A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following medications for this client?

Aspirin

Alteplase

Clopidogrel

Enoxaparin

Answer and Explanation

The Correct Answer is D

Choice A reason: This is incorrect because aspirin is not a suitable medication for preventing venous thromboembolism (VTE) in a client who is postoperative following hip arthroplasty. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that has antiplatelet and analgesic effects, but it is not as effective as anticoagulants for VTE prophylaxis.

Choice B reason: This is incorrect because alteplase is not a medication for preventing VTE, but for treating it. Alteplase is a thrombolytic agent that dissolves existing blood clots by activating plasminogen. It is used for acute ischemic stroke, myocardial infarction, and massive pulmonary embolism, but it has a high risk of bleeding and is contraindicated in clients who have had recent surgery.

Choice C reason: This is incorrect because clopidogrel is not a medication for preventing VTE, but for preventing arterial thrombosis. Clopidogrel is an antiplatelet agent that inhibits the adenosine diphosphate (ADP) receptor on platelets, preventing their aggregation. It is used for clients who have had acute coronary syndrome, percutaneous coronary intervention, or ischemic stroke, but it is not effective for VTE prophylaxis.

Choice D reason: This is correct because enoxaparin is a medication for preventing VTE in a client who is postoperative following hip arthroplasty. Enoxaparin is a low molecular weight heparin (LMWH) that inhibits factor Xa and thrombin, preventing the formation of fibrin. It is administered subcutaneously once or twice daily and does not require routine laboratory monitoring. It has a lower risk of bleeding and heparin-induced thrombocytopenia (HIT) than unfractionated heparin.

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Correct Answer is C

Explanation

Choice A reason: Eating a green salad every night with dinner is not the statement that indicates a need for further teaching. This is a consistent and balanced dietary choice for the client, as long as the amount of vitamin K in the salad is not excessive or variable. Vitamin K is a nutrient that helps the blood to clot and can interfere with the action of warfarin, which is an anticoagulant that inhibits the formation of blood clots. The client should avoid sudden changes in their intake of vitamin K and inform the provider of any dietary modifications.

Choice B reason: Taking this medication at the same time each day is not the statement that indicates a need for further teaching. This is a correct and important instruction for the client, as it helps to maintain a steady and effective level of warfarin in the blood. Warfarin has a narrow therapeutic range and requires frequent monitoring and dose adjustment. The client should take the medication as prescribed and avoid missing or skipping doses.

Choice C reason: Starting to take ginger root to treat joint stiffness is the statement that indicates a need for further teaching. This is a risky and potentially harmful herbal supplement for the client, as it can interact with warfarin and increase its anticoagulant effect. Ginger root has antiplatelet and fibrinolytic properties, which can inhibit the formation of blood clots and enhance the breakdown of fibrin, a protein that stabilizes blood clots. Taking ginger root with warfarin can increase the risk of bleeding and bruising and alter the international normalized ratio (INR), which is a measure of the blood's clotting ability. The client should avoid taking ginger root and other herbal supplements without consulting the provider.

Choice D reason: Having the INR checked three weeks ago is not the statement that indicates a need for further teaching. This is a reasonable and appropriate frequency for the client, depending on their stability and response to warfarin therapy. The INR is a blood test that measures the time it takes for the blood to clot and indicates the effectiveness of warfarin. The target INR range for most clients is 2 to 3, but it may vary depending on the indication and the risk of bleeding. The client should have their INR checked regularly and follow the provider's orders and the protocol for dose adjustment.

A. A history of left-sided heart failure B. Recently treated bilateral pneumonia C. A concurrent prescription for tadalafil D. Diet-controlled Type 2 diabetes mellitus

Correct Answer is C

Explanation

Choice A reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol is a beta-blocker that can reduce the workload of the heart and improve the symptoms of heart failure.

Choice B reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol does not have any significant interactions with antibiotics or other medications used to treat pneumonia.

Choice C reason: This is a problem for a client who has hypertension and a new prescription for metoprolol, as tadalafil is a phosphodiesterase-5 inhibitor that can lower the blood pressure and cause hypotension when taken with metoprolol. The nurse should investigate further and notify the provider of the potential interaction.

Choice D reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol does not affect the blood glucose levels or the management of diabetes.

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A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following medications for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is C

Explanation

A nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. Which of the following findings should the nurse investigate further?

Correct Answer is C

Explanation

A nurse is caring for a client who has a new prescription for propranolol. The nurse should monitor the client for which of the following severe reactions to this medication?

A nurse is preparing to administer heparin to a client. Which of the following actions should the nurse plan to take?

A nurse is reviewing the health history for a client who has angina pectoris and a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider?

A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take?

A nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the client's parent on administering the medication?

A nurse is reviewing the laboratory data on a client who has a new prescription for heparin for treatment of a pulmonary embolism. Which of the following data should the nurse report to the provider?

A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide?

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