Nokea
The nurse administers IV push hydralazine (Apresoline) to a client with severe hypertension. Which assessment finding requires immediate action?
- A. Blood pressure of 140/90 mmHg
- B. Heart rate of 110 beats per minute
- C. Headache
- D. Flushing
Correct Answer: B
Rationale: Hydralazine, a vasodilator, lowers blood pressure but triggers reflex tachycardia. A heart rate of 110 bpm indicates significant compensation, risking ischemia or strain, requiring immediate action (e.g., slowing infusion, notifying physician). BP of 140/90 is improved, not critical. Headache and flushing are expected from vasodilation, less urgent. Tachycardia's potential to destabilize circulation, especially in severe hypertension, aligns with hydralazine's pharmacology'arteriolar relaxation prompts sympathetic response. This finding demands swift intervention to prevent cardiovascular collapse, making B the priority over manageable side effects.
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Why is it important to monitor ins and outs with patients using ACE inhibitors?
- A. To assess for renal impairment
- B. You must make sure the patient is receiving adequate fluid intake
- C. To assess the patient for potential heart failure
- D. To assess for decreased blood pressure
Correct Answer: D
Rationale: It is important to monitor ins and outs with patients using ACE inhibitors to assess for decreased blood pressure. ACE inhibitors are known to lower blood pressure by dilating blood vessels, which can sometimes lead to hypotension (low blood pressure). Monitoring the patient's fluid intake and output helps healthcare providers evaluate the patient's blood pressure response to the medication and make necessary adjustments to prevent complications such as dizziness, falls, or fainting. Regular monitoring is crucial to ensure the patient's safety and optimize the effectiveness of ACE inhibitor therapy.
Action of tranexamic acid
- A. antiplatelet
- B. fibrinolytic
- C. antifibrinolytic
- D. anticoagulant
Correct Answer: C
Rationale: Tranexamic acid is an antifibrinolytic agent, which means it works by inhibiting the breakdown of blood clots. It does this by blocking the activation of plasmin, which is responsible for breaking down fibrin clots. This action helps in promoting clot stability and reducing bleeding. Tranexamic acid is commonly used to treat or prevent excessive bleeding in various conditions, such as heavy menstrual bleeding, surgery, trauma, and certain medical procedures.
Which of the following is NOT an opioid or NSAID?
- A. Morphine
- B. Ibuprofen
- C. Hydromorpho
- D. Acetaminoph en
Correct Answer: D
Rationale: Acetaminophen is not an opioid or NSAID. It is a pain reliever and fever reducer, but it works in a different way compared to opioids and NSAIDs. Unlike opioids, acetaminophen does not have the same risk of physical dependence or addiction. And unlike NSAIDs, acetaminophen does not have anti-inflammatory properties. It is often used for mild to moderate pain relief and as a fever reducer. Be cautious when taking acetaminophen, as high doses can be harmful to the liver.
Depression that occurs during cold winter months would be classified as
- A. baby blues
- B. bipolar disorder
- C. seasonal affective disorder
- D. obsessive-compulsive disorder
Correct Answer: C
Rationale: Seasonal affective disorder (SAD) ties depression to winter-less light, per psychiatry-unlike baby blues (postpartum), bipolar (cycles), or OCD (obsessions). SAD's seasonal link defines it, matching symptoms.
A 48-year-old woman pricks her finger on a rose bush while pruning. A few days later, she develops small, red lesions near the wound and a red track ascending her hand toward her trunk. Her doctor prescribes itraconazole for the sporotrichosis. What is the mechanism of action of this medication?
- A. Disrupts fungal cell membrane by forming pores (nystatin, amphotericin B)
- B. Disrupts fungal microtubules (griseofulvin)
- C. Inhibits conversion of lanosterol to ergosterol
- D. Inhibits squalene monooxygenase (terbinafine)
Correct Answer: C
Rationale: Sporotrichosis, from Sporothrix schenckii, requires antifungals like itraconazole. Option , inhibiting lanosterol to ergosterol conversion, is correct-itraconazole blocks 14-α-demethylase, disrupting fungal membrane synthesis. Option , pore formation, is amphotericin B's mechanism. Option , microtubule disruption, is griseofulvin's. Option , squalene monooxygenase inhibition, is terbinafine's. Option (E), 5-FU conversion, is flucytosine's. Itraconazole's ergosterol inhibition effectively treats this subcutaneous infection, targeting fungal viability.