The client with atrial fibrillation is receiving warfarin (Coumadin). Which laboratory test should be monitored to determine the effectiveness of the therapy?

Correct Answer: A

Rationale: Monitoring Prothrombin time (PT) and international normalized ratio (INR) is crucial when a client is on warfarin therapy. These tests assess the clotting ability of the blood and help determine the appropriate dosage of warfarin to prevent complications such as bleeding or clotting events. PT and INR values within the therapeutic range indicate the effectiveness of warfarin in managing atrial fibrillation. Choice B, activated partial thromboplastin time (aPTT), is not typically used to monitor warfarin therapy; it is more commonly used to assess the effectiveness of heparin therapy. Choice C, complete blood count (CBC), does not directly assess the anticoagulant effect of warfarin. Choice D, fibrinogen level, is not a primary test for monitoring warfarin therapy; it is more relevant in assessing conditions like disseminated intravascular coagulation.

Correct Answer: B

Rationale: The nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk is to have the client sit down. Sitting down reduces the workload on the heart and may alleviate pain by improving oxygen supply. This action aims to reduce the strain on the heart and improve oxygen delivery to the myocardium, which can help relieve the symptoms of angina pectoris. Administering nitroglycerin could be the next step after having the client sit down if the pain persists. Obtaining an electrocardiogram and applying oxygen are not the immediate priority actions when dealing with angina pectoris symptoms.

Correct Answer: B

Rationale: The correct instruction for the nurse to provide to the client prescribed atorvastatin (Lipitor) for hyperlipidemia is to avoid drinking grapefruit juice while taking this medication. Grapefruit juice can interfere with the metabolism of atorvastatin, leading to an increased risk of side effects. It is crucial for the client to adhere to this instruction to ensure the effectiveness and safety of the treatment. Choices A, C, and D are incorrect because taking the medication with breakfast, increasing dietary fiber intake, and avoiding foods high in potassium are not specific instructions related to atorvastatin therapy for hyperlipidemia.

Correct Answer: C

Rationale: The correct answer is C: Hypokalemia. Furosemide, a loop diuretic, commonly causes potassium loss, leading to hypokalemia. The nurse should closely monitor for decreased potassium levels in a client receiving furosemide to prevent complications such as cardiac arrhythmias or muscle weakness. Hyperkalemia (Choice A) is not typically associated with furosemide use. Hypernatremia (Choice B) refers to high sodium levels and is not the primary concern with furosemide. Hyponatremia (Choice D) is low sodium levels, which can occur but is less common than hypokalemia in clients taking furosemide.

Correct Answer: C

Rationale: The correct action for a client experiencing anginal pain, like chest pain after climbing stairs, is to sit the client down and have them rest. Resting reduces myocardial oxygen demand, which can help relieve anginal pain. Administering oxygen or nitroglycerin may be appropriate interventions after the client has been seated and rested. Checking the client's blood pressure is important but not the immediate priority when a client is experiencing anginal pain. Therefore, the first action should be to sit the client down and allow them to rest.