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The client is being admitted with Coumadin (warfarin, an anticoagulant) toxicity. Which laboratory data should the nurse monitor?
- A. Blood urea nitrogen (BUN) levels.
- B. Bilirubin levels.
- C. International normalized ratio (INR).
- D. Partial thromboplastin time (PTT).
Correct Answer: C
Rationale: Warfarin toxicity is monitored via INR (C), which reflects bleeding risk. BUN (A) assesses kidneys, bilirubin (B) liver, and PTT (D) is for heparin.
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The nurse is discussing the importance of exercising with a client who is diagnosed with coronary artery disease. Which statement best describes the scientific rationale for encouraging 30 minutes of walking daily to help prevent complications of atherosclerosis?
- A. Exercise promotes the development of collateral circulation.
- B. Isometric exercises help develop the client's muscle mass.
- C. Daily exercise helps prevent plaque from developing in the vessel.
- D. Isotonic exercises promote the transport of glucose into the cell.
Correct Answer: A
Rationale: Walking promotes collateral circulation (A), improving blood flow in CAD. Isometric exercises (B) increase BP, plaque prevention (C) is indirect, and glucose transport (D) is unrelated.
The client with a prosthetic valve asks why they need antibiotics before dental procedures. What is the best response?
- A. To prevent infection of the valve.
- B. To reduce bleeding during the procedure.
- C. To prevent pain during the procedure.
- D. To improve healing after the procedure.
Correct Answer: A
Rationale: Antibiotics prevent bacterial endocarditis by reducing the risk of valve infection during dental procedures.
The nurse is teaching a client with endocarditis about preventing recurrence. Which statement is most important?
- A. You need antibiotics before dental procedures.
- B. You should avoid all vaccinations.
- C. You can stop antibiotics if you feel better.
- D. You should limit fluid intake.
Correct Answer: A
Rationale: Prophylactic antibiotics before dental procedures prevent bacterial seeding of heart valves.
Which medical treatment would be prescribed for the client with an AAA less than 3 cm?
- A. Ultrasound every six (6) months.
- B. Intravenous pyelogram yearly.
- C. Assessment of abdominal girth monthly.
- D. Repair of abdominal aortic aneurysm.
Correct Answer: A
Rationale: Small AAAs (<3 cm) are monitored with ultrasound every 6 months (A). IV pyelogram (B) is irrelevant, girth (C) is not standard, and repair (D) is for larger AAAs (>5.5 cm).
The client with heart failure is prescribed digoxin. Which finding should the nurse report immediately?
- A. Heart rate of 58 beats per minute
- B. Potassium level of 3.2 mEq/L
- C. Blood pressure of 130/85 mmHg
- D. Respiratory rate of 18 breaths per minute
Correct Answer: B
Rationale: Hypokalemia (low potassium) increases the risk of digoxin toxicity, requiring immediate reporting.