Nokea
The nurse is educating a patient who is starting treatment with warfarin. Which instruction is most important to include in the teaching plan?
- A. "You can continue taking your aspirin as prescribed."
- B. "Be sure to have regular blood tests to monitor your INR."
- C. "You should increase your intake of vitamin K-rich foods."
- D. "If you miss a dose, double the dose the next day."
Correct Answer: B
Rationale: The correct answer is B: "Be sure to have regular blood tests to monitor your INR." Warfarin is a medication that requires close monitoring of the International Normalized Ratio (INR) to ensure it is within the therapeutic range. Regular blood tests are crucial to prevent complications such as bleeding or blood clots.
Choice A is incorrect because aspirin increases the risk of bleeding when taken with warfarin. Choice C is incorrect because increasing vitamin K-rich foods can interfere with the effectiveness of warfarin. Choice D is incorrect because doubling the dose can lead to an increased risk of bleeding. Regular monitoring of INR levels is essential for safe and effective warfarin therapy.
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What causes the systemic effects of viral hepatitis?
- A. Cholestasis
- B. Impaired portal circulation
- C. Toxins produced by the infected liver
- D. Activation of the complement system by antigen-antibody complexes
Correct Answer: D
Rationale: Step-by-step rationale for why choice D is correct: Activation of the complement system by antigen-antibody complexes leads to systemic effects in viral hepatitis. This process triggers inflammation, tissue damage, and immune responses that contribute to the systemic effects seen in viral hepatitis. The other choices (A, B, and C) do not directly cause systemic effects in viral hepatitis. Cholestasis and impaired portal circulation are more localized effects, while toxins produced by the infected liver may contribute to liver damage but not necessarily systemic effects.
Which of the following teaching strategies would the nurse plan for a client with an anal fissure?
- A. Teach the client strategies to relieve diarrhea
- B. Instruct the client to not eat any fiber
- C. Teach the client how to insert a suppository
- D. Teach the client how to apply ice
Correct Answer: D
Rationale: The correct answer is D: Teach the client how to apply ice. Applying ice helps reduce inflammation and pain associated with anal fissures. It constricts blood vessels, decreases blood flow, and numbs the area, promoting healing.
A: Teaching strategies to relieve diarrhea is not directly related to managing anal fissures.
B: Instructing the client to not eat any fiber is incorrect because fiber helps soften stools and prevent constipation, which can worsen anal fissures.
C: Teaching the client how to insert a suppository may not be necessary for managing anal fissures unless prescribed by a healthcare provider for specific reasons.
What is the fate of any excess glucose that goes to the liver that is not required for energy and not stored as glycogen?
- A. it is converted into fat
- B. it is converted into protein
- C. it is immediately released back into the bloodstream
- D. it is degraded
Correct Answer: A
Rationale: The correct answer is A: it is converted into fat. Excess glucose not needed for immediate energy or stored as glycogen is converted into fat through a process called de novo lipogenesis in the liver. This occurs when glucose levels are high and glycogen stores are full. The liver converts the excess glucose into fatty acids and then into triglycerides for storage in adipose tissue. This process helps regulate blood glucose levels and prevents hyperglycemia.
Other choices are incorrect:
B: Glucose is not directly converted into protein. Proteins are synthesized from amino acids, not glucose.
C: Releasing excess glucose back into the bloodstream would lead to high blood sugar levels, which is not a typical physiological response.
D: Glucose is not simply degraded; it is either used for energy, stored as glycogen, or converted into fat when in excess.
Which female patient is most likely to have metabolic syndrome?
- A. BP 128/78 mm Hg, triglycerides 160 mg/dL, fasting blood glucose 102 mg/dL
- B. BP 142/90 mm Hg, high-density lipoproteins 45 mg/dL, fasting blood glucose 130 mg/dL
- C. Waist circumference 36 in, triglycerides 162 mg/dL, high-density lipoproteins 55 mg/dL
- D. Waist circumference 32 in, high-density lipoproteins 38 mg/dL, fasting blood glucose 122 mg/dL
Correct Answer: B
Rationale: The correct answer is B because the patient's blood pressure, HDL levels, and fasting blood glucose levels all indicate a higher likelihood of metabolic syndrome. High blood pressure, low HDL levels, and elevated blood glucose are key components of metabolic syndrome.
Option A has normal blood pressure and slightly elevated triglycerides and blood glucose, but not as concerning as choice B.
Option C has a normal blood pressure, slightly elevated triglycerides, and good HDL levels, which lowers the likelihood of metabolic syndrome.
Option D has a normal blood pressure, very low HDL levels, and slightly elevated blood glucose, but the blood pressure is not in the hypertensive range as in choice B.
Which of these digestive processes occurs in the mouth?
- A. chemical digestion of proteins
- B. mechanical digestion of food
- C. chemical digestion of starch
- D. all of the above
Correct Answer: C
Rationale: The correct answer is C: chemical digestion of starch. In the mouth, salivary glands secrete enzymes like amylase to break down starch into simpler sugars. This process initiates the digestion of carbohydrates. Mechanical digestion (Choice B) occurs in the mouth through chewing and mixing food with saliva, but it does not involve chemical breakdown. Chemical digestion of proteins (Choice A) primarily occurs in the stomach and small intestine with the help of enzymes like pepsin and trypsin. Choice D is incorrect because not all the processes listed occur in the mouth.