A female patient who follows a vegetarian diet has recently been prescribed warfarin. She mentions that she consumes leafy green vegetables daily.
What should be the nurse’s response?

Praise the patient for her healthy lifestyle and encourage her to maintain her current dietary habits.

Assure the patient that her dietary choices will enhance the effectiveness of the medication in preventing blood clots.

Inform the patient that her healthcare provider needs to be informed about her current diet.

Recommend that the patient substitutes the leafy vegetables with a protein source like nuts or beans.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While maintaining a healthy lifestyle and diet is generally beneficial, consuming large amounts of leafy green vegetables, which are high in vitamin K, can interfere with the effectiveness of warfarin, a medication that works by inhibiting the action of vitamin K-dependent clotting factors. Therefore, praising the patient for her healthy lifestyle without addressing the potential interaction between her diet and medication could lead to suboptimal treatment outcomes.

Choice B rationale

This statement is misleading. While a healthy diet can contribute to overall health and well- being, the patient’s dietary choices, specifically her daily consumption of leafy green

vegetables, could actually decrease the effectiveness of warfarin. Warfarin’s ability to prevent blood clots is dependent on a consistent intake of vitamin K67.

Choice C rationale

This is the most appropriate response. The healthcare provider should be informed about the patient’s current diet because it could impact the effectiveness of warfarin. The provider may need to adjust the dose of warfarin or provide additional dietary guidance to ensure the medication works as intended.

Choice D rationale

While this might seem like a reasonable suggestion, it’s important to remember that dietary changes should be made in consultation with a healthcare provider or a dietitian. Substituting leafy green vegetables with other protein sources may not be necessary or appropriate depending on the patient’s overall diet, nutritional needs, and personal preferences.

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Correct Answer is A

Explanation

The correct answer is A:

Choice A reason: Notifying the healthcare provider is crucial because the patient’s carbamazepine level is significantly above the therapeutic range, which is 4-12 mcg/mL. A level of 84 mcg/mL indicates a high risk of toxicity, and the healthcare provider must be informed to take appropriate action, which may include adjusting the dose or discontinuing the medication.

Choice B reason: Administering the carbamazepine as prescribed would not be safe without addressing the elevated drug level. Continuing to administer the medication could increase the risk of severe side effects and toxicity due to the already high serum level.

Choice C reason: Withholding the dose may be a necessary immediate action, but it does not address the need for medical intervention to manage the patient’s elevated drug level. Therefore, while withholding the dose might be part of the response, it should follow notifying the healthcare provider.

Choice D reason: Assessing the patient for side effects is important, but it is not the most immediate action required. The priority is to notify the healthcare provider because of the potential for serious toxicity given the high carbamazepine level.

A. Ask the patient to describe her dietary intake history for the last several days. B. Advise the patient to stop taking the drug and contact her healthcare provider. C. Instruct the patient to increase her intake of saturated fats over the next week. D. Obtain a stool specimen to evaluate for occult blood and fat content.

Correct Answer is A

Explanation

Choice A rationale

If a patient is experiencing increasingly frequent oily stools and gas after taking orlistat for one week, the nurse should ask the patient to describe her dietary intake history for the last

several days. Orlistat works by inhibiting the absorption of dietary fats, which are then excreted in the stool. Consuming a diet high in fat can increase the side effects of orlistat, which include oily or fatty stools and gas.

Choice B rationale

Advising the patient to stop taking the drug and contact her healthcare provider is not the first step. The nurse should first assess the patient’s dietary habits as the side effects may be due to a high-fat diet.

Choice C rationale

Instructing the patient to increase her intake of saturated fats over the next week is not advisable. A high-fat diet can increase the side effects of orlistat.

Choice D rationale

Obtaining a stool specimen to evaluate for occult blood and fat content is not necessary in this case. The symptoms described by the patient are common side effects of orlistat and can often be managed by adjusting the diet.

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A female patient who follows a vegetarian diet has recently been prescribed warfarin. She mentions that she consumes leafy green vegetables daily.What should be the nurse’s response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Before administering the evening dose of carbamazepine, the nurse notes that the patient’s morning carbamazepine level was 84 mcg/mL. What action should the nurse take?

Correct Answer is A

Explanation

After taking orlistat for one week, a female patient tells the home health nurse that she is experiencing increasingly frequent oily stools and gas.What action should the nurse take?

Correct Answer is A

Explanation

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A female patient who follows a vegetarian diet has recently been prescribed warfarin. She mentions that she consumes leafy green vegetables daily.
What should be the nurse’s response?