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The healthcare provider is caring for a patient who is taking warfarin (Coumadin). Which laboratory value should the healthcare provider monitor closely?
- A. Platelet count.
- B. Prothrombin time (PT).
- C. Hemoglobin level.
- D. White blood cell count.
Correct Answer: B
Rationale: The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting clotting factors. Monitoring PT is essential to ensure the patient's blood is clotting within the desired range to prevent both bleeding and clotting events. Platelet count (A) assesses the quantity of platelets, not the clotting function. Hemoglobin level (C) evaluates red blood cell count and oxygen-carrying capacity. White blood cell count (D) assesses immune function and infection risk, not clotting ability. PT is directly related to warfarin's mechanism of action, making it the most crucial parameter to monitor.
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A client with chronic renal failure is prescribed epoetin alfa (Epogen). Which outcome indicates that the medication is effective?
- A. Increased urine output.
- B. Decreased blood pressure.
- C. Improved hemoglobin levels.
- D. Stable potassium levels.
Correct Answer: C
Rationale: The correct answer is C: Improved hemoglobin levels. Epoetin alfa is a medication used to treat anemia in patients with chronic renal failure by stimulating red blood cell production. Improved hemoglobin levels indicate that the medication is effective in addressing the anemia associated with renal failure. Increased urine output (A) is not a direct outcome of epoetin alfa therapy. Decreased blood pressure (B) and stable potassium levels (D) are not specific indicators of the medication's effectiveness in treating anemia.
A client with chronic kidney disease (CKD) is scheduled for a renal biopsy. Which pre-procedure instruction should the nurse provide?
- A. Maintain a low-protein diet for 24 hours before the biopsy.
- B. Avoid taking anticoagulant medications for one week before the biopsy.
- C. Drink plenty of fluids before the procedure.
- D. Take your routine medications with a full glass of water before the biopsy.
Correct Answer: B
Rationale: The correct answer is B: Avoid taking anticoagulant medications for one week before the biopsy. This is essential to prevent excessive bleeding during and after the procedure. Chronic kidney disease patients are at higher risk of bleeding due to impaired kidney function.
A: Maintaining a low-protein diet is not directly related to the biopsy procedure and is not necessary.
C: Drinking plenty of fluids may be beneficial for renal function but is not a specific pre-procedure instruction for a renal biopsy.
D: Taking routine medications with water is important, but specific instructions regarding anticoagulant medications are more critical in this case.
A client with hyperthyroidism is prescribed propylthiouracil (PTU). Which instruction should the nurse include in the client's discharge teaching?
- A. Report any signs of infection, such as sore throat or fever, to your healthcare provider.'
- B. Increase your intake of iodine-rich foods, such as seafood and dairy products.'
- C. Take the medication on an empty stomach for better absorption.'
- D. You may experience weight gain and fatigue as side effects of the medication.'
Correct Answer: A
Rationale: The correct answer is A: "Report any signs of infection, such as sore throat or fever, to your healthcare provider." This is important because PTU can cause agranulocytosis, a serious side effect that can lead to severe infections. By reporting signs of infection early, the healthcare provider can monitor the client's blood counts and adjust treatment if necessary.
Choice B is incorrect because increasing intake of iodine-rich foods can worsen hyperthyroidism. Choice C is incorrect because PTU should be taken with food to minimize gastrointestinal side effects. Choice D is incorrect because weight gain and fatigue are not common side effects of PTU; in fact, weight loss and hyperactivity are more common.
A client with chronic renal failure is scheduled to receive epoetin alfa (Epogen). Which laboratory result should the nurse review before administering the medication?
- A. Blood urea nitrogen (BUN)
- B. Creatinine clearance
- C. Hemoglobin level
- D. Serum potassium
Correct Answer: C
Rationale: The correct answer is C: Hemoglobin level. In chronic renal failure, the kidneys may not produce enough erythropoietin, leading to anemia. Epoetin alfa stimulates red blood cell production. Therefore, reviewing the hemoglobin level is crucial to determine the need for the medication.
Incorrect choices:
A: Blood urea nitrogen (BUN) and B: Creatinine clearance are indicators of kidney function but not directly related to monitoring the effectiveness of epoetin alfa.
D: Serum potassium is important in renal failure but not specifically needed to review before administering epoetin alfa.
A client with type 2 diabetes mellitus presents to the clinic with a foot ulcer. Which instruction should the nurse provide to the client to promote healing of the ulcer?
- A. Apply a heating pad to the ulcer twice daily.
- B. Wear tight-fitting shoes to protect the ulcer.
- C. Keep the ulcer clean and dry.
- D. Limit walking to reduce pressure on the ulcer.
Correct Answer: C
Rationale: The correct answer is C: Keep the ulcer clean and dry. This instruction is essential for promoting healing of the foot ulcer in a client with type 2 diabetes mellitus. Keeping the ulcer clean helps prevent infection, while keeping it dry promotes a better environment for healing.
A: Applying a heating pad can increase the risk of burns and should be avoided.
B: Wearing tight-fitting shoes can cause further damage and hinder healing.
D: Limiting walking may reduce pressure on the ulcer, but mobility is important for circulation and overall health. Keeping the ulcer clean and dry is the most critical instruction.