The nurse notes in the patient™s medication orders that the patient will be starting anticoagulant therapy. What is the primary goal of anticoagulant therapy?

Correct Answer: C

Rationale: The primary goal of anticoagulant therapy is to prevent the formation of blood clots or thrombus. Anticoagulants work by inhibiting the coagulation cascade, which ultimately prevents the blood from clotting too easily. By preventing the formation of clots, anticoagulant therapy helps reduce the risk of conditions such as deep vein thrombosis, pulmonary embolism, stroke, and heart attack, which are all associated with blood clot formation. Anticoagulant therapy does not stabilize or dissolve existing clots but rather focuses on preventing new clots from forming. Dilating the vessel around a clot is not the primary purpose of anticoagulant therapy.

Correct Answer: D

Rationale: Low-molecular-weight heparin is commonly administered to postoperative patients to help prevent thrombus formation caused by slow venous blood flow. This medication works by inhibiting the formation of blood clots. It is considered safer and more effective than unfractionated heparin in preventing venous thromboembolism in surgical patients. Aspirin and clopidogrel are antiplatelet medications that are more commonly used for preventing arterial thrombosis rather than venous thrombosis. Alteplase is a thrombolytic medication used to dissolve existing blood clots, rather than prevent their formation.

Correct Answer: B

Rationale: Fluphenazine, a high-potency first-generation antipsychotic, strongly blocks D2 receptors, requiring lower doses for efficacy but increasing EPS risk (e.g., dystonia, parkinsonism) due to intense dopamine antagonism in the nigrostriatal pathway. Thioridazine and chlorpromazine, low-potency first-generation drugs, have weaker D2 affinity, causing more sedation and anticholinergic effects than EPS. Quetiapine, a second-generation antipsychotic, has low D2 potency and minimal EPS. Clozapine avoids EPS with broad receptor activity. Fluphenazine's potency, measured by dose equivalence and clinical data, correlates with its elevated EPS risk, distinguishing it here.

Correct Answer: A

Rationale: Theophylline, a bronchodilator, treats COPD but has a narrow therapeutic range (10-20 mcg/mL). Monitoring theophylline levels prevents toxicity (e.g., seizures, tachycardia) or subtherapeutic dosing, ensuring efficacy. Sodium , glucose , and platelets aren't directly impacted. Blood level checks align with theophylline's pharmacokinetics'hepatic metabolism, variable clearance'critical in COPD where respiratory support hinges on precision. This focus prevents adverse outcomes, making A the key value to monitor for safe, effective therapy.

Correct Answer: D

Rationale: In the scenario described where the patient has accidentally taken too much warfarin (Coumadin) and is experiencing bleeding, the nurse can anticipate administering Vitamin K. Warfarin is an anticoagulant medication that works by inhibiting vitamin K-dependent clotting factors in the liver. By administering Vitamin K, it helps reverse the anticoagulant effect of warfarin by supplying the needed vitamin K for the production of clotting factors. This aids in the clotting process and helps to stop the bleeding that may occur due to excess warfarin in the system. Other medications listed (such as Protamine sulfate, Alteplase, Reteplase) are not specific antidotes for warfarin overdose-related bleeding but are used for different therapeutic purposes.

Correct Answer: B

Rationale: St. John's Wort is known to interact with phenytoin, a drug commonly used to treat seizures. St. John's Wort can decrease the effectiveness of phenytoin by increasing its metabolism in the liver. This interaction can lead to lower levels of phenytoin in the bloodstream, potentially reducing its therapeutic effects and increasing the risk of seizure recurrence. It is important for individuals taking phenytoin to avoid using St. John's Wort to prevent this drug interaction.

Correct Answer: B

Rationale: Fexofenadine for allergies may cause headache , a frequent side effect of this non-sedating antihistamine. Flank pain , otitis , infection , and tinnitus (E) are rare. Headache monitoring ensures safe symptom relief.

Correct Answer: C

Rationale: Lactic acidosis is an adverse effect specific to the biguanide diabetic drug metformin. It is a rare but serious complication associated with the use of metformin. Lactic acidosis occurs when there is a buildup of lactate in the body, leading to a decrease in pH levels. This condition can be life-threatening and requires immediate medical attention. Symptoms of lactic acidosis include rapid breathing, muscle pain or weakness, abdominal pain, dizziness, and irregular heartbeat. It is important for individuals taking metformin to be aware of the signs and symptoms of lactic acidosis and seek medical help if they experience them.

Correct Answer: D

Rationale: Oxymetazoline causes rebound congestion if used beyond 3-5 days. Asking 'How long have you been using the medication?' identifies misuse, the likely cause of worsening symptoms. Bottle age , temperature , and other medications are secondary. D targets the root issue, making it the best question.