The nurse should teach a patient to take their own pulse with which medication? (Hint: if pulse is <60 or >100, the patient should contact their health care provider before taking the medication)

Correct Answer: A

Rationale: Digoxin is a medication commonly prescribed to patients with heart conditions, such as heart failure and certain types of irregular heartbeats. It primarily works by slowing down the heart rate and increasing the strength of the heart's contractions. This is why patients taking digoxin are typically taught to monitor their own pulse regularly to ensure it stays within a safe range.

Correct Answer: B

Rationale: Epinephrine can compromise the stability of a formed blood clot because it is a fibrinolytic agent. Fibrinolysis is the process of breaking down fibrin, the main protein component of blood clots, and promoting the dissolution of the clot. Epinephrine is a hormone that acts on adrenergic receptors, including beta-2 adrenergic receptors, which can trigger the activation of fibrinolysis pathways. By promoting fibrinolysis, epinephrine can weaken and compromise the stability of a formed blood clot, leading to potential clot breakdown and increased risk of bleeding. This mechanism is important to consider when using epinephrine in situations where clot stability is crucial, such as in patients with bleeding disorders or undergoing surgery.

Correct Answer: D

Rationale: Mefenamic acid is not a phenylpropionic derivative. It is classified as a fenamate, structurally related to fenamic acid. The other options (A. ibuprofen, B. fenoprofen, C. naproxen) are all examples of phenylpropionic derivatives, commonly referred to as propionic acids. These drugs have similar chemical structures and mechanisms of action, making them a distinct group within the nonsteroidal anti-inflammatory drug (NSAID) class.

Correct Answer: A

Rationale: Cephalosporins are antibiotics that can cause nephrotoxicity, particularly in patients with pre-existing renal impairment. Monitoring renal function is essential to detect any decline in kidney function early. Liver function studies are also important because cephalosporins can occasionally cause hepatotoxicity. Intravenous cephalosporins should be infused over 30 minutes to ensure proper absorption and minimize adverse effects. Mouth ulcers are not a common side effect of cephalosporins, but monitoring for superinfections, such as oral thrush, is important. Advising the patient to stop the medication when they feel better is incorrect, as it can lead to antibiotic resistance.

Correct Answer: B

Rationale: Beta-adrenergic blocking agents are contraindicated in patients with bradycardia, heart failure, and heart block. The drug would not be contraindicated in the other patients. The nurse should assess the patient’s medical history and contraindications before administering propranolol to ensure safe and effective treatment.