A nurse is caring for a client who has a deep vein thrombosis, who received IV heparin for the past 5 days, and now has a new prescription for oral warfarin in addition to the heparin. The client asks the nurse if both medications are necessary. Which of the following is an appropriate response by the nurse?

"Heparin enhances the effects of the warfarin."

"Both heparin and warfarin work together to dissolve the clots."

"Heparin will be continued until the warfarin reaches a therapeutic level!"

"I will ask the charge nurse to call your provider and get an explanation"

Answer and Explanation

The Correct Answer is C

A) "Heparin enhances the effects of the warfarin.": This statement is incorrect. Heparin and warfarin work through different mechanisms. Heparin acts quickly by inhibiting clot formation through antithrombin, while warfarin acts slower by inhibiting vitamin K-dependent clotting factors. They do not directly enhance each other's effects.

B) "Both heparin and warfarin work together to dissolve the clots.": This is inaccurate. Neither heparin nor warfarin dissolve existing clots; they prevent new clots from forming and existing clots from growing. The body's natural processes will eventually dissolve the clot.

C) "Heparin will be continued until the warfarin reaches a therapeutic level!": This is correct. Heparin is used initially because it acts quickly. Warfarin takes several days to reach therapeutic levels. Overlapping the two ensures continuous anticoagulation until warfarin is effective.

D) "I will ask the charge nurse to call your provider and get an explanation.": While involving the provider for further explanation can be helpful, it does not directly answer the client’s question. Providing accurate information about the overlapping use of heparin and warfarin is more appropriate in this context.

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Correct Answer is D

Explanation

A) Headache:
Omeprazole is not typically prescribed for headaches. It is a proton pump inhibitor (PPI) used primarily to reduce stomach acid production and treat conditions such as gastroesophageal reflux disease (GERD) and peptic ulcers. It does not directly relieve headache symptoms.

B) Nausea:
While omeprazole can indirectly help alleviate nausea associated with acid reflux or gastritis, it is not primarily indicated for nausea relief. Its main therapeutic effect is on reducing stomach acid production.

C) Diarrhea:
Omeprazole is not used to treat diarrhea. It does not have direct effects on bowel motility or stool consistency.

D) Acid indigestion:
Omeprazole is effective in relieving symptoms of acid indigestion, also known as heartburn or acid reflux. It works by decreasing the production of stomach acid, thereby reducing the burning sensation and discomfort associated with acid reflux.

A. Serum calcium 10.5 mg/dL B. Serum potassium 5.2. C. Serum chloride 99 mEq/L D. Serum sodium 140 mEq/L

Correct Answer is B

Explanation

A) Serum calcium 10.5 mg/dL:
A serum calcium level of 10.5 mg/dL is within the normal range (8.5-10.5 mg/dL). Spironolactone does not typically affect calcium levels significantly.

B) Serum potassium 5.2 mEq/L:
An elevated serum potassium level (hyperkalemia) is a known adverse effect of spironolactone. Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to decreased potassium excretion and potential hyperkalemia, especially in clients with impaired renal function.

C) Serum chloride 99 mEq/L:
A serum chloride level of 99 mEq/L is within the normal range (96-106 mEq/L). Spironolactone does not typically affect chloride levels significantly.

D) Serum sodium 140 mEq/L:
A serum sodium level of 140 mEq/L is within the normal range (135-145 mEq/L). Spironolactone does not typically affect sodium levels significantly.

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Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has been taking omeprazole for the past 4 weeks. The nurse determines that the medication is effective when the client reports relief from which of the following symptoms?

Correct Answer is D

Explanation

A nurse is reviewing the laboratory findings of a client who has liver failure with ascites. The client takes spironolactone. Which of the following findings is an adverse effect of the medication?

Correct Answer is B

Explanation

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