Nokea
A patient asked the nurse what cardiac glycosides do to improve his condition. What is the nurse's best response?
- A. They increase heart rate.
- B. They decrease the force of myocardial contractions.
- C. They decrease conduction velocity.
- D. They help renal blood flow and increase urine output.
Correct Answer: D
Rationale: The correct answer is D because cardiac glycosides, such as digoxin, help improve heart failure by increasing renal blood flow and urine output. This occurs by inhibiting the sodium-potassium pump, leading to increased intracellular calcium levels, which in turn enhances cardiac contractility and renal perfusion. Choices A, B, and C are incorrect because cardiac glycosides do not increase heart rate, decrease the force of myocardial contractions, or decrease conduction velocity. These medications actually have a positive inotropic effect, increasing the force of myocardial contractions.
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What is the action of ergotamine?
- A. Increases hypoperfusion of basilar artery vascular bed.
- B. Decreases hypoperfusion of basilar artery vascular bed.
- C. Increases hyperperfusion of basilar artery vascular bed.
- D. Decreases hyperperfusion of basilar artery vascular bed.
Correct Answer: D
Rationale: The correct answer is D: Decreases hyperperfusion of basilar artery vascular bed. Ergotamine is a vasoconstrictor that acts on serotonin receptors, reducing blood flow and decreasing hyperperfusion in the basilar artery. This helps in treating conditions like migraines by reducing the dilation of blood vessels. Choice A is incorrect because ergotamine does not increase hypoperfusion, but rather decreases hyperperfusion. Choice B is incorrect as ergotamine does not decrease hypoperfusion. Choice C is incorrect since ergotamine does not increase hyperperfusion, rather it decreases it.
A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient?
- A. Deficient Knowledge, unfamiliar with drug therapy.
- B. Ineffective health maintenance, need for medication.
- C. Risk for injury, related to adverse effect of the drug.
- D. Noncompliance, cost of the drug.
Correct Answer: C
Rationale: The correct answer is C: Risk for injury, related to adverse effect of the drug. This is the priority nursing diagnosis because the patient, being 70 years old and receiving a sedating drug, is at an increased risk for falls and other injuries due to sedation. It is crucial for the nurse to monitor the patient closely for signs of sedation and take appropriate measures to prevent potential harm.
Choice A (Deficient Knowledge) is not the priority as the immediate concern is the risk of injury. Choice B (Ineffective health maintenance) focuses on the need for medication, not the potential risk of injury. Choice D (Noncompliance) is not relevant in this situation as it pertains to the cost of the drug, not the immediate safety of the patient.
The nurse is caring for a patient who is taking a calcium-channel blocker. What adverse effects would the nurse caution this patient about?
- A. Itching and rash.
- B. Hypertension and tachycardia.
- C. Nausea and diarrhea.
- D. Headache and dizziness.
Correct Answer: D
Rationale: The correct answer is D: Headache and dizziness. Calcium-channel blockers can cause vasodilation leading to decreased blood pressure, which can manifest as headache and dizziness. Itching and rash (A) are not common adverse effects of calcium-channel blockers. Hypertension and tachycardia (B) are actually treated by calcium-channel blockers. Nausea and diarrhea (C) are not typical side effects of calcium-channel blockers. E, F, and G are not applicable. In summary, the correct answer is D because headache and dizziness are common adverse effects of calcium-channel blockers, while the other choices are not commonly associated with this medication.
A geriatric patient received a narcotic analgesic before leaving the post-anesthesia care unit to return to the regular unit. What is the priority nursing action for the nurse receiving the patient on the regular unit?
- A. Administer a non-steroidal anti-inflammatory drug.
- B. Put side rails up and place bed in the lowest position.
- C. Encourage fluids.
- D. Create a restful dark environment.
Correct Answer: B
Rationale: The correct answer is B: Put side rails up and place bed in the lowest position. This is the priority nursing action as the geriatric patient who received a narcotic analgesic may experience drowsiness or confusion, increasing the risk of falls. By putting up the side rails and lowering the bed, the nurse is ensuring the patient's safety and preventing falls. Administering a non-steroidal anti-inflammatory drug (choice A) is not the priority as the patient's safety should be addressed first. Encouraging fluids (choice C) and creating a restful dark environment (choice D) are important but not as crucial as ensuring the patient's immediate safety.
The nurse is caring for a patient receiving warfarin and notes bruising and petechiae on the patient's extremities. The nurse will request an order for which?
- A. Vitamin K Level.
- B. PTT and aPTT.
- C. International normalized ratio (INR).
- D. Platelet level.
Correct Answer: C
Rationale: The correct answer is C: International normalized ratio (INR). When a patient on warfarin presents with bruising and petechiae, it suggests potential over-anticoagulation. INR measures the effectiveness of warfarin therapy by assessing clotting time. An elevated INR indicates a higher risk of bleeding due to excessive anticoagulation. Ordering a Vitamin K level (choice A) is not necessary as the patient is already on warfarin. PTT and aPTT (choice B) are not specific to monitoring warfarin therapy. Platelet level (choice D) is not indicated for assessing warfarin effects.