Nokea
The client on amiodarone develops symptoms of hypothyroidism. What is the nurse's best response?
- A. Notify the healthcare provider immediately.
- B. Reassure the client that this is a common side effect of amiodarone.
- C. Monitor the client's thyroid function tests regularly.
- D. Discontinue the amiodarone immediately.
Correct Answer: C
Rationale: The correct response is C: Monitor the client's thyroid function tests regularly. This is the best approach because amiodarone can cause hypothyroidism, so monitoring thyroid function tests allows early detection and appropriate management. Option A is not necessary unless the client presents with severe symptoms. Option B is incorrect as hypothyroidism is a serious side effect that requires monitoring and possible treatment adjustments. Option D is not recommended as abruptly stopping amiodarone can lead to serious cardiac arrhythmias. Regular monitoring ensures timely intervention if thyroid levels are abnormal.
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The client is on hydrochlorothiazide and digoxin. What effect can the nurse expect?
- A. Hydrochlorothiazide increases digoxin levels.
- B. Hydrochlorothiazide decreases digoxin levels.
- C. Hydrochlorothiazide decreases potassium, increasing the risk of digoxin toxicity.
- D. Digoxin can increase the effectiveness of hydrochlorothiazide.
Correct Answer: C
Rationale: The correct answer is C because hydrochlorothiazide is a diuretic that can lead to hypokalemia (decreased potassium levels), which increases the risk of digoxin toxicity as digoxin requires adequate potassium levels for proper function.
Choice A is incorrect because hydrochlorothiazide does not increase digoxin levels. Choice B is incorrect because hydrochlorothiazide can actually increase digoxin levels due to potential electrolyte disturbances. Choice D is incorrect as digoxin does not affect the effectiveness of hydrochlorothiazide.
The client on warfarin has an INR of 1.2. What is the nurse's priority action?
- A. Increase the dose of warfarin
- B. Administer vitamin K
- C. Monitor for signs of bleeding
- D. Hold the next dose and notify the healthcare provider
Correct Answer: A
Rationale: The correct answer is A: Increase the dose of warfarin. INR of 1.2 indicates subtherapeutic levels. The nurse's priority is to adjust the dose to achieve a therapeutic range (usually 2-3). Increasing the dose is essential to prevent clot formation. Administering vitamin K (B) is not indicated for a low INR. Monitoring for bleeding (C) is important, but not the priority when the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider (D) may be necessary if the INR is too high, not low.
The nurse is caring for a client with atrial fibrillation on dabigatran (Pradaxa). What is the most important instruction to give to the client?
- A. Take the medication with food to prevent stomach upset.
- B. Do not miss a dose and take it at the same time each day.
- C. Avoid consuming alcohol while on this medication.
- D. Monitor for signs of bleeding.
Correct Answer: B
Rationale: Step-by-step rationale:
1. Dabigatran is an anticoagulant used to prevent blood clots.
2. Consistent dosing is crucial to maintain therapeutic levels.
3. Missing doses increases the risk of clot formation.
4. Taking it at the same time daily helps to ensure effectiveness.
Summary:
A: Taking with food is not essential for dabigatran.
C: Alcohol does not directly interact with dabigatran.
D: Monitoring for bleeding is important, but consistent dosing is the priority for efficacy.
The most life-threatening cardiac arrhythmia following myocardial infarction is
- A. ventricular fibrillation
- B. premature ventricular contractions
- C. premature atrial contractions
- D. atrial fibrillation
Correct Answer: A
Rationale: Ventricular fibrillation disrupts cardiac function and requires immediate intervention.
Which condition is characterized by the right ventricle of the heart failing due to increased pressure in the lungs, often caused by chronic lung disease?
- A. Cor pulmonale
- B. Pulmonary embolism
- C. Aortic stenosis
- D. Hypertrophic cardiomyopathy
Correct Answer: A
Rationale: The correct answer is A: Cor pulmonale. This condition is characterized by right ventricle failure due to increased pulmonary pressure from chronic lung disease. Step 1: Chronic lung disease causes increased pressure in the lungs. Step 2: The increased pressure in the lungs leads to the right ventricle of the heart working harder to pump blood through the lungs. Step 3: Over time, this increased workload can cause right ventricular failure, known as cor pulmonale. Summary: B is incorrect as pulmonary embolism is a sudden blockage of an artery in the lungs. C is incorrect as aortic stenosis involves narrowing of the aortic valve, affecting the left ventricle. D is incorrect as hypertrophic cardiomyopathy is a genetic condition causing thickening of the heart muscle.