Action of tranexamic acid
- A. antiplatelet
- B. fibrinolytic
- C. antifibrinolytic
- D. anticoagulant
Correct Answer: C
Rationale: Tranexamic acid is an antifibrinolytic agent, which means it works by inhibiting the breakdown of blood clots. It does this by blocking the activation of plasmin, which is responsible for breaking down fibrin clots. This action helps in promoting clot stability and reducing bleeding. Tranexamic acid is commonly used to treat or prevent excessive bleeding in various conditions, such as heavy menstrual bleeding, surgery, trauma, and certain medical procedures.
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An overwhelmed nursing student asks the instructor whether there are any tips that will make learning pharmacology easier. The instructor gives an example of the anticoagulant heparin. The instructor indicates that knowing heparin and comparing other drugs to it will facilitate learning the many anticoagulants. Which approach is the instructor using?
- A. Mechanism of action approach
- B. Generic name approach
- C. Trade name approach
- D. Prototype drug approach
Correct Answer: D
Rationale: The prototype approach uses a representative drug like heparin to learn a class (anticoagulants), comparing others to its traits-mechanism, effects, side effects-simplifying study. Mechanism of action is narrower. Generic or trade names focus on nomenclature, not learning strategy. Prototype leverages a familiar example, a proven method for mastering drug groups.
A nurse is providing administration instruction to the wife of a client going home on intermittent enteral nutrition. Which information should the nurse include?
- A. Clean the equipment between each feeding administration
- B. Once mixed, enteral feeding should hang no more than 8 hours
- C. Refrigerate any feeding that is not needed for a feeding
- D. Keep the area around the insertion site clean
Correct Answer: A
Rationale: Cleaning equipment between each enteral feeding is vital to prevent bacterial contamination, as residual formula can foster microbial growth, risking infections like gastroenteritis in a client already nutritionally compromised. While limiting hang time is important, evidence suggests a 4-hour maximum, not 8, to minimize spoilage-though this isn't the focus here. Refrigerating unused feeding preserves its integrity, preventing degradation or bacterial proliferation, which is critical for safety. Keeping the insertion site clean reduces infection risk at the tube entry, a common complication in enteral therapy. Cleaning equipment stands out as a proactive step the wife can take between feedings, directly impacting hygiene and client safety, whereas other points address storage or site care, which, while essential, are secondary to the immediate post-feeding action of equipment maintenance in this context.
Why is it important to monitor ins and outs with patients using ACE inhibitors?
- A. To assess for renal impairment
- B. You must make sure the patient is receiving adequate fluid intake
- C. To assess the patient for potential heart failure
- D. To assess for decreased blood pressure
Correct Answer: D
Rationale: It is important to monitor ins and outs with patients using ACE inhibitors to assess for decreased blood pressure. ACE inhibitors are known to lower blood pressure by dilating blood vessels, which can sometimes lead to hypotension (low blood pressure). Monitoring the patient's fluid intake and output helps healthcare providers evaluate the patient's blood pressure response to the medication and make necessary adjustments to prevent complications such as dizziness, falls, or fainting. Regular monitoring is crucial to ensure the patient's safety and optimize the effectiveness of ACE inhibitor therapy.
Which of the following 'overdoses' is most commonly associated with respiratory alkalosis, but when more severe a metabolic acidosis?
- A. Methanol
- B. Lead
- C. Paracetamol
- D. Salicylate
Correct Answer: D
Rationale: Overdose toxicities differ in acid-base effects. Methanol causes metabolic acidosis via formic acid, not respiratory alkalosis. Lead poisoning leads to anemia or neurologic issues, rarely acid-base shifts. Paracetamol overdose induces lactic acidosis from liver failure, not respiratory changes initially. Salicylate (e.g., aspirin) overdose stimulates the respiratory center early, causing hyperventilation and respiratory alkalosis (low pCO2), but severe cases add metabolic acidosis (high anion gap) from uncoupled oxidative phosphorylation and lactic acid buildup. Codeine, an opioid, depresses respiration, causing acidosis, not alkalosis. Salicylate's dual pattern is distinctive, requiring urgent recognition—initial alkalosis shifts to acidosis as toxicity worsens, guiding bicarbonate or dialysis treatment.
The specificity of the adrenergic blocking agents allows the clinician to select a drug to do what?
- A. Have the desired effect
- B. Multiply undesired effects
- C. Increase specificity with higher serum blood levels
- D. Improving concentration in the body
Correct Answer: A
Rationale: This specificity allows the clinician to select a drug that will have the desired therapeutic effects without the undesired effects that occur when the entire sympathetic nervous system is blocked. In general, however, the specificity of adrenergic blocking agents depends on the concentration of drug in the body. Most specificity is lost with higher serum drug levels. The nurse should understand the importance of drug specificity to ensure safe and effective administration.