A 66-year-old man is a long-time client of the PMHNP. He has been taking several vitamins under the supervision of the provider. Recently, he had a transient ischemic attack (TIA) and was placed on warfarin (Coumadin). Which of the following vitamins or supplements will the client need to discontinue?
L-methyl folate
Vitamin D3
Melatonin
Vitamin E
The Correct Answer is D
Choice A reason: L-methyl folate does not significantly affect coagulation or interact with warfarin and can usually be continued safely.
Choice B reason: Vitamin D3 has no major interaction with warfarin and does not influence clotting, so it is generally safe to continue.
Choice C reason: Melatonin may have minimal effects on blood pressure or sedation but does not interfere with warfarin metabolism.
Choice D reason: Vitamin E has anticoagulant properties and can increase the risk of bleeding when combined with warfarin. Discontinuation is recommended to reduce hemorrhagic risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Bipolar disorder involves mood swings between mania and depression, but frequent temper outbursts that are persistent and disproportionate are more characteristic of disruptive mood dysregulation disorder than classic bipolar episodes.
Choice B reason: Disruptive mood dysregulation disorder is defined by severe, recurrent temper outbursts that are inconsistent with developmental level, occurring frequently over time. This diagnosis accounts for chronic irritability and is appropriate for this patient’s presentation.
Choice C reason: Schizophrenia involves psychotic symptoms such as delusions and hallucinations and does not typically present with recurrent temper outbursts alone.
Choice D reason: Brief psychotic disorder involves sudden onset of psychotic symptoms that last less than one month, which does not align with chronic temper outbursts.
Correct Answer is A
Explanation
Choice A reason: The hippocampus is central to the formation and retrieval of long-term memories. Impairment in this region leads to significant anterograde and retrograde memory deficits seen in dementia.
Choice B reason: The hypothalamus regulates homeostasis and autonomic functions but does not play a primary role in memory recall.
Choice C reason: The thalamus acts as a relay station for sensory and motor signals and contributes to attention and consciousness but is not the main center for episodic memory retrieval.
Choice D reason: The amygdala is involved in emotion, fear responses, and emotional memory processing, not the recall of specific episodic memories.
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