Nokea
A patient with a history of HF presents to the emergency department with difficulty breathing, cough, and edema of the lower extremities. The nurse anticipates administration of which type of medication?
- A. Positive chronotrope
- B. Negative chronotrope
- C. Positive inotrope
- D. Negative inotrope
Correct Answer: C
Rationale: In the scenario described, the patient with a history of heart failure (HF) is presenting with symptoms of difficulty breathing, cough, and edema of the lower extremities. These signs and symptoms suggest acute decompensated heart failure (ADHF), which is characterized by a decrease in cardiac output and inadequate tissue perfusion. In this situation, the nurse would anticipate the administration of a positive inotrope medication.
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The nurse observes a short period of asystole on the cardiac monitor that resolves spontaneously immediately after administering adenosine IV to a patient who was experiencing paroxysmal supraventricular tachycardia. Which initial action is the most appropriate for the nurse?
- A. Call a code to report a cardiac arrest.
- B. Prepare epinephrine and atropine for intravenous administration.
- C. Initiate cardiopulmonary resuscitation (CPR).
- D. Closely observe the patient and the cardiac monitor.
Correct Answer: D
Rationale: Adenosine is used to treat paroxysmal supraventricular tachycardia (PSVT) by temporarily blocking AV node conduction, which can cause a brief period of asystole. This is an expected effect and typically resolves spontaneously. The nurse should closely monitor the patient and the cardiac monitor for the return of a normal rhythm. Calling a code (A), preparing epinephrine and atropine (B), or initiating CPR (C) is unnecessary unless the asystole persists or the patient becomes unstable.
Prototype of narcotic analgesic agents:
- A. morphine
- B. codeine
- C. heroin
- D. meperidine
Correct Answer: A
Rationale: Morphine is the prototype of narcotic analgesic agents. It is a strong opioid analgesic that is commonly used for the relief of severe pain. Morphine acts on the central nervous system to reduce the perception of pain and is often used in medical settings, such as hospitals, to manage post-operative pain or pain associated with certain medical conditions like cancer. Other opioids, such as codeine, heroin, meperidine, and oxycodone, are derived from or related to morphine but may have different or varying levels of potency, side effects, and addiction potential.
Which of the following should be monitored for patients taking diuretics? (select all that apply)
- A. Daily weight
- B. Intake and output
- C. Amount and location of edema
- D. Appetite
Correct Answer: A
Rationale: A. Daily weight should be monitored for patients taking diuretics because diuretics can cause fluid loss which may lead to weight changes. Fluctuations in weight can indicate changes in fluid balance and help determine the effectiveness of the diuretic therapy.
What is the pharmacological action of metformin?
- A. Biguanides
- B. Benzodiazepines
- C. Nitrates
- D. Digitalis glycosides
Correct Answer: A
Rationale: Metformin belongs to the class of medications known as biguanides. Biguanides work by decreasing glucose production in the liver and also improving insulin sensitivity in the muscles, helping to lower blood sugar levels in patients with type 2 diabetes. Additionally, metformin can also reduce glucose absorption in the intestines and increase glucose uptake in peripheral tissues. Its main pharmacological action is to improve glycemic control and reduce hyperglycemia in patients with diabetes.
What is the common side effect that is normal with the initial therapy of Nitroglycerine due to increased vasodilation?
- A. Abdominal cramps
- B. Calf
- C. Headache
- D. Blurred vision
Correct Answer: C
Rationale: The most common side effect that is normal with the initial therapy of Nitroglycerine due to increased vasodilation is a headache. Nitroglycerine causes vasodilation of blood vessels, including the blood vessels in the head and brain. This can lead to headaches as a result of the increased blood flow and changes in blood vessel diameter. Headaches caused by Nitroglycerine are usually mild and transient. It is important to monitor patients for this expected side effect and educate them about it to ensure compliance with the medication regimen.