Nokea
The nurse is caring for a client receiving a continuous infusion of heparin and warfarin. Based on the client's laboratory data, the nurse should take which action? See the image below.
- A. Document the findings
- B. Stop the heparin infusion
- C. Hold future doses of the warfarin
- D. Obtain a prescription of Vitamin K
Correct Answer: B
Rationale: Without specific lab data, stopping heparin is likely if INR is therapeutic (e.g., 2-3 for warfarin), as concurrent heparin and warfarin are typically transitioned. Documenting, holding warfarin, or giving Vitamin K depend on specific INR values.
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The nurse is caring for a client who received a prescription for amlodipine for hypertension and was advised to lose weight. Which of the following statements by the client would require follow-up?
- A. I have enrolled myself at a gym and I am receiving dietary counseling from a nutritionist.
- B. I should drink grapefruit juice while taking the amlodipine.
- C. What is the best way for me to follow my treatment regimen with diet and exercise?
- D. Sometimes I feel dizzy after taking the amlodipine pills.
Correct Answer: B,D
Rationale: Grapefruit juice can increase amlodipine levels, leading to toxicity, and dizziness may indicate hypotension, both requiring follow-up. Gym enrollment and questions about regimen compliance are appropriate.
The nurse is preparing an educational in-service about valsartan. Which of the following information should the nurse include?
- A. Valsartan blocks the conversion of angiotensin I to angiotensin II.
- B. Valsartan antagonizes angiotensin II receptors.
- C. Valsartan stimulates alpha-2 adrenoceptors in the brainstem.
- D. Valsartan blocks response to beta1- and beta2-adrenergic stimulation.
Correct Answer: B
Rationale: Valsartan, an ARB, antagonizes angiotensin II receptors, reducing blood pressure. It does not block angiotensin conversion, stimulate alpha-2 receptors, or block beta-adrenergic responses.
The nurse is reviewing prescriptions for assigned clients. Which prescriptions require follow-up with the primary healthcare provider? A client with
- A. congestive heart failure prescribed diltiazem.
- B. hypertension prescribed clonidine.
- C. diabetes insipidus prescribed hydrocortisone.
- D. pulmonary emboli prescribed clopidogrel.
- E. atrial fibrillation prescribed amiodarone.
- F. bacterial cystitis prescribed valacyclovir.
Correct Answer: C,F
Rationale: Hydrocortisone is not used for diabetes insipidus (desmopressin is typical), and valacyclovir (an antiviral) is incorrect for bacterial cystitis (requires antibiotics). Diltiazem, clonidine, clopidogrel, and amiodarone are appropriate for their respective conditions.
The nurse is caring for a client receiving a continuous infusion of norepinephrine. The nurse should plan to monitor which of the following for the client? Select all that apply.
- A. Blood pressure
- B. Intracranial pressure
- C. Intravenous site
- D. Urine output
- E. Blood glucose
Correct Answer: A,C,D,E
Rationale: Norepinephrine, a vasopressor, requires monitoring blood pressure (to assess efficacy), IV site (for extravasation risk), urine output (to evaluate perfusion), and blood glucose (as it can cause hyperglycemia). Intracranial pressure is not typically monitored unless neurological issues are present.
The nurse is teaching a client who has hypertension about the newly prescribed medication, furosemide. Which of the following should the nurse include in the teaching?
- A. Limit intake of bananas, cantaloupe, and potatoes.
- B. Avoid taking the medication with grapefruit juice.
- C. Take this medication in the early part of the day.
- D. A nagging cough can occur as a side effect of the medication.
Correct Answer: A,C
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, so limiting potassium-rich foods (bananas, cantaloupe, potatoes) is advised, and taking it early prevents nocturia. Grapefruit juice and cough are not concerns.