Nokea
The nurse is teaching a client about taking prophylactic warfarin sodium (Coumadin). Which statement indicates that the client understands how to take the drug?
- A. The drug's execution peaks in 2 hours.
- B. Maximum dosage is not achieved until 3 to 4 days after starting the medication.
- C. Effects of the drug continue for 4 to 5 days after discontinuing the medication.
- D. Protamine sulfate is the antidote for warfarin.
- E. I should have my blood levels tested periodically.
Correct Answer: B,C,E
Rationale: Warfarin's maximum effect takes 3-4 days (B), its effects persist 4-5 days after stopping (C), and periodic blood tests (e.g., INR) are required (E). Peak action is not 2 hours, and protamine sulfate is the antidote for heparin, not warfarin.
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What is a key nursing intervention for a client receiving peritoneal dialysis?
- A. Monitor for signs of peritonitis.
- B. Restrict protein intake.
- C. Administer anticoagulants.
- D. Limit ambulation.
Correct Answer: A
Rationale: Peritonitis is a serious complication of peritoneal dialysis, requiring vigilant monitoring.
A client with a hip fracture is receiving heparin to prevent thromboembolism. Which laboratory value should the nurse monitor?
- A. Prothrombin time (PT).
- B. Activated partial thromboplastin time (aPTT).
- C. International Normalized Ratio (INR).
- D. Platelet count.
Correct Answer: B
Rationale: Heparin's effect is monitored via aPTT to ensure therapeutic anticoagulation.
Which of the following nursing interventions is likely to provide the most relief from the pain associated with renal colic?
- A. Applying moist heat to the flank area.
- B. Administering meperidine (Demerol).
- C. Encouraging high fluid intake.
- D. Maintaining complete bed rest.
Correct Answer: B
Rationale: Meperidine, an opioid, provides the most effective relief for the severe pain of renal colic by directly addressing pain pathways.
Which of the following would be an expected finding in a client with adrenal crisis (addisonian crisis)?
- A. Fluid retention.
- B. Pain.
- C. Peripheral edema.
- D. Hunger.
Correct Answer: B
Rationale: Pain, particularly abdominal, is a common symptom in addisonian crisis due to electrolyte imbalances and hypotension.
A car accident involves four vehicles on a remote interstate. The nearest emergency department is 15 minutes away. Which victim should be transported by helicopter to the nearest hospital?
- A. 10-year-old with a simple fracture of the femur who is crying and cannot find his parents.
- B. Middle-aged woman with cold, clammy skin and a heart rate of 120 bpm who is unconscious.
- C. Middle-aged man with severe asthma and a heart rate of 120 bpm who is having difficulty breathing.
- D. 70-year-old man with a severe headache who is conscious.
Correct Answer: B
Rationale: The unconscious woman with signs of shock (cold, clammy skin, tachycardia) is in critical condition and requires immediate transport to stabilize her condition.