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The nurse is taking a health history on a 38-year-old man who is taking atorvastatin (Lipitor) for high cholesterol. What will the nurse query specifically related to the safety of this drug?
- A. Nicotine.
- B. Caffeine.
- C. Herbal therapy.
- D. Alcohol.
Correct Answer: D
Rationale: The correct answer is D: Alcohol. Atorvastatin is metabolized by the liver, as is alcohol. Consuming alcohol while taking atorvastatin can increase the risk of liver damage. The nurse should query about the man's alcohol consumption to assess potential interactions. Choices A, B, and C do not have significant interactions with atorvastatin. Alcohol poses the most significant risk due to its impact on liver function when combined with atorvastatin.
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The nurse admits a patient to the unit and learns the patient has recently been diagnosed with chronic renal failure but has not informed the primary care provider of this diagnosis. What is the nurse's first priority?
- A. Maintain the patient's confidentiality.
- B. Administer medications ordered immediately.
- C. Provide teaching about chronic renal failure.
- D. Call the admitting physician immediately.
Correct Answer: D
Rationale: The correct answer is D: Call the admitting physician immediately. The nurse's first priority should be to inform the physician of the patient's recent diagnosis of chronic renal failure to ensure appropriate care and treatment. This action is crucial for the patient's safety and well-being. Maintaining confidentiality (A) is important but not the priority in this situation. Administering medications (B) should only be done after informing the physician about the diagnosis. Providing teaching (C) about the condition can wait until the physician is informed.
A geriatric patient received a narcotic analgesic before leaving the post-anesthesia care unit to return to the regular unit. What is the priority nursing action for the nurse receiving the patient on the regular unit?
- A. Administer a non-steroidal anti-inflammatory drug.
- B. Put side rails up and place bed in the lowest position.
- C. Encourage fluids.
- D. Create a restful dark environment.
Correct Answer: B
Rationale: The correct answer is B: Put side rails up and place bed in the lowest position. This is the priority nursing action as the geriatric patient who received a narcotic analgesic may experience drowsiness or confusion, increasing the risk of falls. By putting up the side rails and lowering the bed, the nurse is ensuring the patient's safety and preventing falls. Administering a non-steroidal anti-inflammatory drug (choice A) is not the priority as the patient's safety should be addressed first. Encouraging fluids (choice C) and creating a restful dark environment (choice D) are important but not as crucial as ensuring the patient's immediate safety.
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 patient is diagnosed with borderline hypertension and states a desire to make lifestyle changes to avoid needing to take medication. The nurse advises:
- A. Changing from weight-bearing exercise to yoga.
- B. Decreased fluid intake and increased potassium intake.
- C. Stress reduction and increased protein intake.
- D. Weight reduction and decreased sodium intake.
Correct Answer: D
Rationale: The correct answer is D: Weight reduction and decreased sodium intake. Weight reduction helps lower blood pressure by reducing strain on the heart and blood vessels. Decreasing sodium intake is crucial as high sodium levels can lead to increased blood pressure. Changing from weight-bearing exercise to yoga (choice A) may not be as effective in lowering blood pressure. Decreased fluid intake and increased potassium intake (choice B) might not directly address the root cause of hypertension. Stress reduction and increased protein intake (choice C) may not have a direct impact on blood pressure compared to weight reduction and sodium intake.
A nurse working in radiology administers iodine to a patient who is having a computed tomography (CT) scan. The nurse working on the oncology unit administers chemotherapy to a patient who has cancer. At the public health department, a nurse administers a measles mumps rubella vaccine to a 14-month-old child as a routine immunization. Which branch of pharmacology best describes the actions of the three nurses?
- A. Pharmacodynamics.
- B. Pharmacotherapeutics.
- C. Pharmacoeconomics.
- D. Pharmacokinetics.
Correct Answer: B
Rationale: The correct answer is B: Pharmacotherapeutics. Pharmacotherapeutics focuses on the use of drugs to treat diseases or alleviate symptoms. In this scenario, the nurses are administering medications with the intention of treating or preventing specific conditions: iodine for imaging in radiology, chemotherapy for cancer treatment, and the MMR vaccine for immunization. Pharmacodynamics (A) deals with the effects of drugs on the body, not the therapeutic use. Pharmacoeconomics (C) involves the cost-effectiveness of drug therapy, not the administration of drugs. Pharmacokinetics (D) focuses on drug absorption, distribution, metabolism, and excretion, not the therapeutic purpose of drug administration. Therefore, Pharmacotherapeutics is the best branch of pharmacology to describe the actions of the nurses in this scenario.