A patient is receiving warfarin (Coumadin), which is 98% bound to plasma proteins. The antidepressant paroxetine (Paxil), which is 95% bound to plasma proteins, is added to the patient's daily medication. If the paroxetine displaces warfarin from its protein binding sites, which of the following will most likely to occur?

Diminished effect from warfarin

Diminished effect from paroxetine

Increased effect, and toxicity from paroxetine

Increased effect, and toxicity from warfarin

Answer and Explanation

The Correct Answer is D

A. Diminished effect from warfarin: This is unlikely because displacement of warfarin from protein binding sites would increase its concentration in the bloodstream, potentially leading to increased anticoagulant effects and toxicity.

B. Diminished effect from paroxetine: This is also unlikely because displacement of paroxetine from protein binding sites would increase its concentration in the bloodstream, potentially leading to increased pharmacological effects and toxicity.

C. Increased effect, and toxicity from paroxetine: If paroxetine displaces warfarin from protein binding sites, it can increase the concentration of free warfarin in the bloodstream, leading to increased anticoagulant effects and potential toxicity.

D. Increased effect, and toxicity from warfarin: Correct. If warfarin is displaced from protein binding sites by paroxetine, it can increase the concentration of free warfarin in the bloodstream, leading to increased anticoagulant effects and potential toxicity.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

A. Oprelvekin (Neumega): Oprelvekin is a recombinant human interleukin-11 (IL-11) used to stimulate the production of platelets, not red blood cells. It is primarily indicated for patients with thrombocytopenia (low platelet count) due to chemotherapy.

B. Epoetin alfa (Procrit): Epoetin alfa is a synthetic form of erythropoietin, a hormone produced by the kidneys that stimulates the production of red blood cells in the bone marrow. It is commonly used to treat anemia associated with chronic kidney disease, chemotherapy, or HIV therapy. Therefore, it is administered to increase the number of circulating red blood cells.

C. Clopidogrel (Plavix): Clopidogrel is an antiplatelet medication that inhibits platelet aggregation, thereby reducing the risk of blood clots. It does not directly stimulate the production of red blood cells.

D. Filgrastim (Neupogen): Filgrastim is a recombinant human granulocyte colony-stimulating factor (G-CSF) that stimulates the production of white blood cells, particularly neutrophils, in the bone marrow. It is used to treat neutropenia (low white blood cell count) caused by chemotherapy, bone marrow transplantation, or certain diseases. It does not directly stimulate the production of red blood cells.

Correct Answer is ["7"]

Explanation

Dosage (mL) = Desired dose (mg) / Concentration (mg/mL)

Dosage (mL) = 350 mg / (250 mg/5 mL)

Dosage (mL) = 7 mL (rounded to nearest whole number)

Therefore, the nurse should administer 7 mL of amoxicillin suspension.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following is administered to increase the number of circulating red blood cells?

Correct Answer is B

Explanation

A nurse is preparing to administer amoxicillin 350 mg PO. Available is amoxicillin 250 mg/5 mL. How many mL should the nurse administer? (Round to the nearest whole number.)

Correct Answer is ["7"]

Explanation

A nurse is reviewing laboratory data from a client who has pulmonary embolism and is receiving IV heparin. Which of the following findings should the nurse report to the provider?

A patient has been taking heparin for three days and has developed hematuria. The most appropriate action for the nurse is to:

A patient has started taking clopidogrel (Plavix) after experiencing a transient ischemic attack. What adverse effects are associated with this drug? (Select all that apply)

A nurse is reinforcing teaching with a client who is to start subcutaneous heparin. Which of the following information should the nurse include in the teaching?

What is the primary advantage of using low molecular weight heparins (LMWHs) over heparin?

The most common adverse effect of epoetin alfa is:

A nurse is reviewing the laboratory report of a client and realizes the liver function tests are elevated, indicating liver damage. The client should be monitored for which potential complication?

A nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects?