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A patient with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. What is the primary action of this medication?
- A. Reduce inflammation
- B. Relieve bronchospasm
- C. Suppress cough
- D. Thin respiratory secretions
Correct Answer: B
Rationale: The correct answer is B: Relieve bronchospasm. Ipratropium is an anticholinergic bronchodilator that works by relaxing the muscles in the airways, leading to bronchodilation and improved airflow. This helps to relieve bronchospasm, a common symptom in COPD. Choice A is incorrect because ipratropium does not have significant anti-inflammatory effects. Choice C is incorrect as ipratropium does not directly suppress cough. Choice D is incorrect as ipratropium does not specifically target respiratory secretions.
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A client with a history of peptic ulcer disease is admitted with severe abdominal pain. Which assessment finding should the nurse report to the healthcare provider immediately?
- A. Bowel sounds active in all quadrants.
- B. Blood pressure of 110/70 mm Hg.
- C. Rigid, board-like abdomen.
- D. Heart rate of 90 beats per minute.
Correct Answer: C
Rationale: The correct answer is C: Rigid, board-like abdomen. This finding suggests peritonitis, a serious complication of peptic ulcer disease, requiring immediate medical intervention. A: Active bowel sounds are expected. B: Blood pressure is within normal range. D: Heart rate is slightly elevated but not a critical finding. In summary, a rigid abdomen indicates peritonitis and requires urgent attention compared to the other choices.
What is the primary action of digoxin when prescribed to a patient with heart failure?
- A. Increase heart rate
- B. Decrease cardiac output
- C. Strengthen cardiac contractions
- D. Lower blood pressure
Correct Answer: C
Rationale: The primary action of digoxin in heart failure is to strengthen cardiac contractions. Digoxin inhibits the sodium-potassium pump, leading to an increase in intracellular calcium levels, which enhances the force of myocardial contractions. This helps improve cardiac output and symptoms of heart failure.
Explanation:
A: Incorrect - Digoxin does not increase heart rate, it mainly affects the strength of contractions.
B: Incorrect - Digoxin does not decrease cardiac output; it actually helps improve it by enhancing contractility.
D: Incorrect - Digoxin may have a slight effect on lowering blood pressure, but its primary action in heart failure is to strengthen cardiac contractions, not lower blood pressure.
A client's telemetry monitor indicates the sudden onset of ventricular fibrillation. Which assessment finding should the nurse anticipate?
- A. Bounding erratic pulse.
- B. Regularly irregular pulse.
- C. Thready irregular pulse.
- D. No palpable pulse.
Correct Answer: D
Rationale: The correct answer is D: No palpable pulse. Ventricular fibrillation is a life-threatening arrhythmia where the heart quivers and doesn't effectively pump blood. This results in the absence of a palpable pulse. The nurse should anticipate this finding as it indicates a severe cardiac emergency requiring immediate intervention. Choices A, B, and C are incorrect because ventricular fibrillation leads to ineffective heart contractions, causing a lack of pulse rather than bounding, irregular, or thready pulses. It is crucial for the nurse to recognize the absence of a palpable pulse to initiate prompt resuscitative measures.
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.
While assessing a 70-year-old female client with Alzheimer's disease, the nurse notes deep inflamed cracks at the corners of her mouth. What intervention should the nurse include in this client's plan of care?
- A. Apply a moisturizing cream to the affected areas.
- B. Encourage the client to consume foods rich in vitamin B.
- C. Notify the healthcare provider for further evaluation.
- D. Ensure that the client gets adequate B vitamins in foods or supplements.
Correct Answer: D
Rationale: The correct answer is D because deep inflamed cracks at the corners of the mouth can be a sign of vitamin B deficiency, specifically B2 (riboflavin) or B3 (niacin). Ensuring the client gets adequate B vitamins through foods or supplements can help address the deficiency and improve the condition. Option A is incorrect as simply applying a moisturizing cream does not address the underlying cause. Option B is not the best choice because while vitamin B-rich foods are beneficial, they may not be sufficient to correct a deficiency. Option C is not the immediate priority unless there are other concerning symptoms present.