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What should be monitored to evaluate the effectiveness of enoxaparin in a patient with deep vein thrombosis (DVT)?
- A. Prothrombin time (PT)
- B. Partial thromboplastin time (PTT)
- C. International normalized ratio (INR)
- D. Platelet count
Correct Answer: C
Rationale: Rationale:
1. Enoxaparin is a low molecular weight heparin that primarily affects the intrinsic pathway of coagulation.
2. INR is used to monitor the effectiveness of anticoagulants affecting the intrinsic pathway.
3. Monitoring INR helps ensure the patient is within the therapeutic range to prevent clotting without excessive bleeding.
4. PT and PTT primarily evaluate the extrinsic and intrinsic pathways, respectively, not specific to enoxaparin.
5. Platelet count is not directly related to monitoring the effectiveness of enoxaparin in treating DVT.
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A patient with type 2 diabetes is prescribed metformin. What instruction should the nurse provide regarding this medication?
- A. Take the medication on an empty stomach.
- B. Monitor for signs of hypoglycemia.
- C. Take the medication with meals.
- D. Increase intake of simple carbohydrates.
Correct Answer: C
Rationale: Step-by-step rationale for choice C:
1. Metformin can cause gastrointestinal side effects.
2. Taking it with meals helps reduce stomach upset.
3. It also helps in better absorption and effectiveness.
4. Therefore, the nurse should instruct the patient to take metformin with meals.
Summary of other choices:
A: Taking on an empty stomach can worsen gastrointestinal side effects.
B: Metformin doesn't typically cause hypoglycemia.
D: Increasing simple carbohydrates can counteract the effects of metformin.
A patient with severe pain is prescribed morphine sulfate. What is the most important side effect for the nurse to monitor?
- A. Diarrhea
- B. Hypertension
- C. Respiratory depression
- D. Increased urine output
Correct Answer: C
Rationale: The correct answer is C: Respiratory depression. Morphine sulfate is an opioid analgesic that can suppress the respiratory drive, leading to respiratory depression, which can be life-threatening. Monitoring respiratory status is crucial to prevent complications.
Incorrect choices:
A: Diarrhea - While constipation is a common side effect of opioid use, diarrhea is not a significant concern compared to respiratory depression.
B: Hypertension - Morphine can cause hypotension rather than hypertension, so monitoring blood pressure for hypertension is not the priority.
D: Increased urine output - Morphine can actually cause urinary retention, so increased urine output is not a key side effect to monitor.
What is the primary action of amlodipine when prescribed to a patient with hypertension?
- A. Increase heart rate
- B. Reduce blood pressure
- C. Lower cholesterol levels
- D. Decrease blood sugar levels
Correct Answer: B
Rationale: The primary action of amlodipine is to reduce blood pressure by relaxing and dilating blood vessels, leading to improved blood flow and lower blood pressure. This is achieved by blocking calcium channels in the blood vessels. Increasing heart rate (A), lowering cholesterol levels (C), and decreasing blood sugar levels (D) are not the primary actions of amlodipine and are not directly related to its mechanism of action in treating hypertension.
A patient with rheumatoid arthritis is prescribed methotrexate. What is an important teaching point for the nurse to provide?
- A. Take folic acid supplements as prescribed.
- B. Avoid alcohol completely.
- C. Expect to see immediate results.
- D. Limit fluid intake to 1 liter per day.
Correct Answer: A
Rationale: The correct answer is A: Take folic acid supplements as prescribed. Methotrexate can lead to folic acid deficiency, causing side effects. Supplementing with folic acid can help manage these side effects. It is crucial for the nurse to emphasize the importance of taking folic acid as prescribed to prevent adverse effects.
Summary of Incorrect Choices:
B: Avoid alcohol completely - While alcohol should be limited or avoided due to potential liver toxicity with methotrexate, complete avoidance may not be necessary for all patients.
C: Expect to see immediate results - Methotrexate takes time to work, and patients should not expect immediate results. Patience is necessary.
D: Limit fluid intake to 1 liter per day - There is no specific guideline to limit fluid intake with methotrexate. Adequate hydration is important for overall health.
A patient with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. What is the primary action of this medication?
- A. Reduce inflammation
- B. Relieve bronchospasm
- C. Suppress cough
- D. Thin respiratory secretions
Correct Answer: B
Rationale: The correct answer is B: Relieve bronchospasm. Ipratropium is an anticholinergic bronchodilator that works by relaxing the muscles in the airways, leading to bronchodilation and improved airflow. This helps to relieve bronchospasm, a common symptom in COPD. Choice A is incorrect because ipratropium does not have significant anti-inflammatory effects. Choice C is incorrect as ipratropium does not directly suppress cough. Choice D is incorrect as ipratropium does not specifically target respiratory secretions.