Nursing Elites

1. When teaching a client with a new prescription for warfarin, which statement should the nurse include?

• A. Avoid using a soft toothbrush.
• B. Avoid foods high in vitamin K.
• C. Report any signs of bleeding to your provider.
• D. Use an electric shaver for shaving.

Correct answer: C

Rationale: The correct statement the nurse should include when teaching a client with a new prescription for warfarin is to report any signs of bleeding to their provider. Bleeding can indicate excessive anticoagulation, a potential side effect of warfarin therapy that needs prompt medical attention. Choices A, B, and D are incorrect because while oral hygiene measures, dietary considerations, and skin care are important, they are not the priority when teaching a client about warfarin therapy. Monitoring for and reporting signs of bleeding is crucial due to the anticoagulant effects of warfarin.

2. A client with migraine headaches is starting prophylaxis therapy with Propranolol. Which finding in the client's history should the nurse report to the provider?

• A. The client had a prior myocardial infarction.
• B. The client takes warfarin for atrial fibrillation.
• C. The client takes an SSRI for depression.
• D. An ECG indicates a first-degree heart block.

Correct answer: D

Rationale: Propranolol is contraindicated in clients with first-degree heart block due to its negative inotropic and chronotropic effects. The nurse should report this finding to the provider to consider an alternative therapy to prevent potential worsening of cardiac conduction abnormalities. Choices A, B, and C are not directly contraindications to Propranolol therapy for migraine headaches and do not pose immediate risks that would require reporting to the provider.

3. A healthcare provider is providing discharge instructions to a client who is prescribed Prednisone. Which of the following dietary instructions should the healthcare provider include?

• A. Increase your intake of potassium-rich foods.
• B. Increase your intake of dairy products.
• C. Avoid foods high in vitamin K.
• D. Decrease your intake of protein.

Correct answer: A

Rationale: The correct answer is to increase the intake of potassium-rich foods (Choice A). Prednisone can cause potassium depletion, so clients should increase their intake of foods such as bananas, oranges, and spinach. Potassium-rich foods help maintain electrolyte balance and prevent complications associated with low potassium levels, such as muscle weakness and irregular heartbeats. Choices B, C, and D are incorrect because increasing dairy products (Choice B) or avoiding foods high in vitamin K (Choice C) are not specifically related to Prednisone therapy. Decreasing protein intake (Choice D) is also not necessary in this case.

4. A client is reviewing a new prescription for Terbutaline with a history of preterm labor. Which of the following client statements indicates understanding of the teaching?

• A. I can increase my activity now that I've started on this medication.
• B. I will increase my daily fluid intake to 3 quarts.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider as these are signs of preterm labor. Monitoring contractions is crucial for the management of preterm labor and the safety of both the client and the fetus. Choices A, B, and D are incorrect because increasing activity, fluid intake, or assuming the medication will prevent preterm labor do not address the essential need to report changes in contractions, which are a vital sign of potential complications in preterm labor.

5. A client is being discharged with a new prescription for furosemide 40 mg PO daily. Which of the following instructions should be included?

• A. Avoid foods rich in potassium.
• B. Take the medication with food.
• C. Weigh yourself daily.
• D. Stand up slowly to minimize orthostatic hypotension.

Correct answer: D

Rationale: The correct answer is D: 'Stand up slowly to minimize orthostatic hypotension.' Clients prescribed furosemide are at risk for orthostatic hypotension, a sudden drop in blood pressure when changing positions. Advising the client to stand up slowly can help prevent this complication. Instructing the client to avoid rapid position changes decreases the likelihood of dizziness or fainting episodes. Choices A, B, and C are incorrect because furosemide does not require avoiding potassium-rich foods, taking the medication with food, or daily weighing as specific instructions.

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