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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.
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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.
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.
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.
A patient is receiving an IV infusion of a thrombolytic drug during treatment for an acute MI. The nurse notices that there is a slight amount of bleeding from the antecubital area where venous lab work was drawn. What will the nurse do first?
- A. Monitor the site for further bleeding.
- B. Apply pressure to the site with a gauze pa
- D. Slow the rate of infusion of the thrombolytic drug.
Correct Answer: B
Rationale: Applying pressure to the site with a gauze pad is the first action the nurse should take when noticing bleeding from the antecubital area. This will help control the bleeding and prevent further blood loss. Monitoring the site for further bleeding is important, but immediate intervention by applying pressure is necessary to address the issue. Slowing the rate of infusion of the thrombolytic drug or stopping the infusion should be considered if bleeding continues despite applying pressure or if there are signs of significant bleeding or hemorrhage.
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.