Nokea
Following cardiothoracic surgery where controlled therapeutic hypothermia was utilized to decrease metabolic demands, the nurse responsible for monitoring this client postoperatively should be assessing for which potential complication related to cold cardioplegia?
- A. Thrombocytopenia
- B. Hypokalemia
- C. Hyperglycemia
- D. Coagulopathy
Correct Answer: D
Rationale: Coagulopathy is the correct answer. During therapeutic hypothermia, which lowers the body's temperature to reduce metabolic demands post-surgery, coagulopathy, or impaired blood clotting, is a potential complication due to the effects of cold cardioplegia. Thrombocytopenia (choice A) refers to a low platelet count and is not directly related to cold cardioplegia. Hypokalemia (choice B) is a condition of low potassium levels, and hyperglycemia (choice C) is high blood sugar levels, neither of which are primary complications of cold cardioplegia.
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A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?
- A. History of peptic ulcer disease
- B. Use of nitrates
- C. Use of antihypertensive medications
- D. History of hypertension
Correct Answer: B
Rationale: The correct answer is B: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates combined with sildenafil can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of peptic ulcer disease, use of antihypertensive medications, or a history of hypertension are not direct contraindications for sildenafil use.
A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What is the expected therapeutic effect of this medication?
- A. Decreased urinary frequency and urgency
- B. Decreased blood pressure
- C. Increased urinary output
- D. Increased hair growth
Correct Answer: A
Rationale: The correct answer is A: Decreased urinary frequency and urgency. Finasteride is used to reduce the size of the prostate gland in patients with BPH, which helps alleviate symptoms such as urinary frequency and urgency. Choice B, decreased blood pressure, is incorrect because finasteride is not indicated for lowering blood pressure. Choice C, increased urinary output, is incorrect as finasteride does not typically increase urine production. Choice D, increased hair growth, is incorrect as the primary use of finasteride is not for promoting hair growth but rather for treating BPH.
A patient is diagnosed with ischemic heart disease. She is prescribed filgrastim (Neupogen). What effect will this medication provide in the treatment of ischemic heart disease?
- A. Increase platelets
- B. Decrease platelets
- C. Promote angiogenesis
- D. Prevent thrombus formation
Correct Answer: C
Rationale: Filgrastim (Neupogen) is a medication that promotes the growth of white blood cells. In the context of ischemic heart disease, promoting angiogenesis, the formation of new blood vessels, can improve blood flow to the heart muscle, reducing ischemia and potentially improving cardiac function. Therefore, the correct answer is C. Choices A and B are incorrect because filgrastim does not directly affect platelet levels. Choice D is also incorrect as filgrastim does not prevent thrombus formation.
Which term should the nurse use to document a situation in which cells increase in size and function?
- A. Atrophy
- B. Hypertrophy
- C. Metaplasia
- D. Hyperplasia
Correct Answer: B
Rationale: Hypertrophy is the correct term used to describe the situation in which cells increase in size and function. Atrophy (Choice A) is the opposite, indicating a decrease in cell size. Metaplasia (Choice C) refers to the reversible replacement of one mature cell type by another. Hyperplasia (Choice D) involves an increase in the number of cells, not just an increase in size and function as in hypertrophy.
A group of nursing students and their professor are engaged in a service learning project and will be caring for patients in Haiti. What medication should be administered to prevent the development of malaria?
- A. Metronidazole (Flagyl)
- B. Oprelvekin (Neumega)
- C. Chloroquine phosphate (Aralen)
- D. Chloroprocaine hydrochloride (Nesacaine)
Correct Answer: C
Rationale: The correct answer is Chloroquine phosphate (Aralen). Chloroquine is a medication used to prevent and treat malaria. It works by killing the malaria parasite in the red blood cells. Metronidazole (Flagyl) is an antibiotic used to treat various bacterial and parasitic infections, not malaria. Oprelvekin (Neumega) is a medication used to stimulate platelet production. Chloroprocaine hydrochloride (Nesacaine) is a local anesthetic used for epidural anesthesia. Therefore, Chloroquine phosphate is the appropriate medication for preventing malaria in this scenario.