A nurse is teaching a client who is starting treatment with warfarin. The nurse should plan to include information on which of the following topics to promote the effectiveness of the drug?

Correct Answer: D

Rationale: The correct answer is D: Dietary modifications. Warfarin interacts with vitamin K in the diet, so maintaining consistent levels of vitamin K intake is crucial for the effectiveness of the drug. The nurse should educate the client to consume a consistent amount of foods rich in vitamin K to ensure the warfarin dosage remains effective. Sleep modifications (A), fluid modifications (B), and driving modifications (C) are not directly related to the effectiveness of warfarin. Therefore, they are not the appropriate topics to include in the client education plan.

Correct Answer: B

Rationale: The correct answer is B: Increase in cytoplasm relative to the nucleus. In reactive states, lymphocytes undergo activation and proliferation, leading to an increase in cytoplasm as they synthesize proteins and organelles for cell division. This change is a characteristic feature of lympho-morphologic alterations in reactive states. A: Decrease in cytoplasm relative to the nucleus is incorrect because lymphocytes need to increase their cytoplasmic volume during activation. C: Increase in nucleus relative to the cytoplasm is incorrect as lymphocytes typically increase their cytoplasmic volume during proliferation. D: Decrease in size is incorrect because lymphocytes typically enlarge during activation and proliferation.

Correct Answer: B

Rationale: The correct answer is B: Palmer pallor. This is because pallor, especially on the palms (Palmer pallor), is a common sign of anemia due to the decreased amount of hemoglobin in the blood, leading to reduced oxygen-carrying capacity. Insomnia (A) is not specifically associated with anemia. Fever (C) is not a typical symptom of anemia unless it is due to an underlying infection or inflammatory condition. Angina (D) is chest pain caused by reduced blood flow to the heart, not a direct sign of anemia. In summary, Palmer pallor is the most relevant sign to indicate anemia, while the other choices are not directly related to this condition.

Correct Answer: B

Rationale: The correct answer is B: Stuart Prower factor, also known as Factor X. This coagulation factor is dependent on vitamin K for its synthesis. Vitamin K is essential for the post-translational modification of certain coagulation factors, including Factor X. Thromboplastin (A) is not a coagulation factor, but rather a tissue factor involved in the initiation of coagulation. Hageman factor (C) is Factor XII, which is not vitamin K-dependent. Proaccelerin (D) is also known as Factor V and is not vitamin K-dependent. In summary, only Stuart Prower factor (Factor X) is a vitamin K-dependent coagulation factor among the choices provided.

Correct Answer: A

Rationale: The correct answer is A: Jaundice. Jaundice is a yellowing of the skin and eyes due to an excess of bilirubin, a byproduct of red blood cell breakdown. In this case, rapid destruction of red blood cells leads to an increased production of bilirubin, causing jaundice. Bleeding (B) is not directly related to red blood cell destruction. Diarrhea (C) and cyanosis (D) are not typically associated with red blood cell destruction.