A client who is a vegetarian has a new prescription for warfarin. The client reports eating leafy green vegetables every day. How should the nurse respond?

Advise the client that the healthcare provider needs to be made aware of the current diet.

Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans.

Confirm that the clients diet choices will help the medication be more effective in preventing blood clots.

Commend the patient for a healthy lifestyle and encourage the client to continue current diet habits.

Answer and Explanation

The Correct Answer is A

A. Advise the client that the healthcare provider needs to be made aware of the current diet: This is the most appropriate response. Warfarin is an anticoagulant that works by inhibiting vitamin K, which is essential for blood clotting. Leafy green vegetables, such as spinach and kale, are high in vitamin K and can interfere with the effectiveness of warfarin. It is important for the healthcare provider to be aware of the client’s diet to properly adjust the warfarin dosage and ensure effective anticoagulation while minimizing the risk of bleeding or clotting.
B. Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans: This suggestion is not necessary unless there are specific dietary restrictions. While it's true that leafy green vegetables can affect warfarin, replacing them with other foods is not required. It’s more important to manage vitamin K intake consistently.
C. Confirm that the client’s diet choices will help the medication be more effective in preventing blood clots: This statement is incorrect. Leafy green vegetables can counteract the effects of warfarin due to their high vitamin K content.
D. Commend the patient for a healthy lifestyle and encourage the client to continue current diet habits: Although a diet rich in vegetables is generally healthy, it’s crucial to recognize that the high vitamin K content can impact the effectiveness of warfarin therapy. Therefore, simply encouraging the client to continue the current diet without considering its interaction with the medication is not appropriate

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Correct Answer is B

Explanation

A. Reduce caffeine and acidic intake: This is appropriate advice as caffeine and acidic foods can potentially affect uric acid levels and might exacerbate gout symptoms.
B. Double the dose if a dose is missed: This is incorrect and requires additional instruction. Allopurinol should not be doubled if a dose is missed. Instead, the missed dose should be taken as soon as possible unless it is almost time for the next dose. Doubling the dose could lead to increased risk of side effects or adverse reactions.
C. Avoid taking on an empty stomach: This is generally good advice, although allopurinol can be taken with or without food. Taking it with food might help reduce potential gastrointestinal discomfort.
D. Consume 2 liters of water daily: This is recommended to help prevent the formation of uric acid crystals and to ensure adequate hydration, which is beneficial while on allopurinol.

A. Low-density lipoprotein (LDL) B. Prothrombin time (PT). C. Creatine phosphokinase (CK) D. High-density lipoprotein (HDL).

Correct Answer is D

Explanation

A. Low-density lipoprotein (LDL): Atorvastatin's primary effect is to decrease LDL cholesterol levels. A decrease in LDL levels would indicate the medication is working as intended, not an increase.
B. Prothrombin time (PT): PT is a measure of blood clotting, which is not directly affected by atorvastatin. This value is more relevant for monitoring anticoagulant therapy.

C. Creatine phosphokinase (CK): CK levels can be used to monitor for muscle damage or side effects related to statin use. An increase in CK levels would suggest muscle damage, not the effectiveness of the statin.
D. High-density lipoprotein (HDL): Atorvastatin is a statin medication used to lower cholesterol levels, particularly low-density lipoprotein (LDL) cholesterol, which is a key target in reducing the risk of coronary artery disease (CAD). While the primary goal of atorvastatin is to lower LDL cholesterol, an increase in HDL cholesterol (often termed "good" cholesterol) is also desirable as it can help reduce the risk of CAD. Therefore, an increase in HDL is a positive indicator that the medication is having a beneficial effect.

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A client who is a vegetarian has a new prescription for warfarin. The client reports eating leafy green vegetables every day. How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

Correct Answer is B

Explanation

An increase in which serum lab value indicates to the nurse that a prescription for atorvastatin is having the desired effect for a client at risk for coronary artery disease?

Correct Answer is D

Explanation

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