Review Diagnosis and treatment

Medication Safety and Error Prevention > Pharmacology

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Diagnosis and treatment

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Total Questions : 6

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Question 1:

A nurse is caring for a client who has been prescribed warfarin for atrial fibrillation. Which of the following laboratory tests should the nurse monitor to assess the effectiveness of the medication?

A. Prothrombin time (PT) B. Activated partial thromboplastin time (aPTT) C. Platelet count D. Hemoglobin level

Answer and Explanation

Choice A:

Prothrombin time (PT) is a measure of how long it takes for blood to clot. Warfarin is an anticoagulant that prolongs the PT and prevents blood clots from forming. The nurse should monitor the PT and adjust the warfarin dose accordingly to maintain a therapeutic range.

Choice B:

Activated partial thromboplastin time (aPTT): aPTT is another measure of blood clotting time, but it is used to monitor heparin therapy, not warfarin therapy.

Choice C:

Platelet count is a measure of how many platelets are in the blood. Platelets are involved in blood clotting, but they are not affected by warfarin therapy.

Choice D:

Haemoglobin level is a measure of how much oxygen-carrying protein is in the blood. Haemoglobin level can be affected by bleeding or anaemia, but it is not directly related to warfarin therapy.

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Question 2:

A nurse is teaching a client who has diabetes mellitus about self-monitoring of blood glucose (SMBG). Which of the following statements by the client indicates a need for further teaching?

A. "I should check my blood glucose before meals and at bedtime." B. "I should use the same finger for each blood glucose test." C. "I should wash my hands with soap and water before each test." D. "I should record my blood glucose results in a log book."

Answer and Explanation

Choice A:

This is correct as it follows the recommended frequency of SMBG for most clients with diabetes mellitus.

Choice B:

Using the same finger for each blood glucose test can cause pain, infection, and callus formation. The client should rotate the fingers and use different sites for each test.

Choice C:

This is correct as it prevents contamination and ensures the accuracy of the test results.

Choice D:

This is correct as it helps the client and the health care team to evaluate the effectiveness of the diabetes management plan.

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Question 3:

A nurse is reviewing the medication administration record (MAR) of a client who has hypertension. The nurse notices that the client has been prescribed both lisinopril and spironolactone. Which of the following actions should the nurse take?

A. Administer both medications as ordered B. Hold both medications and notify the provider C. Hold lisinopril and administer spironolactone D. Hold spironolactone and administer lisinopril

Answer and Explanation

Choice A:

This is incorrect as it exposes the client to the risk of hyperkalemia.

Choice B:

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure by blocking the conversion of angiotensin I to angiotensin II, which causes vasoconstriction. Spironolactone is a potassium-sparing diuretic that lowers blood pressure by increasing urine output and preventing sodium and water reabsorption. However, both medications can also increase potassium levels in the blood, which can lead to hyperkalemia, a potentially life-threatening condition. The nurse should hold both medications and notify the provider of this potential drug interaction.

Choice C:

This is incorrect as it does not eliminate the risk of hyperkalemia from spironolactone alone.

Choice D:

This is incorrect as it does not eliminate the risk of hyperkalemia from lisinopril alone.

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Question 4:

A nurse is preparing to administer an intramuscular injection to a client who has a latex allergy. Which of the following actions should the nurse take?

A. Use a latex-free syringe and needle B. Apply a latex bandage over the injection site C. Wear latex gloves during the procedure D. Dilute the medication with normal saline

Answer and Explanation

Choice A:

Using a latex-free syringe and needle is the appropriate action to prevent an allergic reaction in a client who has a latex allergy. The nurse should also check the medication label and vial for any latex content.

Choice B:

This is incorrect as it can cause skin irritation and allergic reaction in a client who has a latex allergy.

Choice C:

This is incorrect as it can expose the client and the nurse to latex particles and cause an allergic reaction.

Choice D:

This is incorrect as it can alter the concentration and effectiveness of the medication.

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Question 5:

A nurse is conducting a health history interview with a client who has a family history of breast cancer. Which of the following questions should the nurse ask to assess the client's risk factors for developing breast cancer?

A. "Have you ever had a mammogram?" B. "Do you perform monthly breast self-examinations?" C. "Have you ever used oral contraceptives?" D. "Do you consume alcohol on a regular basis?"

Answer and Explanation

Choice A:

This is incorrect as it does not assess a risk factor for developing breast cancer, but rather a screening method for detecting breast cancer.

Choice B:

This is incorrect as it does not assess a risk factor for developing breast cancer, but rather a preventive measure for early detection of breast cancer.

Choice C:

This is incorrect as it does not assess a current risk factor for developing breast cancer, but rather a past exposure that may or may not have an effect on the client's risk.

Choice D:

Consuming alcohol on a regular basis is a modifiable risk factor for developing breast cancer. The nurse should ask this question to assess the client's current lifestyle habits and provide education on reducing alcohol intake.

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Question 6:

A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD) and is receiving oxygen therapy via nasal cannula at 2 L/min. The nurse observes that the client's oxygen saturation level is 88%. Which of the following actions should the nurse take?

A. Increase the oxygen flow rate to 4 L/min B. Encourage the client to cough and deep breathe C. Administer bronchodilator medication as prescribed D. Maintain the current oxygen flow rate

Answer and Explanation

Choice A:

This is incorrect as it can cause oxygen toxicity and suppress the respiratory drive, leading to respiratory failure.

Choice B:

This is incorrect as it can increase the work of breathing and cause fatigue and dyspnea in clients who have COPD.

Choice C:

This is incorrect as it does not address the immediate issue of low oxygen saturation level. Bronchodilator medication can help improve airflow and reduce airway inflammation, but it does not directly increase oxygen delivery.

Choice D:

Maintaining the current oxygen flow rate is the appropriate action for the nurse to take. Clients who have COPD have chronically low oxygen saturation levels and high carbon dioxide levels due to impaired gas exchange. Increasing the oxygen flow rate can cause oxygen toxicity and suppress the respiratory drive, leading to respiratory failure. The nurse should aim to keep the oxygen saturation level between 88% and 92% for clients who have COPD.

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Total Questions : 6

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Diagnosis and treatment

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