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 is an anticoagulant that works by inhibiting blood clotting factors, affected by vitamin K in the diet. Clients on warfarin need consistent intake of vitamin K-rich foods to maintain stable blood levels. A nurse should educate the client to have a steady intake of vitamin K-containing foods and avoid drastic dietary changes. Sleep, fluid, and driving modifications are not directly related to the effectiveness of warfarin.

Correct Answer: B

Rationale: The correct answer is B: Increase in cytoplasm relative to the nucleus. In reactive states, lymphocytes can enlarge due to increased cytoplasmic volume to accommodate higher metabolic activity. This change is known as a lympho-morphologic change. Choice A is incorrect because a decrease in cytoplasm relative to the nucleus is not typically seen in reactive states. Choice C is incorrect as an increase in nucleus relative to cytoplasm is not a characteristic change in reactive lymphocytes. Choice D is incorrect because a decrease in size is not typically observed in reactive states where lymphocytes may enlarge due to activation.

Correct Answer: B

Rationale: The correct answer is B: Palmer pallor. Pallor refers to paleness of the skin, and Palmer pallor specifically refers to paleness of the palms. In the context of anaemia, a common symptom is pallor due to decreased red blood cells and oxygen-carrying capacity. Insomnia (choice A), fever (choice C), and angina (choice D) are not typically associated with anaemia. Insomnia is a sleep disorder, fever indicates an infection or inflammation, and angina is chest pain due to reduced blood flow to the heart. So, Palmer pallor is the most relevant sign to indicate anaemia among the given choices.

Correct Answer: B

Rationale: The correct answer is B: Stuart Prower factor, also known as Factor X. This is a vitamin K-dependent coagulation factor because vitamin K is essential for the post-translational modification of certain glutamate residues on coagulation factors, including Factor X. Vitamin K helps these factors bind to calcium ions, which is necessary for their proper function in the coagulation cascade. Thromboplastin (A), also known as tissue factor, is not a vitamin K-dependent coagulation factor. Hageman factor (C), also known as Factor XII, and Proaccelerin (D), also known as Factor V, are not vitamin K-dependent factors either.

Correct Answer: A

Rationale: The correct answer is A: Jaundice. Jaundice is a yellowing of the skin and whites of the eyes due to high levels of bilirubin in the blood, which can occur when red blood cells are being destroyed rapidly. Bilirubin is a byproduct of the breakdown of red blood cells. Therefore, the presence of jaundice indicates excessive red blood cell destruction. Summary: - B: Bleeding is not directly related to the destruction of red blood cells. - C: Diarrhea does not typically indicate red blood cell destruction. - D: Cyanosis is a bluish discoloration of the skin due to lack of oxygen, not directly linked to red blood cell destruction.