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: B

Rationale: Mannitol works osmotically, increasing urine flow without binding to receptors. Others rely on receptor or enzyme-based actions.

Correct Answer: B

Rationale: Aspirin, or acetylsalicylic acid, is metabolized to salicylic acid and acetic acid, not acetone, making the hydrolysis statement false. At low doses, it follows first-order kinetics, where elimination rate is proportional to concentration, a true statement reflecting its predictable clearance under therapeutic levels. It's primarily conjugated in the liver (e.g., to salicyluric acid), but excreted mainly via urine, not bile, so that's false. Aspirin irreversibly inhibits cyclooxygenase (COX) by acetylating it, unlike reversible NSAIDs, making that option false. The correct answer highlights aspirin's pharmacokinetic behavior at low doses, critical for its use in analgesia or cardioprotection, where steady-state effects depend on consistent elimination, contrasting with zero-order kinetics at overdose levels.

Correct Answer: B

Rationale: Atropine is a mydriatic agent that dilates the pupil and can precipitate angle-closure glaucoma in patients with a narrow anterior chamber angle. Therefore, it is critical to inform the ophthalmologist if the patient has a history of angle-closure glaucoma. Cataracts (A), open-angle glaucoma (C), and macular degeneration (D) are not contraindications for the use of atropine.

Correct Answer: D

Rationale: Lanoxin (digoxin) is a medication commonly used to treat heart failure and arrhythmias. The order specifies the dosage and timing but does not indicate the route of administration. Since digoxin can be administered orally, intravenously, or intramuscularly, the nurse must clarify the route with the prescriber to ensure safe and accurate administration. Administering the medication via the wrong route could lead to serious complications, such as toxicity or ineffective treatment. Therefore, contacting the prescriber for clarification is the correct and safest action for the nurse to take.

Correct Answer: B

Rationale: Protamine is the antidote for Heparin. Heparin is an anticoagulant medication that works by increasing the activity of antithrombin III, leading to the inhibition of clotting factors. In cases of excessive bleeding or overdose with Heparin, protamine can be administered to neutralize its anticoagulant effects. Protamine works by binding to heparin to form a stable complex, thereby reversing the anticoagulant activity of Heparin. It is important for healthcare providers to be familiar with the antidotes for various medications to manage potential complications effectively.

Correct Answer: D

Rationale: Fluvoxamine inhibits CYP450 enzymes. It is not an MAOI, has weak anticholinergic effects, and does not require weekly blood counts.

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.

Correct Answer: D

Rationale: Bradykinin is not an eicosanoid. Eicosanoids are signaling molecules derived from arachidonic acid or other polyunsaturated fatty acids, including prostaglandins, prostacyclins, thromboxanes, and leukotrienes. Bradykinin, on the other hand, is a peptide that functions as a mediator of inflammation and pain by promoting vasodilation and increasing vascular permeability.