A client is discharged with a prescription for warfarin. Which discharge instruction should the nurse emphasize to the client?

Take a multi-vitamin supplement daily.

Use an astringent for superficial bleeding.

Add large amounts of spinach to the diet.

Avoid going barefoot, especially outside.

Answer and Explanation

The Correct Answer is D

Choice A reason: Taking a multi-vitamin supplement daily is not a necessary instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. However, some vitamins, such as vitamin K, vitamin E, and vitamin C, can interact with warfarin and affect its effectiveness. Patients should consult their health care provider before taking any supplements or herbal products.

Choice B reason: Using an astringent for superficial bleeding is not a sufficient instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Warfarin can increase the risk of bleeding, both internally and externally. Patients should report any signs of bleeding, such as bruising, nosebleeds, gum bleeding, blood in urine or stool, or prolonged bleeding from cuts or wounds, to their health care provider. They should also avoid activities or products that can increase the risk of bleeding, such as shaving with a razor, using dental floss, or taking aspirin or NSAIDs.

Choice C reason: Adding large amounts of spinach to the diet is an incorrect instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Spinach is a leafy green vegetable that is high in vitamin K, which can counteract the effect of warfarin and increase the risk of clotting. Patients should maintain a consistent intake of vitamin K-rich foods and avoid sudden changes in their diet.

Choice D reason: Avoiding going barefoot, especially outside, is a correct instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Warfarin can increase the risk of bleeding, both internally and externally. Patients should protect their feet from injury or infection by wearing shoes or slippers at all times.

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Correct Answer is D

Explanation

Choice A reason: Expectorating bronchial secretions is not an assessment information that indicates that the antitussive medication benzonatate is effective. Benzonatate is a medication that suppresses the cough reflex by numbing the throat and lungs. It does not loosen or thin the mucus in the airways, which would facilitate expectoration.

Choice B reason: Reports reduced nasal discharge is not an assessment information that indicates that the antitussive medication benzonatate is effective. Benzonatate is a medication that suppresses the cough reflex by numbing the throat and lungs. It does not affect the production or drainage of nasal secretions, which are caused by inflammation and infection in the upper respiratory tract.

Choice C reason: Able to sleep through the night is not an assessment information that indicates that the antitussive medication benzonatate is effective. Benzonatate is a medication that suppresses the cough reflex by numbing the throat and lungs. It does not have any sedative or hypnotic effects, which would promote sleep. However, by reducing coughing, benzonatate may indirectly improve the quality of sleep for the client.

Choice D reason: Denies having coughing spells is an assessment information that indicates that the antitussive medication benzonatate is effective. Benzonatate is a medication that suppresses the cough reflex by numbing the throat and lungs. It reduces the frequency and intensity of coughing, which can relieve discomfort and irritation for the client.

A. Take an initial respiratory rate B. Perform a 12-lead electrocardiogram C. Suction the client to clear the airway D. Have a manual resuscitation bag at the bedside E. Ask the client about other medications she takes F. Restrain the client with soft restraints

Correct Answer is ["A","D","E"]

Explanation

Choice A reason:

Taking an initial respiratory rate is a necessary action to ensure safety during morphine administration, as morphine can cause respiratory depression, which is a potentially life-threatening side effect. The nurse should monitor the client's respiratory rate and oxygen saturation regularly and report any signs of respiratory distress or hypoxia to the physician. Therefore, choice A is correct.

Choice B reason:

Performing a 12-lead electrocardiogram is not a necessary action to ensure safety during morphine administration, as morphine does not have a significant effect on the cardiac rhythm or conduction. The nurse should monitor the client's heart rate and blood pressure regularly and report any signs of bradycardia, hypotension, or chest pain to the physician. Therefore, choice B is incorrect.

Choice C reason:

Suctioning the client to clear the airway is not a necessary action to ensure safety during morphine administration, as morphine does not cause excessive secretions or bronchospasm that would obstruct the airway. The nurse should assess the client's level of consciousness and gag reflex regularly and report any signs of sedation, confusion, or aspiration to the physician. Therefore, choice C is incorrect.

Choice D reason:

Having a manual resuscitation bag at the bedside is a necessary action to ensure safety during morphine administration, as morphine can cause respiratory depression that may require emergency intervention. The nurse should be prepared to administer oxygen and naloxone (an opioid antagonist) as ordered and perform rescue breathing or cardiopulmonary resuscitation if needed. Therefore, choice D is correct.

Choice E reason:

Asking the client about other medications she takes is a necessary action to ensure safety during morphine administration, as morphine can interact with other drugs that may enhance or reduce its effects or cause adverse reactions. The nurse should review the client's medication history and current medications and report any potential drug interactions or contraindications to the physician. Therefore, choice E is correct.

Choice F reason:

Restraining the client with soft restraints is not a necessary action to ensure safety during morphine administration, as morphine does not cause agitation or delirium that would warrant physical restraint. The nurse should provide a safe and comfortable environment for the client and report any signs of anxiety, hallucinations, or psychosis to the physician. Therefore, choice F is incorrect.

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A client is discharged with a prescription for warfarin. Which discharge instruction should the nurse emphasize to the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a cold is taking the antitussive medication benzonatate. Which assessment information indicates to the nurse that the medication is effective?

Correct Answer is D

Explanation

Patient Data Exhibits What actions should the nurse take to ensure safety during morphine administration? Select all that apply.

Correct Answer is ["A","D","E"]

Explanation

Patient Data Exhibits What should the nurse do immediately? Select all that apply.

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