The patient is ordered furosemide (Lasix). Before administering furosemide, it is most important for the nurse to assess the patient for allergies to which drug class?

Correct Answer: B

Rationale: Furosemide (Lasix) belongs to the sulfonamide drug class. Patients with allergies to sulfonamides may experience cross-reactivity and have an increased risk of allergic reactions to furosemide. Therefore, it is essential for the nurse to assess the patient for any allergies to sulfonamides before administering furosemide to prevent potential adverse reactions.

Correct Answer: B

Rationale: The area where the highest percentage of sodium and water are reabsorbed back into the bloodstream is the proximal tubule. In the nephron, the proximal tubule is responsible for reabsorbing approximately 65-70% of filtered sodium and water. This reabsorption is crucial for maintaining the body's electrolyte balance and blood volume. The proximal tubule is lined with specialized cells that actively transport sodium ions out of the tubular fluid, creating an osmotic gradient that allows for passive reabsorption of water. This efficient reabsorption process helps to ensure that essential substances are conserved while waste products are excreted in the urine.

Correct Answer: C

Rationale: Protamine sulfate is the antidote for heparin overdose. Heparin is a commonly used anticoagulant medication that works by inhibiting the activity of thrombin and preventing blood clot formation. In the case of an overdose leading to excessive bleeding, protamine sulfate can be administered to neutralize the effects of heparin. Protamine sulfate forms a complex with heparin, therefore reversing its anticoagulant effects and helping to stop the bleeding. This antidote is especially useful in situations where immediate reversal of heparin's effects is necessary to prevent serious complications.

Correct Answer: D

Rationale: In pharmacology, monitoring patients receiving Phenytoin is crucial to ensure safe and effective treatment. The correct answer is D) all of the above because each option plays a critical role in patient care. Monitoring behavior is important as Phenytoin can cause behavioral changes, such as confusion or agitation, which may indicate toxicity. Therapeutic blood levels must be monitored because Phenytoin has a narrow therapeutic range, and levels outside this range can lead to ineffective treatment or toxicity. Monitoring for Steven Johnson syndrome is essential because Phenytoin is associated with severe skin reactions like this syndrome. Option A, monitoring behavior, is not sufficient on its own as it does not provide objective data on drug levels or potential adverse effects. Option B, monitoring therapeutic blood levels, is important but alone does not address all aspects of patient safety. Option C, monitoring for Steven Johnson syndrome, is crucial but does not cover all potential monitoring parameters for Phenytoin. In an educational context, this question highlights the comprehensive approach needed when administering medications like Phenytoin. It emphasizes the importance of monitoring various aspects of patient health to ensure the best possible outcomes. Understanding the rationale behind monitoring parameters for specific medications is essential for nursing practice to provide safe and effective care to patients.

Correct Answer: C

Rationale: In order to prevent graft-versus-host disease (GVHD) in a severely immunocompromised patient receiving a blood transfusion, the physician will order irradiation of the donor blood. GVHD is a rare but serious complication that can occur when the donor's T lymphocytes attack the recipient's tissues. Irradiation of the blood eliminates the T lymphocytes, thereby reducing the risk of GVHD in immunocompromised patients. Diphenhydramine hydrochloride (Benadryl) and acetaminophen (Tylenol) are commonly used to manage transfusion reactions but do not specifically prevent GVHD. Administering the transfusion slowly over several hours does not directly address the risk of GVHD.