Nokea
The nurse should plan to teach a client who is taking warfarin sodium (Coumadin) to do which of the following?
- A. Consult the physician before undergoing dental work.
- B. Avoid the use of a toothbrush during oral hygiene.
- C. Use rectal suppositories to treat constipation.
- D. Eat green leafy vegetables.
Correct Answer: A
Rationale: Warfarin increases bleeding risk, so consulting a physician before dental work is essential to manage anticoagulation.
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A postmenopausal client with an intact uterus asks the nurse why her hormone medicine has two drugs, estrogen and progesterone. Which of the following statements by the nurse provides the client with accurate information?
- A. The progesterone will help prevent cervical cancer
- B. The progesterone will help prevent breast cancer
- C. The progesterone will help prevent liver disease
- D. The progesterone will help prevent endometrial cancer
Correct Answer: D
Rationale: Progesterone in hormone replacement therapy is used to prevent endometrial hyperplasia and cancer in women with an intact uterus. It does not primarily prevent cervical, breast, or liver disease.
A client with a history of epilepsy is prescribed lamotrigine (Lamictal). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild headache.
- B. Rash.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: A rash may indicate a serious hypersensitivity reaction to lamotrigine, such as Stevens-Johnson syndrome, requiring immediate reporting.
A worried mother confides in the nurse that she wants to change physicians because her infant is not getting better. The best response by the nurse is which of the following?
- A. This doctor has been on our staff for 20 years.'
- B. I know you are worried, but the doctor has an excellent reputation.'
- C. You always have an option to change. Tell me about your concerns.'
- D. I take my own children to this doctor.'
Correct Answer: C
Rationale: Acknowledging the mother's concerns and offering to discuss them respects her autonomy and opens a dialogue to address specific issues, potentially resolving misunderstandings or facilitating a change if needed.
A client has atrial fibrillation. The nurse should monitor the client for:
- A. Cardiac arrest
- B. Cerebrovascular accident
- C. Heart block
- D. Ventricular fibrillation
Correct Answer: B
Rationale: Atrial fibrillation increases the risk of thromboembolism, leading to cerebrovascular accident (stroke). Cardiac arrest, heart block, and ventricular fibrillation are less directly associated.
The nurse is caring for a client with a history of breast cancer who is receiving tamoxifen (Nolvadex). The nurse should instruct the client to report which of the following side effects immediately?
- A. Hot flashes.
- B. Vaginal bleeding.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Vaginal bleeding may indicate endometrial cancer, a serious side effect of tamoxifen, requiring immediate reporting.