Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
44. A home health nurse visits a child with hemophilia following a dental extraction. Which medication would the nurse suggest be removed from the family's bathroom medicine cabinet?
Test-Taking Tip
Select the drug that would be contraindicated. Think "prevent bleeding" in hemophilia, and then select the medication that could cause rather than prevent bleeding.
Content Area: Child Health, Pharmacology; Integrated Process: Teaching and Learning; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Adverse Effects/Contraindications/Interactions
Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
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Answer 1 is incorrect because there is no contraindication for the use of acetaminophen to control pain in the treatment of hemophilia. Answer 2 is incorrect because corticosteroids are given for the hematuria, acute hemarthrosis, and the chronic synovitis associated with hemophilia. Answer 3 is correct because, while nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are effective in relieving pain caused by the chronic synovitis associated with hemophilia, they inhibit platelet function, which is essential in controlling bleeding episodes. Answer 4 is incorrect because oral use of epsilon-aminocaproic acid (Amicar) prevents clot destruction. Its use is limited to mouth trauma or surgery, and a dose of factor concentrate must be given first. The child may rinse the mouth with this medication and then swallow it.
