Following a total knee arthroplasty, the client is discharged from the hospital with a prescription for warfarin. In reviewing discharge teaching, the client recounts to the nurse the need to avoid eating foods high in potassium, such as bananas and melon. How should the nurse respond?

Discuss necessary fluid restrictions as well as food restrictions.

Review teaching about the effects of foods rich in Vitamin K.

Explain that no dietary restrictions are needed with warfarin.

Provide a written list of additional foods high in potassium.

Answer and Explanation

The Correct Answer is B

A. Fluid restrictions are not routinely required for clients taking warfarin unless there is another condition (e.g., heart failure or renal disease) that necessitates it. This option does not address the client’s misunderstanding and introduces unrelated information, making it inappropriate.

B. This is the correct response. Warfarin works by inhibiting Vitamin K–dependent clotting factors. Therefore, foods high in Vitamin K (such as green leafy vegetables like spinach, kale, and broccoli) can reduce the effectiveness of warfarin by promoting clotting. The client has confused potassium with Vitamin K, which is a common misunderstanding. The nurse should correct this by reviewing dietary considerations related to Vitamin K intake, emphasizing consistency rather than complete avoidance to maintain therapeutic anticoagulation.

C. This statement is incorrect. While clients do not need to completely avoid foods with Vitamin K, dietary intake must be consistent to prevent fluctuations in warfarin effectiveness and INR levels. Saying there are no dietary considerations ignores an important aspect of safe medication management.

D. Providing a list of potassium-rich foods reinforces the client’s misunderstanding. Potassium intake is not the primary concern with warfarin therapy. This option fails to correct the error and may lead to improper dietary restrictions.

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Correct Answer is D

Explanation

A. While removing dentures may be necessary for some oral procedures or to prevent choking if they are loose, it does not address the primary concern in this scenario, which is the risk of airway obstruction or respiratory depression caused by morphine in a client with OSA. Removing dentures does not improve oxygenation or ventilation and therefore is not a priority.

B. Raising the head of the bed can help reduce upper airway obstruction by improving the mechanics of breathing in clients with OSA. Elevation may also help with comfort and reduce the risk of aspiration. While this is beneficial, it does not provide the continuous airway support needed for a client who has received an opioid, which depresses respiratory drive and increases the likelihood of airway collapse.

C. Ensuring that side rails are up is a safety measure to prevent falls, particularly in clients who may become drowsy or confused after receiving medications like morphine. Although important for overall safety, this intervention does not address the most immediate risk of airway compromise or hypoventilation, which could be life-threatening.

D. This is the most critical intervention. Clients with OSA are prone to airway collapse during sleep or sedation, and opioids like morphine further depress the central respiratory drive, increasing the risk of apnea and hypoxemia. Using a CPAP or BiPAP device maintains airway patency, improves oxygenation, and reduces the risk of respiratory compromise. Applying the device before leaving the client ensures that ventilation is supported continuously and that the client is protected from potentially life-threatening respiratory events while unattended.

A. Ulcerative colitis. B. Irritable bowel syndrome. C. Lactose intolerance. D. Diverticulitis.

Correct Answer is C

Explanation

A. Ulcerative colitis is an inflammatory bowel disease that primarily affects the colon and rectum, causing symptoms such as diarrhea, rectal bleeding, and abdominal pain. While diet can influence symptoms, lactose-containing foods specifically triggering bloating and cramps is not a hallmark feature of ulcerative colitis.

B. Irritable bowel syndrome (IBS) can cause bloating, abdominal pain, and changes in bowel habits. However, IBS symptoms are not consistently triggered by lactose-containing foods; triggers vary widely among individuals. Therefore, while IBS is possible, the specificity of symptoms after dairy intake points elsewhere.

C. Lactose intolerance is the most likely condition. Lactose intolerance occurs when the body lacks sufficient lactase, the enzyme needed to digest lactose in milk and dairy products. Common symptoms include bloating, abdominal cramps, diarrhea, and gas after consuming foods like ice cream and cheese, matching the client’s reported symptoms.

D. Diverticulitis involves inflammation of diverticula in the colon, causing left lower quadrant abdominal pain, fever, and sometimes constipation or diarrhea. Symptoms are not specifically triggered by dairy intake, making this diagnosis less likely in this scenario.

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Following a total knee arthroplasty, the client is discharged from the hospital with a prescription for warfarin. In reviewing discharge teaching, the client recounts to the nurse the need to avoid eating foods high in potassium, such as bananas and melon. How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse administers morphine to a client for chest pain who also has obstructive sleep apnea (OSA). Which intervention is most important for the nurse to implement before leaving the client alone?

Correct Answer is D

Explanation

A client reports bloating and abdominal cramps after eating ice cream and foods with cheese. Which condition should the nurse suspect?

Correct Answer is C

Explanation

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