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A healthcare professional is reviewing the medication list of a client scheduled for surgery. Which of the following medications places the client at risk for increased bleeding during surgery?
- A. Warfarin
- B. Acetaminophen
- C. Ibuprofen
- D. Aspirin
Correct Answer: D
Rationale: Aspirin is an anticoagulant that inhibits platelet function, increasing the risk of bleeding during surgery. It is important for the healthcare professional to identify this medication, inform the surgical team, and consider withholding it prior to surgery to reduce the risk of excessive bleeding. Warfarin is also an anticoagulant but can be managed by adjusting the dosage or monitoring INR levels. Acetaminophen and ibuprofen are not associated with increased bleeding risk as they do not affect platelet function like aspirin.
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A client is starting a new prescription for verapamil. Which of the following instructions should be included?
- A. Take the medication with a full glass of water.
- B. Avoid grapefruit juice.
- C. Monitor blood pressure regularly.
- D. Monitor heart rate daily.
Correct Answer: B
Rationale: Clients prescribed verapamil should be advised to avoid grapefruit juice as it can potentiate the drug's effects, leading to adverse reactions. Grapefruit juice can inhibit the metabolism of verapamil, resulting in higher blood levels of the medication and an increased risk of side effects. Instructions such as taking the medication with a full glass of water (Choice A) are not specific to verapamil and are generally recommended. While monitoring blood pressure regularly (Choice C) is important for clients on antihypertensive medications, it is not a direct concern related to verapamil. Monitoring heart rate daily (Choice D) is not a primary consideration when starting verapamil, as it is more commonly used for its effects on blood pressure and arrhythmias rather than heart rate.
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 Etravirine, an NNRTI. Which of the following statements should the nurse include in teaching the client?
- A. Take this medication with food.
- B. Take this medication on an empty stomach.
- C. Take this medication at the same time every day.
- D. Take this medication at bedtime to prevent drowsiness.
Correct Answer: C
Rationale: The correct statement the nurse should include in teaching the client is to take Etravirine at the same time every day. This ensures consistent blood levels and effectiveness of the medication. Consistent timing is essential to achieve optimal therapeutic effects and avoid missing doses. Choices A and B are incorrect because Etravirine should not necessarily be taken with or without food; it is more important to take it consistently. Choice D is incorrect as there is no need to take Etravirine at bedtime to prevent drowsiness.
A patient diagnosed with cancer is scheduled to receive vincristine. Which nursing assessment will have the highest priority when providing care for this patient?
- A. Degree of alopecia
- B. Increased digoxin levels
- C. Decreased phenytoin effects
- D. Peripheral neuropathy
Correct Answer: D
Rationale: Vincristine is known to cause peripheral neuropathy, a common and potentially debilitating side effect. The nurse should prioritize assessing for signs of neuropathy, such as tingling, numbness, or weakness in the extremities. Alopecia, while distressing, is not as critical as neuropathy, which can affect the patient's mobility and quality of life. Vincristine does not typically cause significant changes in digoxin or phenytoin levels, making these assessments less relevant. Early detection of neuropathy allows for dose adjustments or supportive interventions to minimize long-term damage.
A healthcare professional is preparing to administer Enoxaparin to a client. Which of the following actions should the healthcare professional take?
- A. Administer the medication orally.
- B. Massage the injection site after administration.
- C. Insert the needle at a 45- to 90-degree angle.
- D. Aspirate before injecting the medication.
Correct Answer: C
Rationale: Enoxaparin should be administered subcutaneously at a 45- to 90-degree angle. This angle ensures proper delivery of the medication. Massaging the injection site should be avoided to prevent bruising and possible tissue damage. Aspiration is not required for subcutaneous injections like Enoxaparin. Therefore, the correct action for administering Enoxaparin is to insert the needle at a 45- to 90-degree angle.