Nursing Elites

1. A client has been prescribed Warfarin for atrial fibrillation. Which of the following instructions should the nurse include in the discharge teaching?

• A. Avoid foods high in vitamin K.
• B. Take this medication with food to prevent nausea.
• C. Monitor your heart rate daily before taking the medication.
• D. Limit your fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for the nurse to include in the discharge teaching for a client prescribed Warfarin is to 'Avoid foods high in vitamin K.' Foods high in vitamin K can decrease the effectiveness of Warfarin by interfering with its anticoagulant effects, potentially leading to blood clotting issues. It is crucial for clients on Warfarin therapy to maintain a consistent intake of vitamin K-containing foods to ensure the stability of the medication's effects. Choices B, C, and D are incorrect because taking Warfarin with food, monitoring heart rate daily, or limiting fluid intake are not directly related to optimizing the effectiveness of Warfarin therapy.

2. When caring for a client prescribed warfarin, which laboratory test should the nurse monitor to evaluate the therapeutic effect of the medication?

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

Correct answer: D

Rationale: The correct laboratory test to monitor the therapeutic effect of warfarin is the PT/INR. Warfarin affects blood clotting, and the PT/INR levels indicate the effectiveness of the medication in preventing clot formation. Therefore, monitoring PT/INR levels helps ensure that the client is within the therapeutic range and is protected from potential complications related to clotting. Choice A (aPTT) is incorrect because while it measures the clotting time, it is not the preferred test for monitoring warfarin therapy. Choice B (Platelet count) is incorrect as it assesses the number of platelets and not the medication's therapeutic effect. Choice C (BUN) is unrelated to monitoring the effects of warfarin therapy and is primarily used to assess kidney function.

3. What is the correct medical term used to describe impaired blood flow in the coronary arteries?

• A. Myocardial infarction
• B. Angina pectoris
• C. Cerebrovascular accident
• D. Coronary heart disease

Correct answer: D

Rationale: The correct medical term for impaired blood flow in the coronary arteries is Coronary heart disease. This condition is characterized by a narrowing or blockage of the coronary arteries, leading to reduced blood flow to the heart muscle. Myocardial infarction (choice A) refers to a heart attack, which occurs when blood flow to a part of the heart is blocked. Angina pectoris (choice B) is chest pain or discomfort that occurs when the heart muscle doesn't receive enough oxygen-rich blood. Cerebrovascular accident (choice C) is the medical term for a stroke, which occurs when blood flow to a part of the brain is interrupted.

4. What is the first type of medication prescribed to prevent angina pain for a client?

• A. Beta blockers
• B. Alpha blockers
• C. Calcium channel blockers
• D. Organic nitrates

Correct answer: A

Rationale: Beta blockers are the first-line medication prescribed to prevent angina pain. They work by reducing the heart rate and blood pressure, decreasing the heart's demand for oxygen. This helps in preventing angina attacks by improving blood flow to the heart. Alpha blockers, calcium channel blockers, and organic nitrates are also used in angina treatment but are typically considered after beta blockers.

5. When teaching a client with a new prescription for furosemide, which instruction should the nurse include?

• A. Take this medication in the morning.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for furosemide, a diuretic, is to take it in the morning to prevent nocturia. Taking it in the morning helps to prevent frequent urination during the night, allowing the client to have uninterrupted sleep. This timing also coincides with the body's natural diuretic response, which is typically more active during the day. Choices B, C, and D are incorrect because furosemide does not require avoiding foods high in potassium, taking it on an empty stomach, or limiting fluid intake to 1 liter per day.

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