Nokea
The healthcare provider is administering IV nitroglycerin to a patient for chest pain. What is the most critical parameter to monitor?
- A. Heart rate
- B. Blood pressure
- C. Oxygen saturation
- D. Respiratory rate
Correct Answer: B
Rationale: The correct answer is B: Blood pressure. When administering IV nitroglycerin for chest pain, monitoring blood pressure is critical due to its vasodilatory effect, which can cause hypotension. Monitoring blood pressure helps prevent potential adverse effects like hypotension-related symptoms or complications. Heart rate, oxygen saturation, and respiratory rate are also important parameters to monitor, but blood pressure takes precedence in this scenario due to the potential for significant hemodynamic changes.
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Which order should the nurse question?
- A. The addition of a loop diuretic with digoxin.
- B. The addition of a beta blocker with digoxin.
- C. A digoxin dose of 0.125 mg per day.
- D. The addition of an ACE inhibitor with digoxin.
Correct Answer: B
Rationale: The correct answer is B: The addition of a beta blocker with digoxin. When combined, beta blockers can enhance the effects of digoxin, leading to an increased risk of bradycardia and heart block. This combination can also exacerbate digoxin toxicity. Therefore, the nurse should question the addition of a beta blocker with digoxin to prevent potential adverse effects.
Incorrect choices:
A: The addition of a loop diuretic with digoxin - Loop diuretics may lead to hypokalemia, which can increase the risk of digoxin toxicity.
C: A digoxin dose of 0.125 mg per day - This is within the recommended dose range for digoxin and does not pose a significant concern.
D: The addition of an ACE inhibitor with digoxin - ACE inhibitors are commonly used in combination with digoxin and do not typically interact negatively.
Which neurotransmitter is released by the sympathetic nervous system (SNS) to increase heart rate and the force of contraction of the heart?
- A. Norepinephrine
- B. Epinephrine
- C. Dopamine
- D. Acetylcholine
Correct Answer: A
Rationale: The correct answer is A: Norepinephrine. Norepinephrine is released by the sympathetic nervous system (SNS) to increase heart rate and the force of contraction. This neurotransmitter acts on beta-1 adrenergic receptors in the heart, leading to these effects. Epinephrine (choice B) is also released by the SNS and acts similarly to norepinephrine but is not as specific for the heart's beta-1 receptors. Dopamine (choice C) primarily acts as a precursor to norepinephrine and epinephrine and does not directly increase heart rate or force of contraction. Acetylcholine (choice D) is released by the parasympathetic nervous system and decreases heart rate and the force of contraction.
Which term refers to the ability of the heart to initiate impulses repetitively and spontaneously?
- A. Contractility
- B. Excitability
- C. Automaticity
- D. Rhythmicity
Correct Answer: C
Rationale: The correct answer is C: Automaticity. Automaticity refers to the ability of the heart to generate electrical impulses spontaneously, without external stimulation. This allows the heart to initiate its own contractions independently of external influences. Contractility (A) refers to the ability of the heart muscle to contract in response to an electrical stimulus. Excitability (B) refers to the ability of cardiac cells to respond to an electrical stimulus. Rhythmicity (D) refers to the regularity of the heart's electrical impulses. Thus, C is the correct answer as it specifically addresses the heart's ability to generate impulses spontaneously.
The client on nitroglycerin patches reports dizziness when standing up. What is the nurse's best response?
- A. Advise the client to rise slowly to prevent dizziness.
- B. Instruct the client to discontinue the nitroglycerin patches.
- C. Encourage the client to rest and avoid physical activity.
- D. Suggest the client take an over-the-counter antiemetic.
Correct Answer: A
Rationale: The correct response is A: Advise the client to rise slowly to prevent dizziness. Nitroglycerin patches can cause orthostatic hypotension, leading to dizziness when standing up quickly. By advising the client to rise slowly, the nurse can help prevent a sudden drop in blood pressure and reduce the risk of dizziness and falls. This response promotes client safety and addresses the underlying cause of the symptom.
Choices B, C, and D are incorrect:
B: Instructing the client to discontinue nitroglycerin patches is not appropriate without consulting the healthcare provider. Abruptly stopping nitroglycerin can lead to serious complications.
C: Encouraging the client to rest and avoid physical activity does not address the issue of orthostatic hypotension caused by nitroglycerin patches.
D: Suggesting an over-the-counter antiemetic is not indicated for dizziness related to orthostatic hypotension. It does not address the underlying cause
What is a condition where the airways become swollen and produce extra mucus, making it difficult to breathe, often associated with COPD?
- A. Chronic bronchitis
- B. Pneumonia
- C. Emphysema
- D. Tuberculosis
Correct Answer: A
Rationale: Rationale:
1. Chronic bronchitis is characterized by inflammation of the airways leading to excess mucus production.
2. It is a common symptom of COPD, obstructing airflow and causing breathing difficulties.
3. Pneumonia, emphysema, and tuberculosis do not primarily involve airway inflammation and mucus production as seen in chronic bronchitis.