Nokea
Which prothrombin time value would be considered normal for a client who is receiving warfarin (Coumadin)?
- A. 12 seconds
- B. 20 seconds
- C. 60 seconds
- D. 98 seconds
Correct Answer: B
Rationale: For a client receiving warfarin, the prothrombin time should be 1.5 to 2 times the normal value (11 to 12.5 seconds). Twenty seconds falls within this therapeutic range. Twelve seconds is normal for someone not on warfarin. Sixty seconds is normal for a partial thromboplastin time (PTT) test, and 98 seconds would be therapeutic for heparin, not warfarin.
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Which assessment finding best supports the assumption that the client is a good treatment.
- A. Pericardial friction rub
- B. Muffled heart sounds
- C. S3 gallop
- D. Systolic murmur
Correct Answer: A
Rationale: Pericardial friction rub is characteristic of pericarditis due to inflamed pericardial layers.
An adult is diagnosed with hypertension. He is prescribed chlorothiazide (Diuril) 500 mg PO. What nursing instruction is essential for him?
- A. Drink at least two quarts of liquid daily.
- B. Avoid hard cheeses.
- C. Drink orange juice or eat a banana daily.
- D. Do not take aspirin.
Correct Answer: C
Rationale: Chlorothiazide, a diuretic, can cause potassium loss. Consuming potassium-rich foods like orange juice or bananas helps prevent hypokalemia.
The nurse is admitting a client diagnosed with coronary artery disease (CAD) and angina. Which concept is priority?
- A. Sleep, rest, activity.
- B. Comfort.
- C. Oxygenation.
- D. Perfusion.
Correct Answer: D
Rationale: CAD and angina impair perfusion (D), the priority concept, as ischemia causes symptoms. Sleep/rest (A), comfort (B), and oxygenation (C) are secondary.
An adult has a coagulation time of 20 minutes. The nurse should observe the client for which of the following?
- A. Blood clots
- B. Ecchymotic areas
- C. Jaundice
- D. Infection
Correct Answer: B
Rationale: The normal clotting time is 9 to 12 minutes. A prolonged clotting time suggests a bleeding tendency, so the client should be observed for signs of bleeding, such as ecchymotic areas. Blood clots would occur with a shorter clotting time. Jaundice is related to liver damage or red blood cell breakdown. Infection is associated with low white blood cell counts.
The best evidence that the client is complying with the diet therapy is the report of using which type of fat for cooking?
- A. Melted margarine
- B. Clarified butter
- C. Cooking spray
- D. Liquid corn oil
Correct Answer: C
Rationale: Cooking spray is low in saturated fat and calories, aligning with a heart-healthy diet to control CAD progression.