A nurse is reinforcing teaching about warfarin with a client who has a new onset of atrial fibrillation. Which of the following statements should the nurse include in the teaching?
"Warfarin dissolves clots in the bloodstream."
"This medication slows the response of the ventricles to the fast atrial impulses."
"Warfarin helps prevent strokes in clients who have atrial fibrillation."
"This medication will help maintain a normal heart rhythm."
The Correct Answer is C
Choice A reason : The statement that warfarin dissolves clots in the bloodstream is incorrect. Warfarin does not dissolve existing clots. Instead, it is an anticoagulant that works by decreasing the production of certain clotting factors in the blood, which helps prevent the formation of new clots.
Choice B reason : This statement is not accurate regarding the action of warfarin. Warfarin does not affect the electrical impulses of the heart. Medications that slow the response of the ventricles to fast atrial impulses are typically antiarrhythmic drugs, not anticoagulants like warfarin.
Choice C reason : This is the correct statement. Warfarin is prescribed for clients with atrial fibrillation to reduce the risk of stroke. Atrial fibrillation increases the risk of forming blood clots in the heart, which can then travel to the brain, causing a stroke. Warfarin's anticoagulant effect helps to prevent these clots from forming.
Choice D reason : Warfarin does not help maintain a normal heart rhythm. It is not an antiarrhythmic drug but an anticoagulant. The purpose of warfarin in atrial fibrillation is to prevent stroke by reducing the risk of clot formation, not to correct the heart rhythm.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: A barrel chest is typically not associated with mitral valve stenosis. It is more commonly seen in chronic obstructive pulmonary disease (COPD) due to hyperinflation of the lungs. Mitral valve stenosis affects the heart and not the lung structure.
Choice B reason: Clubbing of the fingers is a sign that can be associated with chronic hypoxia and certain types of congenital heart disease. While it can be seen in some heart conditions, it is not a specific finding for mitral valve stenosis.
Choice C reason: A heart murmur, specifically a diastolic murmur, is a classic finding in mitral valve stenosis. As the stenotic mitral valve obstructs blood flow from the left atrium to the left ventricle, a pressure gradient is created, which produces a murmur that can be heard upon auscultation.
Choice D reason: Bradycardia, or a slower than normal heart rate, is not a direct finding associated with mitral valve stenosis. Mitral valve stenosis may lead to arrhythmias such as atrial fibrillation due to atrial enlargement, but bradycardia is not typically induced by this condition.
Correct Answer is A
Explanation
Choice A reason : In atrial fibrillation, the heartbeat is known to be irregular and often rapid. This irregularity is due to the disorganized electrical signals in the heart's upper chambers, which cause a fast and chaotic heartbeat. Therefore, when documenting the pulse of a client with atrial fibrillation, the term "irregular" is appropriate.
Choice B reason : "Not palpable" would indicate that the pulse cannot be felt, which is not typically the case with atrial fibrillation. While the pulse may be irregular, it is usually still palpable unless the rate is extremely rapid or associated with other complications.
Choice C reason : "Bounding" refers to a pulse that feels strong and full. This is not characteristic of atrial fibrillation. Instead, the pulse in atrial fibrillation may feel weak and irregular due to the ineffective contraction of the atria.
Choice D reason : "Regular" is not an appropriate term to describe the pulse in a client with atrial fibrillation because the condition is characterized by an irregular heart rhythm. The term would be used for a pulse that has consistent beats at regular intervals, which is not the case in atrial fibrillation.
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