Heparin is classified under what class?
- A. Laxative
- B. ACE inhibitor
- C. Anti-convulsant
- D. Antithrombotic
Correct Answer: D
Rationale: Heparin is classified as an antithrombotic agent. It is a medication that helps prevent blood clot formation by inhibiting the activity of certain clotting factors in the blood. Heparin is commonly used in the treatment and prevention of conditions such as deep vein thrombosis, pulmonary embolism, and during certain medical procedures to prevent clot formation. It is not classified as a laxative, ACE inhibitor, or anti-convulsant based on its mechanism of action and therapeutic use.
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Serious adverse effects of oral contraceptives include:
- A. Increase in skin oil followed by acne.
- B. Headache and dizziness.
- C. Early or mid-cycle bleeding.
- D. Thromboembolic complications.
Correct Answer: D
Rationale: Thromboembolic complications, such as deep vein thrombosis and pulmonary embolism, are serious adverse effects of oral contraceptives. These occur due to the estrogen component, which increases the risk of blood clots. While headaches, dizziness, and breakthrough bleeding are common side effects, they are not as severe as thromboembolic events.
For the patient taking acetaminophen, what should the nurse do? (Select all that apply.)
- A. Monitor routine liver enzyme tests.
- B. Encourage the patient to check package labels of over-the-counter drugs to avoid overdosing.
- C. Report side effects immediately, as toxicity can cause severe hepatic damage.
- D. Teach the female patient that oral contraceptives can increase the effect of acetaminophen.
Correct Answer: D
Rationale: Acetaminophen is metabolized in the liver, and excessive doses can lead to hepatotoxicity. Routine monitoring of liver enzymes is essential to detect early signs of liver damage. Patients should also be educated to check the acetaminophen content in over-the-counter medications to avoid accidental overdose. Reporting side effects promptly is crucial, as acetaminophen toxicity can cause severe and potentially fatal liver damage. While oral contraceptives can affect drug metabolism, they do not significantly increase the effects of acetaminophen. Therefore, the correct actions are to monitor liver enzymes, educate about over-the-counter medications, and report side effects.
An injection of penicillin into a penicillin-sensitized person may lead to death due to:
- A. absence of histamine
- B. a Shwartzman's reaction
- C. release of enzymes from polymorphonuclear leukocytes
- D. constriction of bronchioli and drop in blood pressure
Correct Answer: B
Rationale: A Shwartzman's reaction is a severe inflammatory response that occurs when a person who has previously been sensitized to penicillin is re-exposed to the drug. This exaggerated response can lead to widespread activation of inflammatory mediators and is characterized by endotoxin-induced intravascular coagulation. This can result in a cascade of events leading to tissue damage, organ failure, and potentially death. It is different from a typical allergic reaction mediated by histamine release or constriction of bronchioli and drop in blood pressure. Additionally, the release of enzymes from polymorphonuclear leukocytes is not directly related to the fatal outcome of a penicillin injection in a sensitized individual.
Which drug concentration is appropriate to administer in an order for epinephrine 0.3 mg IM to treat a severe allergic reaction in an adult patient?
- A. 1:10,000
- B. 0.736111111
- C. 0.111111111
- D. 1:10
Correct Answer: B
Rationale: The appropriate concentration for epinephrine 0.3 mg IM in an adult for a severe allergic reaction is 1:1000. This concentration is used for intramuscular administration, while 1:10,000 (A) is used for intravenous administration in cardiac arrest. Concentrations of 1:100 (C) and 1:10 (D) are not standard for this purpose.
Which of the following drugs has a therapeutic effect that increases cardiac output and slows heart rate?
- A. Heparin
- B. Alprazola
- C. Digoxin
- D. Levothyroxine
Correct Answer: C
Rationale: Digoxin is a medication commonly used to treat heart failure and certain types of irregular heartbeats. It works by increasing the force of contraction of the heart muscle, thereby increasing cardiac output. Additionally, digoxin also has the ability to slow down the heart rate, making it helpful in conditions such as atrial fibrillation. Heparin is an anticoagulant medication used to prevent blood clot formation, while Alprazolam is a benzodiazepine used to treat anxiety disorders. Levothyroxine is a thyroid hormone replacement medication to treat hypothyroidism. None of these drugs have the therapeutic effects of increasing cardiac output and slowing heart rate like digoxin.