A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse™s response is based on which rationale?

Correct Answer: D

Rationale: Heparin is a fast-acting, short-term anticoagulant that is often used to rapidly initiate anticoagulation in situations where immediate blood thinning is necessary, such as in patients with certain medical conditions or undergoing procedures. On the other hand, warfarin (Coumadin) is a slower-acting, longer-term anticoagulant that takes time to reach therapeutic levels in the bloodstream. By using heparin to start anticoagulation, the patient is protected against clot formation while waiting for the warfarin to reach adequate levels to provide ongoing anticoagulation therapy. This approach minimizes the risk of clot formation during the transition period between medications.

Correct Answer: C

Rationale: An agonist is a substance that binds to a receptor and activates it, leading to a biological response. Agonists mimic the action of endogenous ligands that normally bind to the receptor, resulting in activation of downstream signaling pathways. This activation can lead to various physiological effects depending on the specific receptor and pathway involved. In contrast, antagonists block or inhibit the actions of agonists by binding to the receptor without activating it, therefore not producing a response. Therefore, the correct answer is that an agonist activates a receptor.

Correct Answer: C

Rationale: Phenytoin is commonly used as an anticonvulsant and antiarrhythmic medication. In addition to its approved uses, phenytoin has demonstrated effectiveness in managing neuropathic pain, which is pain caused by damage or dysfunction of the nervous system. While this use for phenytoin is off-label, it has been shown to be beneficial in certain individuals with neuropathic pain conditions. However, it is essential for a healthcare provider to prescribe phenytoin off-label for neuropathic pain, as the dosage and monitoring may differ from its standard use for epilepsy and arrhythmias.

Correct Answer: C

Rationale: Nitroglycerin is an antianginal medication that belongs to the class of nitrates. It is used to relieve chest pain or angina by dilating blood vessels, which reduces the workload of the heart and improves blood flow to the heart muscle. Nitroglycerin helps to relax and widen blood vessels, increasing the supply of oxygen and blood to the heart. It is often used for the treatment and prevention of angina attacks. In contrast, options A, B, and D are not antianginal medications or nitrates.

Correct Answer: C

Rationale: Paradoxical bronchospasm is a major side effect of Albuterol, which is a medication commonly used to treat bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease (COPD). It is characterized by a sudden worsening of breathing difficulty after using the medication, rather than an improvement. This adverse reaction can be serious and requires immediate medical attention. It is crucial for healthcare providers to monitor patients for this side effect when using Albuterol to ensure proper management and prevent complications.