Nokea
The nurse is reinforcing teaching for a client with atrial fibrillation who has a new prescription for warfarin. The nurse should instruct the client to avoid excess or inconsistent intake of which of the following foods? Select all that apply.
- A. red meat
- B. bananas
- C. broccoli
- D. spinach
- E. kale
Correct Answer: C,D,E
Rationale: Broccoli, spinach, and kale are high in vitamin K, which can antagonize warfarin's anticoagulant effect. Consistent intake is key, but excess can reduce effectiveness. Red meat and bananas have minimal vitamin K and don't significantly affect warfarin.
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A client with ascites due to cirrhosis has increasing shortness of breath and abdominal pain and is scheduled for paracentesis. Which of the following nursing actions should be implemented prior to the procedure? Select all that apply.
- A. Ensure that informed consent has been obtained
- B. Place the client in reverse Trendelenburg position
- C. Place the client on NPO status
- D. Request the client empty their bladder
- E. Take baseline vital signs and weight
Correct Answer: A,D,E
Rationale: Informed consent ensures understanding, emptying the bladder prevents injury during needle insertion, and baseline vital signs/weight monitor fluid shifts. Reverse Trendelenburg is inappropriate; upright positioning is typical. NPO status isn't required for paracentesis.
Vital signs
Temperature 99.2 F (37.3 C)
Blood pressure 134/89 mm Hg
Heart rate 98/min
Respirations 19/min
Oz saturation (SpO) 99%
Sedation Awake, alert
A client reports 7 of 10 on the pain scale at 2300 and asks if it is too soon to receive 'another pain pill.' The nurse reviews the medication administration record. Which intervention should the nurse implement?
- A. Administer the hydrocodone/acetaminophen as prescribed
- B. Call the health care provider to request a prescription for a different analgesic
- C. Decrease the dose of hydrocodone/acetaminophen from 2 tablets to 1
- D. Prepare to administer naloxone
Correct Answer: A
Rationale: Pain rated 7/10 warrants administration of the prescribed analgesic if within the dosing interval. No indications suggest overdose (naloxone) or need for a different medication. Reducing the dose may inadequately manage pain.
The nurse, assisting in applying a cast to a client with a broken arm, knows that the
- A. Cast material should be dipped several times into the warm water
- B. Cast should be covered until it dries
- C. Wet cast should be handled with the palms of hands
- D. Casted extremity should be placed on a cloth-covered surface
Correct Answer: C
Rationale: Wet cast should be handled with the palms of hands. This prevents damage to the cast and ensures proper setting.
A nurse is teaching a class for new parents at a local community center. The nurse would stress that what is most hazardous for an 8 month-old child?
- A. Riding in a car
- B. Falling off a bed
- C. An electrical outlet
- D. Eating peanuts
Correct Answer: D
Rationale: Eating peanuts. Asphyxiation due to foreign materials in the respiratory tract is the leading cause of death in children younger than 6 years of age.
An adult is taking phenazopyridine hydrochloride (Pyridium) 200 mg PO tid after meals. Which comment by the client indicates a lack of understanding about the medication?
- A. If I take my medications after meals, I avoid upsetting my stomach.'
- B. I am concerned that my urine is bright orange.'
- C. I do not have as great an urge to urinate since I have been on Pyridium.'
- D. I have to let my doctor know if my skin or eyes turn yellow.'
Correct Answer: B
Rationale: Bright orange urine is a normal effect of Pyridium, so concern about it indicates a lack of understanding of the medication's side effects.