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: The onset of IV heparin is not dose-dependent; it is immediate due to its direct interaction with antithrombin, inhibiting clotting factors. While therapeutic aPTT varies with dose, anticoagulation begins instantly upon IV administration, making this response incorrect for onset timing.

Choice B reason: IV heparin does not require multiple doses to start working. Its immediate onset enhances antithrombin activity, providing instant anticoagulation. Multiple doses may be needed for sustained therapeutic aPTT, but the initial effect is immediate, making this an incorrect response.

Choice C reason: A 20-minute onset is incorrect for IV heparin, which acts immediately by binding antithrombin, inhibiting thrombin and factor Xa. Subcutaneous heparin has a delayed onset (20-60 minutes), but IV administration ensures rapid anticoagulation, critical for acute conditions like thrombosis.

Choice D reason: IV heparin starts working immediately by enhancing antithrombin’s inhibition of thrombin and factor Xa, preventing clot formation. This rapid onset, measurable by aPTT within minutes, makes it ideal for acute anticoagulation needs, like pulmonary embolism, aligning with its pharmacokinetic profile.

A. Urine culture, antibiotic dose, blood culture B. Antibiotic dose, blood and urine cultures C. Blood and urine cultures, antibiotic dose D. Blood culture, antibiotic dose, urine culture

Correct Answer is C

Explanation

Choice A reason: Collecting urine culture before blood culture and antibiotics is incorrect. Blood cultures are prioritized to detect systemic infection, as fever suggests possible bacteremia. Administering antibiotics before cultures may sterilize samples, reducing diagnostic accuracy, making this sequence inappropriate for identifying the infection source.

Choice B reason: Administering antibiotics before cultures is incorrect, as it may reduce culture sensitivity by killing bacteria, leading to false-negative results. Blood and urine cultures must be obtained first to identify the causative organism and its antibiotic susceptibility, ensuring accurate treatment for suspected urinary tract infection.

Choice C reason: Obtaining blood and urine cultures before antibiotics is correct. Cultures identify the causative organism and guide targeted therapy, especially with fever and cloudy urine suggesting a urinary tract infection. Administering antibiotics after cultures ensures diagnostic accuracy, as antibiotics may sterilize samples, reducing culture yield.

Choice D reason: Collecting blood culture before antibiotics and urine culture after is suboptimal. Both cultures should be obtained before antibiotics to maximize diagnostic yield, as fever and urinary symptoms suggest possible systemic or urinary infection. Delaying urine culture risks missing the primary infection source.

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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?

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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