Nokea
A client with deep vein thrombosis has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?
- A. Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
- B. I will call the provider to get a prescription for discontinuing the IV heparin today.
- C. Both heparin and warfarin work together to dissolve the clots.
- D. The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.
Correct Answer: A
Rationale: The correct answer is A because warfarin takes several days to reach a therapeutic level and exert its full anticoagulant effect. During this time, the IV heparin is continued to prevent clotting until the warfarin is effective. Both medications are used together temporarily for this reason. Discontinuing heparin prematurely can increase the risk of clot formation. Therefore, the nurse should explain to the client that the IV heparin will be continued until the warfarin reaches a therapeutic level.
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A 19-year-old G1P0 woman at 34 weeks gestation lost her eyeglasses for a day. Constant squinting causes her to develop a headache. She asks her doctor for a pain reliever. Which of the following drugs may disrupt her fetus' circulatory system?
- A. Acetaminophen
- B. Codeine
- C. Hydrocodone
- D. Ketorolac
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which of the following does not describe intravenous injection.
- A. tend to produce more immediate adverse reaction.
- B. Too high concentration of the drug is readily obtained
- C. Chance of penetration into an artery instead of vein
- D. Convenient, safe , economica l
Correct Answer: D
Rationale: The statement "Convenient, safe, economical" does not accurately describe intravenous injection. Intravenous injection is generally considered to be less convenient compared to other routes of administration due to the need for proper training, sterile technique, and close monitoring during drug administration. While it can be effective in delivering drugs quickly and directly into the bloodstream, it is not always the safest or most economical option. Intravenous administration carries risks such as infection, phlebitis, and possible adverse reactions that need to be carefully monitored. Additionally, the cost of intravenous drug administration tends to be higher due to the need for specialized equipment and trained personnel.
What is the therapeutic use of Phenytoin?
- A. Replacement in hypothyroidism to restore normal hormonal balance
- B. Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux
- C. Diminished seizure activity, termination of ventricular arrhythmias
- D. Prevention of thrombus formation, prevention of extension of existing thrombi
Correct Answer: C
Rationale: Phenytoin is primarily used to diminish seizure activity and is effective in terminating ventricular arrhythmias. It works by stabilizing neuronal membranes, reducing repetitive neuronal firing, and limiting the spread of seizure activity in the brain. While phenytoin does not have a direct role in preventing thrombus formation or extending existing thrombi, it is crucial in managing seizures and certain arrhythmias.
A nurse is providing teaching to a client who has asthma and is beginning to take montelukast. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will use this medication as a rescue inhaler during asthma attacks.
- B. I should take this medication once daily in the evening.
- C. I need to have my blood levels checked regularly while taking this medication.
- D. I should take this medication before exercising to prevent bronchospasm.
Correct Answer: B
Rationale: Montelukast is typically taken once daily in the evening for long-term control of asthma symptoms. It helps prevent asthma attacks by reducing inflammation in the airways. While montelukast can also be used for exercise-induced bronchospasm in some cases, it is generally not a rescue medication and should be taken regularly, not on an as-needed basis.
A client has a new prescription for Enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the following adverse reactions?
- A. Bone marrow suppression
- B. Pancreatitis
- C. Pancreatitis
- D. Bone marrow suppression
Correct Answer: D
Rationale: While bone marrow suppression is not typically associated with Enfuvirtide, a more relevant concern is the risk of severe allergic reactions such as anaphylaxis. Enfuvirtide, an HIV fusion inhibitor, can cause local injection site reactions and systemic allergic responses. Monitoring for signs of allergic reactions, such as rash, fever, and difficulty breathing, is crucial to ensure the client's safety.