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The patient accidentally takes too much of the prescribed warfarin (Coumadin) and is readmitted to the hospital with bleeding. Which drug can the nurse anticipates administrating?
- A. Protamine sulfate
- B. Alteplase (Activase, Cathflo Activas
- D. Reteplase (Retavas
Correct Answer: D
Rationale: Warfarin, also known as Coumadin, is an anticoagulant medication that works by inhibiting the production of clotting factors in the liver, specifically factors II, VII, IX, and X. In the event of warfarin overdose, which can lead to excessive bleeding, the antidote is vitamin K. Vitamin K promotes the production of these clotting factors and helps reverse the effects of warfarin. Therefore, in this situation, the nurse can anticipate administering vitamin K to the patient to help stop the bleeding caused by the excess warfarin in the system.
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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.
Which patient-teaching instructions are appropriate for a patient taking an antidysrhythmic drug? (Select all that apply.)
- A. Do not chew or crush extende
- B. release forms of medication.
- C. Take the medication with food if gastrointestinal distress occurs.
- D. If a dose is missed, the missed dose should be taken along with the next dose that is due to be taken.
Correct Answer: A
Rationale: A. Do not chew or crush extended-release forms of medication. This is an appropriate instruction because chewing or crushing extended-release forms of medication can alter their intended time-release action, leading to an overdose or underdose.
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.
A patient is experiencing mucositis (stomatitis) after receiving chemotherapy. Which symptomatic treatments will be appropriate? (Select all that apply.)
- A. Frequent mouth rinses
- B. Antiemetics
- C. Topical anesthetics
- D. Stress reduction
Correct Answer: A
Rationale: Mucositis, or stomatitis, is a painful inflammation of the mucous membranes caused by chemotherapy. Frequent mouth rinses with saline or baking soda solutions help keep the mouth clean and promote healing. Topical anesthetics, such as lidocaine, can provide pain relief. Stress reduction techniques, such as relaxation or mindfulness, may help manage the discomfort associated with mucositis. Antiemetics are used to control nausea and vomiting, which are not directly related to mucositis. Antibiotics are only necessary if there is a secondary infection, which is not mentioned in this scenario.
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.