Nokea
The healthcare provider is monitoring a client following cardioversion. Which observation should be of the highest priority to the healthcare provider?
- A. Blood pressure
- B. Status of airway
- C. Oxygen flow rate
- D. Level of consciousness
Correct Answer: B
Rationale: The status of the airway is the highest priority following cardioversion as it ensures proper oxygenation and helps prevent complications such as airway obstruction and respiratory distress. Maintaining a patent airway is crucial for the client's respiratory function and overall well-being immediately after cardioversion. Monitoring the airway ensures that the client can breathe effectively and minimizes the risk of hypoxia and other serious respiratory issues. While blood pressure, oxygen flow rate, and level of consciousness are also important parameters to monitor, they are secondary to ensuring a clear and patent airway for adequate oxygenation.
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A client with a history of congestive heart failure (CHF) is receiving digoxin (Lanoxin). The nurse should monitor the client for which sign of digoxin toxicity?
- A. Hypertension
- B. Bradycardia
- C. Hyperglycemia
- D. Insomnia
Correct Answer: B
Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin can cause bradycardia due to its effects on the heart's electrical conduction system. The nurse should closely monitor the client's heart rate for any signs of slowing down, as it can indicate toxicity and potentially lead to serious complications. Hypertension, hyperglycemia, and insomnia are not typically associated with digoxin toxicity. Hypertension is more commonly associated with other conditions or medications, hyperglycemia can be seen in conditions like diabetes or certain medications, and insomnia is not a typical sign of digoxin toxicity.
Strategies to prevent misuse of prescription drugs include:
- A. Using prescription drug monitoring programs
- B. Educating patients about risks
- C. Prescribing the lowest effective dose
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because PDMPs track dispensing, education deters misuse, and lowest doses minimize excess—all proven prevention methods. Choice A is incorrect alone as it's one tool. Choice B is wrong by itself because education is just part. Choice C is incorrect solo since dosing is only one strategy.
The nurse is caring for a client with hypertension who is prescribed enalapril (Vasotec). The nurse should monitor the client for which potential adverse effect?
- A. Hypertension
- B. Hypotension
- C. Tachycardia
- D. Hyperglycemia
Correct Answer: B
Rationale: The correct answer is B: Hypotension. Enalapril is an ACE inhibitor that works by dilating blood vessels and reducing blood pressure. Therefore, a potential adverse effect of enalapril is hypotension, not hypertension (choice A), tachycardia (choice C), or hyperglycemia (choice D). Monitoring for hypotension is crucial to prevent complications.
Nurse practitioner prescriptive authority is regulated by:
- A. The National Council of State Boards of Nursing
- B. The U.S. Drug Enforcement Administration
- C. The State Board of Nursing for each state
- D. The State Board of Pharmacy
Correct Answer: C
Rationale: The correct answer is choice C, the State Board of Nursing for each state, because these boards establish the legal scope of practice for nurse practitioners, including prescriptive authority, which varies by state due to differing regulations. Choice A, the National Council of State Boards of Nursing, is incorrect as it provides guidelines and licensure standards but doesn't directly regulate state-specific authority. Choice B, the U.S. Drug Enforcement Administration, is wrong because it oversees controlled substances, not general prescribing rights. Choice D, the State Board of Pharmacy, is also incorrect since it governs pharmacists, not NPs, and has no jurisdiction over their prescriptive authority.
Phase IV clinical trials in the United States are also known as:
- A. Human bioavailability trials
- B. Post marketing research
- C. Human safety and efficacy studies
- D. The last stage of animal trials before the human trials begin
Correct Answer: B
Rationale: Choice B is correct because phase IV trials occur after drug approval, monitoring long-term effects and safety in the general population, known as post-marketing research. Choice A is incorrect as bioavailability is studied earlier, like phase I. Choice C is wrong because safety and efficacy are pre-approval (phases I-III). Choice D is incorrect since phase IV isn't animal-based—it's post-approval human study.