Nokea
What is a side effect of Heparin?
- A. nausea
- B. diarrhea
- C. bleeding
- D. bronchospasms
Correct Answer: C
Rationale: A common side effect of Heparin, which is an anticoagulant medication, is the risk of bleeding. Heparin works by preventing the formation of blood clots, which can lead to a bleeding risk as it inhibits the normal clotting process. Patients taking Heparin should be monitored closely for signs of bleeding, such as easy bruising, prolonged bleeding from minor cuts, or blood in the urine or stools. It is important for healthcare providers to closely monitor patients on Heparin therapy and adjust the dosage as needed to minimize the risk of excessive bleeding.
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The pregnant patient tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. What is the best response by the nurse?
- A. This is because your blood volume has increased
- B. Tell me how you have been taking your medication
- C. This is because your baby is receiving part of the medication
- D. Maybe the medication has expired; check the label
Correct Answer: A
Rationale: Pregnancy increases blood volume (50% more), diluting drugs, reducing efficacy-e.g., lower concentration per unit volume, a pharmacokinetic shift. Asking about administration checks adherence, not cause. Baby receiving drug is unlikely-placental transfer varies. Expiration is a guess, not tied to pregnancy. Blood volume explains the change, addressing her concern.
Acyclovir has been ordered for a patient with genital herpes. Which nursing interventions are appropriate for this patient? (Select all that apply.)
- A. Monitor the patient’s blood urea nitrogen and creatinine.
- B. Monitor the patient’s blood pressure for hypertension.
- C. Administer intravenous acyclovir over 30 minutes.
- D. Advise maintenance of adequate fluid intake.
Correct Answer: A
Rationale: Acyclovir can cause nephrotoxicity, so monitoring blood urea nitrogen (BUN) and creatinine levels is essential. Hypertension is not a common side effect of acyclovir. Intravenous acyclovir should be administered over at least 1 hour to prevent renal toxicity. Adequate fluid intake helps prevent crystalluria and nephrotoxicity.
A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered
- A. . The patient asks the nurse why the medication is ordere
- B. What is the nurse™s best response?
- C. It will increase your heart rat
- D.
Correct Answer: B
Rationale: The correct response is to inform the patient that the medication, likely an antiarrhythmic agent such as digoxin immune fab (Digibind), helps to convert the irregular heart rhythm caused by digoxin toxicity to a more normal rhythm. This explanation provides a clear understanding of why the medication is being administered in cases of digoxin toxicity. It is important for the nurse to educate the patient about the purpose of the medication and how it will help manage the symptoms of digoxin toxicity.
If you inject a drug with a pH of 6.5 and pka of 8.1 into a tissue with a pH of 7.4, to what extent would you expect this drug to be ionized in the tissue?
- A. over 50%
- B. 50%
- C. under 50%
- D. 100%
Correct Answer: A
Rationale: The percentage of ionization of a weak acid or base can be estimated using the Henderson-Hasselbalch equation:
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.