Nokea
The nurse is preparing to assist with blood collection on a newly admitted patient who has been taking phenytoin for several years. The provider has ordered a complete blood count and liver function tests. Which other blood test will the nurse discuss with the provider?
- A. Coagulation studies.
- B. Serum electrolytes.
- C. Renal function tests.
- D. Blood glucose.
Correct Answer: D
Rationale: The correct answer is D: Blood glucose. Phenytoin can potentially affect blood glucose levels by causing hyperglycemia. Monitoring blood glucose levels is important to ensure the patient's safety and adjust medication dosages if needed.
Other choices are incorrect:
A: Coagulation studies are not typically affected by phenytoin therapy.
B: Serum electrolytes may need monitoring for other reasons, but not specifically related to phenytoin use.
C: Renal function tests are important for monitoring kidney function but are not directly influenced by phenytoin.
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The provider has ordered intramuscular (IM) injections of morphine, a narcotic, every 4 hours as needed for pain in a motor vehicle accident victim. The nurse is aware this drug has a high abuse potential. Under what category would morphine be classified?
- A. Schedule I.
- B. Schedule III.
- C. Schedule IV.
- D. Schedule II.
Correct Answer: D
Rationale: The correct answer is D: Schedule II. Morphine is classified as a Schedule II controlled substance due to its high potential for abuse and risk of dependence. Schedule I drugs have no accepted medical use and a high potential for abuse, which does not apply to morphine. Schedule III and IV drugs have lower abuse potential compared to Schedule II drugs. Therefore, morphine being a potent narcotic with a high abuse potential places it in Schedule II.
When the nurse administers a cholinergic agonist to the patient the nurse's expectation is what system will be stimulated.
- A. Central nervous system.
- B. Parasympathetic nervous system.
- C. Sympathetic nervous system.
- D. Voluntary nervous system.
Correct Answer: B
Rationale: The correct answer is B: Parasympathetic nervous system. Cholinergic agonists stimulate the parasympathetic nervous system by mimicking the action of acetylcholine, the neurotransmitter of the parasympathetic nervous system. This leads to increased activity in organs innervated by the parasympathetic system, such as slowing heart rate and increasing gastrointestinal motility.
A: Central nervous system - Cholinergic agonists primarily act on the peripheral nervous system, not the central nervous system.
C: Sympathetic nervous system - Cholinergic agonists do not stimulate the sympathetic nervous system; they have opposite effects.
D: Voluntary nervous system - Cholinergic agonists do not directly affect the voluntary nervous system, which controls skeletal muscles.
What electrolyte inactivates troponin and allows actin and myosin to form a bridge enabling fibers to contract?
- A. Magnesium.
- B. Sodium.
- C. Potassium.
- D. Calcium.
Correct Answer: D
Rationale: The correct answer is D: Calcium. Calcium is the electrolyte that inactivates troponin, allowing actin and myosin to form a bridge for muscle contraction. Calcium binds to troponin, causing a conformational change that moves tropomyosin out of the way, exposing the binding sites on actin for myosin. Magnesium (A) is important for muscle relaxation, not contraction. Sodium (B) and Potassium (C) are involved in action potential generation and propagation, not in the direct mechanism of muscle contraction.
The nurse teaches the patient receiving propranolol (Inderal) at home for management of ventricular arrhythmias to monitor what parameter?
- A. Weekly pulse.
- B. Daily fluid intake.
- C. Daily blood pressure.
- D. Weekly weight.
Correct Answer: C
Rationale: The correct answer is C: Daily blood pressure. Monitoring daily blood pressure is crucial for a patient taking propranolol for ventricular arrhythmias as it helps assess the effectiveness of the medication in controlling the arrhythmias and ensuring the patient's safety. Changes in blood pressure can indicate potential side effects or worsening of the condition. Monitoring pulse alone (choice A) may not provide a comprehensive picture of the cardiac status. Daily fluid intake (choice B) and weekly weight (choice D) are not specific parameters for monitoring the effects of propranolol on ventricular arrhythmias.
A 54-year-old man has a myocardial infarction, resulting in left-sided heart failure. The nurse caring for the man is most concerned that he will develop edema in what area of the body.
- A. Peripheral.
- B. Pulmonary.
- C. Liver.
- D. Abdominal.
Correct Answer: B
Rationale: The correct answer is B: Pulmonary. Left-sided heart failure leads to the accumulation of fluid in the lungs, causing pulmonary edema. As the heart fails to pump effectively, blood backs up into the pulmonary circulation, leading to increased pressure in the blood vessels of the lungs. This results in fluid leakage into the alveoli, impairing gas exchange and causing symptoms like shortness of breath and coughing. Peripheral edema (choice A) occurs in right-sided heart failure due to fluid accumulation in the extremities. Liver congestion (choice C) can lead to hepatomegaly but is not the primary concern in this case. Abdominal edema (choice D) may occur in severe cases but is not as immediate a concern as pulmonary edema in left-sided heart failure.