Correct Answer: D

Rationale: Conjugated equine estrogens are contraindicated in clients with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is characterized by inflammation of a vein with the formation of a clot, and estrogen can further exacerbate this condition, leading to serious complications.

Correct Answer: A

Rationale: The correct instruction is to remove the nitroglycerin patch each evening to prevent tolerance. This allows for a 10- to 12-hour nitrate-free period daily, reducing the risk of developing tolerance to nitroglycerin. Cutting the patch in half, taking it off for a headache, or applying a new patch every 48 hours are not recommended practices for managing angina with nitroglycerin patches.

Correct Answer: A

Rationale: St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism pathways, potentially leading to decreased anticoagulant effects. Therefore, clients on Warfarin therapy should avoid St. John's wort. While echinacea, garlic, and ginseng are also herbal supplements that can interact with Warfarin, St. John's wort is particularly known for its significant impact on Warfarin metabolism.

Correct Answer: C

Rationale: Fresh frozen plasma is the appropriate blood product for a client with an elevated aPTT as it contains various coagulation factors that can help correct coagulopathies and prevent bleeding. It is not necessary to transfuse whole blood, platelets, or packed red blood cells in this situation as they do not directly address the coagulation factor deficiencies associated with an elevated aPTT.

Correct Answer: A

Rationale: Enalapril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. The nurse should closely monitor the client for this and instruct them to report it to the healthcare provider if it occurs.