A nurse is reviewing the medical records of four clients. The nurse should identify which of the following client findings that requires follow-up care.

A client who received a Mantoux test 48 hr ago and has an induration

A client who is taking bumetanide and has a potassium level of 3.6 mEq/L

A client who is scheduled for a colonoscopy and is taking sodium phosphate

A client who is taking warfarin and has an INR of 1.8

Answer and Explanation

The Correct Answer is D

A.    Induration after a Mantoux test is a common response and does not necessarily require follow-up care.
B.    A potassium level of 3.6 mEq/L is within the normal range (3.5-5.0 mEq/L).
C.    Sodium phosphate is commonly used for bowel preparation before procedures like colonoscopy.
D.    Correct. An INR of 1.8 for a client on warfarin is below the therapeutic range (usually 2.0- 3.0 for most indications), indicating that the client's blood may not be adequately anticoagulated. This requires follow-up to adjust the warfarin dose.

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Correct Answer is C

Explanation

A. Incorrect. Family history of malignant hypertension is not a contraindication for alteplase.

B. Incorrect. COPD itself is not a contraindication for alteplase. While it can complicate overall management, it does not increase the immediate risk of bleeding associated with thrombolytics.

C. Correct. Recent surgery, especially orthopedic surgery like hip arthroplasty, is a contraindication for thrombolytic therapy due to the increased risk of bleeding and hematoma formation at the surgical site.

D. Incorrect. Acute renal failure from six months ago is not a contraindication for alteplase.

A. Encourage rural residents to focus health spending on tertiary health interventions. B. Launch a media campaign to increase awareness about industrial pollution. C. Have a nurse from outside the community provide health lectures at the county hospital. D. Provide anticipatory guidance classes to parents through public schools.

Correct Answer is D

Explanation

A. Incorrect. Encouraging a focus on tertiary health interventions might not address the preventive health needs of the population.

B. Incorrect. While raising awareness about industrial pollution is important, it might not be the primary focus of a public health program in a rural area.

C. Incorrect. Utilizing a nurse from outside the community might not be the most effective approach for understanding the specific health needs and context of the local population.

D. Correct. Providing anticipatory guidance classes to parents through public schools is a community-based preventive approach that can address the health needs of families and children in the area.

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A nurse is reviewing the medical records of four clients. The nurse should identify which of the following client findings that requires follow-up care.

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Naxlex Comprehensive Predictor Exams

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