The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?

Give the next scheduled dose.

Obtain another blood sample.

Monitor for signs of bleeding.

Notify the healthcare provider.

Answer and Explanation

The Correct Answer is D

Choice A reason: Giving the next scheduled dose without further assessment is not advisable. An INR of 2.8 is within the therapeutic range for many conditions treated with warfarin, but it is important to ensure that the INR is stable and not trending higher, which could increase the risk of bleeding.

Choice B reason: Obtaining another blood sample might be necessary if there is suspicion of an error or if the INR is unexpectedly high or low. However, in this scenario, the INR is within the therapeutic range, so this action is not immediately necessary.

Choice C reason: Monitoring for signs of bleeding is always important for clients on warfarin, but it does not address the immediate need to communicate with the healthcare provider about the current INR level and any potential adjustments to the medication.

Choice D reason: Notifying the healthcare provider is the most appropriate action. The healthcare provider needs to be aware of the current INR level to make any necessary adjustments to the warfarin dosage and to provide further instructions on monitoring and follow-up.

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Correct Answer is A

Explanation

Choice A reason: Bupropion is known to cause side effects such as insomnia and weight loss. These side effects are due to its stimulant properties, which can interfere with sleep patterns and suppress appetite1. Patients should be informed about these potential side effects so they can monitor their symptoms and seek medical advice if necessary.

Choice B reason: While changes in taste can occur with some medications, it is not a common side effect of bupropion. Therefore, it is not necessary to specifically instruct patients to notify their healthcare provider about changes in taste when taking bupropion.

Choice C reason: There is no specific requirement to administer bupropion with 8 ounces of water. Bupropion can be taken with or without food, and the amount of water consumed with the medication does not impact its effectiveness.

Choice D reason: Consuming tyramine-free foods is crucial for patients taking monoamine oxidase inhibitors (MAOIs) due to the risk of hypertensive crisis. However, bupropion is not an MAOI, so this dietary restriction is not applicable.

A. Irritable bowel syndrome. B. Coronary artery disease. C. Seasonal allergic rhinitis. D. Type 2 diabetes mellitus.

Correct Answer is B

Explanation

Choice A reason:

Irritable bowel syndrome (IBS) is not a primary concern when administering sumatriptan succinate. While IBS can cause significant discomfort and affect the quality of life, it does not pose a direct contraindication to the use of sumatriptan. Sumatriptan is primarily metabolized in the liver and excreted by the kidneys, and its use is not significantly impacted by gastrointestinal conditions like IBS1.

Choice B reason:

Coronary artery disease (CAD) is a critical consideration before administering sumatriptan succinate. Sumatriptan is a selective serotonin receptor agonist that causes vasoconstriction of cranial blood vessels to relieve migraine symptoms. However, it can also cause vasoconstriction in coronary arteries, which can be dangerous for clients with CAD. This can lead to serious cardiovascular events such as myocardial infarction or angina. Therefore, it is essential to assess for any history of CAD or other significant cardiovascular conditions before administering this medication.

Choice C reason:

Seasonal allergic rhinitis is not a significant concern when administering sumatriptan succinate. While allergic rhinitis can cause symptoms such as nasal congestion, sneezing, and itching, it does not interact with the pharmacological action of sumatriptan. Therefore, it is not a contraindication for the use of this medication.

Choice D reason:

Type 2 diabetes mellitus is not a primary concern when administering sumatriptan succinate. Although diabetes can increase the risk of cardiovascular disease, the presence of diabetes alone does not contraindicate the use of sumatriptan. However, it is important to consider the overall cardiovascular risk profile of the client, including any complications related to diabetes.

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The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a history of smoking cigarettes for many years arrives at the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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