Action of tranexamic acid

Correct Answer: C

Rationale: Tranexamic acid is an antifibrinolytic agent, which means it works by inhibiting the breakdown of blood clots. It does this by blocking the activation of plasmin, which is responsible for breaking down fibrin clots. This action helps in promoting clot stability and reducing bleeding. Tranexamic acid is commonly used to treat or prevent excessive bleeding in various conditions, such as heavy menstrual bleeding, surgery, trauma, and certain medical procedures.

Correct Answer: D

Rationale: These are direct oral anticoagulants (DOACs), which do not require regular INR monitoring.

Correct Answer: D

Rationale: In the emergency management of a patient with extremely high blood pressure, intravenous (IV) administration of nitroglycerin is the most appropriate form of delivery. IV infusion provides rapid and precise control of blood pressure by allowing the medication to take effect quickly and be titrated to the desired blood pressure level. This route of administration is crucial in acute settings like the emergency department, where immediate blood pressure management is needed. Other forms of nitroglycerin, such as sublingual spray, transdermal patch, or oral capsule, may not provide the rapid onset of action required in this critical situation.

Correct Answer: A

Rationale: ACE inhibitors, such as enalapril and lisinopril, work by blocking the enzyme angiotensin-converting enzyme (ACE), which is responsible for converting angiotensin I into angiotensin II. By inhibiting this conversion, ACE inhibitors prevent the vasoconstrictor and aldosterone-stimulating effects of angiotensin II at the receptor sites. This leads to vasodilation, decreased blood pressure, and reduced aldosterone secretion. This mechanism of action makes ACE inhibitors an important class of medications for managing conditions such as hypertension, heart failure, and chronic kidney disease.

Correct Answer: D

Rationale: Enteric-coated tablets should not be crushed or opened, as this disrupts their protective coating and can cause gastric irritation. The patient should be instructed to swallow the tablets whole with plenty of water or milk. Crushing (A) or opening the tablets (C) is inappropriate. Notifying the healthcare provider (B) may be necessary if the patient cannot tolerate the medication.

Correct Answer: D

Rationale: Depo-Provera, a progestin injection, provides contraception by inhibiting ovulation for 3 months , requiring re-administration every 12 weeks. This duration is based on its pharmacokinetic profile, ensuring reliable hormone levels. Two months underestimates, risking unprotected gaps. Six months or 1 year overestimate, reducing efficacy mid-cycle. The nurse's accurate response (D) educates the client on timing, ensuring adherence and preventing unintended pregnancy, aligning with clinical standards for injectable contraceptives.

Correct Answer: C

Rationale: Heparin is an anticoagulant medication that works by preventing the formation of blood clots. One of the main side effects of heparin therapy is an increased risk of bleeding. Since heparin inhibits the body's ability to clot blood, it can lead to easy bruising, nosebleeds, gastrointestinal bleeding, or bleeding at the injection site. Patients on heparin therapy must be closely monitored for signs of bleeding, and their dosage may need to be adjusted to minimize this risk.

Correct Answer: A

Rationale: This specificity allows the clinician to select a drug that will have the desired therapeutic effects without the undesired effects that occur when the entire sympathetic nervous system is blocked. In general, however, the specificity of adrenergic blocking agents depends on the concentration of drug in the body. Most specificity is lost with higher serum drug levels. The nurse should understand the importance of drug specificity to ensure safe and effective administration.

Correct Answer: C

Rationale: Carbon tetrachloride exposure causes nausea , reflecting GI and hepatic toxicity. Convulsions and stupor occur with high doses. Eye irritation and vomiting (E) are less specific. Low-dose ingestion aligns with nausea as a primary symptom.