Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 63-year-old man was recently placed on warfarin (Coumadin) by his nurse practitioner. Which of the following supplements will he need to discontinue?
A. Sam-e
Sam-e is primarily used for depression and joint pain. While it may have mild anticoagulant effects, it is not as significant in potentiating warfarin’s effects as omega-3 fatty acids.
B. Omega-3 fatty acids
This choice is correct because omega-3 fatty acids have antiplatelet properties and can increase the risk of bleeding when combined with warfarin. Patients on anticoagulants are typically advised to limit or discontinue omega-3 supplementation.
C. Melatonin
Melatonin is a sleep-regulating supplement and does not significantly affect coagulation or interact with warfarin to increase bleeding risk.
D. Tryptophan
Tryptophan is an amino acid precursor to serotonin used for sleep or mood regulation. It does not have a clinically significant interaction with warfarin.
This question is an excerpt from Nurse Dive's nursing test bank - Mental Health Northern Kentucky University Proctored Exam 6. Take the full exam now
Full Explanation
Choice A reason: Sam-e is primarily used for depression and joint pain. While it may have mild anticoagulant effects, it is not as significant in potentiating warfarin’s effects as omega-3 fatty acids.
Choice B reason: This choice is correct because omega-3 fatty acids have antiplatelet properties and can increase the risk of bleeding when combined with warfarin. Patients on anticoagulants are typically advised to limit or discontinue omega-3 supplementation.
Choice C reason: Melatonin is a sleep-regulating supplement and does not significantly affect coagulation or interact with warfarin to increase bleeding risk.
Choice D reason: Tryptophan is an amino acid precursor to serotonin used for sleep or mood regulation. It does not have a clinically significant interaction with warfarin.
Similar Questions
The PMHNP is working on an inpatient geropsychiatric unit. He is conducting the Montreal Cognitive Assessment (MoCA) on an 89-year-old woman with suspected dementia. He asks her to draw a clock to test her praxis abilities. Which area of the brain is responsible for this function?
A. Left (dominant) parietal
The left parietal lobe is primarily involved in language, calculation, and sequential tasks, not spatial construction and praxis, which are essential for clock drawing.
B. Right (nondominant) parietal
This choice is correct because the right (nondominant) parietal lobe is responsible for visuospatial processing and praxis, including the ability to perceive spatial relationships and reproduce them accurately, as required in clock-drawing tasks.
C. Temporal lobe
The temporal lobe is involved in memory, auditory processing, and language comprehension, not visuospatial praxis.
D. Occipital lobe
The occipital lobe is responsible for primary visual processing, but the integration of spatial planning for drawing tasks involves parietal lobe function.
Full Explanation
Choice A reason: The left parietal lobe is primarily involved in language, calculation, and sequential tasks, not spatial construction and praxis, which are essential for clock drawing.
Choice B reason: This choice is correct because the right (nondominant) parietal lobe is responsible for visuospatial processing and praxis, including the ability to perceive spatial relationships and reproduce them accurately, as required in clock-drawing tasks.
Choice C reason: The temporal lobe is involved in memory, auditory processing, and language comprehension, not visuospatial praxis.
Choice D reason: The occipital lobe is responsible for primary visual processing, but the integration of spatial planning for drawing tasks involves parietal lobe function.
A 10-year-old girl presents to the urgent care clinic with a dislocated elbow sustained in a roller skating accident. Which of the following is NOT an expected treatment for this girl?
A. Physical therapy
Physical therapy is commonly used after elbow dislocation to restore range of motion and prevent stiffness, making it a standard component of care.
B. Reduction
Reduction, or realignment of the dislocated joint, is the primary initial treatment and is expected in managing elbow dislocations.
C. Splinting
Splinting or immobilization following reduction is standard to maintain stability while soft tissues heal, and it is a routine part of management.
D. Surgical intervention
Surgical intervention is typically not required for uncomplicated elbow dislocations in children, as most can be managed with closed reduction and conservative care. Surgery is reserved for complex fractures or persistent instability.
Full Explanation
Choice A reason: Physical therapy is commonly used after elbow dislocation to restore range of motion and prevent stiffness, making it a standard component of care.
Choice B reason: Reduction, or realignment of the dislocated joint, is the primary initial treatment and is expected in managing elbow dislocations.
Choice C reason: Splinting or immobilization following reduction is standard to maintain stability while soft tissues heal, and it is a routine part of management.
Choice D reason: Surgical intervention is typically not required for uncomplicated elbow dislocations in children, as most can be managed with closed reduction and conservative care. Surgery is reserved for complex fractures or persistent instability.
The psychiatric-mental health nurse practitioner evaluates an 81-year-old man who was admitted to the hospital 3 days ago for community-acquired pneumonia and dehydration. Today, he has an altered level of consciousness and is only oriented to person. The nurses report he has become withdrawn and has refused to eat. He has no previous psychiatric history. Based on this scenario, what medication should the PMHNP prescribe for agitation as needed?
A. Benztropine (Cogentin)
Benztropine is primarily used to treat extrapyramidal symptoms from antipsychotic medications and does not address agitation in delirium.
B. Diphenhydramine (Benadryl)
Diphenhydramine may cause sedation but has anticholinergic properties that can worsen delirium in elderly patients, making it inappropriate.
C. Lorazepam (Ativan)
Lorazepam can exacerbate delirium in older adults and is generally avoided unless agitation is due to alcohol or benzodiazepine withdrawal.
D. Haloperidol (Haldol)
This choice is correct because haloperidol is the preferred first-line antipsychotic for acute agitation in elderly patients with delirium. It has minimal anticholinergic effects and can safely manage agitation while monitoring for extrapyramidal or cardiac side effects.
Full Explanation
Choice A reason: Benztropine is primarily used to treat extrapyramidal symptoms from antipsychotic medications and does not address agitation in delirium.
Choice B reason: Diphenhydramine may cause sedation but has anticholinergic properties that can worsen delirium in elderly patients, making it inappropriate.
Choice C reason: Lorazepam can exacerbate delirium in older adults and is generally avoided unless agitation is due to alcohol or benzodiazepine withdrawal.
Choice D reason: This choice is correct because haloperidol is the preferred first-line antipsychotic for acute agitation in elderly patients with delirium. It has minimal anticholinergic effects and can safely manage agitation while monitoring for extrapyramidal or cardiac side effects.