Nokea
Which of the following should the nurse include when providing dietary teaching for the patient receiving warfarin (Coumadin) therapy?
- A. Avoid drinking large amounts of green te
- C. Cranberry juice will provide you with needed nutrients while taking Coumadin.
- D. You must never eat spinach.
Correct Answer: A
Rationale: The nurse should include the instruction to avoid drinking large amounts of green tea when providing dietary teaching for a patient receiving warfarin (Coumadin) therapy because green tea contains vitamin K, which can interfere with the anticoagulant effects of warfarin. Maintaining consistent intake of vitamin K is important to ensure the effectiveness of warfarin therapy. Therefore, it is recommended for patients on warfarin to consume a consistent amount of vitamin K-containing foods and avoid sudden, significant changes in their intake.
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Pregnancy advise is given in what Part of the MIMS:
- A. Preg. Cat.
- B. pre and post prandial advice ;
- C. drug category;
- D. abbreviations
Correct Answer: A
Rationale: Pregnancy advice is typically provided under the "Preg. Cat." section in the MIMS (Monthly Index of Medical Specialities) guide or database. This section specifically categorizes medications based on their safety profiles during pregnancy, providing healthcare professionals with essential information to make informed decisions regarding drug use in pregnant patients. It includes details on pregnancy categories that classify drugs according to their potential risks during pregnancy, guiding healthcare providers on the appropriateness of prescribing certain medications to pregnant individuals. Therefore, for pregnancy-related advice in the context of medication safety, referring to the "Preg. Cat." section in the MIMS is the most relevant source of information.
A client with active tuberculosis asks why he must take four different medications. Which of the following responses should the nurse make?
- A. Four medications decrease the risk of a severe allergic reaction.
- B. Four medications reduce the chance that the bacteria will become resistant.
- C. Four medications reduce the risk of adverse reactions.
- D. Four medications decrease the chance of having a positive tuberculin skin test.
Correct Answer: B
Rationale: The correct answer is B. When treating tuberculosis, using a combination of medications is crucial to reduce the risk of bacteria developing resistance to any single drug. This approach helps prevent treatment failure and ensures successful treatment outcomes. Choice A is incorrect because the primary purpose of using multiple medications is not related to allergic reactions. Choice C is incorrect as the risk reduction is mainly focused on bacterial resistance rather than adverse reactions. Choice D is not relevant as the purpose of taking multiple medications is not to affect the tuberculin skin test results.
The newly licensed nurse is preparing to administer a high dose of androgen to the female client. The nurse manager asks for the rationale. What is the best response by the new nurse?
- A. My client wants to improve athletic performance
- B. My client has breast cancer
- C. My client has brain cancer
- D. My client is planning on sexual reassignment surgery
Correct Answer: B
Rationale: High-dose androgen therapy in females is occasionally used as a palliative treatment for certain breast cancers, particularly hormone-sensitive types, where it suppresses estrogen-driven tumor growth, offering symptom relief in advanced stages. Using androgens for athletic performance enhancement, while possible due to their anabolic effects, isn't a clinical indication and is illegal in regulated settings. Brain cancer lacks evidence supporting androgen use, as it doesn't target neurological malignancies. Sexual reassignment involves testosterone for masculinization, but high doses in a clinical context typically align with cancer care, not transition protocols. The breast cancer rationale reflects a recognized, albeit niche, therapeutic use, leveraging androgens' anti-estrogenic properties to slow disease progression, making it the most defensible clinical justification in this scenario.
A patient diagnosed with cancer is scheduled to receive vincristine. Which nursing assessment will have the highest priority when providing care for this patient?
- A. Degree of alopecia
- B. Increased digoxin levels
- C. Decreased phenytoin effects
- D. Peripheral neuropathy
Correct Answer: D
Rationale: Vincristine is known to cause peripheral neuropathy, a common and potentially debilitating side effect. The nurse should prioritize assessing for signs of neuropathy, such as tingling, numbness, or weakness in the extremities. Alopecia, while distressing, is not as critical as neuropathy, which can affect the patient's mobility and quality of life. Vincristine does not typically cause significant changes in digoxin or phenytoin levels, making these assessments less relevant. Early detection of neuropathy allows for dose adjustments or supportive interventions to minimize long-term damage.
A client has a new prescription for Metoclopramide to treat nausea. Which of the following client statements indicates an understanding of the teaching?
- A. I should take this medication before bedtime.
- B. I will discontinue this medication if I experience drowsiness.
- C. I should report restlessness or involuntary movements.
- D. This medication can change the color of my urine to orange.
Correct Answer: C
Rationale: The correct answer is C. Reporting restlessness or involuntary movements is crucial as they can be signs of extrapyramidal symptoms, a potential side effect of Metoclopramide. These symptoms should be reported promptly to the healthcare provider for appropriate management. Choices A, B, and D are incorrect because taking the medication before bedtime, discontinuing it due to drowsiness, or expecting urine color changes are not relevant teaching points for Metoclopramide use.