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The emergency department nurse is administering IV lidocaine to patients. What adverse effect of lidocaine therapy should the nurse assess for?
- A. Tinnitus.
- B. Dizziness.
- C. Dysphagia.
- D. Excessive bruising.
Correct Answer: B
Rationale: The correct answer is B: Dizziness. Lidocaine is a local anesthetic that can cause dizziness as an adverse effect due to its effect on the central nervous system. The nurse should assess for dizziness as it can impact the patient's safety and may indicate toxicity. Tinnitus (A) is a potential side effect of lidocaine, but it is less common than dizziness. Dysphagia (C) is not a typical adverse effect of lidocaine. Excessive bruising (D) is not associated with lidocaine therapy.
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When involved in phase III drug evaluation studies, what responsibilities would the nurse have?
- A. Working with animals who are given experimental drugs.
- B. Conducting research to determine the effectiveness of the drug.
- C. Monitoring and observing patients closely for adverse effects.
- D. Choosing appropriate patients to be involved in the study.
Correct Answer: C
Rationale: The correct answer is C because in phase III drug evaluation studies, nurses are responsible for monitoring and observing patients closely for any adverse effects of the experimental drug. This is crucial to ensure patient safety and to gather data on the drug's efficacy and safety profile. Nurses play a key role in identifying and reporting any adverse reactions promptly.
Choice A is incorrect as nurses do not work with animals in drug evaluation studies.
Choice B is incorrect as conducting research to determine drug effectiveness is typically done by researchers and physicians, not nurses.
Choice D is incorrect as choosing appropriate patients for the study is usually the responsibility of the study's principal investigator or a designated research team.
What assessment finding would indicate the patient's left-sided heart failure is worsening?
- A. Increased jugular venous pressure.
- B. Liver enlargement.
- C. Increased pulse rate.
- D. Increased crackles in lung fields.
Correct Answer: D
Rationale: The correct answer is D: Increased crackles in lung fields. Worsening left-sided heart failure causes fluid to accumulate in the lungs, leading to crackles on auscultation. Increased jugular venous pressure (A) is more indicative of right-sided heart failure. Liver enlargement (B) is a sign of congestive hepatomegaly, common in right-sided heart failure. Increased pulse rate (C) may indicate heart failure exacerbation but is not specific to left-sided failure. Therefore, choice D is the best indicator of worsening left-sided heart failure.
A patient asked the nurse what cardiac glycosides do to improve his condition. What is the nurse's best response?
- A. They increase heart rate.
- B. They decrease the force of myocardial contractions.
- C. They decrease conduction velocity.
- D. They help renal blood flow and increase urine output.
Correct Answer: D
Rationale: The correct answer is D because cardiac glycosides, such as digoxin, help improve heart failure by increasing renal blood flow and urine output. This occurs by inhibiting the sodium-potassium pump, leading to increased intracellular calcium levels, which in turn enhances cardiac contractility and renal perfusion. Choices A, B, and C are incorrect because cardiac glycosides do not increase heart rate, decrease the force of myocardial contractions, or decrease conduction velocity. These medications actually have a positive inotropic effect, increasing the force of myocardial contractions.
The nurse is caring for a patient with Parkinson's Disease. While writing the care plan for the patient, what would be an appropriate diagnosis?
- A. Constipation related to dopaminergic effects.
- B. Risk for injuries related to CVS effects and PVD.
- C. Risk for injury related to CVS effects and incidence of orthostatic hypotension.
- D. Diarrhea related to dopaminergic effects.
Correct Answer: C
Rationale: The correct answer is C, "Risk for injury related to CVS effects and incidence of orthostatic hypotension." This is the most appropriate diagnosis for a patient with Parkinson's Disease because they are at increased risk for falls due to cardiovascular (CVS) effects such as orthostatic hypotension, which can lead to dizziness and falls. This diagnosis addresses the specific risk factor associated with Parkinson's Disease and focuses on preventing potential injuries.
Choice A, "Constipation related to dopaminergic effects," is incorrect as constipation is a common symptom in Parkinson's Disease but does not directly relate to the risk of injury.
Choice B, "Risk for injuries related to CVS effects and PVD," is incorrect because it includes peripheral vascular disease (PVD) which is not typically associated with Parkinson's Disease.
Choice D, "Diarrhea related to dopaminergic effects," is also incorrect as diarrhea is not a common symptom or risk factor for patients with Parkinson's Disease.
The nurse is teaching a class on muscular coordination and explains it is the movement of what electrolyte that contributes to the process of muscle contraction and relaxation?
- A. Magnesium.
- B. Chloride.
- C. Calcium.
- D. Hydrogen.
Correct Answer: C
Rationale: The correct answer is C: Calcium. Calcium plays a crucial role in muscle contraction and relaxation. During muscle contraction, calcium ions bind to proteins in muscle fibers, allowing the actin and myosin filaments to slide past each other. This sliding action is what causes muscle contraction. When muscle relaxation is needed, calcium ions are pumped back into storage within the muscle cells, leading to relaxation. Magnesium (A), chloride (B), and hydrogen (D) do not directly influence muscle contraction and relaxation like calcium does.