Nokea
A client with heart failure is prescribed furosemide (Lasix). Which instruction should the nurse include in the client's teaching plan?
- A. Take the medication before bedtime.
- B. Report any weight gain of more than 2 pounds in a day.
- C. Increase your intake of high-sodium foods.
- D. Limit your fluid intake to less than 1 liter per day.
Correct Answer: B
Rationale: The correct answer is B: Report any weight gain of more than 2 pounds in a day. This instruction is crucial for a client with heart failure taking furosemide as sudden weight gain can indicate fluid retention, which can worsen heart failure. Monitoring weight daily can help detect early signs of fluid overload.
A: Taking the medication before bedtime is not a critical instruction for furosemide as it is usually taken in the morning to prevent nocturia.
C: Increasing intake of high-sodium foods contradicts the purpose of furosemide, which is a diuretic used to reduce fluid retention by promoting diuresis.
D: Limiting fluid intake to less than 1 liter per day can lead to dehydration and electrolyte imbalances, which can be harmful for a client with heart failure.
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What should be monitored to evaluate the effectiveness of enoxaparin in a patient with deep vein thrombosis (DVT)?
- A. Prothrombin time (PT)
- B. Partial thromboplastin time (PTT)
- C. International normalized ratio (INR)
- D. Platelet count
Correct Answer: C
Rationale: Rationale:
1. Enoxaparin is a low molecular weight heparin that primarily affects the intrinsic pathway of coagulation.
2. INR is used to monitor the effectiveness of anticoagulants affecting the intrinsic pathway.
3. Monitoring INR helps ensure the patient is within the therapeutic range to prevent clotting without excessive bleeding.
4. PT and PTT primarily evaluate the extrinsic and intrinsic pathways, respectively, not specific to enoxaparin.
5. Platelet count is not directly related to monitoring the effectiveness of enoxaparin in treating DVT.
A patient with an anxiety disorder is prescribed alprazolam. What is the primary action of this medication?
- A. Increase energy levels
- B. Induce sedation
- C. Elevate mood
- D. Reduce anxiety
Correct Answer: D
Rationale: The correct answer is D: Reduce anxiety. Alprazolam is a benzodiazepine that acts on the central nervous system to enhance the effects of a neurotransmitter called GABA, which helps to calm the brain and reduce anxiety. This medication does not increase energy levels (choice A), induce sedation (choice B), or elevate mood (choice C). Alprazolam's primary action is to target and alleviate the symptoms of anxiety by promoting relaxation and reducing excessive brain activity associated with anxiety disorders.
For a patient with asthma, what is the primary purpose of prescribing montelukast?
- A. Relieve acute bronchospasm
- B. Prevent asthma attacks
- C. Thin respiratory secretions
- D. Suppress cough
Correct Answer: B
Rationale: The primary purpose of prescribing montelukast for a patient with asthma is to prevent asthma attacks. Montelukast is a leukotriene receptor antagonist that helps to reduce inflammation in the airways, thereby preventing asthma symptoms and attacks. It is not used to relieve acute bronchospasm (Choice A), as it is not a fast-acting rescue medication like a bronchodilator. Montelukast also does not thin respiratory secretions (Choice C) or suppress cough (Choice D) as its main mechanism of action is to prevent and control asthma symptoms by inhibiting leukotrienes.
A patient with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. What is the primary action of this medication?
- A. Reduce inflammation
- B. Relieve bronchospasm
- C. Suppress cough
- D. Thin respiratory secretions
Correct Answer: B
Rationale: The correct answer is B: Relieve bronchospasm. Ipratropium is an anticholinergic bronchodilator that works by relaxing the muscles in the airways, leading to bronchodilation and improved airflow. This helps to relieve bronchospasm, a common symptom in COPD. Choice A is incorrect because ipratropium does not have significant anti-inflammatory effects. Choice C is incorrect as ipratropium does not directly suppress cough. Choice D is incorrect as ipratropium does not specifically target respiratory secretions.
The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant weighing 4 pounds. The drug is diluted in 25 ml of D5W to run over 8 hours. How much Streptomycin will the infant receive?
- A. 9 mg
- B. 18 mg
- C. 27 mg
- D. 36 mg
Correct Answer: A
Rationale: To calculate the dose of Streptomycin, we first need to convert the infant's weight from pounds to kg (4 lbs = 1.81 kg). Then, we multiply the weight in kg by the prescribed dose (15 mg/kg) to get the total dose (1.81 kg * 15 mg/kg = 27.15 mg). Since the drug is diluted in 25 ml of D5W, the infant will receive 27.15 mg in 25 ml solution. To find how much Streptomycin the infant actually receives, we need to calculate the amount in 1 ml (27.15 mg / 25 ml = 1.086 mg/ml). Finally, to determine how much the infant will receive over 8 hours, we multiply the concentration by the infusion rate (1.086 mg/ml * 25 ml * 8 hours = 217.2 mg). Therefore, the correct answer is A: 9 mg, as it represents the amount