What is the primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT)?

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Question 1 of 9

What is the primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT)?

Correct Answer: A

Rationale: The primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of DVT is the absence of regular INR monitoring required with rivaroxaban. This is because rivaroxaban is a direct oral anticoagulant with more predictable pharmacokinetics, eliminating the need for monitoring. Regular INR monitoring is necessary with warfarin to ensure the drug is within the therapeutic range, which can be burdensome for patients and healthcare providers. The other choices are incorrect as they do not directly address the primary advantage of rivaroxaban over warfarin for this specific patient population.

Question 2 of 9

The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant weighing 4 pounds. The drug is diluted in 25 ml of D5W to run over 8 hours. How much Streptomycin will the infant receive?

Correct Answer: A

Rationale: To calculate the dose of Streptomycin, we first need to convert the infant's weight from pounds to kg (4 lbs = 1.81 kg). Then, we multiply the weight in kg by the prescribed dose (15 mg/kg) to get the total dose (1.81 kg * 15 mg/kg = 27.15 mg). Since the drug is diluted in 25 ml of D5W, the infant will receive 27.15 mg in 25 ml solution. To find how much Streptomycin the infant actually receives, we need to calculate the amount in 1 ml (27.15 mg / 25 ml = 1.086 mg/ml). Finally, to determine how much the infant will receive over 8 hours, we multiply the concentration by the infusion rate (1.086 mg/ml * 25 ml * 8 hours = 217.2 mg). Therefore, the correct answer is A: 9 mg, as it represents the amount

Question 3 of 9

An elderly female client comes to the clinic for a regular check-up. The client tells the nurse that she has increased her daily doses of acetaminophen (Tylenol) for the past month to control joint pain. Based on this client's comment, what previous lab values should the nurse compare with today's lab report?

Correct Answer: B

Rationale: The correct answer is B. The nurse should look for an increase in today's LDH compared to the previous one to assess for possible liver damage. Acetaminophen overdose can lead to liver toxicity, which can be indicated by elevated LDH levels. LDH is an enzyme released during liver damage. Checking for LDH levels can help assess the impact of increased acetaminophen doses on the liver. Choices A, C, and D are incorrect: A: Looking at hemoglobin and hematocrit is not directly related to acetaminophen use for joint pain. It does not provide information about liver damage. C: APTT measures blood clotting time and is not directly affected by acetaminophen use for joint pain. It does not provide information about liver damage. D: Serum potassium levels are not typically affected by acetaminophen use for joint pain. It does not provide information about liver damage.

Question 4 of 9

A client is being discharged with a new prescription for enoxaparin (Lovenox). Which instruction should the nurse include?

Correct Answer: B

Rationale: The correct answer is B because expelling the air bubble from the syringe before injection helps ensure accurate dosage delivery and prevents air from being injected into the patient. Administering the injection in the thigh (A) is incorrect as enoxaparin is typically given in the abdomen. Massaging the injection site (C) can cause bruising or hematoma formation. Alternating injection sites between arms (D) is not relevant as enoxaparin is usually given in the abdomen.

Question 5 of 9

A client with heart failure is prescribed digoxin (Lanoxin). Which instruction should the nurse include in the client's teaching plan?

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Digoxin is a medication that can cause bradycardia as a side effect. 2. Instructing the client to take their pulse before each dose is crucial to monitor for bradycardia. 3. Holding the medication if the pulse is below 60 beats per minute helps prevent potential adverse effects. 4. This instruction ensures the client's safety and adherence to the prescribed regimen. Summary: - Choice B is incorrect because increasing potassium intake can lead to hyperkalemia when taking digoxin. - Choice C is incorrect as taking digoxin with a high-fiber meal may affect absorption negatively. - Choice D is incorrect because skipping a dose based on dizziness or lightheadedness may lead to suboptimal treatment outcomes.

Question 6 of 9

What is the primary action of digoxin when prescribed to a patient with heart failure?

Correct Answer: C

Rationale: The primary action of digoxin in heart failure is to strengthen cardiac contractions. Digoxin inhibits the sodium-potassium pump, leading to an increase in intracellular calcium levels, which enhances the force of myocardial contractions. This helps improve cardiac output and symptoms of heart failure. Explanation: A: Incorrect - Digoxin does not increase heart rate, it mainly affects the strength of contractions. B: Incorrect - Digoxin does not decrease cardiac output; it actually helps improve it by enhancing contractility. D: Incorrect - Digoxin may have a slight effect on lowering blood pressure, but its primary action in heart failure is to strengthen cardiac contractions, not lower blood pressure.

Question 7 of 9

A patient with an anxiety disorder is prescribed alprazolam. What is the primary action of this medication?

Correct Answer: D

Rationale: The correct answer is D: Reduce anxiety. Alprazolam is a benzodiazepine that acts on the central nervous system to enhance the effects of a neurotransmitter called GABA, which helps to calm the brain and reduce anxiety. This medication does not increase energy levels (choice A), induce sedation (choice B), or elevate mood (choice C). Alprazolam's primary action is to target and alleviate the symptoms of anxiety by promoting relaxation and reducing excessive brain activity associated with anxiety disorders.

Question 8 of 9

A patient with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. What is the primary purpose of this medication?

Correct Answer: B

Rationale: The correct answer is B: Relieve bronchospasm. Tiotropium is an anticholinergic medication that acts by relaxing the muscles around the airways, thereby helping to relieve bronchospasm in patients with COPD. This results in improved airflow and reduced shortness of breath. A: Reduce mucus production - This is incorrect as tiotropium does not directly affect mucus production but rather focuses on bronchospasm relief. C: Suppress cough - Tiotropium may help with cough associated with COPD by improving airflow, but its primary purpose is not to suppress cough. D: Thin respiratory secretions - Tiotropium does not have a direct effect on thinning respiratory secretions; its main action is bronchodilation to relieve bronchospasm in COPD.

Question 9 of 9

A patient with chronic pain is prescribed gabapentin. What is the primary purpose of this medication?

Correct Answer: A

Rationale: The correct answer is A: Relieve neuropathic pain. Gabapentin is commonly used to treat neuropathic pain by stabilizing electrical activity in the brain and nervous system. It is effective in conditions such as diabetic neuropathy and postherpetic neuralgia. Choice B is incorrect because gabapentin does not have anti-inflammatory properties. Choice C is incorrect as gabapentin does not enhance opioid analgesia, but it can be used in conjunction with opioids for pain management. Choice D is incorrect as gabapentin is not indicated for cough suppression.

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