Nursing Elites

1. A client with deep vein thrombosis has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?

• A. Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
• B. I will call the provider to get a prescription for discontinuing the IV heparin today.
• C. Both heparin and warfarin work together to dissolve the clots.
• D. The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.

Correct answer: A

Rationale: The correct answer is A because warfarin takes several days to reach a therapeutic level and exert its full anticoagulant effect. During this time, the IV heparin is continued to prevent clotting until the warfarin is effective. Both medications are used together temporarily for this reason. Discontinuing heparin prematurely can increase the risk of clot formation. Therefore, the nurse should explain to the client that the IV heparin will be continued until the warfarin reaches a therapeutic level.

2. A client is starting a new prescription for furosemide. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Weigh yourself daily.
• C. Take potassium supplements as needed.
• D. Decrease intake of foods high in sodium.

Correct answer: B

Rationale: When a client is prescribed furosemide, it is important to monitor for fluid loss. Weighing oneself daily helps track changes in weight due to fluid loss, which can indicate the effectiveness of the medication. This monitoring assists in managing fluid balance and adjusting the dosage if necessary to achieve the desired therapeutic effect. Choice A is incorrect because furosemide is usually recommended to be taken on an empty stomach. Choice C is incorrect because potassium supplements should only be taken if prescribed by a healthcare provider due to the risk of hyperkalemia with furosemide. Choice D is incorrect because decreasing sodium intake is generally a good dietary practice but not a specific instruction related to furosemide therapy.

3. Which of the following is the primary site of activity for the drug Warfarin?

• A. Kidney
• B. Liver
• C. Blood
• D. Heart

Correct answer: B

Rationale: Warfarin primarily affects the liver where it inhibits the synthesis of clotting factors.

4. When teaching a client with a new prescription for Warfarin, which herbal supplement should the nurse instruct the client to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: The correct answer is St. John's wort. St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism, potentially leading to decreased anticoagulant effects. Therefore, the nurse should instruct the client to avoid using St. John's wort while taking Warfarin to prevent adverse drug interactions. Echinacea, garlic, and ginseng are not the correct answers in this case. While these herbal supplements may also interact with Warfarin and affect its efficacy, St. John's wort has a well-known interaction with Warfarin that can significantly impact its anticoagulant effects. Educating the client about the specific interaction between St. John's wort and Warfarin is crucial to ensure patient safety and the medication's therapeutic benefit.

5. A drug ending in the suffix (navir) is considered a ______.

• A. Antidepressant
• B. Protease inhibitor
• C. Beta antagonist
• D. H antagonist

Correct answer: B

Rationale: When a drug name ends in the suffix -navir, it indicates that the drug is a protease inhibitor. Protease inhibitors are commonly used in antiviral therapy to treat infections by inhibiting viral replication. Therefore, the correct answer is B: Protease inhibitor.

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