A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory value should the nurse monitor to assess the effectiveness of the medication?

Correct Answer: B

Rationale: Prothrombin time (PT) and international normalized ratio (INR) are the laboratory values used to monitor the effectiveness of warfarin therapy. These values help ensure that the client is within the therapeutic range for anticoagulation. PT measures the time it takes for blood to clot, while INR standardizes PT results to minimize variations between laboratories. Monitoring these values is crucial to prevent complications such as bleeding or clot formation. Activated partial thromboplastin time (aPTT) (Choice A) is more commonly used to monitor heparin therapy. Platelet count (Choice C) assesses the number of platelets in the blood and is not specific to warfarin therapy. Erythrocyte sedimentation rate (ESR) (Choice D) is a non-specific marker of inflammation and is not used to monitor the effectiveness of warfarin therapy.

Correct Answer: D

Rationale: Grapefruit juice should be avoided while taking verapamil as it can increase drug levels and the risk of side effects. The interaction between grapefruit juice and verapamil can lead to higher concentrations of the medication in the bloodstream, potentially causing adverse effects. Orange juice, coffee, and milk do not have significant interactions with verapamil. Therefore, it is crucial for the client to avoid grapefruit juice to ensure the safe and effective use of verapamil.

Correct Answer: A

Rationale: The correct answer is A because oral elixirs ensure even drug distribution and good GI absorption in infants. Choice B is incorrect (rectal absorption is unreliable). Choice C is wrong (lipid solubility doesn’t ensure distribution). Choice D is inaccurate (sustained-release is poorly absorbed in infants).

Correct Answer: D

Rationale: Choice D is correct because explaining purpose (improves adherence), safe administration (prevents errors), and side effects (enhances safety) are all key for elderly education, per geriatric care. Choice A is incorrect alone as it's one aspect. Choice B is wrong by itself because administration is just part. Choice C is incorrect solo since side effects are only one element.

Correct Answer: A

Rationale: Choice A is correct because estrogen counteracts testosterone's masculinizing effects in transgender men, conflicting with therapy aims, so it's avoided. Choice B is incorrect as alpha blockers don't interfere with testosterone goals. Choice C is wrong because beta blockers are unrelated to therapy effects. Choice D is incorrect since only estrogen applies.

Correct Answer: B

Rationale: Choice B is correct because amitriptyline, a tricyclic antidepressant, is avoided in the elderly (per Beers Criteria) due to anticholinergic effects causing confusion, constipation, and falls. Choice A is incorrect as acetaminophen is safe. Choice C is wrong because amoxicillin is appropriate with dose adjustment. Choice D is incorrect since only amitriptyline fits.

Correct Answer: D

Rationale: Choice D is correct because PDMPs track prescriptions, education informs risks, and urine screening detects misuse—all key monitoring tools per guidelines. Choice A is incorrect alone as it's one method. Choice B is wrong by itself because education is just part. Choice C is incorrect solo since screening is only one approach.

Correct Answer: D

Rationale: Choice D is correct because explaining purpose (improves adherence), safe administration (prevents errors), and side effects (enhances safety) are all key for elderly education, per geriatric care. Choice A is incorrect alone as it's one aspect. Choice B is wrong by itself because administration is just part. Choice C is incorrect solo since side effects are only one element.

Correct Answer: B

Rationale: The correct answer is B because levofloxacin has lower hepatic risk, safer for liver-damaged patients. Choices A, C, and D are incorrect (higher hepatic risk).