A patient who is taking clopidogrel (Plavix) and aspirin is preparing for orthopedic surgery. The nurse will consult with the surgeon and provide which instruction to the patient?

Correct Answer: A

Rationale: The correct instruction for the patient taking clopidogrel (Plavix) and aspirin prior to orthopedic surgery is to continue taking aspirin and stop taking clopidogrel 2 weeks before the surgery. This recommendation is based on the pharmacokinetics of clopidogrel, which has a longer duration of action and requires a longer timeframe for platelet function to return to baseline after discontinuation. Aspirin, on the other hand, has a shorter duration of action, and its antiplatelet effects diminish more rapidly once it is stopped. By continuing aspirin and stopping clopidogrel 2 weeks before surgery, the patient can minimize the risk of excessive bleeding during the surgical procedure while still maintaining some level of antiplatelet effect to prevent thrombotic events.

Correct Answer: C

Rationale: Pregnancy limits arthritis options-splinting supports joints safely, per non-drug care. Heat helps, not avoided. Hydroxychloroquine needs caution (Category C). Glucocorticoids (D) risk cleft palate-unsafe. Splinting fits pregnancy, per safety.

Correct Answer: B

Rationale: The presence of small crystals in the IV tubing indicates that the mannitol solution is not suitable for administration due to the risk of causing adverse effects to the patient. Discarding the solution and obtaining a new bag of medication is the most appropriate action to ensure the safety and effectiveness of the infusion. Infusing a solution with crystals can lead to complications such as embolism or tissue damage. It is important to always verify the integrity and clarity of IV solutions before administration to prevent potential harm to the patient.

Correct Answer: D

Rationale: Antiepileptics vary in side effects. Valproate causes tremor or hepatotoxicity, not visual defects. Carbamazepine risks rash or hyponatremia, not eyes. Lamotrigine is linked to rash, tiagabine to dizziness, without visual impact. Vigabatrin, a GABA-transaminase inhibitor, causes irreversible concentric visual field defects in ~30-40% of users due to retinal toxicity, a unique and serious adverse effect. This necessitates ophthalmologic monitoring, distinguishing it in epilepsy treatment choices.

Correct Answer: A

Rationale: Albuterol is a medication commonly used to treat asthma and other respiratory conditions. It works by relaxing the muscles in the airways, allowing the air passages to widen and making it easier to breathe. This bronchodilation effect helps to relieve symptoms such as wheezing, shortness of breath, and chest tightness. Albuterol is classified as a short-acting beta-agonist, and its therapeutic use lies in its ability to provide quick relief during acute asthma attacks or to prevent exercise-induced bronchospasm.