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A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct Answer: C
Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.
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A patient with type 2 diabetes is prescribed metformin. What instruction should the nurse provide regarding this medication?
- A. Take the medication on an empty stomach.
- B. Monitor for signs of hypoglycemia.
- C. Take the medication with meals.
- D. Increase intake of simple carbohydrates.
Correct Answer: C
Rationale: Step-by-step rationale for choice C:
1. Metformin can cause gastrointestinal side effects.
2. Taking it with meals helps reduce stomach upset.
3. It also helps in better absorption and effectiveness.
4. Therefore, the nurse should instruct the patient to take metformin with meals.
Summary of other choices:
A: Taking on an empty stomach can worsen gastrointestinal side effects.
B: Metformin doesn't typically cause hypoglycemia.
D: Increasing simple carbohydrates can counteract the effects of metformin.
An outcome for treatment of peripheral vascular disease is, 'The client will have decreased venous congestion.' What client behavior would indicate to the nurse that this outcome has been met?
- A. Avoids prolonged sitting or standing.
- B. Avoids trauma and irritation to skin.
- C. Wears protective shoes.
- D. Quits smoking.
Correct Answer: A
Rationale: The correct answer is A because avoiding prolonged sitting or standing helps improve venous return by preventing blood from pooling in the legs, reducing venous congestion. This behavior promotes circulation and decreases the risk of complications. Choices B, C, and D do not directly address venous congestion or circulation improvement, making them incorrect options. Avoiding trauma and irritation to the skin (B) is important for skin integrity but not specifically for venous congestion. Wearing protective shoes (C) is related to preventing foot injuries but does not directly impact venous congestion. Quitting smoking (D) is beneficial for overall health but does not directly target venous congestion.
A patient with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. What is the primary purpose of this medication?
- A. Reduce mucus production
- B. Relieve bronchospasm
- C. Suppress cough
- D. Thin respiratory secretions
Correct Answer: B
Rationale: The correct answer is B: Relieve bronchospasm. Tiotropium is an anticholinergic medication that acts by relaxing the muscles around the airways, thereby helping to relieve bronchospasm in patients with COPD. This results in improved airflow and reduced shortness of breath.
A: Reduce mucus production - This is incorrect as tiotropium does not directly affect mucus production but rather focuses on bronchospasm relief.
C: Suppress cough - Tiotropium may help with cough associated with COPD by improving airflow, but its primary purpose is not to suppress cough.
D: Thin respiratory secretions - Tiotropium does not have a direct effect on thinning respiratory secretions; its main action is bronchodilation to relieve bronchospasm in COPD.
When should the charge nurse intervene based on the observed behavior?
- A. Two staff members are overheard talking about a cure for AIDS outside a client's room.
- B. A hospital transporter is reading a client's history and physical while waiting for an elevator.
- C. A UAP tells a client, 'It's hard to quit drinking but Alcoholics Anonymous helped me.'
- D. Two visitors are discussing a hospitalized client's history of drug abuse in the visitor's lounge.
Correct Answer: B
Rationale: The correct answer is B because it violates patient confidentiality. Reading a client's history and physical in a public area breaches the client's privacy rights. The other choices do not directly compromise patient confidentiality. A involves discussing a cure for AIDS, which is not a breach of confidentiality. C involves sharing personal experiences with the client, and D involves discussing a client's history of drug abuse in a visitor's lounge, which may not be overheard by the client or staff directly involved in the client's care.
An elderly female client comes to the clinic for a regular check-up. The client tells the nurse that she has increased her daily doses of acetaminophen (Tylenol) for the past month to control joint pain. Based on this client's comment, what previous lab values should the nurse compare with today's lab report?
- A. Look at last quarter's hemoglobin and hematocrit to assess for dehydration.
- B. Look for an increase in today's LDH compared to the previous one to assess for possible liver damage.
- C. Expect to find an increase in today's APTT compared to last quarter's due to bleeding.
- D. Determine if there is a decrease in serum potassium due to renal compromise.
Correct Answer: B
Rationale: The correct answer is B. The nurse should look for an increase in today's LDH compared to the previous one to assess for possible liver damage. Acetaminophen overdose can lead to liver toxicity, which can be indicated by elevated LDH levels. LDH is an enzyme released during liver damage. Checking for LDH levels can help assess the impact of increased acetaminophen doses on the liver.
Choices A, C, and D are incorrect:
A: Looking at hemoglobin and hematocrit is not directly related to acetaminophen use for joint pain. It does not provide information about liver damage.
C: APTT measures blood clotting time and is not directly affected by acetaminophen use for joint pain. It does not provide information about liver damage.
D: Serum potassium levels are not typically affected by acetaminophen use for joint pain. It does not provide information about liver damage.