Nokea
A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication?
- A. I've had a backache for several days
- B. I feel nauseated and have no appetite
- C. I can walk a mile a day
- D. I am urinating more frequently
Correct Answer: B
Rationale: Digoxin's tightrope nausea and anorexia flag toxicity, a common adverse hit as levels climb, risking arrhythmias. Backache's vague, walking's a win, urination's unrelated. Nurses catch this, checking levels, a red light in this heart-boosting med's dance.
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The antidiabetic also effective in lowering the cholesterol level is
- A. Rosiglitazone
- B. Metformin
- C. Chlorpropamide
- D. Repaglinide
Correct Answer: B
Rationale: Metformin's the cholesterol-trimming antidiabetic cuts glucose and lipids, a dual chronic win. Rosiglitazone ups insulin sensitivity, risks heart fat; chlorpropamide pumps insulin, no lipid perk; repaglinide's quick insulin hit misses cholesterol. Nurses flag metformin's bonus, a type 2 staple with vascular edge.
When assigning staff to patients who are receiving chemotherapy, what is the major consideration about chemotherapeutic drugs?
- A. During preparation, drugs may be absorbed through the skin or inhaled
- B. Many chemotherapeutics are vesicants
- C. Chemotherapeutics are frequently given through central venous access devices
- D. Oral and venous routes are the most common
Correct Answer: A
Rationale: Chemotherapy's potency demands safety focus preparation risks skin absorption or inhalation, exposing staff to toxins, necessitating specialized training and protective gear. Vesicants, causing tissue damage if extravasated, are a concern, but preparation hazards affect all drugs, broader in scope. Central venous access is common but a procedural detail, not the primary staffing issue. Route prevalence is logistical, not safety-centric. Prioritizing exposure risk ensures staff handling mixing, drawing minimizes occupational harm, a legal and ethical imperative, shaping assignments to trained personnel, critical in chemotherapy's high-stakes delivery.
A nurse reviews the arterial blood gas (ABG) values of a client admitted with end-stage kidney disease; pH 7.26; PaCO2 37 mm Hg; PaO2 94 mm Hg and HCO3 15 mEq/L. What do these values indicate?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: A
Rationale: End-stage kidney disease hampers acid excretion pH 7.26 (below 7.35) and HCO3 15 mEq/L (below 22) confirm metabolic acidosis, as kidneys fail to buffer, dropping bicarbonate. PaCO2 37 mm Hg (normal) rules out respiratory issues lungs aren't compensating yet. PaO2 94 mm Hg shows oxygenation's fine. Alkalosis options contradict low pH; respiratory acidosis needs high CO2. Nurses recognize this acid-base shift, anticipating bicarbonate or dialysis, a key intervention in renal failure's metabolic chaos.
Which statement is not true?
- A. negative thick and thin smears does not adequately rule out malaria
- B. falciparum malaria will always show up on thick and thin smears where the others may not
- C. chloroquine is the drug of choice to treat falciparum
- D. vivax and ovale are more likely to reactivate at a later stage
Correct Answer: C
Rationale: Chloroquine flops for falciparum resistance rules, not smears' miss, relapse, or anemia truths. Nurses dodge this chronic treatment trap.
Which of the following is FALSE about reduced ejection fraction heart failure (HFrEF)?
- A. The goals of therapy are to reduce morbidity (i.e., reducing symptoms, improving health-related quality of life and functional status, decreasing the rate of hospitalisation) and to reduce mortality
- B. Beta blockers, angiotensin converting enzyme (ACE) inhibitor, angiotensin II receptor blocker (ARB), or angiotensin receptor-neprilysin inhibitor (ARNI) and mineralocorticoid receptor antagonist (MRA) are the preferred antihypertensive agents because these agents improve survival
- C. Recommended lifestyle modifications include smoking cessation, restriction of alcohol consumption, salt restriction, weight reduction in obese patients, as well as daily weight monitoring to detect fluid accumulation before it becomes symptomatic
- D. Patients at high risk for re-hospitalisation should be referred to a long-term care facility
Correct Answer: D
Rationale: HFrEF goals, preferred drugs (beta blockers, ACEi, ARBs, ARNI, MRA), and lifestyle changes are true, per ESC/ACC guidelines. However, high re-hospitalization risk doesn't mandate long-term care referral outpatient management or cardiac rehab is preferred unless dependency justifies it. This false claim refines chronic HFrEF management focus.