The nurse is admitting a patient to the unit. While obtaining a health history from the spouse, the nurse is notified that the patient takes 2.5 mg of warfarin (Coumadin) daily and has been taking levothyroxine (Levothroid) for 3 weeks
The nurse calls the prescriber to order lab tests, because the nurse knows that warfarin (Coumadin) taken concurrently with levothyroxine (Levothroid) may result in which of the following?
a. Increased levothyroxine (Levothroid) levels
b. Enhanced warfarin (Coumadin) levels
c. Decreased warfarin (Coumadin) levels
d. Decreased levothyroxine (Levothroid) levels
ANS: B
Levothyroxine accelerates the degradation of warfarin and enhances its effects; the dose may need to be reduced.
Increased levothyroxine levels and decreased warfarin levels would not be expected.
Decreased levothyroxine levels would not be anticipated.
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The home health nurse caring for a patient with multiple sclerosis (MS) is planning an exercise program with the patient. Which is the best type of exercise for this patient?
a. Swimming b. Progressive walking c. Weight training d. Isometric exercises
A client with depression has not been attending group therapy sessions but has been able to meet with visitors, eat meals, and watch television. He states, "I have a brain illness—a chemical imbalance. I have no control over my behavior
I'll just have to wait until the medications kick in." Which is the appropriate nursing response to this client's comments? A) "In addition to biological factors, a complex interplay of environmental and interpersonal events contributes to the onset and maintenance of depression." B) "Given this is the 'decade of the brain,' you are correct in saying that biological factors cause depression." C) "Biological factors have been shown to exert the most influence in the development of mental illness." D) "Researchers have been unable to adequately demonstrate the link between nature (biology and genetics) and nurture (environment)."
Which teaching points are included in a care plan for a patient who is taking laxatives for constipation? (Select all that apply.)
a. Drink between 1500 and 2000 mL of fluids every day. b. Avoid bulk foods such as whole grain bread and vegetables. c. Use the bathroom right away when you feel the urge to have a bowel movement. d. Try to get some regular exercise each day to prevent constipation. e. Take your laxative with at least 4 ounces of water so it can be effective.
A nurse orienting to the home health role states, "I don't understand why we have to collaborate with so many other disciplines; this conflicts with the concept of nurses providing all direct care to the client in the home?"
Which of the following would be the best response? a. "The nurse still provides direct care for the client; however, interdisciplinary collaboration is necessary to prevent fragmentation of care." b. "Direct nursing care is a concept applied to care in tertiary facilities, such as hospitals, where materials are centrally located in one facility. In home health, this is not possible." c. "Even though home health nursing does not provide as much direct care as other nursing specialties in the community, each discipline contributes to client needs from its special knowledge base." d. "Yes, it does create conflict, but Medicare mandates interdisciplinary collaboration."