a client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator alteplase activase tpa which action is a prior
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Nursing Elites

HESI RN

Pharmacology HESI

1. A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?

Correct answer: C

Rationale: The priority nursing intervention for a client receiving tissue plasminogen activator (alteplase) for an acute myocardial infarction is to monitor for signs of bleeding. Alteplase is a thrombolytic medication that can lead to hemorrhage as a complication. Therefore, closely monitoring the client for any signs of bleeding is essential to promptly address and manage this potential adverse effect.

2. The healthcare provider should anticipate that the most likely medication to be prescribed prophylactically for a child with spina bifida (myelomeningocele) who has a neurogenic bladder would be:

Correct answer: B

Rationale: Children with spina bifida, especially those with a neurogenic bladder, are at an increased risk of urinary tract infections. Sulfisoxazole, an antibiotic, is commonly prescribed prophylactically to prevent UTIs in this population. Prednisone (Choice A) is a corticosteroid and is not typically used for prophylaxis in this scenario. Furosemide (Lasix) (Choice C) is a diuretic used to treat fluid retention and hypertension, not for preventing UTIs. Intravenous immune globulin (IVIG) (Choice D) is used to boost the immune system, not for UTI prophylaxis in this case.

3. When monitoring a client for acute toxicity associated with bethanechol chloride (Urecholine), what sign should the nurse check for to indicate toxicity?

Correct answer: C

Rationale: The correct answer is C: Bradycardia. Toxicity from bethanechol chloride (Urecholine) can lead to excessive muscarinic stimulation, resulting in manifestations like salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension. When facing toxicity, treatment involves supportive measures and administering atropine sulfate subcutaneously or intravenously.

4. A client is receiving vancomycin (Vancocin). Which of the following is the most important action for the nurse to take?

Correct answer: A

Rationale: The most important action for the nurse to take when a client is receiving vancomycin is to monitor for signs of nephrotoxicity. Vancomycin can cause kidney damage, so monitoring kidney function and signs of nephrotoxicity are crucial to prevent harm. While monitoring for ototoxicity and ensuring adequate hydration are important nursing actions, they are not as critical as preventing nephrotoxicity when administering vancomycin.

5. A client who received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client indicates a need for further instructions?

Correct answer: B

Rationale: Azathioprine is an immunosuppressant taken for life. Discontinuing the medication after 14 days is incorrect.

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