Nokea
A 75-year-old man with a history of intermittent angina presents to his primary physician. The anginal attacks are becoming more frequent, and therapy is considered for this reason. His blood pressure is 160/95 mm Hg. Which of the following agents would be least likely to be administered as a first-line agent for this patient?
- A. Diltiazem
- B. Nifedipine
- C. Nitroglycerine
- D. Ranolazine
Correct Answer: D
Rationale: Ranolazine is a second-line agent for chronic angina, targeting sodium channels, while diltiazem, nifedipine, nitroglycerin, and verapamil are first-line due to vasodilation or heart rate control.
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All statements are true EXCEPT: Doxazosin:
- A. Is a selective reversible alpha_1 receptor antagonist
- B. Should always be prescribed with a beta blocker to prevent reflex tachycardia
- C. Is associated with first-dose hypotension
- D. Reduces plasma LDL/high-density lipoprotein (HDL) cholesterol ratio
Correct Answer: B
Rationale: Doxazosin is an alpha-1 antagonist (A), causes first-dose hypotension (C), improves lipid profiles (D), and may worsen incontinence (E); a beta blocker is not mandatory (B).
General contraindications for anticancer drugs are:
- A. Depression of bone marrow
- B. Acute infections
- C. Severe hepatic and/or renal insufficiency
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. General contraindications for anticancer drugs include depression of bone marrow, which can lead to decreased production of blood cells; acute infections, as these drugs can further compromise the immune system; and severe hepatic and/or renal insufficiency, as these organs are responsible for drug metabolism and elimination. These contraindications are crucial to consider to prevent further harm to the patient. Choices A, B, and C individually are incorrect because they do not encompass all the general contraindications associated with anticancer drugs.
The toxic effects of a large dose of nicotine include all of the following EXCEPT:
- A. Hypotension and bradycardia
- B. Convulsions coma and respiratory arrest
- C. Skeletal muscle depolarization blockade and respiratory paralysis
- D. Hypertension and cardiac arrhythmias
Correct Answer: A
Rationale: The correct answer is A: Hypotension and bradycardia. Nicotine is a stimulant that typically causes hypertension and tachycardia due to its effects on the sympathetic nervous system. Therefore, hypotension and bradycardia are not consistent with the toxic effects of nicotine. Choices B, C, and D are incorrect because convulsions, coma, respiratory arrest, skeletal muscle depolarization blockade, respiratory paralysis, hypertension, and cardiac arrhythmias are all potential toxic effects of a large dose of nicotine due to its impact on various physiological systems.
Which doses of Aspirin may be more effective in inhibiting Tromboxane A2?
- A. Low
- B. High
- C. All of the Above
- D. None of the above
Correct Answer: A
Rationale: The correct answer is A: Low. Low doses of Aspirin are more effective in inhibiting Thromboxane A2 because they irreversibly inhibit cyclooxygenase-1 in platelets, which is necessary for Thromboxane A2 synthesis. High doses can lead to non-specific inhibition of COX-1 and COX-2, which may cause side effects. Choice B is incorrect because high doses can lead to non-specific inhibition. Choice C is incorrect because high doses are not more effective. Choice D is incorrect as low doses are effective.
A client has been severely depressed and suicidal. After admission to an inpatient psychiatric unit, antidepressant medication is administered. As the client becomes more energized and communicative, what should be the priority nursing intervention for this client?
- A. Allowing the client to have unsupervised passes to his or her home
- B. Encouraging the client to participate in group activities
- C. Increasing the vigilance regarding the client's suicidal precautions
- D. Recognizing that the client's suicidal potential has decreased
Correct Answer: C
Rationale: Correct Answer: C - Increasing the vigilance regarding the client's suicidal precautions
Rationale:
1. The client was admitted for severe depression and suicidal ideation, indicating a high suicide risk.
2. Antidepressants can initially increase energy before improving mood, potentially raising suicide risk.
3. As the client becomes more energized and communicative, the risk of impulsive actions, including suicide, may increase.
4. Therefore, increasing vigilance and maintaining strict suicidal precautions are crucial to ensure the client's safety.
Summary of Incorrect Choices:
A: Allowing unsupervised passes may expose the client to triggers or opportunities for self-harm.
B: Group activities can be beneficial but do not address the immediate safety concern of suicidal risk.
D: Assuming suicidal potential has decreased prematurely can be dangerous, as the client may still be at risk.