A nurse is caring for a client who is receiving warfarin therapy to prevent deep vein thrombosis. Which of the following medications should the nurse have available in the event of an overdose?
Epinephrine
Vitamin K
Atropine
Protamine
The Correct Answer is B
Choice A reason : Epinephrine is an adrenergic agonist primarily used in the management of cardiac arrest, anaphylaxis, and severe asthma attacks. It is not used to reverse the effects of warfarin overdose. Warfarin acts as an anticoagulant by inhibiting vitamin K-dependent clotting factors, and epinephrine has no role in this mechanism.
Choice B reason : Vitamin K is the antidote for warfarin toxicity. Warfarin works by inhibiting the vitamin K-dependent clotting factors II, VII, IX, and X. In the event of an overdose, vitamin K is administered to reverse the anticoagulant effects of warfarin and restore the clotting factor levels to normal. The administration can be oral or intravenous, depending on the severity of the overdose and the urgency of the situation.
Choice C reason : Atropine is an anticholinergic drug used to treat bradycardia (slow heart rate) and as an antidote for organophosphate poisoning. It does not have a role in reversing warfarin overdose as it does not affect the clotting cascade or vitamin K metabolism.
Choice D reason : Protamine is used to reverse the effects of heparin, another anticoagulant, but not warfarin. Protamine sulfate binds to heparin, forming a stable complex and neutralizing its anticoagulant effects. Since warfarin's mechanism of action is different from heparin's, protamine is not effective in reversing warfarin toxicity.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
Choice A reason: Monitoring cholesterol levels is essential while taking lisinopril. This medication is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure, heart failure, and heart attack. Regular monitoring helps assess the impact of lisinopril on lipid levels and overall cardiovascular health. Elevated cholesterol can contribute to heart disease, so monitoring allows for timely interventions and adjustments in treatment.
Choice C reason: Potassium-rich foods are relevant because lisinopril can affect potassium levels. ACE inhibitors may lead to hyperkalemia (high potassium levels), especially in patients with impaired kidney function. Encouraging potassium-rich foods helps maintain a balance and prevent complications.
Choice D reason: Reporting a persistent dry cough is crucial. Lisinopril is associated with a common side effect: a dry, persistent cough. This occurs due to increased levels of bradykinin, a substance affected by ACE inhibitors. If the client experiences this cough, it's essential to notify the doctor for potential medication adjustments.
Choice E reason: Monitoring blood pressure aligns with the purpose of lisinopril. Regular blood pressure checks help assess the effectiveness of the medication in controlling hypertension. Consistent monitoring ensures timely adjustments and prevents complications related to high blood pressure.
Correct Answer is D
Explanation
Choice A reason: Scheduling the next appointment for 1 year from now is a standard practice for patients who are considered to be in good health and have no immediate medical concerns. Given the patient's normal BP and BMI, along with no reported medical problems, this would typically be an appropriate action. However, it is essential to consider the patient's age and race, as African American men are at a higher risk for certain conditions, such as prostate cancer, which may warrant more frequent monitoring.
Choice B reason: While providing information for a weight loss plan that includes increasing physical activity is generally beneficial, it may not be necessary for this patient. His BMI is 24, which falls within the normal range (18.5-24.9), indicating that he is not overweight. Therefore, unless the patient expresses a desire to lose weight or improve fitness, this action might not be a priority.
Choice C reason:Offering information on reducing risk factors for hypertension is always a positive step in preventive healthcare. However, the patient's BP is 126 mm Hg, which is considered a normal reading (normal BP range is 90/60 mm Hg to 120/80 mm Hg). Therefore, while education on maintaining a healthy lifestyle is valuable, it may not be the most critical action for this visit.
Choice D reason:Scheduling a PSA test is recommended for African American men starting at age 45 due to their increased risk of prostate cancer. The PSA test measures the level of prostate-specific antigen in the blood, which can be an indicator of prostate cancer. Given the patient's demographic, this proactive screening measure is advisable, despite the absence of symptoms or previous medical problems.
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