A patient on a heparin infusion has an aPTT of 90 and is showing signs of excessive bleeding. What prescription will the nurse anticipate administering?

Protamine sulfate

Vitamin E

Vitamin K

Potassium chloride

Answer and Explanation

The Correct Answer is A

Choice A reason: Protamine sulfate is the antidote for heparin overdose, neutralizing heparin’s anticoagulant effect by binding to it, forming an inactive complex. This reverses excessive anticoagulation, reducing bleeding risk in patients with prolonged aPTT (e.g., 90 seconds), making it the appropriate treatment for heparin-induced bleeding.

Choice B reason: Vitamin E has no role in reversing heparin-induced bleeding. It is an antioxidant with potential antiplatelet effects, which could worsen bleeding. Heparin’s action, enhancing antithrombin to inhibit thrombin and factor Xa, is specifically countered by protamine sulfate, not vitamin E.

Choice C reason: Vitamin K reverses warfarin, not heparin, by restoring vitamin K-dependent clotting factors. Heparin acts via antithrombin, independent of vitamin K, and its overdose causes bleeding correctable by protamine sulfate. Vitamin K is ineffective for heparin-related bleeding, making this incorrect.

Choice D reason: Potassium chloride treats hypokalemia, not heparin-induced bleeding. Heparin’s anticoagulant effect, prolonging aPTT, is unrelated to potassium levels. Administering potassium chloride would not address excessive anticoagulation or bleeding, making it irrelevant for managing heparin overdose complications.

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Correct Answer is D

Explanation

Choice A reason: Immunosuppression is not significantly increased with inhaled fluticasone and hydrochlorothiazide. Fluticasone has minimal systemic absorption, limiting systemic immunosuppression. Hydrochlorothiazide, a diuretic, does not enhance immune suppression but affects electrolytes, making hypokalemia a more relevant concern in this combination.

Choice B reason: Increased clearance of fluticasone is unlikely with hydrochlorothiazide. Fluticasone is metabolized by hepatic CYP3A4, and hydrochlorothiazide does not significantly induce this enzyme. Drug interactions affecting clearance are minimal, and the primary concern is the additive effect on potassium levels, not fluticasone metabolism.

Choice C reason: Reduced clearance of fluticasone is not a known interaction with hydrochlorothiazide. Fluticasone’s low systemic absorption and hepatic metabolism are unaffected by hydrochlorothiazide, which primarily affects renal electrolyte excretion. The combination does not increase fluticasone’s systemic side effects but may exacerbate electrolyte imbalances.

Choice D reason: Hydrochlorothiazide, a thiazide diuretic, promotes potassium excretion, causing hypokalemia. Inhaled fluticasone has minimal systemic effects but may contribute to hypokalemia when combined with systemic corticosteroids. The nurse should monitor potassium levels, as the diuretic’s effect is the primary driver of this electrolyte imbalance in this scenario.

A. Delayed growth development B. Permanent discoloration of the teeth C. Drug-induced neurotoxicity D. Gastrointestinal and rectal bleeding

Correct Answer is B

Explanation

Choice A reason: Delayed growth development is not a primary adverse effect of tetracycline in children. Tetracyclines inhibit protein synthesis and may affect bone growth minimally, but this is not well-documented. Their primary concern in children under 8 is tooth discoloration, making this incorrect.

Choice B reason: Tetracycline use in children under 8 causes permanent tooth discoloration by binding to calcium in developing teeth, forming a yellow-gray stain. This occurs during tooth enamel formation, making it a significant adverse effect, as the discoloration is irreversible, requiring cosmetic dental intervention.

Choice C reason: Drug-induced neurotoxicity is not a common effect of tetracycline. While tetracyclines can cause rare side effects like intracranial hypertension, neurotoxicity is more associated with drugs like aminoglycosides. Tooth discoloration is the primary concern in children, making this an incorrect choice.

Choice D reason: Gastrointestinal and rectal bleeding are not typical tetracycline side effects. Tetracyclines may cause gastrointestinal upset, like nausea, but bleeding is more associated with anticoagulants or NSAIDs. In children, tooth discoloration is the most significant adverse effect, making this choice incorrect.

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A patient on a heparin infusion has an aPTT of 90 and is showing signs of excessive bleeding. What prescription will the nurse anticipate administering?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which effect would a nurse anticipate might occur in a patient receiving inhaled fluticasone who is also prescribed hydrochlorothiazide for hypertension?

Correct Answer is D

Explanation

Which adverse effect can result if tetracycline is administered to children younger than 8 years of age?

Correct Answer is B

Explanation

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The nurse is providing teaching to a patient taking tetracycline. Which statement by the nurse is correct?

The nurse is preparing to administer heparin intravenously (IV). Which response by the nurse would be appropriate when the patient asks when the medication will start working?