A client with Angina Pectoris asks the nurse about the next step if one tablet does not relieve Anginal pain after waiting 5 minutes. Which of the following responses should the nurse make?

Correct Answer: B

Rationale: In a situation where Anginal pain persists after taking one sublingual tablet and waiting 5 minutes, it is crucial to call emergency services (911) immediately. This could indicate a myocardial infarction (heart attack) rather than a typical Anginal attack. The client can take a second sublingual tablet while waiting for emergency assistance. If the pain persists after taking the second tablet, a third tablet can be taken after an additional 5 minutes. Prompt action is essential in such situations to ensure appropriate and timely medical intervention.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Take colesevelam with food and at least one glass of water. Colesevelam is a bile acid sequestrant that can bind to other drugs in the digestive tract, potentially decreasing their absorption. Taking it with food and water helps prevent this interaction, ensuring optimal absorption of both medications. Option A is incorrect because taking digoxin with colesevelam may lead to reduced digoxin absorption due to the binding effects of colesevelam. Option B is unrelated to the interaction between digoxin and colesevelam. Option C is not relevant to the instructions for taking colesevelam. From an educational perspective, it is crucial for nurses to understand drug interactions and how certain medications should be taken to maximize their effectiveness. Teaching patients about the proper administration of medications helps prevent adverse effects and ensures treatment success. This question highlights the importance of considering drug-drug interactions when managing a patient's medication regimen.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Omeprazole. Dabigatran is a direct thrombin inhibitor used for anticoagulation in conditions like atrial fibrillation. One common adverse effect of Dabigatran is gastrointestinal irritation, which can lead to gastritis or ulcers. Omeprazole is a proton pump inhibitor that helps reduce stomach acid production, thereby alleviating gastrointestinal symptoms associated with Dabigatran therapy. Option A) Vitamin K1 is used as an antidote for warfarin, a vitamin K antagonist, and is not indicated for the adverse effects of Dabigatran. Option B) Protamine is used to reverse the anticoagulant effects of heparin, not Dabigatran. Option D) Probenecid is a uricosuric agent used in gout to increase excretion of uric acid and is not relevant to the scenario. Educationally, this question highlights the importance of understanding not only the primary pharmacological actions of medications but also their potential adverse effects and how to manage them effectively to ensure patient safety and optimal outcomes. It underscores the need for healthcare providers to have a comprehensive knowledge of pharmacology to make informed clinical decisions.

Correct Answer: B

Rationale: The correct answer is to obtain help from another healthcare provider to confirm the correct client and blood product. This action is crucial in preventing an acute hemolytic reaction, which is caused by ABO or Rh incompatibility. Verifying the correct client and blood product before the transfusion ensures that there are no errors in identification, reducing the risk of a potentially life-threatening reaction.

Correct Answer: C

Rationale: In this scenario, the correct instruction that the nurse should provide is option C: Allow a 2-hour interval between taking sucralfate and phenytoin. This is because sucralfate can decrease the absorption of phenytoin due to its binding properties in the gastrointestinal tract, potentially leading to subtherapeutic levels of phenytoin and ineffective seizure control. By spacing out the administration of these medications by 2 hours, the interaction between sucralfate and phenytoin can be minimized, allowing for optimal absorption and effectiveness of both drugs. Option A (Take an antacid with sucralfate) is incorrect because combining sucralfate with an antacid can reduce its effectiveness by altering its pH-dependent mechanism of action. Option B (Take sucralfate with a glass of milk) is incorrect as milk may also interfere with the absorption of sucralfate. Option D (Chew the sucralfate thoroughly before swallowing) is incorrect because sucralfate should not be chewed but rather swallowed whole to ensure its proper functioning in coating the stomach lining. From an educational perspective, this question highlights the importance of understanding drug interactions and the significance of timing when administering medications that may interact with each other. Nurses must be knowledgeable about potential interactions to ensure the safety and efficacy of drug therapy for their patients.