a nurse is caring for a client who has a new prescription for warfarin which of the following instructions should the nurse include a nurse is caring for a client who has a new prescription for warfarin which of the following instructions should the nurse include
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Nursing Elites

ATI RN

ATI Proctored Pharmacology 2023

1. A client has a new prescription for Warfarin. Which of the following instructions should the nurse include?

Correct answer: A

Rationale: The correct instruction for a client starting Warfarin is to monitor for signs of bleeding. Warfarin is an anticoagulant that increases the risk of bleeding; therefore, it is crucial for the client to watch for any signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stools, or unusual bleeding from gums or nose. If any of these signs occur, the client should promptly report them to their healthcare provider for further evaluation and management. Choices B, C, and D are incorrect because avoiding foods high in vitamin K is related to other medications like Coumadin, increased urination is not a common side effect of Warfarin, and taking Warfarin with an antacid can potentially interfere with its absorption.

2. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?

Correct answer: B

Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.

3. Based on universally-accepted color codes, what color would you expect a tank containing nitrous oxide (laughing gas) to have?

Correct answer: A

Rationale: The correct answer is A: Red. In the medical field, tanks containing nitrous oxide (laughing gas) are typically color-coded with a specific color for easy identification. Nitrous oxide tanks are commonly labeled with a red color code. This color-coding system helps healthcare providers quickly and accurately identify the contents of the tanks, reducing the risk of errors in administering gases to patients. Choices B, C, and D are incorrect because the universally-accepted color for nitrous oxide tanks is red, not blue, green, or orange.

4. What is the priority nursing intervention for a patient with hyperkalemia?

Correct answer: A

Rationale: The correct answer is to administer calcium gluconate. In hyperkalemia, the priority is to protect the heart from potential complications like arrhythmias. Calcium gluconate is the first-line treatment as it stabilizes the cardiac cell membrane. Insulin (Choice B) and sodium bicarbonate (Choice C) can be used in conjunction with other treatments to shift potassium into cells, but calcium gluconate is the priority. Administering a diuretic (Choice D) is not the primary intervention for hyperkalemia and can even worsen the condition by reducing potassium excretion.

5. A client has a new prescription for Methotrexate. Which of the following instructions should be included in the teaching?

Correct answer: A

Rationale: The correct instruction for a client taking Methotrexate is to avoid drinking alcohol. Methotrexate can cause liver toxicity, and alcohol consumption can increase this risk. It is important to emphasize the avoidance of alcohol while on this medication to prevent adverse effects and ensure treatment effectiveness. The other options are incorrect: Taking Methotrexate with a high-fat meal is not necessary as it can be taken with or without food. Increased hair growth is not an expected effect of Methotrexate; in fact, hair loss is a potential side effect. Stopping the medication without consulting a healthcare provider can be dangerous and may lead to worsening of symptoms or relapse, making option D incorrect.

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