Nokea
A patient accidentally took an overdose of the anticoagulant warfarin (Coumadin), and the nurse is preparing to administer vitamin K as an antidote. Which statement about vitamin K is accurate?
- A. The vitamin K dose will be given intramuscularly.
- B. The patient will take oral doses of vitamin K after the initial injection.
- C. The vitamin K cannot be given if the patient has renal disease.
- D. The patient will be unresponsive to warfarin therapy for 1 week after the vitamin K is given.
Correct Answer: D
Rationale: When vitamin K is used as an antidote to warfarin therapy, the patient becomes unresponsive to warfarin for approximately 1 week after vitamin K administration. The use of vitamin K products is contraindicated in patients who are in the last few weeks of pregnancy and in patients with severe hepatic disease. Vitamin K is given subcutaneously and not intramuscularly when used to reverse warfarin effects.
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A patient will be receiving monthly injections of cyanocobalamin. The dose is 100 mcg/month IM. The medication is available in a strength of 1000 mcg/mL. Identify how many milliliters the nurse will draw up into the syringe. (Record answer using one decimal place.)
Correct Answer: 0.1 mL
Rationale: 1000 mcg : 1 mL :: 100 mcg : x mL. (1000 ?? x) = (1 ?? 100); 1000x = 100; x = 0.1 mL.
The nurse is reviewing conditions caused by nutrient deficiencies. Conditions such as infantile rickets, tetany, and osteomalacia are caused by a deficiency in which vitamin or mineral?
- A. Vitamin D
- B. Vitamin C
- C. Zinc
- D. Cyanocobalamin (vitamin B12)
Correct Answer: A
Rationale: Infantile rickets, tetany, and osteomalacia are all a result of long-term vitamin D deficiency. The other options are incorrect.
The nurse is counseling a patient about calcium supplements. Which dietary information is appropriate during this teaching session?
- A. Take oral calcium supplements with meals.
- B. There are no drug interactions with calcium products.
- C. Avoid foods that are high in calcium, such as beef, egg yolks, and liver.
- D. Be sure to eat foods high in calcium, such as dairy products and salmon.
Correct Answer: D
Rationale: Foods high in calcium include dairy products, fortified cereals, calcium-fortified orange juice, sardines, and salmon. Patients can be encouraged to add dietary sources of calcium to their diets. Oral-dosage forms of calcium need to be given 1 to 3 hours after meals. Calcium salts will bind with tetracycline and quinolone antibiotics and result in an insoluble complex.
A patient with a history of alcohol abuse has been admitted for severe weakness and malnutrition. The nurse will prepare to administer which vitamin preparation to prevent Wernicke's encephalopathy?
- A. Vitamin B6
- B. Vitamin B1
- C. Vitamin B12
- D. Folic acid
Correct Answer: B
Rationale: Thiamine (vitamin B1) is necessary for the treatment of a variety of thiamine deficiencies, including Wernicke's encephalopathy. The other options are incorrect.
Niacin is prescribed for a patient who has hyperlipidemia. The nurse checks the patient's medical history, knowing that this medication is contraindicated in which disorder?
- A. Renal disease
- B. Cardiac disease
- C. Liver disease
- D. Diabetes mellitus
Correct Answer: C
Rationale: Niacin, unlike certain other B-complex vitamins, has additional contraindications besides drug allergy. They include liver disease, severe hypotension, arterial hemorrhage, and active peptic ulcer disease. The other options are incorrect.