Nokea
The nurse is caring for a client with atrial fibrillation on dabigatran (Pradaxa). What is the most important instruction to give to the client?
- A. Take the medication with food to prevent stomach upset.
- B. Do not miss a dose and take it at the same time each day.
- C. Avoid consuming alcohol while on this medication.
- D. Monitor for signs of bleeding.
Correct Answer: B
Rationale: Step-by-step rationale:
1. Dabigatran is an anticoagulant used to prevent blood clots.
2. Consistent dosing is crucial to maintain therapeutic levels.
3. Missing doses increases the risk of clot formation.
4. Taking it at the same time daily helps to ensure effectiveness.
Summary:
A: Taking with food is not essential for dabigatran.
C: Alcohol does not directly interact with dabigatran.
D: Monitoring for bleeding is important, but consistent dosing is the priority for efficacy.
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The nurse is monitoring a client on dobutamine. What adverse effect should the nurse watch for?
- A. Tachycardia
- B. Bradycardia
- C. Hypertension
- D. Respiratory distress
Correct Answer: A
Rationale: The correct answer is A: Tachycardia. Dobutamine is a beta-adrenergic agonist that stimulates the heart, increasing heart rate and contractility. Therefore, tachycardia is an expected adverse effect. Bradycardia (B) would be unlikely due to dobutamine's cardiac stimulant effects. Hypertension (C) could occur but is less common than tachycardia. Respiratory distress (D) is not a common adverse effect of dobutamine.
What is a condition where a blood clot forms in a deep vein, usually in the legs, and can lead to serious complications if it travels to the lungs?
- A. Deep vein thrombosis (DVT)
- B. Pulmonary embolism
- C. Varicose veins
- D. Raynaud's disease
Correct Answer: A
Rationale: The correct answer is A: Deep vein thrombosis (DVT). DVT is a condition where a blood clot forms in a deep vein, typically in the legs. It can lead to serious complications if the clot breaks loose and travels to the lungs, causing a pulmonary embolism. Varicose veins (C) are enlarged, twisted veins, not related to blood clots. Raynaud's disease (D) is a condition affecting blood flow to the extremities, not related to clot formation. Pulmonary embolism (B) is a consequence of DVT, not the initial condition of clot formation in the deep veins.
The client on furosemide (Lasix) has a potassium level of 3.1 mEq/L. What is the nurse's priority action?
- A. Administer a potassium supplement.
- B. Hold the furosemide and notify the healthcare provider.
- C. Continue the current dose of furosemide.
- D. Administer Digibind.
Correct Answer: A
Rationale: The correct answer is A because a potassium level of 3.1 mEq/L indicates hypokalemia, a common side effect of furosemide. Administering a potassium supplement is essential to prevent complications like cardiac dysrhythmias. Choice B is incorrect because holding furosemide can worsen the client's condition. Choice C is incorrect as continuing the current dose can further lower potassium levels. Choice D is incorrect as Digibind is used to treat digoxin toxicity, not hypokalemia. Administering a potassium supplement addresses the underlying issue.
What procedure uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent?
- A. Angioplasty
- B. Echocardiogram
- C. CT angiography
- D. Coronary artery bypass graft (CABG)
Correct Answer: A
Rationale: The correct answer is A: Angioplasty. During angioplasty, a catheter with a balloon at its tip is inserted into the blocked or narrowed coronary artery to widen the artery and improve blood flow. This procedure often involves the placement of a stent to help keep the artery open. Angioplasty is a minimally invasive procedure compared to a coronary artery bypass graft (CABG), which requires open-heart surgery. Echocardiogram and CT angiography are diagnostic imaging tests and do not involve the insertion of a catheter to treat a blocked or narrowed coronary artery.
What is the average cardiac output?
- A. Approximately 4 to 6 L per minute
- B. Approximately 4 to 8 L per minute
- C. Approximately 5 to 8 L per minute
- D. Approximately 3 to 7 L per minute
Correct Answer: B
Rationale: The correct answer is B (Approximately 4 to 8 L per minute) because the average cardiac output in a healthy adult at rest is around 5 L per minute. This range of 4 to 8 L per minute encompasses the typical cardiac output values. Choice A (Approximately 4 to 6 L per minute) is too narrow and excludes the upper range, while Choice C (Approximately 5 to 8 L per minute) is slightly broader but still within the acceptable range. Choice D (Approximately 3 to 7 L per minute) is too low and does not cover the full spectrum of average cardiac output values.