An older adult patient with a hip fracture became unresponsive 20 minutes after receiving morphine 3 mg intravenously. Which actions would the nurse take?

Correct Answer: C

Rationale: The patient's unresponsiveness after receiving morphine is likely due to opioid-induced respiratory depression, a potentially life-threatening side effect. The nurse should first assess the patient's airway, breathing, and circulation (ABCs) and call for additional assistance. Supporting breathing with a bag-valve-mask device is critical to ensure adequate oxygenation. Naloxone, an opioid antagonist, should be prepared to reverse the effects of morphine. Flumazenil (A) is used for benzodiazepine overdose, not opioids. Reporting a stroke (B) is incorrect because the symptoms are consistent with opioid toxicity, not a stroke. Explaining unresponsiveness as a desired outcome (D) is inappropriate and dangerous.

Correct Answer: B

Rationale: - Antacids can reduce the absorption of tetracycline when taken together. It is recommended to separate the administration of tetracycline and antacids by at least 2-3 hours to minimize this interaction.

Correct Answer: D

Rationale: Kallidin is a peptide, specifically a kinin, and is not classified as an eicosanoid. Eicosanoids are a group of lipid mediators derived from arachidonic acid or other fatty acids, including prostaglandins, prostacyclin, thromboxane, and leukotrienes. Although kallidin also plays a role in inflammation and vasodilation like some eicosanoids, it is not part of the eicosanoid family.

Correct Answer: D

Rationale: Milrinone and furosemide are two medications that are known to interact when mixed together in the same intravenous line. Milrinone is a phosphodiesterase inhibitor that works to increase cardiac contractility and output, while furosemide is a loop diuretic used to promote diuresis. When mixed together, the pH level of the solution can become altered, leading to potential precipitation or inactivation of one or both drugs.

Correct Answer: C

Rationale: Propranolol is the drug that undergoes extensive first-pass hepatic metabolism. First-pass metabolism refers to the metabolism of a drug by the liver before it enters the systemic circulation. In the case of propranolol, a significant portion of the drug is metabolized by the liver before reaching the systemic circulation, leading to reduced bioavailability. This is why propranolol is often given in higher doses to achieve the desired therapeutic effect. Heparin, insulin, nitroglycerine, and warfarin do not undergo significant first-pass metabolism by the liver.

Correct Answer: A

Rationale: When a patient is on Warfarin therapy, the two primary tests that need to be monitored are the Prothrombin Time (PT) and the International Normalized Ratio (INR). Warfarin works by inhibiting the activity of Vitamin K-dependent clotting factors, and both PT and INR are measures of the extrinsic pathway of coagulation, which is primarily affected by Warfarin. PT measures the time it takes for blood to clot, while INR is a standardized calculation based on the PT value to monitor the effectiveness and safety of Warfarin therapy. Monitoring these tests helps ensure that the patient's blood is not too thick (increased risk of clotting) or too thin (increased risk of bleeding) while on Warfarin.

Correct Answer: B

Rationale: The Drug Enforcement Administration (DEA) is the agency responsible for enforcing the control of drugs considered to have a potential for abuse in the United States. It is the primary federal agency involved in combating drug trafficking and the illegal distribution of controlled substances. The DEA works to regulate and enforce the Controlled Substances Act, which classifies drugs into different schedules based on their accepted medical use and potential for abuse and addiction. This agency plays a crucial role in preventing the diversion and misuse of controlled substances, as well as ensuring public safety and health.

Correct Answer: C

Rationale: The patient's unresponsiveness after receiving morphine is likely due to opioid-induced respiratory depression, a potentially life-threatening side effect. The nurse should first assess the patient's airway, breathing, and circulation (ABCs) and call for additional assistance. Supporting breathing with a bag-valve-mask device is critical to ensure adequate oxygenation. Naloxone, an opioid antagonist, should be prepared to reverse the effects of morphine. Flumazenil (A) is used for benzodiazepine overdose, not opioids. Reporting a stroke (B) is incorrect because the symptoms are consistent with opioid toxicity, not a stroke. Explaining unresponsiveness as a desired outcome (D) is inappropriate and dangerous.

Correct Answer: A

Rationale: Iron supplements are known to commonly cause gastrointestinal side effects, such as constipation, upset stomach, and nausea. Constipation is a common side effect of iron supplements due to the way iron can harden the stool and slow down bowel movements. Upset stomach and nausea can occur because iron supplements can irritate the stomach lining, leading to discomfort and feelings of queasiness. It is important for individuals taking iron supplements to be aware of these potential side effects and to speak with their healthcare provider if they are experiencing severe or persistent symptoms.