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The client on furosemide (Lasix) is complaining of muscle cramps. What electrolyte imbalance should the nurse suspect?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypocalcemia
- D. Hypokalemia
Correct Answer: D
Rationale: The correct answer is D: Hypokalemia. Furosemide is a loop diuretic that causes potassium excretion, leading to low potassium levels and muscle cramps. Hypokalemia is associated with muscle weakness and cramps due to altered muscle function. Hyperkalemia (A) is high potassium levels, not typically associated with furosemide. Hyponatremia (B) is low sodium levels, not directly related to furosemide use. Hypocalcemia (C) is low calcium levels, which can cause muscle cramps but is not the most likely electrolyte imbalance with furosemide.
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What is a condition where the heart's valves do not function properly, leading to disrupted blood flow within the heart?
- A. Valvular heart disease
- B. Myocarditis
- C. Endocarditis
- D. Aneurysm
Correct Answer: A
Rationale: The correct answer is A: Valvular heart disease. Valvular heart disease refers to conditions where the heart's valves do not function properly, leading to disrupted blood flow within the heart. This can result in symptoms like chest pain, shortness of breath, and fatigue. Myocarditis (B) is inflammation of the heart muscle, Endocarditis (C) is an infection of the inner lining of the heart, and Aneurysm (D) is a bulge in a blood vessel. These conditions do not specifically involve malfunctioning heart valves as seen in valvular heart disease.
A client on a beta blocker has a heart rate of 52 bpm. What is the nurse's priority action?
- A. Hold the beta blocker and notify the healthcare provider.
- B. Administer the beta blocker as ordered.
- C. Increase the dose of the beta blocker.
- D. Continue to monitor the client and reassess in 30 minutes.
Correct Answer: A
Rationale: The correct answer is A: Hold the beta blocker and notify the healthcare provider. With a heart rate of 52 bpm, the client may be experiencing bradycardia, a potential side effect of beta blockers. Holding the medication and informing the healthcare provider is crucial to prevent further complications. Administering the beta blocker (B) can exacerbate bradycardia. Increasing the dose (C) can further decrease the heart rate. Continuing to monitor (D) without intervention can lead to worsening of the bradycardia.
You make a home visit to evaluate a hypertensive patient who has been taking enalapril (Vasotec) for 3 weeks. Which information indicates that you need to contact the physician about a change in the drug therapy?
- A. Patient complains of frequent urination.
- B. Patient's blood pressure is 138/86.
- C. Patient coughs often during the visit.
- D. Patient complains of occasional dizziness.
Correct Answer: C
Rationale: A persistent cough is a common side effect of ACE inhibitors like enalapril, and it may warrant a change in medication.
Which medication is used to prevent blood clots by thinning the blood, reducing the risk of stroke and heart attack?
- A. Anticoagulant
- B. ACE inhibitor
- C. Beta-blocker
- D. Calcium channel blocker
Correct Answer: A
Rationale: The correct answer is A: Anticoagulant. Anticoagulants prevent blood clots by thinning the blood, reducing the risk of stroke and heart attack. They work by inhibiting clot formation. ACE inhibitors (B), Beta-blockers (C), and Calcium channel blockers (D) are not used to prevent blood clots. ACE inhibitors are used to treat high blood pressure and heart failure, Beta-blockers are used to treat high blood pressure and heart conditions, and Calcium channel blockers are used to treat high blood pressure and certain heart conditions.
Which neurotransmitter released by the parasympathetic nervous system can decrease heart rate?
- A. Acetylcholine
- B. Norepinephrine
- C. Dopamine
- D. Serotonin
Correct Answer: A
Rationale: The correct answer is A: Acetylcholine. Acetylcholine is released by the parasympathetic nervous system and acts on the heart to decrease heart rate. It binds to muscarinic receptors in the heart, leading to a decrease in heart rate through inhibition of the SA node. Norepinephrine (B) is released by the sympathetic nervous system and increases heart rate. Dopamine (C) and Serotonin (D) are not directly involved in regulating heart rate through the parasympathetic pathway.