Nokea
How do ACE inhibitors work?
- A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
- B. Block stimulation of beta 1 and beta 2 at the receptor sites
- C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
- D. None of the above
Correct Answer: C
Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.
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Which of the following drugs has a therapeutic effect that increases cardiac output and slows heart rate?
- A. Heparin
- B. Alprazolam
- C. Digoxin
- D. Levothyroxine
Correct Answer: C
Rationale: Digoxin is the correct answer. It is a medication known for its positive inotropic effects, which increase cardiac output, and negative chronotropic effects, which slow the heart rate. These effects are achieved by inhibiting the sodium-potassium ATPase pump in myocardial cells. Therefore, Digoxin is commonly prescribed to manage conditions like heart failure and atrial fibrillation, where enhancing cardiac output and reducing heart rate are beneficial. Choices A, B, and D are incorrect because Heparin is an anticoagulant, Alprazolam is a benzodiazepine used for anxiety disorders, and Levothyroxine is a thyroid hormone replacement drug, none of which have the specified therapeutic effects on cardiac function.
A client receiving chemotherapy reports nausea and vomiting. Which of the following medications should the nurse anticipate administering?
- A. Ondansetron
- B. Metoclopramide
- C. Promethazine
- D. Lorazepam
Correct Answer: A
Rationale: The correct answer is A: Ondansetron. Ondansetron is a commonly used antiemetic for managing nausea and vomiting in clients undergoing chemotherapy. It works by blocking serotonin to reduce these symptoms effectively. Metoclopramide (choice B) is another antiemetic but is more commonly used for gastric motility disorders. Promethazine (choice C) is an antihistamine with antiemetic properties, but ondansetron is often preferred for chemotherapy-induced nausea and vomiting due to its efficacy and fewer side effects. Lorazepam (choice D) is a benzodiazepine used for anxiety and insomnia, not typically for managing nausea and vomiting in this context.
When educating a client who has a new prescription for Levothyroxine to treat hypothyroidism, which of the following instructions should be included?
- A. Take the medication first thing in the morning before eating.
- B. Take the medication at bedtime to avoid drowsiness.
- C. Take the medication with food to prevent nausea.
- D. Take the medication with a glass of milk.
Correct Answer: A
Rationale: Levothyroxine should be taken first thing in the morning before eating to ensure optimal absorption. Taking it on an empty stomach helps prevent interactions with food or other medications that may decrease its effectiveness. It is important to follow this timing recommendation to maintain consistent thyroid hormone levels in the body. Choice B is incorrect as taking Levothyroxine at bedtime may lead to inconsistent absorption and affect its efficacy. Choice C is incorrect because taking Levothyroxine with food can interfere with its absorption. Choice D is incorrect as Levothyroxine should be taken with a full glass of water, not milk, to aid in proper absorption.
Before administering lithium to a client with bipolar disorder who has been taking the medication for 1 year, the nurse should check to see that which of the following tests has been completed?
- A. Thyroid hormone assay
- B. Liver function tests
- C. Erythrocyte sedimentation rate
- D. Brain natriuretic peptide
Correct Answer: A
Rationale: The correct answer is to check the thyroid hormone assay. Long-term lithium use can result in thyroid dysfunction, making it crucial to monitor the client's thyroid function regularly to detect any abnormalities early and prevent potential complications. Liver function tests (choice B) are not specifically associated with lithium therapy. Erythrocyte sedimentation rate (choice C) is a nonspecific test for inflammation and not directly related to lithium therapy. Brain natriuretic peptide (choice D) is a test used to diagnose heart failure and is not relevant to monitoring lithium therapy.
A client has a new prescription for Furosemide to treat heart failure. Which of the following laboratory results should the nurse monitor?
- A. Potassium level
- B. Sodium level
- C. Hemoglobin A1C
- D. BUN
Correct Answer: A
Rationale: The nurse should monitor the client's potassium levels when taking Furosemide because the medication can lead to hypokalemia. Hypokalemia is a potential side effect of Furosemide, a loop diuretic, due to increased potassium excretion in the urine. Monitoring potassium levels is crucial to prevent complications such as cardiac dysrhythmias associated with low potassium levels. Therefore, choices B (Sodium level), C (Hemoglobin A1C), and D (BUN) are incorrect as they are not directly influenced by Furosemide therapy for heart failure.