A client is discharged with a prescription for warfarin. Which discharge instruction should the nurse emphasize to the client?

Take a multi-vitamin supplement daily.

Use an astringent for superficial bleeding.

Add large amounts of spinach to the diet.

Avoid going barefoot, especially outside.

Answer and Explanation

The Correct Answer is D

Choice A reason: Taking a multi-vitamin supplement daily is not a necessary instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. However, some vitamins, such as vitamin K, vitamin E, and vitamin C, can interact with warfarin and affect its effectiveness. Patients should consult their health care provider before taking any supplements or herbal products.

Choice B reason: Using an astringent for superficial bleeding is not a sufficient instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Warfarin can increase the risk of bleeding, both internally and externally. Patients should report any signs of bleeding, such as bruising, nosebleeds, gum bleeding, blood in urine or stool, or prolonged bleeding from cuts or wounds, to their health care provider. They should also avoid activities or products that can increase the risk of bleeding, such as shaving with a razor, using dental floss, or taking aspirin or NSAIDs.

Choice C reason: Adding large amounts of spinach to the diet is an incorrect instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Spinach is a leafy green vegetable that is high in vitamin K, which can counteract the effect of warfarin and increase the risk of clotting. Patients should maintain a consistent intake of vitamin K-rich foods and avoid sudden changes in their diet.

Choice D reason: Avoiding going barefoot, especially outside, is a correct instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Warfarin can increase the risk of bleeding, both internally and externally. Patients should protect their feet from injury or infection by wearing shoes or slippers at all times.

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Correct Answer is D

Explanation

Choice A reason: Using a Snellen chart to assess visual acuity is not a direct measure of the effectiveness of pilocarpine, which is used to lower intraocular pressure by constricting the pupil and increasing aqueous humor outflow. Visual acuity may be affected by other factors, such as refractive errors, cataracts, or macular degeneration.

Choice B reason: Checking the amount of drainage from each eye is not a relevant action for evaluating the effectiveness of pilocarpine, which does not affect tear production or drainage. Excessive or abnormal eye drainage may indicate an infection, allergy, or injury.

Choice C reason: Palpating the eyelids for decreased swelling is not a useful action for evaluating the effectiveness of pilocarpine, which does not cause or reduce eyelid swelling. Eyelid swelling may be caused by inflammation, infection, allergy, or trauma.

Choice D reason: Reviewing eye pressure measurements is the correct action for evaluating the effectiveness of pilocarpine, which is used to lower intraocular pressure in patients with open-angle glaucoma. High intraocular pressure can damage the optic nerve and cause vision loss. Pilocarpine reduces intraocular pressure by constricting the pupil and increasing aqueous humor outflow.

A. Sleeps soundly through the night. B. Decreased episodes of incontinence. C. Improved ability to concentrate. D. Exhibits fewer emotional outbursts.

Correct Answer is A

Explanation

Choice A reason: Sleeping soundly through the night is the desired outcome of administering zolpidem, which is a sedative-hypnotic that induces sleep by enhancing the activity of GABA, an inhibitory neurotransmitter. Zolpidem is used to treat insomnia, especially difficulty falling asleep.

Choice B reason: Decreasing episodes of incontinence is not a relevant outcome of administering zolpidem, which does not affect urinary function or bladder control. Incontinence may be caused by other factors, such as aging, prostate problems, or urinary tract infections.

Choice C reason: Improving ability to concentrate is not a pertinent outcome of administering zolpidem, which does not affect cognitive function or attention span. Zolpidem may actually impair memory and cause daytime drowsiness or confusion in some patients.

Choice D reason: Exhibiting fewer emotional outbursts is not a significant outcome of administering zolpidem, which does not affect mood or behavior. Zolpidem may actually cause paradoxical reactions, such as agitation, aggression, or hallucinations in some patients.

: [Zolpidem (Oral Route)]

: [Insomnia]

: [Urinary Incontinence]

: [Concentration Problems]

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A client is discharged with a prescription for warfarin. Which discharge instruction should the nurse emphasize to the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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A client is discharged with a prescription for warfarin. Which discharge instruction should the nurse emphasize to the client?