a client with a history of atrial fibrillation is receiving warfarin coumadin therapy which laboratory result indicates that the therapy is effective

HESI RN

Community Health HESI

1. A client with a history of atrial fibrillation is receiving warfarin (Coumadin) therapy. Which laboratory result indicates that the therapy is effective?

A. International normalized ratio (INR) of 1.0.
B. Prothrombin time (PT) of 12 seconds.
C. Partial thromboplastin time (PTT) of 60 seconds.
D. International normalized ratio (INR) of 2.5.

Correct answer: D

Rationale: An International Normalized Ratio (INR) of 2.5 indicates that warfarin therapy is within the therapeutic range for a client with atrial fibrillation. A lower INR (such as 1.0) would suggest subtherapeutic levels, risking blood clots. Prothrombin time (PT) and partial thromboplastin time (PTT) are not specific to monitoring warfarin therapy.

2. During a home health visit, the nurse notices that an older male client with type 2 diabetes mellitus is wearing loose cloth slippers. The client reports that he cannot comfortably wear other shoes because his toenails get in the way. The nurse inspects the client's feet and finds long thick nails that curl down under some of the toes. Which action should the nurse take?

A. demonstrate proper foot care to the client and family
B. have a home health aide assist the client with hygiene weekly
C. schedule an appointment for the client with a podiatrist
D. trim the client's toenails gradually over several visits

Correct answer: C

Rationale: Scheduling an appointment with a podiatrist is the most appropriate action in this scenario. For a client with long thick nails that curl under the toes, professional foot care by a podiatrist is necessary to prevent complications, especially in a client with diabetes mellitus. Demonstrating proper foot care (choice A) may not address the immediate need for nail trimming. Having a home health aide assist with hygiene weekly (choice B) may not be sufficient for managing the client's toenail issue effectively. Trimming the client's toenails gradually over several visits (choice D) should be performed by a professional like a podiatrist to avoid potential complications.

3. An older client requiring total care resides with a family consisting of two daughters who take shifts providing care around-the-clock. During a home visit, the daughters ask the nurse about resources that are available for client care while they attend a scheduled family reunion. Which information is best for the nurse to provide?

A. propose the family seek assistance for care in the area of the reunion's location
B. tell the caregivers to consider hiring a private duty nurse during the time away
C. advise to have a case management evaluation of the client's home environment
D. suggest social services be contacted to find a respite care facility for the client

Correct answer: D

Rationale: Respite care provides temporary relief for primary caregivers, allowing them to attend the reunion while ensuring the client is cared for.

4. The nurse is preparing a teaching plan for a client who is newly diagnosed with hypothyroidism. Which instruction should the nurse include?

A. Take levothyroxine (Synthroid) at bedtime.
B. Increase fiber intake to prevent constipation.
C. Take the medication on an empty stomach.
D. Take a double dose if a dose is missed.

Correct answer: C

Rationale: The correct instruction for a client newly diagnosed with hypothyroidism is to take the medication on an empty stomach. This is important because taking levothyroxine on an empty stomach ensures better absorption of the medication. Choice A, taking levothyroxine at bedtime, is incorrect as it does not promote optimal absorption. Choice B, increasing fiber intake to prevent constipation, is important but not the priority when it comes to medication administration. Choice D, taking a double dose if a dose is missed, is dangerous and should never be advised as it can lead to overdose and serious side effects.

5. The nurse is developing a program to educate parents on the importance of childhood immunizations. Which topic should be prioritized?

A. the benefits of immunizations
B. the potential side effects of vaccines
C. the immunization schedule
D. ways to comfort children during vaccinations

Correct answer: A

Rationale: The correct answer is A: the benefits of immunizations. Emphasizing the benefits of immunizations helps parents understand the importance of vaccines in protecting their children from preventable diseases. This choice should be prioritized as it focuses on the positive outcomes of immunizations, which can motivate parents to vaccinate their children. Choices B, C, and D are not the top priority because while it's important to address potential side effects, the immunization schedule, and comforting children during vaccinations, the main focus should be on highlighting the benefits to encourage parents to make informed decisions regarding their child's immunizations.