooth muscle constriction occurs in bronchioles, not alveoli, and hyperventilation typically leads to respiratory acidosis due to CO2 retention.
Which clinical manifestation indicates to the nurse the child has cystic fibrosis?
- A. Wheezing with a productive cough.
- B. Excessive salty sweat secretions.
- C. Multiple vitamin deficiencies.
- D. Clubbing of all fingers.
Correct Answer: B
Rationale: Excessive salty sweat (B) is a hallmark of cystic fibrosis due to defective chloride transport, detectable via sweat chloride testing. Wheezing/cough (A) is non-specific. Vitamin deficiencies (C) and clubbing (D) occur later but are not diagnostic.
Which symptom reported by the client to the nurse is the best indicator that complications are developing from this cold?
- A. Visual stuffiness
- B. Dry cough
- C. High fever
- D. Scratchy throat
Correct Answer: C
Rationale: A high fever suggests a possible secondary bacterial infection or other complication, such as sinusitis or pneumonia, which is more serious than typical cold symptoms.