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.

Answer and Explanation

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.

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Correct Answer is ["A","C","E"]

Explanation

Choice A reason: Inability to concentrate is a common symptom of hypoglycemia in type 1 diabetes, as low blood glucose impairs brain function, leading to confusion and difficulty focusing. This neuroglycopenic symptom results from insufficient glucose for cerebral energy, making it a critical indicator requiring prompt intervention like glucose administration.
Choice B reason: Polydipsia is associated with hyperglycemia, not hypoglycemia, in type 1 diabetes. It results from osmotic diuresis due to high blood glucose, causing dehydration and thirst. This symptom does not indicate low blood sugar, making it incorrect for identifying hypoglycemia in this scenario.
Choice C reason: Tremors are a hallmark of hypoglycemia, caused by the sympathetic nervous system’s response to low blood glucose, triggering catecholamine release. This leads to shakiness, a common adrenergic symptom, signaling the need for immediate glucose to restore normal levels, making it a correct indicator.
Choice D reason: Acetone breath odor is linked to diabetic ketoacidosis (DKA), a complication of hyperglycemia, not hypoglycemia. It results from ketone production during fat metabolism in uncontrolled diabetes. This finding is irrelevant to low blood sugar, making it incorrect for this scenario.
Choice E reason: Diaphoresis, or excessive sweating, is a classic hypoglycemia symptom due to autonomic activation from low blood glucose. The body releases adrenaline, causing sweating as a stress response. This reliable indicator prompts urgent treatment to prevent severe complications, making it a correct choice.

A. Ask an experienced nurse to assist with the procedure. B. Refuse to take the assignment. C. Identify that the task is in the scope of RN practice and perform the suctioning. D. Delegate the task to assistive personnel.

Correct Answer is A

Explanation

Choice A reason: Asking an experienced nurse to assist ensures the procedure is performed safely while allowing the newly licensed nurse to gain competence. Tracheal suctioning requires sterile technique and skill to avoid complications like hypoxia or trauma. This approach supports patient safety and professional development, aligning with nursing standards.
Choice B reason: Refusing the assignment is inappropriate, as tracheal suctioning is within an RN’s scope of practice. Refusal avoids responsibility without addressing the client’s needs or the nurse’s professional growth. Seeking assistance ensures safe care while building skills, making this choice less effective and unprofessional.
Choice C reason: Performing tracheal suctioning without prior experience risks patient harm, as it requires precise technique to prevent complications like mucosal damage or infection. Without guidance, errors are more likely. Seeking supervision ensures safety and competence, making this choice unsafe and inappropriate for a novice nurse.
Choice D reason: Delegating tracheal suctioning to assistive personnel is inappropriate, as it is a sterile procedure requiring RN-level skills and judgment. Assistive personnel are not trained for invasive procedures like suctioning, which risks complications. This choice violates delegation principles and compromises patient safety, making it incorrect.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has type 1 diabetes mellitus. The client reports that she is not feeling well. Which of the following findings should indicate to the nurse that the client is hypoglycemic? (Select all that apply)

Correct Answer is ["A","C","E"]

Explanation

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Correct Answer is A

Explanation

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