A 78-year-old woman with ovarian cancer and pancreatitis is hospitalized for acute treatment of a massive pulmonary embolism. She is immediately given an intravenous dose of alteplase once the diagnosis of pulmonary embolism was made. Characteristics of this agent include which of the following?

Correct Answer: D

Rationale: Alteplase treats pulmonary embolism by dissolving clots. Success at clot resolution is correct-it converts plasminogen to plasmin, breaking fibrin. Option , free plasminogen, is less specific than its fibrin-bound action. Option , high antigenicity, and , low specificity, are false-alteplase is fibrin-specific and recombinant. Option (E), long half-life, isn't true. Its efficacy in clot lysis is key in this acute setting.

Correct Answer: B

Rationale: Meperidine hydrochloride (Demerol) is an opioid analgesic commonly used for post-operative pain management. The common side effects of meperidine include tremors, sweating, and dizziness. Diarrhea is not a common side effect associated with meperidine use. Opioid analgesics like meperidine more commonly cause constipation rather than diarrhea. Therefore, choice B is the correct answer as the side effect of diarrhea is not typically seen with meperidine administration.

Correct Answer: A

Rationale: Warfarin is an anticoagulant medication that works by inhibiting the action of vitamin K, reducing blood clotting. In cases of Warfarin overdose or excessive anticoagulation resulting in bleeding complications, the antidote is vitamin K. Vitamin K helps the liver produce clotting factors, which can counteract the effects of Warfarin and restore normal blood clotting. Other options such as Naloxone, Digibind, and Flumazenil are antidotes used for specific situations like opioid overdose, digoxin toxicity, and benzodiazepine overdose, respectively, and are not relevant for Warfarin antidote.

Correct Answer: D

Rationale: In the case of a Heparin overdose, the antidote of choice is Protamine sulfate. Heparin is a commonly used anticoagulant medication, and if an overdose occurs leading to excessive bleeding, Protamine sulfate can be administered to reverse the effects of Heparin by neutralizing its anticoagulant activity. It forms a complex with Heparin, rendering it inactive and helping to slow down or stop the bleeding. Naloxone is used as an antidote for opioid overdose, Ibutilide is used for arrhythmias, and Methylphenidate is a central nervous system stimulant commonly used to treat ADHD. But these antidotes are not appropriate for reversing the effects of a Heparin overdose.

Correct Answer: D

Rationale: Terfenadine is a second-generation antihistamine, but it is not an H1 receptor antagonist like the other options listed. Terfenadine was once used for the treatment of allergic conditions, but it is known for its potential to cause cardiac side effects due to its interaction with other medications and prolongation of the QT interval. Consequently, terfenadine has been largely replaced by newer, safer antihistamines. The rest of the options listed (chlorpheniramine, promethazine, cimetidine, and diphenhydramine) are all H1 receptor antagonists commonly used to block the action of histamine and relieve symptoms of allergies.

Correct Answer: C

Rationale: Aspirin causes gastrointestinal upset because it inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. These enzymes are responsible for the production of prostaglandins, which are important in protecting the stomach lining. Inhibition of COX-1 reduces the production of protective prostaglandins that help maintain the integrity of the stomach lining, leading to irritation and potential damage, which can manifest as gastrointestinal upset. This is why patients taking aspirin may experience gastrointestinal side effects such as stomach pain, ulcers, or bleeding.

Correct Answer: B

Rationale: The nurse's best response would be, It takes 6 to 8 weeks to see a change in cholesterol levels. Statin drugs typically start to show an effect on lowering cholesterol levels within 6 to 8 weeks of starting therapy. It may take some time for the medication to reach its maximum effectiveness, but a noticeable change can usually be seen within this time frame. Monitoring cholesterol levels through blood tests is important to assess the effectiveness of the medication and make any necessary adjustments to the treatment plan.

Correct Answer: B

Rationale: Therapeutic range balances efficacy-treating the condition (indication)-with safety, avoiding serious side effects, a clinical goal. No adverse effects alone doesn't confirm efficacy. Dose amount doesn't ensure range. Effectiveness with lethal effects exceeds range. Achieving indication safely defines therapeutic success, per pharmacology.

Correct Answer: D

Rationale: Alteplase treats pulmonary embolism by dissolving clots. Success at clot resolution is correct-it converts plasminogen to plasmin, breaking fibrin. Option , free plasminogen, is less specific than its fibrin-bound action. Option , high antigenicity, and , low specificity, are false-alteplase is fibrin-specific and recombinant. Option (E), long half-life, isn't true. Its efficacy in clot lysis is key in this acute setting.