Nursing Elites

1. A client with Atrial Fibrillation is prescribed Dabigatran to prevent Thrombosis. Which medication is prescribed concurrently to treat an adverse effect of Dabigatran?

• A. Vitamin K1
• B. Protamine
• C. Omeprazole
• D. Probenecid

Correct answer: C

Rationale: Omeprazole or another proton pump inhibitor is commonly prescribed for clients taking dabigatran who experience abdominal pain and other gastrointestinal adverse effects associated with dabigatran use. Proton pump inhibitors help alleviate these symptoms by reducing gastric acid secretion, which can contribute to gastrointestinal discomfort. Vitamin K1 is not indicated for adverse effects of dabigatran. Protamine is used to reverse the anticoagulant effects of heparin, not dabigatran. Probenecid is not typically used to treat adverse effects of dabigatran.

2. A client is prescribed Propranolol for dysrhythmia. Which action should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Monitor the client's blood pressure after administering Propranolol.
• C. Assist the client when transitioning to a sitting or standing position after taking Propranolol.
• D. Monitor the client's potassium levels for signs of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol to a client with dysrhythmia is to assist the client when transitioning to a sitting or standing position. Propranolol can cause orthostatic hypotension, leading to dizziness during position changes, so it is essential to help the client move slowly to prevent falls or injuries. Choices A, B, and D are incorrect because holding Propranolol based on pulse rate, monitoring blood pressure after administration, and monitoring potassium levels are not directly related to the common side effect of orthostatic hypotension associated with Propranolol.

3. Potassium-sparing diuretics primarily affect which part of the kidney?

• A. Proximal convoluted tubule
• B. Loop of Henle
• C. Collecting duct
• D. Distal convoluted tubule

Correct answer: D

Rationale: Potassium-sparing diuretics exert their primary effects on the distal convoluted tubule in the kidney. By acting on this specific part of the nephron, these diuretics promote sodium excretion while sparing potassium, thus helping to maintain potassium levels in the body. This mechanism differs from other diuretics that may cause potassium loss as a side effect. Understanding the site of action of potassium-sparing diuretics is crucial in clinical practice for managing conditions like hypertension and edema where diuresis is necessary without the risk of hypokalemia.

4. A client has Diabetes Mellitus, Pulmonary Tuberculosis, and a new prescription for Isoniazid. Which of the following supplements should the nurse expect to administer to prevent an adverse effect of INH?

• A. Ascorbic acid
• B. Pyridoxine
• C. Folic acid
• D. Cyanocobalamin

Correct answer: B

Rationale: Pyridoxine is administered with Isoniazid to prevent peripheral neuropathy, a common adverse effect of the drug. It is essential to provide this supplement to the client to minimize the risk of developing this adverse effect. Ascorbic acid (Vitamin C) is not typically given to prevent INH adverse effects. Folic acid and Cyanocobalamin are not commonly administered with INH for this purpose.

5. What is the primary action of warfarin as an anticoagulant?

• A. Prevents the formation of blood clots
• B. Dissolves existing blood clots
• C. Dilates coronary arteries
• D. Treats rhythm disturbances

Correct answer: A

Rationale: The correct answer is A: "Prevents the formation of blood clots." Warfarin acts as an anticoagulant by inhibiting the synthesis of certain clotting factors in the liver. This action reduces the blood's ability to clot, making it effective in preventing the formation of blood clots. Choice B is incorrect because warfarin does not dissolve existing blood clots; it prevents their formation. Choice C is incorrect because warfarin's primary action is not to dilate coronary arteries. Choice D is incorrect as warfarin is not used to treat rhythm disturbances, but rather to prevent clot formation.

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