A client has been diagnosed with a deep vein thrombosis and is to be discharged on warfarin.
The client is adamant about refusing the drug because "it's dangerous.”. What action by the nurse is best?

Assess the reason behind the client's fear.

Remind the client about laboratory monitoring.

Tell the client that drugs are safer today than before.

Warn the client about the consequences of noncompliance.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Assessing the client's specific fears about warfarin is the best action. The client's refusal stems from their perception of the drug's danger. By understanding the underlying fear, the nurse can provide targeted, accurate education about the drug's mechanism, safety protocols, and the benefits of anticoagulation, empowering the client to make an informed decision.

Choice B rationale

While laboratory monitoring (e.g., INR) is a critical component of warfarin therapy, simply reminding the client about it does not address the underlying emotional and psychological barriers to compliance. The client must first accept the drug and its importance before they can be educated on the practical aspects of its management.

Choice C rationale

Vague assurances about drug safety are unhelpful and can erode client trust. The client's concern is specific and real to them. The nurse must provide a scientific explanation of how warfarin works, its therapeutic benefits in preventing clot propagation, and how modern monitoring has made it safer, directly addressing their fears.

Choice D rationale

Warning the client about consequences can be perceived as an intimidating or judgmental approach, which can create a negative therapeutic relationship and increase resistance. A better strategy is to use a collaborative, non-coercive approach that focuses on client education and informed consent rather than using fear as a motivator. .

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Correct Answer is C

Explanation

Choice A rationale

There is no known or documented significant drug-food interaction between griseofulvin and citrus fruits or juice. Griseofulvin absorption is actually enhanced by a high-fat meal. The biological mechanism of action for griseofulvin does not involve competition with compounds found in citrus.

Choice B rationale

Shellfish allergies are a common food allergy, but there is no specific interaction between griseofulvin, an antifungal, and shellfish consumption. Griseofulvin's mechanism of action involves disrupting fungal mitosis, which is not affected by dietary intake of shellfish.

Choice C rationale

Alcohol consumption while taking griseofulvin can lead to a disulfiram-like reaction, which is a severe adverse response. This reaction is characterized by flushing, headache, nausea, vomiting, and a rapid heartbeat. The exact mechanism is not fully understood, but it is a significant and dangerous interaction.

Choice D rationale

Griseofulvin is an antifungal medication, while corticosteroids are anti-inflammatory and immunosuppressive agents. There is no known direct pharmacological interaction between these two drug classes. Taking them concurrently is not contraindicated, although they treat different conditions.

A. "Wool is the best fabric for the infant's clothing.”. B. "I should avoid laundry detergents with fragrances.”. C. "I put cotton gloves on the infant's hands.”. D. "The infant's fingernails are kept short.”.

Correct Answer is A

Explanation

Choice A rationale

Wool fibers have a rough, coarse texture that can mechanically irritate the delicate skin of an infant with eczema. This physical abrasion can trigger an inflammatory response and exacerbate the itching and rash associated with the condition. The goal is to use smooth, breathable fabrics like cotton to minimize skin friction.

Choice B rationale

Fragrances and dyes in laundry detergents are common chemical irritants and allergens that can cause contact dermatitis and worsen eczema symptoms. Avoiding these additives is crucial for minimizing exposure to potential triggers and reducing inflammation and itching in sensitive skin.

Choice C rationale

Putting cotton gloves or socks on an infant's hands is a practical strategy to prevent the infant from scratching their skin. The mechanical trauma from scratching can break the skin barrier, leading to secondary infections and worsening the eczema flare-up.

Choice D rationale

Keeping fingernails short is a fundamental measure to prevent the skin damage caused by scratching. Long, sharp nails can tear the skin, creating entry points for bacteria and increasing the risk of infection, a common complication of poorly controlled eczema.

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A client has been diagnosed with a deep vein thrombosis and is to be discharged on warfarin. The client is adamant about refusing the drug because "it's dangerous.”. What action by the nurse is best?

Nursing Test Bank

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A client has been diagnosed with a deep vein thrombosis and is to be discharged on warfarin.
The client is adamant about refusing the drug because "it's dangerous.”. What action by the nurse is best?