A nurse is assessing a client who has taken Procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following adverse effects of this medication? (Select one that does not apply.)
- A. Joint swelling
- B. Widened QRS complex
- C. Narrowed QT interval
- D. Easy bruising
Correct Answer: C
Rationale: Procainamide can widen QRS , cause bruising from lupus-like syndrome, and joint swelling .
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Kenneth is taking warfarin and is asking about what he can take for minor aches and pains. The best recommendation is:
- A. Ibuprofen 400 mg three times a day
- B. Acetaminophen, not to exceed 4 grams per day
- C. Prescribe acetaminophen with codeine
- D. Aspirin 640 mg three times a day
Correct Answer: B
Rationale: Acetaminophen is safest with warfarin, avoiding bleeding risks from ibuprofen or aspirin ; codeine is unnecessary for minor pain.
Which of the following beta-blockers also has additional alpha-blocking activity?
- A. Nadolol
- B. Pindolol
- C. Labetalol
- D. Esmolol
Correct Answer: C
Rationale: Labetalol has both beta and alpha-1 blocking activity, making it unique among beta-blockers.
Bromocriptine is (select one that does not apply)
- A. A partial agonist of dopamine
- B. A partial antagonist of dopamine
- C. Used in the treatment of parkinsonism
- D. Used to reduce GH secretion in acromegaly
Correct Answer: B
Rationale: Bromocriptine is a dopamine agonist used in parkinsonism and acromegaly; all except B are correct.
The home health nurse is caring for a 77-year-old patient with congestive heart failure. What would the nurse consider a priority to assess to develop the most effective plan of care related to medication administration?
- A. Description of the patient's living environment
- B. Required lifestyle changes
- C. Family members in the community
- D. Compliance with therapy to reduce risk of skin breakdown
Correct Answer: A
Rationale: Living environment affects medication storage, access, and administration, critical for an elderly patient with CHF.
Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following EXCEPT:
- A. Notify your health-care provider immediately if you have visual change.
- B. Monitor your own blood pressure and pulse daily.
- C. Take a hot shower or bath if you feel dizzy.
- D. Use a sunscreen on exposed body surfaces.
Correct Answer: C
Rationale: Hot showers can worsen amiodarone-induced hypotension, not help it.