A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following medications for this client?

Aspirin

Alteplase

Clopidogrel

Enoxaparin

Answer and Explanation

The Correct Answer is D

Choice A reason: This is incorrect because aspirin is not a suitable medication for preventing venous thromboembolism (VTE) in a client who is postoperative following hip arthroplasty. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that has antiplatelet and analgesic effects, but it is not as effective as anticoagulants for VTE prophylaxis.

Choice B reason: This is incorrect because alteplase is not a medication for preventing VTE, but for treating it. Alteplase is a thrombolytic agent that dissolves existing blood clots by activating plasminogen. It is used for acute ischemic stroke, myocardial infarction, and massive pulmonary embolism, but it has a high risk of bleeding and is contraindicated in clients who have had recent surgery.

Choice C reason: This is incorrect because clopidogrel is not a medication for preventing VTE, but for preventing arterial thrombosis. Clopidogrel is an antiplatelet agent that inhibits the adenosine diphosphate (ADP) receptor on platelets, preventing their aggregation. It is used for clients who have had acute coronary syndrome, percutaneous coronary intervention, or ischemic stroke, but it is not effective for VTE prophylaxis.

Choice D reason: This is correct because enoxaparin is a medication for preventing VTE in a client who is postoperative following hip arthroplasty. Enoxaparin is a low molecular weight heparin (LMWH) that inhibits factor Xa and thrombin, preventing the formation of fibrin. It is administered subcutaneously once or twice daily and does not require routine laboratory monitoring. It has a lower risk of bleeding and heparin-induced thrombocytopenia (HIT) than unfractionated heparin.

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Free Nursing Study Resources

Correct Answer is ["A","B","D"]

Explanation

Choice A reason: Removing the patch for 10 to 12 hours daily is a correct instruction. This allows the client to have a nitrate-free period, which prevents the development of tolerance to the medication. Tolerance reduces the effectiveness of nitroglycerin in relieving anginal pain. The client should remove the patch at night, when the risk of angina is lower, and apply a new patch in the morning.

Choice B reason: Applying the patch to a hairless area and rotating sites is a correct instruction. This prevents skin irritation and enhances absorption of the medication. The client should avoid applying the patch to areas that are exposed to heat, sunlight, or friction, as these factors can increase the release of nitroglycerin and cause hypotension.

Choice C reason: Applying a new patch at the onset of anginal pain is not a correct instruction. Transdermal nitroglycerin is used for the prevention, not the treatment, of anginal attacks. The onset of action of transdermal nitroglycerin is slow, and it may take several hours to reach peak effect. The client should use sublingual nitroglycerin, which has a rapid onset of action, to treat acute anginal pain.

Choice D reason: Applying a new patch each morning is a correct instruction. This ensures that the client has a steady and adequate supply of nitroglycerin throughout the day, when the risk of angina is higher. The client should apply the patch to a different site each day, and remove the old patch before applying the new one.

Choice E reason: Applying the patch to dry skin and covering the area with plastic wrap is not a correct instruction. This can cause skin maceration, which is the softening and breaking down of the skin due to moisture. This can increase the risk of infection and reduce the absorption of the medication. The client should apply the patch to clean and dry skin, and avoid covering the area with any dressing or tape.

A. Grapefruit juice B. Orange juice C. Milk D. Coffee

Correct Answer is A

Explanation

Choice A reason: Grapefruit juice should be avoided while taking verapamil, as it can increase the blood levels of the medication and cause adverse effects such as hypotension, bradycardia, and dizziness. Grapefruit juice inhibits the enzyme that metabolizes verapamil in the liver, leading to higher concentrations of the drug in the bloodstream.

Choice B reason: Orange juice is not a contraindication for verapamil, as it does not affect the metabolism or absorption of the medication. Orange juice is a good source of vitamin C and potassium, which may benefit clients with hypertension.

Choice C reason: Milk is not a contraindication for verapamil, as it does not affect the metabolism or absorption of the medication. Milk is a good source of calcium and protein, which may benefit clients with hypertension.

Choice D reason: Coffee is not a contraindication for verapamil, as it does not affect the metabolism or absorption of the medication. However, coffee contains caffeine, which is a stimulant that can increase the heart rate and blood pressure. Therefore, clients with hypertension should limit their intake of caffeine and other stimulants.

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A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following medications for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has stable angina and a new prescription for transdermal nitroglycerin. Which of the following instructions should the nurse include? (Select all that apply.)

Correct Answer is ["A","B","D"]

Explanation

A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication?

Correct Answer is A

Explanation

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