Nokea
The nurse is caring for a 27-year-old African American woman who was just prescribed an ACE inhibitor for the management of her hypertension. What should be advised related to contraception?
- A. No special precautions need to be taken.
- B. The use of spermicidal jellies is recommended.
- C. The minipill is the contraceptive of choice.
- D. Use barrier contraception to prevent pregnancy while taking these drugs.
Correct Answer: D
Rationale: The correct answer is D: Use barrier contraception to prevent pregnancy while taking these drugs. ACE inhibitors are contraindicated during pregnancy as they can cause harm to the fetus. Therefore, advising the patient to use barrier contraception is essential to prevent pregnancy while on this medication. Choice A is incorrect because special precautions are indeed needed. Choice B is incorrect as spermicidal jellies do not provide effective contraception on their own. Choice C is incorrect as the minipill may not be sufficient to prevent pregnancy while on ACE inhibitors.
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A student asked the pharmacology instructor to describe the function of a cholinergic agonist. What would be the instructor's reply?
- A. Cholinergic agonist decreases the activity of gamma-aminobutyric acid (GABA) receptor sites throughout the body.
- B. Cholinergic agonist decreases the activity of norepinephrine throughout the body.
- C. Cholinergic agonist increases the activity of dopamine receptor sites throughout the brain and spinal cord.
- D. Cholinergic agonist increases the activity of acetylcholine receptor sites throughout the body.
Correct Answer: D
Rationale: The correct answer is D: Cholinergic agonist increases the activity of acetylcholine receptor sites throughout the body. A cholinergic agonist is a drug that mimics the action of acetylcholine, the neurotransmitter that binds to and activates cholinergic receptors. By increasing the activity of acetylcholine receptor sites, a cholinergic agonist enhances cholinergic neurotransmission, leading to various physiological responses.
Incorrect choices:
A: Cholinergic agonists do not affect gamma-aminobutyric acid (GABA) receptor sites.
B: Cholinergic agonists do not affect norepinephrine activity.
C: Cholinergic agonists do not affect dopamine receptor sites.
In summary, the correct answer is D because cholinergic agonists specifically target and enhance the activity of acetylcholine receptor sites, leading to increased cholinergic neurotransmission.
The nurse is preparing to care for a patient who has myasthenia gravis. The nurse will be alert to symptoms affecting which body system in the patient?
- A. Gastrointestinal (GI) and lower extremity muscles.
- B. Central nervous system (CNS), memory, and cognition.
- C. Respiratory and facial muscles.
- D. Cardiovascular system and postural muscles.
Correct Answer: C
Rationale: The correct answer is C: Respiratory and facial muscles. Myasthenia gravis is an autoimmune disorder that affects the neuromuscular junction, leading to muscle weakness and fatigue. Symptoms commonly affect muscles involved in breathing (respiratory) and facial expressions, such as difficulty swallowing, breathing, speaking, and facial drooping. Monitoring these systems is crucial as respiratory muscle weakness can lead to respiratory failure. Choice A is incorrect because myasthenia gravis does not typically affect gastrointestinal or lower extremity muscles primarily. Choice B is incorrect as the primary symptoms of myasthenia gravis do not involve the central nervous system but rather the neuromuscular junction. Choice D is incorrect as myasthenia gravis does not directly impact the cardiovascular system or postural muscles.
What drug would the nurse administer to treat a patient diagnosed with bronchospasm associated with chronic obstructive pulmonary disease (COPD)?
- A. Glycopyrrolate.
- B. Ipratropium.
- C. Atropine.
- D. Flavoxate.
Correct Answer: B
Rationale: The correct answer is B: Ipratropium. Ipratropium is an anticholinergic bronchodilator that helps relax the muscles in the airways, making it effective in treating bronchospasm in COPD. Glycopyrrolate (A) is also an anticholinergic but not commonly used for bronchospasm. Atropine (C) is not typically used for COPD-related bronchospasm. Flavoxate (D) is a urinary antispasmodic and not indicated for bronchospasm.
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.
A nurse admits an older patient to the emergency room with reports of shortness of breath on exertion and a productive cough. The nurse reviews the patient's current medications and the patient says, “I take one pink pill every morning.†The nurse asks the name of the drug and the patient says she doesn't know. This happens with four other medications the patient says she takes. What is an appropriate nursing diagnosis for this patient?
- A. Ineffective health maintenance.
- B. Noncompliance.
- C. Acute confusion.
- D. Risk-prone health behavior.
Correct Answer: A
Rationale: The correct answer is A: Ineffective health maintenance. This diagnosis is appropriate because the patient's inability to identify their medications indicates a lack of understanding and engagement in managing their own health. The patient's confusion about their medications can lead to noncompliance and potential health risks. The other choices are not as appropriate because the patient's issue is related to a lack of knowledge and understanding rather than deliberate noncompliance (B), acute confusion (C), or a risky behavior (D). To address the issue, the nurse should focus on education and support to improve the patient's health maintenance skills.