Nokea
A nurse is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the nurse plan to take?
- A. Administer IM Enoxaparin along with the Alteplase dose.
- B. Hold direct pressure on puncture sites for up to 30 min.
- C. Administer Aminocaproic acid IV prior to alteplase infusion.
- D. Prepare to administer Alteplase within 8 hr of manifestation onset.
Correct Answer: B
Rationale: Holding pressure prevents bleeding at puncture sites after alteplase, a thrombolytic.
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Which of the following is a thiazolidinediones:
- A. Pioglitazone
- B. Exenatide
- C. Sitagliptine
- D. Chlorpropamide
Correct Answer: A
Rationale: Pioglitazone is a thiazolidinedione that enhances insulin sensitivity via PPAR-gamma.
An order is written for a patient to receive 1000 mL of normal saline IV over 8 hours. If the IV infusion set is a microdrip set that delivers 60 drops/mL, how many drops per minute should the patient be receiving?
- A. 60 drops/min
- B. 120 drops/min
- C. 240 drops/min
- D. 480 drops/min
Correct Answer: B
Rationale: If a patient were to receive 1000 mL in 8 hours, dividing 1000 by 8 would mean that the patient would receive 125 mL in 1 hour, or 60 minutes. Setting up the equation, 60 drops/mL X = 125 mL/60 min, and cross-multiplying, the answer is 120 drops/min.
Discharge summaries using information technology have several advantages. They can:
- A. Replace the need for oral instruction because the patient has printed material to read at home
- B. Be filed with the patient's chart to document patient teaching
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: B
Rationale: IT discharge summaries document teaching but do not replace oral instructions.
Hypoglycemic effects of repaglinide and nateglinide is determined with:
- A. Closure of ATP sensitive K+ channels
- B. Increase numbers of insulin receptors
- C. Stimulation of PPAR-Y receptors
- D. Degradation of incretin
Correct Answer: A
Rationale: Repaglinide and nateglinide close ATP-sensitive K+ channels on beta cells, triggering insulin release.
The nurse is talking with a group of nursing students who are doing clinical hours on the unit. A student asks if all intramuscular (IM) drugs are absorbed the same. What factor would the floor nurse tell the students to affect absorption of the IM administration of drugs?
- A. Perfusion of blood to the subcutaneous tissue
- B. Integrity of the mucous membranes
- C. Environmental temperature
- D. Blood flow to the gastrointestinal tract
Correct Answer: C
Rationale: A cold environmental temperature can cause blood vessels to vasoconstrict and decreases absorption or in a hot environment vasodilate and increase absorption of IM medications. Blood flow to the subcutaneous tissues interferes with subcutaneous injection and blood flow to the gastrointestinal (GI) tract causes alterations in absorption for oral medications. The condition of mucous membranes can interfere with sublingual (under the tongue) and buccal (in the cheek) administration of drugs.