Cardiac
A client with a history of seizure disorder is prescribed valproic acid for maintenance therapy. The nurse notes that the client has also been prescribed warfarin for a coagulation disorder. What is the nurse's priority intervention?
Administer aspirin to further enhance anticoagulation.
Increase the warfarin dose to counteract the effects of valproic acid.
Discontinue valproic acid immediately to prevent toxicity.
Monitor the client’s INR and assess for signs of bleeding.
Monitor the client’s INR and assess for signs of bleeding.
Valproic acid can increase the anticoagulant effects of warfarin, raising the risk of bleeding. Monitoring INR and bleeding signs is critical.
What is the primary action of mucolytic medications in managing respiratory tract disorders?
Increasing bronchoconstriction for better airflow.
Suppressing cough reflex.
Breaking down mucus to improve airflow.
Increasing mucus production.
Breaking down mucus to improve airflow.
Mucolytic medications act by breaking down thickened mucus, thus reducing its viscosity and helping to clear it from the airways, which improves airflow.
A client is receiving chemotherapy and is prescribed filgrastim to support their immune system. The nurse should ensure the filgrastim is administered:
Simultaneously with an antiemetic
At least 24 hours after chemotherapy
During chemotherapy
24 hours before chemotherapy
At least 24 hours after chemotherapy
Administration 24 hours after chemotherapy reduces drug interaction and supports the recovery of neutrophil levels.
A client with a urinary tract infection is prescribed a combination of trimethoprim and sulfamethoxazole. What is the primary mechanism of action of this medication combination?
Prevents bacterial replication of nucleic acids
Disrupts bacterial DNA through free radical formation
Blocks protein synthesis at the ribosome
Inhibits bacterial cell wall synthesis
Prevents bacterial replication of nucleic acids
Trimethoprim-sulfamethoxazole interferes with folic acid synthesis, preventing nucleic acid replication.
A nurse is educating a client on ketoconazole therapy for histoplasmosis. Which point should the nurse emphasize regarding administration?
Take with dairy products to enhance effectiveness.
Increase intake of vitamin C to boost absorption.
Avoid antacids 2 hours before or after taking the medication.
Take on an empty stomach for better absorption.
Avoid antacids 2 hours before or after taking the medication.
Antacids can interfere with the absorption of ketoconazole, reducing its effectiveness.
Which medication combination would be most appropriate for a client with chronic stable angina to prevent myocardial infarction?
Antiplatelet, anticoagulant, and thrombolytic.
Beta-blocker, anticoagulant, and an antiarrhythmic.
Calcium channel blocker, nitrate, and a diuretic.
Aspirin, statin, and an ACE inhibitor.
Aspirin, statin, and an ACE inhibitor.
This combination helps prevent myocardial infarction by thinning the blood, lowering cholesterol, and reducing blood pressure.
A client with sinusitis complains of persistent nasal congestion despite using over-the-counter decongestants. What potential complication should the nurse identify if the client has used decongestants for more than 5 days?
Sinus rupture
Bacterial rhinitis
Respiratory alkalosis
Rebound congestion
Rebound congestion
Prolonged use of decongestants, especially nasal sprays, can lead to worsening nasal congestion due to a rebound effect.
A nurse is preparing to administer a monoclonal antibody to a client with advanced cancer. What is the primary action of monoclonal antibodies in cancer treatment?
They inhibit all cell division, regardless of cell type, to slow tumor growth.
They replace defective DNA in cancer cells, restoring normal function.
They enhance the radiosensitivity of cancer cells, improving the effectiveness of radiation therapy.
They target specific cancer cell antigens, leading to immune system activation against the cancer.
They target specific cancer cell antigens, leading to immune system activation against the cancer.
Monoclonal antibodies are designed to bind to specific antigens on cancer cells, marking them for destruction by the immune system.
A client taking nitrofuran for a lower urinary tract infection reports brownish urine. What should the nurse explain?
The dose needs to be adjusted
Report this to the healthcare provider immediately
This is an expected harmless side effect
Diarrhea is a common side effect
This is an expected harmless side effect
Nitrofuran can cause harmless discoloration of urine.
A client presents with suspected methicillin-resistant Staphylococcus aureus (MRSA) infection. Before starting antimicrobial therapy, which is the most appropriate nursing action?
Prescribe a broad-spectrum antibiotic to cover all possible pathogens.
Isolate the client in a negative-pressure room.
Obtain a specimen for culture and sensitivity testing.
Administer vancomycin immediately to address the MRSA infection.
Obtain a specimen for culture and sensitivity testing.
This ensures the causative pathogen is identified and the appropriate targeted therapy is selected.
Which lab result would indicate the effectiveness of enoxaparin therapy for a client with deep vein thrombosis?
An aPTT of 75 seconds.
A platelet count of 50,000/mm³
A decreasing D-dimer level.
An INR of 4.0
A decreasing D-dimer level.
A decreasing D-dimer level suggests successful resolution or control of clot formation, indicating effective enoxaparin therapy.
D dimer detects protein fragments created when a blood clot dissolves in your body
In the treatment of COPD, which class of medications is primarily used to dilate the bronchioles and optimize airflow?
Mucolytics.
Antibiotics.
Corticosteroids.
Beta-2 adrenergic agonists.
Beta-2 adrenergic agonists.
Beta-2 adrenergic agonists bind to specific receptors in the lungs, leading to bronchodilation and improved airflow.
What is the primary nursing safety consideration when handling biological therapy medications for cancer treatment?
Administering medications without PPE for better dexterity.
Preparing biological therapies in the same area as oral medications.
Wearing appropriate PPE and safely disposing of residual materials.
Ensuring biological therapies are stored at room temperature at all times.
Wearing appropriate PPE and safely disposing of residual materials.
Proper PPE use and safe disposal of materials are essential to limit exposure to potentially hazardous substances in biological therapy.
How do penicillins act to resolve urinary tract infections?
By altering bacterial folate pathways
By binding to bacterial ribosomes
By preventing bacterial cell wall synthesis
By damaging bacterial DNA
By preventing bacterial cell wall synthesis
Penicillins act by inhibiting the enzymes that form bacterial cell walls, leading to bacterial death.
Which precaution is most crucial for a client with a severe fungal infection treated with IV antifungals?
Monitor liver and kidney function regularly.
Avoid sunlight exposure to reduce skin reactions.
Limit fluid intake to prevent fluid overload.
Daily caloric intake should be increased to support infection healing.
Monitor liver and kidney function regularly.
IV antifungals can cause liver and kidney impairment, necessitating regular monitoring.
A client is being assessed for the appropriate use of antiplatelet therapy. Which statement indicates a correct understanding of antiplatelet medications?
They increase the viscosity of blood.
They inhibit platelet aggregation and prevent clot formation.
They actively break down existing clots.
They prevent the formation of fibrin clots.
They inhibit platelet aggregation and prevent clot formation.
Antiplatelet medications, such as aspirin and clopidogrel, prevent platelets from aggregating, thus inhibiting clot formation.
Which side effect is commonly associated with the long-term use of inhaled corticosteroids in respiratory disorders?
Increased mucus production.
Urinary retention.
Palpitations.
Oral thrush.
Oral thrush.
Long-term use of inhaled corticosteroids can lead to oral thrush due to the local immune-suppressing effects in the mouth.
A client receiving hematopoietic growth factor therapy reports bone pain. What is the most appropriate initial nursing intervention?
Encourage increased activity to reduce stiffness
Administer prescribed analgesics for pain relief
Reduce the dosage of the hematopoietic growth factor
Discontinue the therapy immediately
Administer prescribed analgesics for pain relief
Analgesics can effectively manage the bone pain associated with growth factor therapy.
A client is prescribed sucralfate for managing peptic ulcer disease (PUD). What is the primary action of this medication?
Stimulating serotonin receptors to enhance motility.
Neutralizing stomach acid directly.
Blocking proton receptors on parietal cells.
Creating a protective coating on the gastrointestinal mucosa.
Creating a protective coating on the gastrointestinal mucosa.
Sucralfate creates a protective barrier along the mucosa to prevent further damage from gastric acid.
For a client receiving biologic DMARDs, which co-prescribed medication could further elevate their infection risk?
Antihistamines
Antihypertensives
Corticosteroids
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Corticosteroids
Corticosteroids can suppress the immune system, compounding infection risk when combined with DMARDs.
A nurse is preparing to administer warfarin to a client. Which concurrent medication should prompt additional INR monitoring?
Levothyroxine
Amiodarone
Lisinopril
Furosemide
Amiodarone
Amiodarone can increase the anticoagulant effects of warfarin, necessitating tighter INR monitoring.
A client with a history of COPD reports black tarry stools. What potential medication side effect should the nurse consider?
Urinary retention from bronchodilators.
Gastrointestinal bleeding from corticosteroid use.
Infection from biologics.
Increased mucus production.
Gastrointestinal bleeding from corticosteroid use.
Corticosteroids can cause gastrointestinal bleeding, which may result in black tarry stools.
The nurse is caring for a client on erythropoietin-stimulating agents (ESAs). Which lab result would indicate the need to reduce the dosage?
White blood cell count of 5,000/μL
Platelet count of 150,000/μL
Hemoglobin level of 13 g/dL
Hemoglobin level of 9.5 g/dL
Hemoglobin level of 13 g/dL
A hemoglobin level above 12 g/dL increases the risk of adverse effects such as thromboembolism, requiring a dosage reduction.
A nurse is educating a client receiving proton pump inhibitors (PPIs). What contraindication must the nurse emphasize?
Concurrent use of PPIs with clopidogrel.
Simultaneous use with serotonin receptor agonists.
Using PPIs during pregnancy.
Taking PPIs with antacids.
Concurrent use of PPIs with clopidogrel.
PPIs can reduce the effectiveness of clopidogrel, potentially increasing cardiovascular risks.
What distinguishes carbapenems from other beta-lactam antibiotics?
Carbapenems do not contain a beta-lactam ring.
Carbapenems target viral cells in addition to bacteria.
Carbapenems lack activity against anaerobic organisms.
Carbapenems have a broader antimicrobial spectrum.
Carbapenems have a broader antimicrobial spectrum.
Carbapenems are beta-lactam antibiotics with a uniquely broad spectrum of activity, effective against diverse gram-positive and gram-negative organisms.