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The nurse is caring for a patient who is receiving a high dose of intravenous azithromycin to treat an infection. The patient is also taking acetaminophen for pain. The nurse should expect to review which lab value when monitoring for this drug side effect?
- A. Complete blood count.
- B. Urinalysis.
- C. Electrolytes.
- D. Liver enzymes.
Correct Answer: D
Rationale: The correct answer is D: Liver enzymes. Azithromycin can cause liver toxicity as a side effect. Monitoring liver enzymes such as AST and ALT levels is crucial to detect any signs of liver damage. Acetaminophen is also metabolized in the liver, so combining it with azithromycin may increase the risk of liver injury. Checking liver enzymes helps the nurse assess the patient's liver function and adjust the medication regimen if necessary.
A: Complete blood count is not typically affected by azithromycin or acetaminophen.
B: Urinalysis is not relevant for monitoring liver toxicity.
C: Electrolytes are important but not specifically related to the side effects of azithromycin or acetaminophen in this scenario.
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The nurse evaluates an improvement in the patient's heart failure (HF) status based on what assessment finding?
- A. Improved mental status.
- B. Using fewer pillows at night.
- C. Increased skin turgor.
- D. Heart rate regular.
Correct Answer: B
Rationale: The correct answer is B: Using fewer pillows at night. This indicates decreased fluid retention, a common symptom of heart failure. Improved mental status (A) may not directly correlate with HF improvement. Increased skin turgor (C) is more related to dehydration. A regular heart rate (D) is a positive sign but not specific to HF improvement.
What is the action of the thiazide diuretic?
- A. Blocks the sodium pump.
- B. Block the chloride pump.
- C. Blocks the carbonic anhydrase pump.
- D. Blocks the potassium pump.
Correct Answer: B
Rationale: The correct answer is B: Blocks the chloride pump. Thiazide diuretics inhibit the sodium-chloride symporter in the distal convoluted tubule of the nephron, leading to increased excretion of sodium and chloride ions, resulting in diuresis. Choice A is incorrect as thiazides do not block the sodium pump. Choice C is incorrect as carbonic anhydrase inhibitors, not thiazides, block the carbonic anhydrase enzyme. Choice D is incorrect as thiazides do not block the potassium pump.
Sympathetic stimulation of the respiratory system leads to what?
- A. Decreased depth of respirations.
- B. Increased perfusion of lungs.
- C. Increase respiratory rate.
- D. Decreased respiratory rate.
Correct Answer: C
Rationale: Sympathetic stimulation of the respiratory system causes an increase in respiratory rate to enhance oxygen intake during fight or flight response. This is due to activation of sympathetic nerves that stimulate the respiratory muscles and increase the rate of breathing. Choice A is incorrect as sympathetic stimulation typically increases, not decreases, the depth of respirations. Choice B is incorrect because sympathetic stimulation does not directly affect lung perfusion. Choice D is incorrect because sympathetic stimulation generally increases, rather than decreases, the respiratory rate.
The nurse evaluates the effects of warfarin by monitoring what lab test?
- A. Platelet count.
- B. Activated thromboplastin time (APT).
- C. Red blood count (RBC).
- D. Prothrombin time (PT) and international normalized ratio (INR).
Correct Answer: D
Rationale: The correct answer is D: Prothrombin time (PT) and international normalized ratio (INR). Warfarin is an anticoagulant medication that works by inhibiting vitamin K-dependent clotting factors. Monitoring PT and INR levels helps assess the effectiveness and safety of warfarin therapy. PT measures the time it takes for blood to clot, while INR standardizes PT results. Platelet count (A) assesses clot formation ability, not warfarin effects. APT (B) primarily evaluates the intrinsic pathway of coagulation. RBC count (C) measures oxygen-carrying capacity, unrelated to warfarin effects.
The nursing instructor asks the student nurse to explain the action of sumatriptan. What is the student's best response?
- A. Vasodilation of peripheral blood vessels.
- B. Depresses pain response in the central nervous system.
- C. Vasoconstrictive on cranial blood vessels.
- D. Binds to acetylcholine receptors to prevent nerve transmission.
Correct Answer: C
Rationale: The correct answer is C: Vasoconstrictive on cranial blood vessels. Sumatriptan is a medication used to treat migraines by constricting blood vessels in the brain, which helps to reduce inflammation and pain associated with migraines. This action helps to alleviate migraine symptoms. Choices A, B, and D are incorrect because sumatriptan does not cause vasodilation, depress pain response in the central nervous system, or bind to acetylcholine receptors. Sumatriptan specifically targets cranial blood vessels to relieve migraine symptoms.