Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A client is started on warfarin therapy. Identify the appropriate nursing implications associated with this medication. (Select all that apply.)
A. Advise the client to avoid prolonged immobility and participate in exercise activities while on warfarin.
Advising the client to avoid prolonged immobility and participate in exercise activities is a general health recommendation but not specifically related to warfarin therapy.
B. Safe and effective warfarin therapy requires rigid adherence to the dosing schedule.
Safe and effective warfarin therapy requires rigid adherence to the dosing schedule to maintain therapeutic anticoagulation levels.
C. Therapy will be evaluated by monitoring PT/INR frequently at first, then every 2-4 weeks after that.
Monitoring PT/INR frequently initially and then regularly helps assess the effectiveness and safety of warfarin therapy.
D. The client should be encouraged to use non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief while on warfarin.
Encouraging the use of NSAIDs is not recommended with warfarin due to the increased risk of bleeding.
E. Instruct the client to avoid foods high in Vitamin K while on warfarin.
Instructing the client to avoid foods high in Vitamin K is important because Vitamin K can interfere with the anticoagulant effects of warfarin.
This question is an excerpt from Nurse Dive's nursing test bank - Ramsussen Section 4 Module 11. Pharmocology For Professional Nursing Proctored Exam. Take the full exam now
Full Explanation
a) Advising the client to avoid prolonged immobility and participate in exercise activities is a general health recommendation but not specifically related to warfarin therapy.
b) Safe and effective warfarin therapy requires rigid adherence to the dosing schedule to maintain therapeutic anticoagulation levels.
c) Monitoring PT/INR frequently initially and then regularly helps assess the effectiveness and safety of warfarin therapy.
d) Encouraging the use of NSAIDs is not recommended with warfarin due to the increased risk of bleeding.
e) Instructing the client to avoid foods high in Vitamin K is important because Vitamin K can interfere with the anticoagulant effects of warfarin.
Similar Questions
A pregnant client asks the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the client?
A. Antihistamines are safe to take during breastfeeding, but they cause spina bifida in pregnancy.
Antihistamines are generally considered safe during breastfeeding, but this statement does not address the safety during pregnancy.
B. Antihistamines should be avoided in pregnancy unless necessary.
The general recommendation is to avoid unnecessary medication use during pregnancy, including antihistamines, especially during the first trimester.
C. The margin of safety for antihistamines is clearly understood for pregnant clients.
The margin of safety for antihistamines is not universally understood, and caution is advised during pregnancy.
D. Second-generation antihistamines are completely safe to take during the first trimester.
While second-generation antihistamines are considered safer than first-generation ones, the safety of any medication during pregnancy should be discussed with a healthcare provider.
Full Explanation
a) Antihistamines are generally considered safe during breastfeeding, but this statement does not address the safety during pregnancy.
b) The general recommendation is to avoid unnecessary medication use during pregnancy, including antihistamines, especially during the first trimester.
c) The margin of safety for antihistamines is not universally understood, and caution is advised during pregnancy.
d) While second-generation antihistamines are considered safer than first-generation ones, the safety of any medication during pregnancy should be discussed with a healthcare provider.
A client who reports routine consumption of more than three alcoholic beverages per day asks about taking acetaminophen when needed for occasional recurrent pain. What will the nurse tell the client?
A. "Do not take a scheduled-dose preparation of acetaminophen with opioid analgesics."
The statement about not taking a scheduled-dose preparation of acetaminophen with opioid analgesics is unrelated to the client's question about alcohol consumption.
B. "Do not take more than 3 gm of acetaminophen a day."
Excessive alcohol intake increases the risk of acetaminophen-induced liver damage. The recommended maximum dose is 3 grams per day to minimize the risk of hepatotoxicity.
C. "Do not take more than 2 gm of acetaminophen a day."
The recommendation of not exceeding 2 gm of acetaminophen a day is conservative, but the commonly accepted maximum is 3 grams per day.
D. "Do not take more than 4 gm of acetaminophen a day."
While the general guideline is not to exceed 4 grams of acetaminophen per day for the general population, individuals with alcohol consumption may be more susceptible to liver damage, so a lower limit is often advised.
Full Explanation
a) The statement about not taking a scheduled-dose preparation of acetaminophen with opioid analgesics is unrelated to the client's question about alcohol consumption.
b) Excessive alcohol intake increases the risk of acetaminophen-induced liver damage. The recommended maximum dose is 3 grams per day to minimize the risk of hepatotoxicity.
c) The recommendation of not exceeding 2 gm of acetaminophen a day is conservative, but the commonly accepted maximum is 3 grams per day.
d) While the general guideline is not to exceed 4 grams of acetaminophen per day for the general population, individuals with alcohol consumption may be more susceptible to liver damage, so a lower limit is often advised.
Insulin glargine is prescribed for a hospitalized client who has diabetes. When will the nurse expect to administer this drug?
A. Approximately 15 to 30 minutes before each meal
Insulin glargine is a long-acting basal insulin and is not typically administered before each meal.
B. After meals and at bedtime
Administering insulin glargine after meals is not the standard practice. It is given once daily to provide a continuous basal insulin level.
C. Once-daily at the same time every day
Insulin glargine is a once-daily basal insulin that is usually administered at the same time every day to maintain a consistent level of insulin in the body.
D. With meals
Unlike short-acting insulins, insulin glargine is not given with meals but provides a basal level of insulin throughout the day.
Full Explanation
a) Insulin glargine is a long-acting basal insulin and is not typically administered before each meal.
b) Administering insulin glargine after meals is not the standard practice. It is given once daily to provide a continuous basal insulin level.
c) Insulin glargine is a once-daily basal insulin that is usually administered at the same time every day to maintain a consistent level of insulin in the body.
d) Unlike short-acting insulins, insulin glargine is not given with meals but provides a basal level of insulin throughout the day.