The patient accidentally takes too much of the prescribed warfarin (Coumadin) and is readmitted to the hospital with bleeding. Which drug can the nurse anticipates administrating?

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: C

Rationale: Codeine sulfate, a narcotic analgesic, commonly causes constipation as a side effect. It works by binding to opioid receptors in the central nervous system, which can slow down gastrointestinal motility, leading to constipation. Clients taking codeine sulfate should be advised to increase their fluid intake, eat high-fiber foods, and possibly use stool softeners to prevent or alleviate constipation. Monitoring for constipation and providing appropriate interventions are essential to improve the client's comfort and prevent complications.

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: B

Rationale: Methylphenidate boosts dopamine in prefrontal cortex, enhancing focus/attention in ADHD-per neuroscience-not blocking PNS, reducing levels, or deactivating areas. Activation explains efficacy, per mechanism.

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: B

Rationale: Metformin (Glucophage) is a biguanide medication used to manage type 2 diabetes. While it is generally well-tolerated, one of its rare but serious adverse effects is lactic acidosis, a condition characterized by the buildup of lactic acid in the bloodstream. This can occur in patients with renal impairment or other risk factors. Hypoglycemia is uncommon with metformin alone, and GI distress, though common, is not life-threatening. Somnolence is not typically associated with metformin. Therefore, lactic acidosis is the most specific and serious adverse effect.

Correct Answer: C

Rationale: Unusual nitroglycerin reactions (itching, toe pain) unwitnessed by family suggest noncompliance or psychogenic issues. Encourage use and explore reasons . Psychiatric or behavioral consults are premature. Switching or antipsychotics (E) ignores clarification. This approach ensures proper angina management.

Correct Answer: A

Rationale: Finasteride, a 5-alpha reductase inhibitor, is prescribed as Proscar for benign prostatic hyperplasia (BPH) but also as Propecia for male pattern baldness, reducing dihydrotestosterone levels to slow hair loss. Without a prostate disorder, baldness becomes a plausible alternative indication. Erectile dysfunction isn't treated by finasteride-it may even cause it as a side effect-making that question irrelevant. Stomach ulcers and high blood pressure have no connection to finasteride's mechanism, which targets androgen pathways, not gastrointestinal or cardiovascular systems. Asking about baldness aligns with finasteride's dual use, probing a condition tied to its action on hair follicles, offering a logical explanation for its prescription in the absence of BPH, and guiding the nurse's understanding of the client's treatment rationale.

Correct Answer: C

Rationale: Chronic renal failure impairs kidney excretion, critical for drugs cleared renally-like metformin-raising toxicity risk if doses aren't adjusted, a targeted concern. Liver compensation aids metabolism, not excretion, so effectiveness isn't assured. Toxicity from all drugs assumes universal renal clearance, too broad. Decreased effectiveness ignores accumulation risks. Assessing for renal-excreted drugs' toxicity aligns with kidney function's role, ensuring safety by checking specific drug profiles.