A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?
- A. Vitamin K
- B. Calcium carbonate
- C. Acetaminophen
- D. Ranitidine
Correct Answer: C
Rationale: The correct answer is Acetaminophen (Choice C). Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking Warfarin. It can potentiate the anticoagulant effect of Warfarin, leading to an increased risk of bleeding. Nurses should monitor clients closely for signs of bleeding when these two medications are used together.
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A healthcare professional is preparing to administer Pamidronate to a client who has bone pain related to cancer. Which of the following precautions should the healthcare professional take when administering pamidronate?
- A. Inspect the skin for redness and irritation when changing the intradermal patch.
- B. Assess the IV site for thrombophlebitis frequently during administration.
- C. Instruct the client to sit upright or stand for 30 min following oral administration.
- D. Watch for manifestations of anaphylaxis for 20 min after IM administration.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?
- A. 22 gtt/min
- B. 24 gtt/min
- C. 20 gtt/min
- D. 18 gtt/min
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
While caring for a client receiving Heparin therapy, which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?
- A. PT
- B. INR
- C. aPTT
- D. Platelet count
Correct Answer: C
Rationale: The nurse should monitor the aPTT (activated partial thromboplastin time) when caring for a client receiving Heparin therapy. The aPTT reflects the intrinsic pathway of the clotting cascade and is used to monitor the effectiveness of heparin, which primarily affects this pathway by potentiating antithrombin III. Monitoring the aPTT helps ensure that the client's blood is within the therapeutic range to prevent thrombus formation.
A client has been prescribed Phenelzine for depression. Which of the following indicates that the client has developed an adverse effect of this medication?
- A. Orthostatic hypotension
- B. Hearing loss
- C. Gastrointestinal bleeding
- D. Weight loss
Correct Answer: A
Rationale: Orthostatic hypotension is a known adverse effect of Phenelzine, a monoamine oxidase inhibitor (MAOI) used for depression. It is caused by a sudden drop in blood pressure when changing positions, leading to symptoms like dizziness or fainting. Monitoring for orthostatic hypotension is crucial during Phenelzine therapy to prevent complications.
In caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT) and presents with a pulse rate of 98/min and blood pressure of 74/44 mm Hg, the nurse should anticipate a prescription for which of the following IV medications?
- A. Calcium gluconate
- B. Sodium bicarbonate
- C. Potassium chloride
- D. Magnesium sulfate
Correct Answer: A
Rationale: In this scenario, the client is experiencing severe hypotension due to Verapamil administration. The appropriate medication to counteract the vasodilation caused by Verapamil and reverse severe hypotension is Calcium gluconate, which should be administered slowly IV. Therefore, the correct choice is Calcium gluconate (Choice A).