Nokea
The nurse notes in the patient™s medication orders that the patient will be taking ibutilide (Corvert). Based on this finding, the nurse interprets that the patient has which disorder?
- A. Ventricular ectopy
- B. Atrial fibrillation
- C. Supraventricular tachycardia
- D. Bradycardia
Correct Answer: B
Rationale: Ibutilide (Corvert) is a medication commonly used to treat atrial fibrillation, a type of irregular heart rhythm that originates in the heart's upper chambers (atria). It works by restoring normal heart rhythm in patients with atrial fibrillation. Therefore, the nurse notes the use of ibutilide in the patient's medication orders, indicating that the patient has atrial fibrillation.
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A patient in the outpatient oncology clinic complains of fatigue after receiving chemotherapy. Which initial nursing intervention will be most appropriate?
- A. Assess for other factors contributing to her fatigue, such as trouble sleeping.
- B. Encourage a high-protein, high-calorie diet, and design it with the patient.
- C. Refer the patient to a physical therapist to develop a strenuous exercise program.
- D. Encourage the patient to sleep as much as possible during the day to ease fatigue.
Correct Answer: A
Rationale: Fatigue is a common side effect of chemotherapy and can be caused by various factors, including anemia, poor nutrition, sleep disturbances, or psychological stress. The nurse's first step should be to assess for underlying causes of fatigue, such as trouble sleeping, anemia, or depression. Once the cause is identified, appropriate interventions can be implemented, such as dietary changes, sleep hygiene strategies, or treatment for anemia. Encouraging excessive daytime sleep or strenuous exercise without assessment may worsen fatigue or lead to other complications.
A patient with a history of HF presents to the emergency department with difficulty breathing, cough, and edema of the lower extremities. The nurse anticipates administration of which type of medication?
- A. Positive chronotrope
- B. Negative chronotrope
- C. Positive inotrope
- D. Negative inotrope
Correct Answer: C
Rationale: In the scenario described, the patient with a history of heart failure (HF) is presenting with symptoms of difficulty breathing, cough, and edema of the lower extremities. These signs and symptoms suggest acute decompensated heart failure (ADHF), which is characterized by a decrease in cardiac output and inadequate tissue perfusion. In this situation, the nurse would anticipate the administration of a positive inotrope medication.
A patient is receiving an IV infusion of heparin and was started on warfarin therapy the night
- A. Which statement is most correct?
- B. The patient is receiving a double dose of anticoagulants.
- C. The heparin therapy was ineffective, so the warfarin was starte
- D. The heparin provides anticoagulation until therapeutic levels of warfarin are reache
Correct Answer: D
Rationale: The correct statement is that the heparin provides anticoagulation until therapeutic levels of warfarin are reached. Heparin and warfarin are both anticoagulants but work in different ways. Heparin acts quickly to prevent blood clot formation while warfarin takes several days to reach its full effect. Therefore, heparin is often used initially to provide immediate anticoagulation while waiting for the warfarin to reach therapeutic levels. This dual therapy is common in clinical practice to ensure continuous anticoagulation.
Penicillin's effectiveness against rapidly growing cell is primarily due to its effect on what?
- A. protein synthesis
- B. chelation of metal ions
- C. cell wall synthesis
- D. cell membrane permeability
Correct Answer: C
Rationale: Penicillin is a type of antibiotic that works by disrupting the synthesis of the bacterial cell wall. Bacterial cells have a cell wall that provides structural support and protection. The cell wall is composed of peptidoglycan, a complex molecule that gives the cell wall its strength. Penicillin interferes with the formation of peptidoglycan by inhibiting the enzyme transpeptidase, which is essential for cross-linking the peptidoglycan strands. As a result, bacterial cells become more susceptible to osmotic pressure and eventually burst, leading to their death. This mechanism of action is particularly effective against rapidly growing bacterial cells because they are actively synthesizing new cell wall components to keep up with their growth. Thus, penicillin's primary effectiveness against rapidly growing cells is primarily due to its disruption of cell wall synthesis.
Reye's syndrome, a potentially fatal illness associated with liver failure and encephalopathy is associated with the administration of which over-the-counter (OTC) medication?
- A. acetaminophen (Tylenol)
- B. ibuprofen (Motrin)
- C. aspirin
- D. brompheniramine/pseudoephedrine (Dimetapp)
Correct Answer: C
Rationale: Reye's syndrome is linked to the use of aspirin in children and adolescents, particularly during viral infections. It causes severe liver and brain damage. Acetaminophen, ibuprofen, and antihistamines are not associated with this condition. Avoiding aspirin in pediatric patients is critical to prevent this rare but life-threatening syndrome.