Correct Answer: A

Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications.

Correct Answer: B

Rationale: When treating tuberculosis, using a combination of multiple medications is crucial to reduce the risk of bacterial resistance. The use of four medications helps to target the bacteria from different angles, making it harder for them to develop resistance to the treatment. This approach is essential to ensure the effectiveness of the treatment regimen and to prevent the spread of drug-resistant strains of tuberculosis.

Correct Answer: B

Rationale: Smoking can interfere with the effectiveness of ranitidine and worsen ulcer symptoms. Clients should avoid smoking while taking this medication to ensure optimal therapeutic outcomes.

Correct Answer: B

Rationale: The client stating that they have been taking an antacid to help with indigestion while on naproxen requires further discussion as it can indicate gastrointestinal distress or potential interactions between the medications. Antacids may affect the absorption of naproxen or lead to other complications, so it is important for the nurse to address this statement with the client.

Correct Answer: A

Rationale: The correct answer is extremity paresthesias. Streptomycin, used to treat infections like Subacute Bacterial Endocarditis, can cause paresthesias in the hands and feet as an adverse effect. Monitoring for this symptom is vital to detect and manage it promptly.