Nokea
The nurse is caring for a client on amiodarone. What adverse effect is the nurse most concerned about?
- A. Pulmonary toxicity
- B. Liver toxicity
- C. Thyroid dysfunction
- D. Renal dysfunction
Correct Answer: A
Rationale: The correct answer is A: Pulmonary toxicity. Amiodarone is known to cause potentially life-threatening pulmonary toxicity, including interstitial pneumonitis and pulmonary fibrosis. The nurse must closely monitor the client for signs such as cough, dyspnea, and chest pain. Liver toxicity (B), thyroid dysfunction (C), and renal dysfunction (D) are also possible adverse effects of amiodarone, but pulmonary toxicity is the most concerning due to its severe and rapid progression. Monitoring and early detection are crucial to prevent serious complications.
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What is the abnormal accumulation of fluid in the pleural space, often associated with infections or malignancies?
- A. Pleural effusion
- B. Pneumothorax
- C. Pulmonary edema
- D. Atelectasis
Correct Answer: A
Rationale: The correct answer is A: Pleural effusion. Pleural effusion is the abnormal accumulation of fluid in the pleural space, commonly caused by infections or malignancies. This condition leads to symptoms like chest pain and difficulty breathing. Pneumothorax (B) is the presence of air in the pleural space, not fluid. Pulmonary edema (C) is the accumulation of fluid in the lungs' air sacs, not the pleural space. Atelectasis (D) is the collapse of a lung or part of a lung, not fluid accumulation in the pleural space.
Which of the following is a rare genetic disorder that affects the lungs, liver, and skin, causing the buildup of a specific protein that damages organs?
- A. Alpha-1 antitrypsin deficiency
- B. Cystic fibrosis
- C. Wegener's granulomatosis
- D. Marfan syndrome
Correct Answer: A
Rationale: Alpha-1 antitrypsin deficiency is the correct answer. This disorder affects the lungs, liver, and skin due to the buildup of a specific protein (alpha-1 antitrypsin) that damages organs. This deficiency can lead to lung and liver diseases. Cystic fibrosis primarily affects the lungs and digestive system, not the liver and skin. Wegener's granulomatosis is a condition that affects the blood vessels, lungs, and kidneys, not the liver. Marfan syndrome is a connective tissue disorder that affects the heart, blood vessels, bones, and eyes, not the lungs, liver, and skin.
What is a type of heart disease that involves the thickening or stiffening of the heart muscle, reducing its ability to pump blood?
- A. Hypertrophic cardiomyopathy
- B. Dilated cardiomyopathy
- C. Restrictive cardiomyopathy
- D. Arrhythmia
Correct Answer: A
Rationale: The correct answer is A: Hypertrophic cardiomyopathy. This condition involves the thickening of the heart muscle, leading to reduced blood pumping ability. This thickening makes it harder for the heart to relax and fill with blood properly, impairing its ability to pump effectively. Dilated cardiomyopathy (B) involves the enlargement of the heart chambers, not thickening. Restrictive cardiomyopathy (C) involves stiffening but not necessarily thickening of the heart muscle. Arrhythmia (D) refers to irregular heart rhythms and does not relate to the structural changes in the heart muscle seen in hypertrophic cardiomyopathy.
What test measures the electrical activity of the heart over a 24- or 48-hour period?
- A. Holter monitor
- B. Electrocardiogram
- C. Stress test
- D. Chest X-ray
Correct Answer: A
Rationale: The correct answer is A: Holter monitor. This device records the electrical activity of the heart over an extended period, typically 24-48 hours, providing a more comprehensive assessment compared to a standard ECG (choice B). A stress test (choice C) evaluates the heart's response to physical exertion, not prolonged monitoring. A chest X-ray (choice D) is used to visualize the heart and lungs, but does not measure electrical activity. Therefore, the Holter monitor is the most appropriate test for continuous monitoring of heart activity over an extended period.
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.