Nokea
A patient is receiving an IV infusion of heparin and was started on warfarin therapy the night
- A. Which statement is most correct?
- B. The patient is receiving a double dose of anticoagulants.
- C. The heparin therapy was ineffective, so the warfarin was starte
- D. The heparin provides anticoagulation until therapeutic levels of warfarin are reache
Correct Answer: D
Rationale: The correct statement is that the heparin provides anticoagulation until therapeutic levels of warfarin are reached. Heparin has an immediate onset of action and is used initially to rapidly provide anticoagulation. Warfarin, on the other hand, has a delayed onset of action and requires several days to reach therapeutic levels in the bloodstream. Therefore, heparin is often overlapped with warfarin until the latter reaches its full anticoagulant effect. This overlapping strategy helps prevent a gap in anticoagulation and reduces the risk of blood clots. So, the statement that the heparin provides anticoagulation until therapeutic levels of warfarin are reached is the most correct in this case.
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Which of the following has the shortest elimination half-life?
- A. Naloxone
- B. Morphine
- C. Methadone
- D. Remifentanil
Correct Answer: D
Rationale: Elimination half-life measures how quickly a drug is cleared from plasma. Naloxone's half-life is about 1-2 hours, used for opioid reversal. Morphine's is 2-4 hours, reflecting its duration as an analgesic. Methadone's is long, 15-60 hours, suiting addiction maintenance. Fentanyl's is 2-4 hours, typical for anesthesia. Remifentanil, an ultra-short-acting opioid, has a half-life of 3-10 minutes due to rapid esterase metabolism, making it ideal for procedures needing quick offset. Its brevity contrasts with others, ensuring minimal residual effects, a key advantage in critical care settings where rapid recovery is essential.
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.
A client is undergoing preparation for extensive colorectal surgery. Which of the following oral antibiotics should be administered to suppress normal flora in the GI tract?
- A. Kanamycin
- B. Gentamicin
- C. Neomycin
- D. Tobramycin
Correct Answer: C
Rationale: The correct answer is C: Neomycin. Neomycin, an aminoglycoside antibiotic, is administered orally before GI surgery to eliminate the normal flora in the large intestine. This helps reduce the risk of postoperative infections by decreasing the bacterial load in the gut. Choices A, B, and D (Kanamycin, Gentamicin, Tobramycin) are not typically used to suppress normal flora in the GI tract before colorectal surgery.
A healthcare professional is about to administer Propranolol to a patient. The healthcare professional takes the patient's apical pulse and documents it as 58 bpm. How should the healthcare professional proceed?
- A. Administer the medication as prescribed
- B. Administer half of the normal dose
- C. Consider the extended-release form of the medication
- D. Withhold administration of the medication and notify the healthcare provider
Correct Answer: D
Rationale: When a patient's apical pulse is 58 bpm, it is below the normal range. Propranolol is a beta-blocker that can further lower the heart rate. Therefore, it is crucial to withhold the medication and notify the healthcare provider to evaluate the patient's condition. Administering Propranolol in this situation can exacerbate bradycardia, leading to serious complications. Choosing to administer the medication as prescribed (Choice A) can put the patient at risk. Administering half of the normal dose (Choice B) without healthcare provider guidance is not appropriate in this case. Considering the extended-release form of the medication (Choice C) does not address the immediate concern of bradycardia and is not the best course of action.
The nurse is caring for a client receiving tamoxifen (Nolvadex) for breast cancer. Which side effect should the nurse monitor for?
- A. Hot flashes
- B. Hair loss
- C. Nausea
- D. Diarrhea
Correct Answer: A
Rationale: Tamoxifen, an estrogen receptor modulator, treats breast cancer but blocks estrogen in some tissues, causing hot flashes , a common menopausal-like effect. Monitoring this ensures client comfort and adherence, as it's frequent and distressing. Hair loss is more chemotherapy-related, not tamoxifen. Nausea and diarrhea occur less often and are less specific. Hot flashes align with tamoxifen's anti-estrogenic action, a key consideration in breast cancer management where long-term use is common. This focus aids in symptom management, distinguishing it from cytotoxic effects, making A the priority side effect to monitor.