A 74-year-old woman with a history of atrial fibrillation presents to the emergency department after bowel movement with bright red blood. Her blood pressure is 88/56 mm Hg with a pulse of 118 beats/minute. She is on warfarin for anticoagulation and a stat INR is 7.2. The decision is made to start transfusing blood. What is the most appropriate treatment to reverse the warfarin?

Correct Answer: D

Rationale: In this scenario, the most appropriate treatment to reverse the effects of warfarin in the patient with a significantly elevated INR of 7.2 is option D) Vitamin K. Vitamin K is the antidote for warfarin as it helps in the synthesis of clotting factors, thereby restoring the coagulation cascade. Fresh frozen plasma (option A) contains various clotting factors but is not the first-line agent for warfarin reversal. Platelet transfusion (option B) is not indicated in warfarin reversal as warfarin affects clotting factors rather than platelet function. Protamine sulfate (option C) is the antidote for heparin, not warfarin. From an educational perspective, it is crucial for healthcare providers to understand the specific antidotes for various anticoagulants to effectively manage patients presenting with bleeding complications. Understanding the mechanism of action of different antidotes and their appropriate use is essential in clinical practice to ensure patient safety and positive outcomes. Regular review and practice of such scenarios can enhance healthcare professionals' confidence and competence in managing emergency situations effectively.

Correct Answer: D

Rationale: Dextromethorphan (DM), a cough suppressant, can cause dizziness, hallucinations, and confusion, especially with alcohol, which amplifies CNS depression . Dialysis isn't standard for DM overdose; it's not an opioid , though it acts centrally; and addiction isn't the acute issue. The nurse considers dizziness as a key adverse effect, worsened by beer, guiding a response to seek medical help.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Actifed Plus. Actifed Plus is an over-the-counter antihistamine combination that contains an analgesic property, specifically the analgesic pseudoephedrine. Pseudoephedrine is a decongestant with analgesic properties commonly used to relieve sinus congestion and pain. Option A) Sudafed PE Sinus and Allergy contains phenylephrine, which is a decongestant but lacks analgesic properties. Option B) Triaminic Cold/Allergy contains chlorpheniramine, an antihistamine, but does not have analgesic properties. Option C) Tavist Allergy 12-hour contains clemastine, an antihistamine without analgesic properties. Educationally, understanding the components of common OTC medications is essential for healthcare professionals to make informed recommendations to patients. Knowing the specific properties of each medication helps in proper selection based on patient symptoms and conditions. In this case, recognizing that Actifed Plus contains both an antihistamine and an analgesic component is crucial for addressing allergy symptoms accompanied by pain or discomfort effectively.

Correct Answer: A

Rationale: Mannitol, an osmotic diuretic, reduces cerebral edema by drawing fluid into the vasculature, excreted via urine. Monitoring urine output ensures efficacy and prevents fluid overload or renal strain, critical in brain injury. BP and pupils matter but follow diuresis. Temperature is unrelated. Urine output aligns with mannitol's action, key in cerebral edema where ICP reduction hinges on fluid shift, making A the priority parameter.

Correct Answer: C

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