The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?

Carvedilol

Captopril

Isosorbide dinitrate

Fluticasone

Answer and Explanation

The Correct Answer is A

A. Carvedilol: Carvedilol is a non-selective beta-blocker that blocks both beta-1 and beta-2 adrenergic receptors. Beta-2 blockade can lead to bronchoconstriction, which can exacerbate asthma symptoms. Clarification is needed to see if a cardioselective beta-blocker (like metoprolol) would be safer.

B. Captopril: Captopril is an ACE inhibitor commonly used in heart failure to reduce blood pressure and decrease the workload on the heart. It does not have bronchoconstrictive effects and is safe for use in clients with asthma.

C. Isosorbide dinitrate: Isosorbide dinitrate is a nitrate used to manage heart failure by dilating blood vessels and reducing the workload of the heart. It has no effect on bronchial smooth muscle and is not contraindicated in asthma, so no clarification is needed.

D. Fluticasone: Fluticasone is an inhaled corticosteroid used to manage asthma by reducing inflammation in the airways. It is beneficial in clients with asthma and does not pose a risk to clients with heart failure. There is no need to clarify this medication.

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Correct Answer is A

Explanation

A. Cabbage: This is the correct answer. Cabbage is a food high in vitamin K, which can antagonize the effects of warfarin. Warfarin is an anticoagulant that works by inhibiting vitamin K-dependent clotting factors. Consistent intake of vitamin K-rich foods, such as cabbage, can affect the stability of the client's international normalized ratio (INR).

B. Green beans: Green beans are not particularly high in vitamin K, and their consumption is not usually restricted for clients taking warfarin.

C. White beans: White beans are not particularly high in vitamin K, and their consumption is not usually restricted for clients taking warfarin.

D. Cantaloupe: Cantaloupe is not high in vitamin K, and its consumption is not usually restricted for clients taking warfarin.

A. Platelets 156,000/mm³ B. Fibrinogen 85 mg/dL C. PT 12 seconds D. PTT 64 seconds

Correct Answer is B

Explanation

A. Platelets 156,000/mm³: This platelet count is within the normal range (normal range: 150,000 to 400,000/mm³). Although disseminated intravascular coagulopathy (DIC) can lead to thrombocytopenia (low platelet count), the platelet count in this scenario is not indicative of DIC.

B. Fibrinogen 85 mg/dL: This is the correct answer. A decreased fibrinogen level is often seen in DIC. Fibrinogen is consumed in the formation of microclots, and a low level may indicate ongoing coagulation.

C. PT 12 seconds: The prothrombin time (PT) is within the normal range. In DIC, the PT may be prolonged due to the consumption of clotting factors, but in this case, the PT is normal.

D. PTT 64 seconds: The partial thromboplastin time (PTT) is prolonged, which can be an indication of DIC. However, the more specific indicator in this scenario is the low fibrinogen level.

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The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a clinic is caring for a client who has recently begun taking warfarin. The nurse is reviewing potential drug and food interaction risks and should instruct the client to avoid which of the following?

Correct Answer is A

Explanation

A nurse is reviewing the laboratory values of a client who is at risk for disseminated intravascular coagulopathy. Which of the following values should the nurse report to the provider?

Correct Answer is B

Explanation

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