Nursing Elites

1. A client informs a healthcare professional about taking Gingko Biloba. Which of the following medications is contraindicated for a client using Gingko Biloba?

• A. Acetaminophen
• B. Warfarin
• C. Digoxin
• D. Lisinopril

Correct answer: B

Rationale: Warfarin is contraindicated for a client taking Gingko Biloba due to the potential interaction that can lead to suppressed coagulation and an increased risk of bleeding or hemorrhage. Warfarin is an anticoagulant, and when combined with Gingko Biloba, which also has anticoagulant properties, the risk of bleeding complications is significantly heightened. Acetaminophen (Choice A), Digoxin (Choice C), and Lisinopril (Choice D) do not have significant interactions with Gingko Biloba compared to Warfarin. Acetaminophen is a pain reliever, Digoxin is a medication for heart conditions, and Lisinopril is an ACE inhibitor for hypertension.

2. A client is receiving heparin therapy. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?

• A. PT
• B. aPTT
• C. INR
• D. Platelet count

Correct answer: B

Rationale: The corrected answer is B: aPTT. The activated partial thromboplastin time (aPTT) is the laboratory value used to monitor the effectiveness of heparin therapy. The aPTT should be maintained at 1.5 to 2 times the normal level to ensure therapeutic anticoagulation. Monitoring aPTT helps healthcare providers adjust heparin doses to achieve the desired anticoagulant effects and prevent complications such as bleeding or clotting. Choice A, PT (prothrombin time), is used to monitor warfarin therapy, not heparin. Choice C, INR (international normalized ratio), is also used to monitor warfarin therapy. Choice D, platelet count, is important for assessing the risk of bleeding, but it does not directly monitor the effectiveness of heparin therapy.

3. A client has a new prescription for Furosemide. Which of the following adverse effects should the nurse monitor?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypernatremia
• D. Hypercalcemia

Correct answer: B

Rationale: Furosemide is a diuretic that commonly causes hyponatremia (low sodium levels) due to its effect on sodium and water excretion. The nurse must closely monitor the client for signs of hyponatremia, such as weakness, confusion, and muscle cramps, and promptly intervene to prevent complications. Choices A, C, and D are incorrect because Furosemide is not associated with hyperkalemia, hypernatremia, or hypercalcemia. Understanding the medication's mechanism of action helps prioritize monitoring for potential adverse effects.

4. What should a patient avoid while taking Angiotensin-converting enzymes?

• A. Salt substitutes
• B. Foods high in potassium
• C. Foods high in sodium
• D. All of the above

Correct answer: A

Rationale: Patients taking Angiotensin-converting enzyme (ACE) inhibitors should avoid salt substitutes because they can contain potassium chloride, which may lead to hyperkalemia. It is important to restrict potassium-rich foods while on ACE inhibitors, but the primary concern with salt substitutes is their potassium content.

5. When educating a client with a new prescription for Losartan, which instruction should the nurse provide?

• A. Avoid consuming grapefruit juice.
• B. Take this medication with a full glass of water.
• C. Take this medication with food.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct answer is to instruct the client to monitor for signs of dehydration when taking Losartan. Losartan can lead to dehydration, so it is crucial for the client to watch out for symptoms like dry mouth, increased thirst, and reduced urine output. Monitoring for these signs can help prevent complications associated with dehydration while taking this medication. Choices A, B, and C are incorrect because Losartan is not known to have interactions with grapefruit juice, does not require a specific amount of water for intake, and can be taken with or without food.

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