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A client with thrombophlebitis receiving heparin by continuous IV infusion asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?
- A. It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.
- B. A pharmacist is the person to answer that question.
- C. Heparin does not dissolve clots. It stops new clots from forming.
- D. The oral medication you will take after this IV will dissolve the clot.
Correct Answer: C
Rationale: The correct response is C. Heparin does not dissolve clots; it prevents new clots from forming. Heparin works by inhibiting the formation of new clots and the extension of existing clots, rather than directly dissolving them. The client should be informed that the purpose of heparin therapy is to prevent the clot from getting larger and to reduce the risk of new clots forming. Choices A, B, and D are incorrect. Choice A talks about reaching a therapeutic blood level of heparin, which is not related to clot dissolution. Choice B deflects the question to a pharmacist without providing relevant information. Choice D inaccurately suggests that an oral medication will dissolve the clot, which is not the mechanism of action for heparin.
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What is the therapeutic use of Albuterol?
- A. Bronchodilation
- B. Anti-coagulant
- C. Anti-arrhythmic
- D. Proton-pump inhibitor
Correct Answer: A
Rationale: The correct answer is A: Bronchodilation. Albuterol is primarily used for bronchodilation, where it relaxes the muscles in the airways to make breathing easier. This medication is commonly prescribed for conditions such as asthma, chronic obstructive pulmonary disease (COPD), and other respiratory conditions where bronchodilation is beneficial. Choices B, C, and D are incorrect because Albuterol is not used as an anti-coagulant, anti-arrhythmic, or proton-pump inhibitor.
When administering medications to a 4-month-old infant, which of the following pharmacokinetic principles should be considered? (Select all that apply.)
- A. Infants have a more rapid gastric emptying time.
- B. Infants have immature liver function.
- C. Infants' blood-brain barrier is poorly developed.
- D. Infants have an increased ability to absorb topical medications.
Correct Answer: B
Rationale: When administering medications to a 4-month-old infant, the pharmacokinetic principle to consider is that infants have immature liver function until 1 year of age. This requires medications metabolized by the liver to be administered in smaller dosages. While infants do have a more rapid gastric emptying time, immature liver function is a more critical pharmacokinetic consideration in this context. Additionally, although infants have a poorly developed blood-brain barrier, this relates more to pharmacodynamic effects rather than pharmacokinetic principles. The statement about infants having an increased ability to absorb topical medications is not directly related to pharmacokinetic principles, making choice B the correct answer.
A client has a new prescription for Alendronate to treat osteoporosis. Which of the following instructions should the nurse include?
- A. Take the medication with a full glass of water after rising in the morning.
- B. Lie down for at least 30 minutes after taking the medication.
- C. Take the medication before bedtime to reduce the risk of esophageal irritation.
- D. Crush the tablet and mix it with applesauce if having difficulty swallowing.
Correct Answer: A
Rationale: The correct instruction is to take Alendronate with a full glass of water after rising in the morning. This helps reduce the risk of esophageal irritation, as the medication can cause irritation if not taken correctly. Taking it before bedtime (choice C) can increase the risk of irritation as the individual lies down. Lying down after taking the medication (choice B) can also lead to esophageal irritation. Crushing the tablet (choice D) is not recommended as Alendronate should be taken whole with a full glass of water.
A client has a new prescription for Atenolol. Which of the following instructions should the nurse provide?
- A. Take this medication with grapefruit juice.
- B. Monitor your blood pressure and heart rate regularly.
- C. You may experience a rapid heart rate.
- D. Increase your intake of potassium-rich foods.
Correct Answer: B
Rationale: The correct answer is B: 'Monitor your blood pressure and heart rate regularly.' Atenolol is a beta-blocker used to treat hypertension and other cardiovascular conditions. Patients should monitor their blood pressure and heart rate regularly to assess the medication's effectiveness and check for adverse effects like bradycardia or hypotension. Choice A is incorrect because Atenolol should not be taken with grapefruit juice, which can interfere with its absorption. Choice C is incorrect because Atenolol typically causes a decrease in heart rate, not a rapid heart rate. Choice D is incorrect because there is no specific need to increase potassium-rich foods while taking Atenolol.
What should you assess for in a patient who is on Valproate?
- A. Suicidal thoughts
- B. Monitor for seizures
- C. Bipolar disorder
- D. Migraines
Correct Answer: A
Rationale: The correct answer is A: Suicidal thoughts. When a patient is prescribed Valproate, it is crucial to assess for suicidal thoughts as it is a serious side effect associated with this medication. Valproate has been linked to an increased risk of suicidal ideation and behavior, particularly in patients with epilepsy or bipolar disorder. Monitoring for signs of depression or changes in behavior is essential to ensure patient safety and well-being. Choices B, C, and D are incorrect because while monitoring for seizures, managing bipolar disorder, and treating migraines are also important considerations when a patient is on Valproate, assessing for suicidal thoughts takes priority due to the serious nature of this potential side effect.