A client with peptic ulcer disease is being taught about managing the condition. Which of the following statements indicates an understanding of the teaching?

Correct Answer: B

Rationale: Limiting intake of caffeine-containing beverages is important for managing peptic ulcer disease as caffeine can stimulate gastric acid secretion, which may worsen the condition. It is advisable to choose decaffeinated beverages and avoid caffeinated drinks to help reduce the risk of aggravating the ulcer.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver, specifically factors II, VII, IX, and X. Prothrombin time (PT) measures the extrinsic pathway of the coagulation cascade, primarily assessing the functionality of factors II, VII, and X. Monitoring PT levels is crucial when a patient is on warfarin therapy to ensure the proper anticoagulant effect without increasing the risk of bleeding. Option A) Hemoglobin is not directly related to the therapeutic effect of warfarin. Hemoglobin levels are monitored to assess for anemia or other blood disorders. Option C) Bleeding time assesses the time it takes for blood to clot, but it is not a specific indicator of warfarin's therapeutic effect. Prolonged bleeding time may indicate a platelet disorder. Option D) Activated partial thromboplastin time (aPTT) primarily measures the intrinsic pathway of the coagulation cascade and is more commonly used to monitor heparin therapy, not warfarin. Monitoring aPTT is essential for assessing the effectiveness of heparin in preventing thrombus formation. Educationally, understanding the rationale behind selecting PT for monitoring warfarin therapy is crucial for nursing practice. It highlights the importance of selecting appropriate laboratory tests to assess the therapeutic effects of medications accurately. This knowledge enhances patient care by ensuring the safe and effective use of anticoagulants in clinical practice.

Correct Answer: A

Rationale: In pharmacology, monitoring for signs of digoxin toxicity is crucial for client safety. The correct answer is A) Visual disturbances. Digoxin toxicity often presents with visual disturbances such as yellow-green halos around objects due to its effect on the optic nerve. This is a classic indicator of digoxin toxicity. Option B) Tachycardia is incorrect because digoxin toxicity typically presents with bradycardia, not tachycardia. Digoxin slows the heart rate, so an increase in heart rate would be an atypical finding. Option C) Increased appetite is incorrect because it is not a typical symptom of digoxin toxicity. In fact, anorexia or decreased appetite is more common with digoxin toxicity due to its effects on the gastrointestinal system. Option D) Constipation is incorrect as well. Digoxin toxicity is more likely to cause gastrointestinal disturbances such as nausea, vomiting, or diarrhea rather than constipation. Educationally, understanding the manifestations of digoxin toxicity is essential for nurses and healthcare providers to ensure early detection and intervention. This knowledge helps in preventing serious complications and providing safe and effective care to clients receiving digoxin therapy.

Correct Answer: A

Rationale: Spironolactone, a potassium-sparing diuretic, can lead to hyperkalemia due to its mechanism of action. Hyperkalemia, or elevated potassium levels, can result in serious cardiac complications and requires immediate medical attention. Therefore, the nurse should promptly report any signs or symptoms of hyperkalemia to prevent potential adverse outcomes in the patient.

Correct Answer: B

Rationale: In educating a client starting a new prescription for simvastatin, it is crucial to emphasize reporting any muscle pain immediately (Option B). This instruction is essential because simvastatin, as a statin medication, can rarely cause a serious side effect called rhabdomyolysis, characterized by muscle pain, weakness, and dark urine. Early detection and management of this adverse effect are vital to prevent serious complications. Option A (Take the medication in the morning) is incorrect because the timing of simvastatin administration is not as critical as adherence to the prescribed schedule. However, some healthcare providers may recommend taking it in the evening based on individual patient factors. Option C (Avoid taking the medication with grapefruit juice) is generally a good practice for certain medications, but it is not specifically related to simvastatin. Grapefruit juice can interfere with the metabolism of some drugs but not usually with simvastatin. Option D (Take the medication at bedtime) is not the most critical instruction for a client starting simvastatin. While some providers do recommend taking statins in the evening based on their pharmacokinetics, the key focus should be on monitoring and reporting muscle pain promptly. Educationally, this rationale highlights the importance of recognizing and managing potential adverse effects of medications, emphasizing patient safety and adherence to instructions. It underscores the significance of patient education in promoting medication safety and optimizing therapeutic outcomes.