Nokea
A healthcare professional is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion. Which of the following results indicates that the heparin infusion should be increased?
- A. aPTT of 90 seconds
- B. Platelet count of 150,000/mm³
- C. INR of 1.0
- D. Hgb of 15 g/dL
Correct Answer: A
Rationale: An aPTT of 90 seconds is above the therapeutic range for heparin, which typically falls between 60-80 seconds. This indicates that the current heparin dose is too high, and the infusion rate should be decreased to avoid excessive anticoagulation and the risk of bleeding. Monitoring aPTT is crucial in adjusting heparin therapy to maintain it within the therapeutic range.
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Which of the following drugs causes the most significant inhibition of metabolism of rifabutin?
- A. Zidovudine
- B. Ritonavir
- C. Enfuvirtide
- D. Nevirapine
Correct Answer: B
Rationale: Rifabutin, metabolized by CYP3A4, is affected by inhibitors. Zidovudine, enfuvirtide, and nevirapine don't strongly inhibit CYP3A4. St John's wort induces it, lowering levels. Ritonavir, a potent CYP3A4 inhibitor, significantly slows rifabutin metabolism, raising levels and toxicity risk (e.g., uveitis), the most impactful. This interaction requires dose adjustment, critical in HIV-TB co-treatment.
What is one of the therapeutic uses of Valproate?
- A. Suppression of seizure activity
- B. Replacement of hypothyroidism to restore normal hormone balance
- C. Maintenance of blood glucose
- D. Lowering of blood pressure
Correct Answer: A
Rationale: Valproate, also known as Valproic acid, is commonly used in medicine for the suppression of seizure activity. It is an anticonvulsant medication that helps manage and prevent seizures in various conditions such as epilepsy. While it is not used for replacing hypothyroidism, maintaining blood glucose levels, or lowering blood pressure, its primary therapeutic use is in managing seizures.
A client is receiving discharge teaching for a new prescription of Fluoxetine for PTSD. Which of the following statements should be included in the teaching?
- A. You may experience a decreased desire for intimacy while taking this medication.
- B. You should take this medication in the evening to help promote sleep.
- C. You may experience fewer urinary adverse effects if you urinate just before taking this medication.
- D. You should wear sunglasses when outdoors due to the light sensitivity caused by this medication.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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.
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.