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A patient has been receiving a cardiac glycoside, a diuretic, and a vasodilator and is on bedrest. The patient's apical pulse rate is 44.
The nurse concludes that this pulse rate is most likely a result of the:
- A. Diuretic
- B. Vasodilator
- C. Bedrest regimen
- D. Cardiac glycoside
Correct Answer: D
Rationale: Cardiac glycosides like digoxin can cause bradycardia, especially at a pulse of 44.
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The nurse is caring for a client with a spinal cord injury at the T4 level. Which of the following findings would be MOST concerning?
- A. Blood pressure of 80/50 mmHg with a pulse of 50.
- B. Temperature of 99°F (37.2°C).
- C. Spasticity in the lower extremities.
- D. Numbness in the hands and fingers.
Correct Answer: A
Rationale: A T4 spinal cord injury can cause autonomic dysreflexia or neurogenic shock, leading to severe hypotension (80/50) and bradycardia (pulse 50), which are life-threatening and require immediate intervention. Low-grade fever (B), spasticity (C), and numbness (D) are expected or less urgent.
Anaphylactic shock is a serious type of blood transfusion reaction.
The pathophysiology of anaphylaxis is
- A. It is treated with adrenalin or epinephrine.
- B. A severe vasoconstriction and profound bronchodilation.
- C. Characterized by presence of rashes all throughout the body.
- D. A profound hypotension due to profound vasodilation and severe bronchoconstriction.
Correct Answer: D
Rationale: Anaphylaxis involves vasodilation and bronchoconstriction, leading to hypotension and respiratory distress.
Homonymous hemianopsia:
Homonymous hemianopsia:
- A. Half of the visual field of the affected eye is lost.
- B. The pupil in the affected eye is always dilated.
- C. Lost of vision on the affected eye.
- D. The pupil in the affected eye is not constricting.
Correct Answer: A
Rationale: Homonymous hemianopsia involves loss of half the visual field in both eyes, same side.
The client presents to the clinic with a serum cholesterol of 275 mg/dL and is placed on rosuvastatin (Crestor). Which instruction should be given to the client?
- A. Report muscle weakness to the physician.
- B. Allow six months for the drug to take effect.
- C. Take the medication with fruit juice.
- D. Ask the doctor to perform a complete blood count prior to starting the medication.
Correct Answer: A
Rationale: The client taking antilipidemics should be encouraged to report muscle weakness because this is a sign of rhabdomyolysis. The medication takes effect within one month of beginning therapy, so answer B is incorrect. The medication should be taken with water. Fruit juice, particularly grapefruit juice, can decrease the drug's effectiveness, so answer C is incorrect. Liver function studies, not a CBC, should be checked prior to beginning the medication, so answer D is incorrect.
Hirschprung's Disease is somewhat similar to cystic fibrosis. In both diseases, the newborn does not pass out meconium.
Pathophysiologically, in Hirschprung's Disease, the child's affected organ is:
- A. Small intestine
- B. Large intestine
- C. Stomach
- D. Liver
Correct Answer: B
Rationale: Hirschprung's disease involves aganglionic segments of the large intestine, causing obstruction.