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If Dr. Baker complains of loss of appetite and nausea after starting chlorothiazide, it would be important to
- A. check her digitalis and potassium levels
- B. obtain a urine specimen
- C. get an electrocardiogram immediately
- D. reassure her that since her blood pressure is normal these symptoms are to be expected
Correct Answer: A
Rationale: Chlorothiazide can affect electrolyte balance, requiring monitoring.
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The client on nitroglycerin complains of a headache. What is the most appropriate response by the nurse?
- A. Administer acetaminophen as prescribed for the headache.
- B. Hold the next dose of nitroglycerin.
- C. Discontinue the nitroglycerin immediately.
- D. Notify the healthcare provider immediately.
Correct Answer: A
Rationale: The correct response is to administer acetaminophen as prescribed for the headache. This is because headaches are a common side effect of nitroglycerin due to vasodilation. Acetaminophen can help relieve the headache without interfering with the therapeutic effects of nitroglycerin. Holding the next dose (B) is not appropriate as it can lead to inadequate treatment of the client's condition. Discontinuing nitroglycerin (C) abruptly can be dangerous as it may cause rebound hypertension. Notifying the healthcare provider (D) is not necessary unless the headache persists or worsens.
What type of heart disease is characterized by the heart muscle becoming enlarged and weakened, reducing its ability to pump blood effectively?
- A. Dilated cardiomyopathy
- B. Hypertrophic cardiomyopathy
- C. Restrictive cardiomyopathy
- D. Myocarditis
Correct Answer: A
Rationale: The correct answer is A: Dilated cardiomyopathy. This condition is characterized by the heart muscle becoming enlarged and weakened, leading to reduced pumping efficiency. This results in symptoms like fatigue, shortness of breath, and swelling. In contrast, hypertrophic cardiomyopathy (B) is characterized by thickening of the heart muscle, restrictive cardiomyopathy (C) involves stiffness of the heart muscle, and myocarditis (D) is inflammation of the heart muscle. These conditions do not specifically involve the enlargement and weakening seen in dilated cardiomyopathy.
What type of medication is used to reduce high blood pressure by relaxing the blood vessels?
- A. Calcium channel blocker
- B. Beta-blocker
- C. ACE inhibitor
- D. Diuretic
Correct Answer: A
Rationale: The correct answer is A: Calcium channel blocker. These medications work by relaxing the blood vessels, leading to lower blood pressure. They inhibit the entry of calcium into the smooth muscle cells of the blood vessels, causing vasodilation. Beta-blockers (B) reduce heart rate and contractility. ACE inhibitors (C) block the conversion of angiotensin I to angiotensin II, leading to vasodilation. Diuretics (D) work by increasing urine output to lower blood volume and pressure. In this case, the mechanism of action aligns with the desired effect of relaxing blood vessels to reduce high blood pressure.
Which of the following are the consequences of fluid and electrolyte imbalances resulting from diuretic therapy in older adults?
- A. Fatigue
- B. Dyspnea
- C. Chest pain
- D. Heart palpitations
Correct Answer: A
Rationale: Fluid and electrolyte imbalances can lead to fatigue, a common side effect of diuretic use in older adults.
As the charge nurse in a long-term-care (LTC) facility that has RN, LPN/LVN, and nursing assistant staff members, you have developed a plan for ongoing assessment of all residents with a diagnosis of heart failure. Which of these activities included in the plan is most appropriate to delegate to an LPN/LVN team leader?
- A. Weigh all residents with heart failure each morning.
- B. Listen to lung sounds and check for edema weekly.
- C. Review all heart failure medications with residents every month.
- D. Update activity plans for residents with heart failure every quarter.
Correct Answer: A
Rationale: Weighing residents is a routine task suitable for delegation to an LPN/LVN.