A nurse is preparing a client for discharge home after an admission for bilateral pulmonary emboli. The client is prescribed warfarin in addition to regular daily medications. Which of the following actions should the nurse take?
Advise the client that over-the-counter medications remain safe to consume as needed.
Consult the pharmacist about potential interactions between the client’s regular medications and warfarin.
Recommend the client take warfarin at the same time as other medications.
Tell the client they can continue to drink cranberry juice while taking warfarin.
The Correct Answer is B
Choice A reason: Advising over-the-counter medications as safe is incorrect, as many, like NSAIDs, increase warfarin’s bleeding risk by inhibiting platelets or affecting liver metabolism. Warfarin’s narrow therapeutic index requires careful management to prevent hemorrhage, making broad safety claims dangerous without specific evaluation.
Choice B reason: Consulting the pharmacist identifies interactions with warfarin, a vitamin K antagonist metabolized by CYP450 enzymes. Many drugs alter warfarin’s efficacy, risking thrombosis or bleeding. Pharmacist expertise ensures safe polypharmacy, maintaining therapeutic INR levels critical for managing pulmonary emboli effectively.
Choice C reason: Recommending warfarin with other medications ignores interaction risks and timing needs. Warfarin’s absorption is unaffected by timing, but CYP450 interactions can alter INR. This advice is irrelevant to safety, missing the need for individualized regimen assessment to prevent complications in anticoagulation therapy.
Choice D reason: Cranberry juice may enhance warfarin’s effect by inhibiting CYP2C9, increasing INR and bleeding risk. Advising its use without monitoring is unsafe, as dietary factors can destabilize anticoagulation, potentially causing hemorrhage in clients with pulmonary emboli, requiring careful dietary guidance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: A 10-year budget is impractical for cost containment, as healthcare costs fluctuate due to economic and technological changes. Long-term budgets lack flexibility for staffing or equipment needs, making them ineffective for ensuring cost-effective care delivery in dynamic healthcare environments.
Choice B reason: Hiring travel nurses increases costs due to high salaries and agency fees compared to permanent staff. While addressing short-term shortages, it does not promote long-term savings, as temporary labor is expensive, contrasting with strategies like workforce planning for cost containment.
Choice C reason: Reducing training programs may lower short-term costs but risks errors and lawsuits, increasing long-term expenses. Well-trained staff improve efficiency and outcomes, reducing readmissions. Training is critical for cost containment, as it enhances care quality in healthcare settings.
Choice D reason: Electronic health records (EHRs) reduce long-term costs by streamlining documentation and improving care coordination. EHRs enhance billing accuracy and reduce errors, offsetting initial costs with decreased administrative burdens and better patient outcomes, aligning with evidence-based cost containment strategies in healthcare.
Correct Answer is B
Explanation
Choice A reason: Amitriptyline, a tricyclic antidepressant, typically causes hypotension via alpha-adrenergic blockade, not hypertension. Expecting blood pressure elevation shows misunderstanding, as its cardiovascular effects require monitoring for orthostatic changes, not hypertensive risks, in depression treatment.
Choice B reason: Acknowledging a 2-4 week delay for amitriptyline’s effect shows understanding, as tricyclics increase synaptic serotonin and norepinephrine gradually, requiring neuroplastic changes for mood improvement. This reflects accurate knowledge of the drug’s onset, critical for managing expectations in depression therapy.
Choice C reason: Taking amitriptyline on an empty stomach is incorrect, as food reduces gastrointestinal side effects like nausea. Its absorption is unaffected by food, but taking it with meals improves tolerability, indicating a misunderstanding of administration guidelines for effective therapy.
Choice D reason: Morning dosing of amitriptyline is incorrect, as its sedative effects, via histamine blockade, are best utilized at bedtime to aid sleep. Morning use may cause daytime drowsiness, reducing adherence, indicating a misunderstanding of its pharmacological profile in depression management.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.