A nurse is reviewing the chart of a client who has a prescription for eptifibatide. The nurse should identify which of the following medications as a contraindication for this medication?

Warfarin

Metoprolol

Sertraline

Lisinopril

Answer and Explanation

The Correct Answer is A

Choice A reason: Warfarin is an anticoagulant, and when combined with eptifibatide, which is a glycoprotein IIb/IIIa inhibitor that prevents platelet aggregation, the risk of severe bleeding increases significantly. This drug interaction is contraindicated because it can lead to life-threatening hemorrhage. This makes Warfarin the correct answer.

Choice B reason: Metoprolol is a beta-blocker used for hypertension and cardiac conditions. It does not directly interact with eptifibatide in a way that increases bleeding risk. Therefore, it is not contraindicated.

Choice C reason: Sertraline is an SSRI antidepressant. While SSRIs can increase bleeding risk slightly due to platelet effects, they are not considered absolute contraindications with eptifibatide. The risk is lower compared to anticoagulants like warfarin.

Choice D reason: Lisinopril is an ACE inhibitor used for hypertension and heart failure. It does not have a direct interaction with eptifibatide that would contraindicate use. While monitoring for hypotension and renal function is necessary, it is not a contraindication.

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Correct Answer is A

Explanation

Choice A reason: Applying a saturated abdominal dressing (with sterile normal saline) is correct. Moist dressings prevent the exposed abdominal organs from drying out and reduce the risk of tissue necrosis. This is the immediate priority intervention until surgical repair can be performed.

Choice B reason: Cleansing the site with hydrogen peroxide is inappropriate because it can damage exposed tissues and increase the risk of infection. Hydrogen peroxide is not used for internal organ exposure.

Choice C reason: Covering the site with dry, sterile gauze is incorrect because dry gauze can adhere to the viscera, causing tissue damage when removed. Moist dressings are required to protect the organs.

Choice D reason: Reinserting protruding viscera is unsafe and contraindicated. Attempting to push organs back into the abdominal cavity can cause trauma, infection, and further complications. The nurse should protect the viscera and notify the surgical team immediately.

A. "I don't hear the voices. Concentrate on my voice instead." B. "They cannot hurt you. Don't be afraid of what they say." C. "Let's go to a quiet room where the voices won't follow." D. "The voices are not real, and you need to get to group."

Correct Answer is A

Explanation

Choice A reason: Telling the client “I don’t hear the voices. Concentrate on my voice instead” is therapeutic because it acknowledges the client’s experience without reinforcing the hallucination. It helps the client refocus on reality and provides grounding, which is an effective strategy in managing hallucinations. This is the correct answer.

Choice B reason: Saying “They cannot hurt you” invalidates the client’s perception and may increase anxiety. While intended to reassure, it does not help the client differentiate between hallucinations and reality.

Choice C reason: Suggesting that the voices won’t follow to a quiet room reinforces the hallucination as real. This is non-therapeutic because it validates the client’s distorted perception rather than helping them manage it.

Choice D reason: Telling the client “The voices are not real” is dismissive and can make the client feel misunderstood. It does not provide support or coping strategies, and directing them to group without addressing their immediate distress is inappropriate.

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A nurse is reviewing the chart of a client who has a prescription for eptifibatide. The nurse should identify which of the following medications as a contraindication for this medication?

Nursing Test Bank

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