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A patient is being taught the action of digoxin, which is an inotropic agent. The nurse defines an inotropic agent as a medication that has which of the following actions?
- A. Decreases heart rate
- B. Increases conduction time
- C. Increases heart rate
- D. Strengthens heart contraction
Correct Answer: D
Rationale: An inotropic agent, such as digoxin, is a medication that strengthens the contraction of the heart muscle. It works by increasing the force of each heartbeat, helping the heart pump more efficiently. This can be beneficial in conditions such as heart failure or certain types of arrhythmias where the heart's pumping ability is compromised. Inotropic agents do not decrease heart rate, increase conduction time, or increase heart rate; their primary action is to enhance the heart's contractility.
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How should the nurse prepare a suspension before administration?
- A. By diluting it with normal saline solution
- B. By diluting it with 5% dextrose solution
- C. By shaking it so that all the drug particles are dispersed uniformly
- D. By crushing remaining particles with a mortar and pestle
Correct Answer: C
Rationale: The correct way to prepare a suspension before administration is by shaking it so that all the drug particles are dispersed uniformly. Suspending agent particles settle over time, creating a layer of liquid at the top and a layer of solid at the bottom. By shaking the suspension, the nurse ensures that the drug particles are fully mixed and distributed evenly throughout the liquid. This step is crucial to ensure that the patient receives the correct dosage of the medication with each administration. Diluting the suspension with normal saline or dextrose solutions or crushing remaining particles with a mortar and pestle are not recommended methods for preparing a suspension before administration.
A client tells the nurse that she has been working hard for the last 3 months to control her type 2 diabetes mellitus with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check:
- A. Urine glucose level
- B. Serum fructosamine level
- C. Fasting blood glucose level
- D. Glycosylated hemoglobin level
Correct Answer: D
Rationale: Checking the glycosylated hemoglobin (HbA1c) level is the most appropriate way to determine the effectiveness of the client's efforts to control type 2 diabetes mellitus over the past few months. HbA1c provides an average of the blood glucose levels over the past 2-3 months, reflecting how well the client has been managing their diabetes. This test is not affected by recent food intake or physical activity, making it a reliable indicator of long-term glucose control. Unlike fasting blood glucose levels or urine glucose levels, which can fluctuate throughout the day, HbA1c gives a more comprehensive view of glucose control and helps guide treatment decisions.
A 2-month-old premature infant born at 30 weeks gestation is scheduled for an inguinal hernia repair. Which of the following preoperative findings would BEST predict an increased risk of postoperative apnea?
- A. Hemoglobin 7 gm/dL
- B. Glucose 61 mg/dL
- C. Room air SpO2 92%
- D. N/A
Correct Answer: A
Rationale: Low hemoglobin levels in a premature infant can increase the risk of postoperative apnea due to reduced oxygen-carrying capacity.
Hepatitis C virus infection is a risk factor for which of the following malignancy?
- A. hepatoblastoma
- B. splenic lymphoma
- C. Hodgkin lymphoma
- D. nasopharyngeal carcinoma
Correct Answer: B
Rationale: Hepatitis C is a known risk factor for splenic lymphoma and other B-cell lymphoproliferative disorders.
Which is descriptive of attention deficit hyperactivity disorder (ADHD)?
- A. Manifestations exhibited are so bizarre that the diagnosis is fairly easy.
- B. Manifestations affect every aspect of the child's life but are most obvious in the classroom.
- C. Learning disabilities associated with ADHD eventually disappear when adulthood is reached.
- D. Diagnosis of ADHD requires that all manifestations of the disorder be present.
Correct Answer: B
Rationale: Option B is descriptive of attention deficit hyperactivity disorder (ADHD). Manifestations of ADHD can significantly impact the child's life, but are most noticeable in the classroom setting. Children with ADHD may struggle with paying attention, staying organized, controlling impulsive behavior, and following instructions in the school environment. While symptoms can also affect other areas of life, such as social interactions and familial relationships, they are typically most prominently displayed in the structured school setting, making it easier to recognize and diagnose the disorder.