An older adult patient who had a mitral valve replacement with a mechanical valve is taking warfarin. What should the nurse include in discharge teaching?

Correct Answer: C

Rationale: The correct answer is C: Need for frequent laboratory blood testing. For a patient on warfarin with a mechanical valve, regular monitoring of the international normalized ratio (INR) is essential to ensure the medication's effectiveness and prevent complications like clotting or bleeding. Incorrect choices: A - Aspirin is not recommended with warfarin due to increased bleeding risk. B - Knowing how to take radial pulse is not directly related to warfarin therapy. D - Avoiding physical activity is not necessary; instead, patients should engage in regular, moderate exercise unless advised otherwise by a healthcare provider.

Correct Answer: C

Rationale: The correct answer is C: Natural active immunity. This type of immunity is the longest acting because it results from the body's exposure to a pathogen, leading to the production of memory cells that provide long-lasting protection. Natural active immunity involves the immune system responding to an actual infection or exposure to a pathogen, which triggers the production of antibodies and memory cells for future protection. In contrast, artificial active immunity (choice A) involves vaccines, which may require booster shots for long-lasting protection. Inflammatory response (choice B) is not a type of immunity but rather a non-specific defense mechanism against pathogens. Natural passive immunity (choice D) is short-lived and acquired from maternal antibodies, providing temporary protection.

Correct Answer: B

Rationale: The correct answer is B: speech therapist. Speech therapists specialize in evaluating and treating swallowing difficulties (dysphagia) after a stroke. They can provide techniques and exercises to improve swallowing function. Physical therapists focus on mobility and strength, social workers address psychosocial needs, and respiratory therapists manage breathing-related issues. However, in this case, the primary concern is swallowing dysfunction, making the speech therapist the most appropriate referral.

Correct Answer: A

Rationale: The correct answer is A because the patient's medical record should accompany them to the long-term care facility to ensure continuity of care. This is essential for healthcare providers at the new facility to have access to the patient's medical history, diagnoses, treatments, and medications. Choice B is incorrect because leaving the record in the hospital could lead to delays in treatment and jeopardize patient safety. Choice C is incorrect as shredding the record would violate patient privacy laws and hinder the patient's care continuity. Choice D is incorrect because only the original record should go with the patient to ensure accuracy and completeness.

Correct Answer: C

Rationale: The correct answer is C: patient's record. The patient's record is a legal document that provides an accurate and detailed account of the care provided, actions taken, and assessments made by the nurse. It serves as concrete evidence to defend against allegations of nursing negligence. Testimony of other nurses (A) may be biased or inconsistent. Testimony of expert witnesses (B) may not always be available or reliable. Patients' families (D) are not directly involved in the care provided and may not have accurate information. The patient's record is the most reliable and objective source of evidence to refute claims of nursing negligence.