Nokea
The nurse is caring for a client with a history of deep vein thrombosis (DVT) who is receiving warfarin (Coumadin). Which laboratory value should the nurse 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 affects the clotting process by inhibiting vitamin K-dependent clotting factors. Monitoring PT helps assess the effectiveness of warfarin therapy and prevent complications like bleeding. Platelet count (A) is important but not directly affected by warfarin. Hemoglobin level (C) and white blood cell count (D) are not typically affected by warfarin therapy.
You may also like to solve these questions
A 70-year-old woman presents with fatigue, anorexia, and weight loss. She has noticed darkening of her skin, particularly in sun-exposed areas. Laboratory tests reveal hyponatremia, hyperkalemia, and low cortisol levels. What is the most likely diagnosis?
- A. Cushing's syndrome
- B. Addison's disease
- C. Hypothyroidism
- D. Pheochromocytoma
Correct Answer: B
Rationale: The most likely diagnosis for the 70-year-old woman is Addison's disease. The symptoms of fatigue, anorexia, weight loss, darkened skin, along with hyponatremia, hyperkalemia, and low cortisol levels indicate adrenal insufficiency. Addison's disease is characterized by inadequate production of cortisol and aldosterone by the adrenal glands. The darkening of the skin, known as hyperpigmentation, is a classic sign of Addison's due to increased ACTH levels stimulating melanin production. In contrast, Cushing's syndrome presents with weight gain, hypertension, and high cortisol levels. Hypothyroidism typically presents with weight gain, cold intolerance, and constipation. Pheochromocytoma presents with hypertension, palpitations, and headaches due to excess catecholamine production. Therefore, the correct diagnosis in this case is Addison's disease.
A 50-year-old man presents with fatigue, arthralgia, and darkening of the skin. Laboratory tests reveal elevated liver enzymes and high serum ferritin levels. What is the most likely diagnosis?
- A. Wilson's disease
- B. Hemochromatosis
- C. Alpha-1 antitrypsin deficiency
- D. Autoimmune hepatitis
Correct Answer: B
Rationale: The correct answer is B: Hemochromatosis. In this case, the patient's symptoms of fatigue, arthralgia, darkening of the skin, elevated liver enzymes, and high serum ferritin levels point towards iron overload disorder. Hemochromatosis is a genetic condition characterized by excessive absorption and accumulation of iron in various organs, leading to liver damage and skin pigmentation. Wilson's disease (A) presents with copper accumulation, not iron. Alpha-1 antitrypsin deficiency (C) primarily affects the lungs and liver, not causing iron overload. Autoimmune hepatitis (D) does not typically present with elevated ferritin levels.
The healthcare provider is preparing to administer a blood transfusion. Which action is most important to ensure client safety?
- A. Check the client's vital signs before starting the transfusion.
- B. Verify the client's identity and blood compatibility.
- C. Administer the blood with normal saline.
- D. Monitor the client for the first 15 minutes of the transfusion.
Correct Answer: B
Rationale: The correct answer is B: Verify the client's identity and blood compatibility. This step is crucial to prevent transfusion reactions due to compatibility issues. By confirming the client's identity and ensuring that the blood type matches, the healthcare provider minimizes the risk of adverse reactions such as hemolytic transfusion reactions. Checking vital signs (A) is important but ensuring blood compatibility takes precedence. Administering blood with normal saline (C) is incorrect as blood should be infused with the appropriate blood administration set. Monitoring the client for the first 15 minutes (D) is essential but verification of identity and blood compatibility is the primary step to prioritize safety.
When assessing a client with a chest tube connected to suction, which observation indicates that the chest tube is functioning properly?
- A. Continuous bubbling in the water seal chamber.
- B. Intermittent bubbling in the suction control chamber.
- C. No fluctuation in the water seal chamber.
- D. Steady bubbling in the suction control chamber.
Correct Answer: D
Rationale: The correct answer is D: Steady bubbling in the suction control chamber. This indicates proper functioning as it shows that the suction is maintaining a consistent pressure, which is essential for effective drainage and lung re-expansion. Continuous bubbling in the water seal chamber (choice A) indicates an air leak. Intermittent bubbling in the suction control chamber (choice B) could suggest fluctuating pressure. No fluctuation in the water seal chamber (choice C) indicates either a blockage or disconnection. Steady bubbling in the suction control chamber (choice D) indicates the suction is working consistently, ensuring proper drainage and lung re-expansion.
A 60-year-old woman presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. What is the most likely diagnosis?
- A. Hepatitis C
- B. Primary biliary cirrhosis
- C. Hemochromatosis
- D. Wilson's disease
Correct Answer: B
Rationale: The most likely diagnosis is B: Primary biliary cirrhosis. This condition commonly presents with fatigue, pruritus, jaundice, elevated bilirubin, and alkaline phosphatase levels in older women. Primary biliary cirrhosis is an autoimmune liver disease that leads to destruction of bile ducts. The other choices are less likely because Hepatitis C typically presents with acute symptoms, Hemochromatosis presents with iron overload symptoms, and Wilson's disease presents with copper accumulation symptoms, which do not match the patient's clinical presentation.