The nurse is reviewing chloroquine with a patient and instructs the patient to watch for and report which potential adverse reactions?

Drowsiness

Constipation

Dizziness

Insomnia

Answer and Explanation

The Correct Answer is C

Choice A reason: Drowsiness is not a common adverse effect of chloroquine, an antimalarial drug. Chloroquine inhibits heme polymerization in Plasmodium, with side effects like visual disturbances or dizziness. Drowsiness is more associated with antihistamines or CNS depressants, not chloroquine’s mechanism or pharmacokinetic profile.

Choice B reason: Constipation is not a typical side effect of chloroquine. Its primary adverse effects include gastrointestinal upset, visual toxicity, or neurological symptoms like dizziness. Chloroquine’s action on parasitic metabolism does not significantly affect gastrointestinal motility, making constipation an unlikely reaction to report.

Choice C reason: Dizziness is a known adverse effect of chloroquine, potentially due to its effects on the central nervous system or ototoxicity. Patients should report dizziness, as it may indicate toxicity or neurological involvement, requiring dose adjustment or monitoring to ensure safe antimalarial or anti-inflammatory therapy.

Choice D reason: Insomnia is not a primary adverse effect of chloroquine. While neurological effects like headache or dizziness may occur, insomnia is less common. Chloroquine’s toxicity profile focuses on visual, cardiac, or neurological symptoms, and insomnia is not typically reported, making this less critical to monitor.

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Correct Answer is D

Explanation

Choice A reason: A higher dose of rifampin is not necessary due to oral contraceptives. Rifampin induces hepatic CYP450 enzymes, increasing contraceptive metabolism and reducing their efficacy, not vice versa. Dosing adjustments are not required for rifampin, which remains effective for tuberculosis treatment.

Choice B reason: The incidence of adverse effects is not significantly increased by combining rifampin with oral contraceptives. Rifampin’s side effects, like hepatotoxicity, are independent of contraceptives. The primary concern is rifampin’s induction of contraceptive metabolism, reducing their effectiveness, not an increase in adverse effects.

Choice C reason: Rifampin does not increase the risk of thrombophlebitis in women. Oral contraceptives may increase thromboembolism risk, but rifampin’s enzyme induction reduces contraceptive levels, potentially lowering this risk. Thrombophlebitis is not a known side effect of rifampin, making this statement incorrect.

Choice D reason: Rifampin, a CYP450 enzyme inducer, accelerates the metabolism of oral contraceptives, reducing their plasma levels and effectiveness. This can lead to breakthrough ovulation and unintended pregnancy. Patients should use alternative contraception, like barrier methods, during rifampin therapy to ensure reliable pregnancy prevention.

A. Protamine sulfate B. Vitamin E C. Vitamin K D. Potassium chloride

Correct Answer is A

Explanation

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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The nurse is reviewing chloroquine with a patient and instructs the patient to watch for and report which potential adverse reactions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is counseling a woman who will be starting rifampin. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient?

Correct Answer is D

Explanation

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?

Correct Answer is A

Explanation

Which time frame describes the onset of action for intravenous (IV) heparin?

Which range is the targeted therapeutic adult dosage range of theophylline?

The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate? (Select all that apply)

What body system will the nurse assess for common adverse effects of traditional antihistamines?

The nurse is caring for a client receiving an intravenous heparin infusion. The client has a new prescription for warfarin and asks the nurse why he has to be on two medications. What response by the nurse is appropriate?

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