Nokea
A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose?
- A. 0.25
- B. 0.5
- C. 1
- D. 1.5
Correct Answer: B
Rationale: Digoxin math: 125 mcg ordered, 0.25 mg (250 mcg) per tablet 125 ÷ 250 = 0.5 tablets, a precise dose nurses calc to boost heart failure's pump, avoiding toxicity's narrow edge. Wrong cuts (0.25, 1, 1.5) miss the mark. Accuracy here rules, a daily win in this med game.
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Which of the following laboratory abnormalities is NOT associated with fatty liver?
- A. Elevated uric acid
- B. Elevated LDL-cholesterol
- C. Elevated fasting glucose
- D. Elevated creatinine kinase
Correct Answer: D
Rationale: Fatty liver (NAFLD) links to metabolic syndrome elevated uric acid, LDL-cholesterol, fasting glucose, and triglycerides reflect insulin resistance and dyslipidemia. Elevated creatinine kinase (CK) indicates muscle damage (e.g., myopathy), not a typical NAFLD feature, though liver enzymes (ALT/AST) rise. CK's absence from NAFLD profiles guides physicians in differential diagnosis during chronic liver disease assessment.
During artificial ventilation in a patient with chronic obstructive pulmonary disease, air trapping:
- A. Leads to hypotension when venous return is reduced significantly.
- B. Is likely to be present when the capnogram fails to reach a plateau in expiration.
- C. May be reduced by using a low respiratory rate.
- D. Is reduced by decreasing the ratio of inspiratory time to expiratory time.
Correct Answer: A
Rationale: Air trapping in COPD during mechanical ventilation occurs due to incomplete exhalation from airway obstruction, leading to intrinsic positive end-expiratory pressure (auto-PEEP). This increases intrathoracic pressure, compressing the vena cava and reducing venous return, which can cause hypotension a critical complication. A capnogram failing to plateau suggests prolonged exhalation, consistent with air trapping, but it's a diagnostic sign, not a consequence. A low respiratory rate allows more exhalation time, reducing air trapping, while decreasing the inspiratory-to-expiratory time ratio (e.g., shortening inspiration) similarly helps by extending exhalation. Positive end-expiratory pressure (PEEP) can exacerbate air trapping if excessive, but its effect depends on levels used. Hypotension from reduced venous return is a direct physiological result of severe air trapping, making it the most definitive statement in this context.
Which of these organisms causing gastroenteritis produce the toxin in the food prior to ingestion?
- A. vibrio cholera
- B. salmonella
- C. staph aureus
- D. clostridium perfringens
Correct Answer: C
Rationale: Staph aureus pre-toxins food, not cholera, salmonella, E. coli, Clostrid's gut brew. Nurses tag this chronic picnic poison.
Which agent should not be part of the management of generalized tetanus?
- A. metronidazole
- B. penicillin
- C. midazolam
- D. tetanus immunoglobulin
Correct Answer: B
Rationale: Tetanus penicillin's old school, metronidazole's better for Clostridium now; midazolam calms, Ig neutralizes, labetalol steadies. Nurses skip this chronic bug zapper.
People with metabolic syndrome have an increased risk of which of the following disorders, besides type 2 diabetes mellitus?
- A. Hypertension, infections
- B. Myocardial infarction, hypertension
- C. Myocardial infarction, infections
- D. Myocardial infarction, liver cirrhosis
Correct Answer: B
Rationale: Metabolic syndrome hikes heart attacks, hypertension vascular hits, not infections or cirrhosis extras. Nurses track this, a chronic CV duo.