Nokea
The client is being taught about their warfarin. What does the nurse say about warfarin?
- A. It antagonizes vitamin K and blocks the production of some clotting factors.
- B. It acts as an antiplatelet drug.
- C. It causes fibrinolysis.
- D. It inactivates certain clotting factors.
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Warfarin antagonizes vitamin K, inhibiting the production of clotting factors II, VII, IX, and X. This action leads to decreased blood clotting ability.
Summary for Incorrect Choices:
B: Warfarin is not an antiplatelet drug; it works by affecting clotting factors, not platelets.
C: Warfarin does not cause fibrinolysis (breakdown of blood clots); it inhibits clotting factor production.
D: Warfarin does not directly inactivate clotting factors; it interferes with their synthesis through vitamin K antagonism.
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The client is taking Ticlid and is anticipating surgery. What does the nurse advice the client to do about taking the Ticlid around the time of surgery?
- A. Ticlid should be withheld on the day of surgery.
- B. Ticlid can be taken with a small sip of water on the day of surgery.
- C. The client must stop the Ticlid a month before having surgery.
- D. The client must stop the Ticlid 7 days prior to surgery.
Correct Answer: A
Rationale: The correct answer is A: Ticlid should be withheld on the day of surgery. Ticlid is an antiplatelet medication that can increase the risk of bleeding during surgery. It is crucial to withhold Ticlid on the day of surgery to minimize the risk of excessive bleeding during the procedure. Choices B, C, and D are incorrect because taking Ticlid on the day of surgery or stopping it too far in advance can lead to increased bleeding risks. Stopping Ticlid a month before surgery (C) is unnecessary and can increase the risk of clot formation. Stopping Ticlid 7 days before surgery (D) is also too close to the surgery date and may not provide enough time for the medication to clear the system, potentially leading to increased bleeding risks.
The client has been prescribed gemfibrozil. The nurse explains the function of the drug as what?
- A. It reduces cholesterol levels
- B. It destabilizes cholesterol plaques.
- C. It prevents a recurrent MI.
- D. It lowers triglyceride levels.
Correct Answer: D
Rationale: The correct answer is D: It lowers triglyceride levels. Gemfibrozil is a fibric acid derivative that primarily works by decreasing triglyceride levels. It does not directly reduce cholesterol levels (A), destabilize cholesterol plaques (B), or prevent a recurrent MI (C). Lowering triglyceride levels helps reduce the risk of cardiovascular events such as heart attacks and strokes. Therefore, the explanation that gemfibrozil lowers triglyceride levels aligns with its mechanism of action and therapeutic effects.
The client is taking a calcium channel blocker for an arrhythmia. What is a contraindication to giving the client this drug?
- A. Hypertension
- B. First degree AV block
- C. Wolff-Parkinson White syndrome
- D. Glaucoma
Correct Answer: C
Rationale: The correct answer is C: Wolff-Parkinson White syndrome. Calcium channel blockers can worsen the pre-excitation in patients with WPW syndrome, leading to rapid conduction through the accessory pathway and potentially causing ventricular fibrillation.
A: Hypertension is not a contraindication for calcium channel blockers as they are commonly used to treat hypertension.
B: First degree AV block is not a contraindication, as calcium channel blockers can be used cautiously in patients with conduction abnormalities.
D: Glaucoma is not a contraindication to calcium channel blockers, as they are not known to exacerbate glaucoma.
A nurse is describing one of the waveforms to a novice critical care nurse. S/he describes this wave as being upright rounded and symmetrical and occurring after the QRS. The nurse is describing the
- A. P wave
- B. QRS
- C. ST segment
- D. T wave
Correct Answer: D
Rationale: The correct answer is D: T wave. The T wave is upright, rounded, and symmetrical, occurring after the QRS complex on an ECG. This wave represents ventricular repolarization. The P wave (Choice A) represents atrial depolarization, the QRS complex (Choice B) represents ventricular depolarization, and the ST segment (Choice C) represents the period between ventricular depolarization and repolarization. Therefore, the T wave is the only waveform that fits the description given in the question.
The client has a myocardial infarction and going into shock. What might be a medication to give to counteract shock in cases of myocardial infarction?
- A. Atropine
- B. Dopamine
- C. Digoxin
- D. Adenosine
Correct Answer: B
Rationale: The correct answer is B: Dopamine. Dopamine is a vasopressor that helps increase blood pressure and cardiac output, which can counteract shock in cases of myocardial infarction. It improves blood flow to vital organs. Atropine (A) is used for bradycardia, not shock. Digoxin (C) and Adenosine (D) are not indicated for treating shock in myocardial infarction as they have different mechanisms of action.