Nokea
The nurse should inform a client taking carbamazepine (Tegretol) that it can affect other medications in which of the following ways?
- A. It decreases the effects of oral anticoagulants
- B. It decreases the serum concentration of verapamil (Calan)
- C. It increases the serum concentration of other anticonvulsants
- D. It increases the effects of oral contraceptives
Correct Answer: A
Rationale: Carbamazepine induces liver enzymes, reducing the effects of oral anticoagulants like warfarin by increasing their metabolism. It does not typically affect verapamil, other anticonvulsants, or contraceptives in the ways described.
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A client is admitted with severe abdominal pains and the diagnosis of acute pancreatitis. The nurse should develop a plan of care during the acute phase of pancreatitis that will involve interventions targeting which of the following problems?
- A. Drug and alcohol abuse.
- B. Risk for injury.
- C. Severe pain.
- D. Ineffective airway clearance.
Correct Answer: C
Rationale: Severe pain is a primary concern in acute pancreatitis, requiring targeted interventions like analgesics.
The nurse is caring for a client who has been diagnosed with deep vein thrombosis. When assessing the client's vital signs, the nurse notes an apical pulse of 150 bpm, a respiratory rate of 46 breaths/minutes, and blood pressure of 100/60 mm Hg. The client appears anxious and restless. What should be the nurse's first course of action?
- A. Notify the physician.
- B. Administer a sedative.
- C. Try to elicit a positive Homan's sign.
- D. Increase the flow rate of intravenous fluids.
Correct Answer: A
Rationale: These symptoms suggest a possible pulmonary embolism, a life-threatening complication of DVT, requiring immediate physician notification.
A client with a history of peptic ulcer disease is prescribed lansoprazole (Prevacid). The nurse should instruct the client to:
- A. Take the medication before meals.
- B. Take the medication with meals.
- C. Take the medication at bedtime.
- D. Stop the medication if heartburn resolves.
Correct Answer: A
Rationale: Lansoprazole is most effective when taken before meals to reduce acid production.
What type of immunity occurs when a person has an infectious, communicable disease like the measles?
- A. Adaptive immunity
- B. Passive natural immunity
- C. Active natural immunity
- D. Active artificial immunity
Correct Answer: C
Rationale: Active natural immunity occurs when a person develops immunity after exposure to an infectious disease like measles, producing antibodies through natural infection.
The nurse is preparing to administer a dose of warfarin (Coumadin) to a client. The client's International Normalized Ratio (INR) is 4.0. What should the nurse do?
- A. Administer the dose as ordered.
- B. Hold the dose and notify the physician.
- C. Administer half the prescribed dose.
- D. Administer vitamin K as an antidote.
Correct Answer: B
Rationale: An INR of 4.0 is above the therapeutic range (2-3), indicating a risk of bleeding, so the nurse should hold the dose and notify the physician.