Nokea
The pregnant patient tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. What is the best response by the nurse?
- A. This is because your blood volume has increased
- B. Tell me how you have been taking your medication
- C. This is because your baby is receiving part of the medication
- D. Maybe the medication has expired; check the label
Correct Answer: A
Rationale: Pregnancy increases blood volume (50% more), diluting drugs, reducing efficacy-e.g., lower concentration per unit volume, a pharmacokinetic shift. Asking about administration checks adherence, not cause. Baby receiving drug is unlikely-placental transfer varies. Expiration is a guess, not tied to pregnancy. Blood volume explains the change, addressing her concern.
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The nurse administers IV push hydralazine (Apresoline) to a client with severe hypertension. Which assessment finding requires immediate action?
- A. Blood pressure of 140/90 mmHg
- B. Heart rate of 110 beats per minute
- C. Headache
- D. Flushing
Correct Answer: B
Rationale: Hydralazine, a vasodilator, lowers blood pressure but triggers reflex tachycardia. A heart rate of 110 bpm indicates significant compensation, risking ischemia or strain, requiring immediate action (e.g., slowing infusion, notifying physician). BP of 140/90 is improved, not critical. Headache and flushing are expected from vasodilation, less urgent. Tachycardia's potential to destabilize circulation, especially in severe hypertension, aligns with hydralazine's pharmacology'arteriolar relaxation prompts sympathetic response. This finding demands swift intervention to prevent cardiovascular collapse, making B the priority over manageable side effects.
Morphine over dose is treated with_____
- A. Naloxone
- B. Vitamin K
- C. Time
- D. Grapefruit juice
Correct Answer: A
Rationale: Morphine overdose is a medical emergency that can result in respiratory depression and potentially lead to death. Naloxone is a medication used to counteract the effects of opioids like morphine by binding to the same receptors in the brain and reversing the respiratory depression. Naloxone works quickly to restore normal breathing and consciousness in individuals who have overdosed on morphine. It is a critical intervention used to prevent fatal outcomes of opioid overdose, including morphine. Other options like Vitamin K, time, and grapefruit juice are not effective treatments for morphine overdose.
A local municipality is alerted that low doses of carbon tetrachloride have been dumped into the drinking water. A public health alert is transmitted to all residents of this town. Which of the following signs and symptoms should these residents be aware of?
- A. Convulsions
- B. Eye irritation
- C. Nausea
- D. Stupor
Correct Answer: C
Rationale: Carbon tetrachloride exposure causes nausea , reflecting GI and hepatic toxicity. Convulsions and stupor occur with high doses. Eye irritation and vomiting (E) are less specific. Low-dose ingestion aligns with nausea as a primary symptom.
A 59-year-old man with a history of depression cuts his wrists in a suicide attempt. He is brought to the local emergency department for care. He has bilateral medial 3-cm lacerations through the skin and subcutaneous tissues that will require sutures. A review of his prior medical history indicates an allergy to 2% lidocaine. The most likely explanation for this is which of the following?
- A. Allergic
- B. Mast cell mediated
- C. Neurogenic
- D. Psychogenic
Correct Answer: A
Rationale: Lidocaine allergy causing an issue with suturing suggests an allergic reaction , likely IgE-mediated (overlapping with B, but A is broader). Neurogenic , psychogenic , and vascular (E) don't fit. True local anesthetic allergies are rare but explain this history.
A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered
- A. . The patient asks the nurse why the medication is ordere
- B. What is the nurse™s best response?
- C. It will increase your heart rat
- D.
Correct Answer: B
Rationale: The correct response is to inform the patient that the medication, likely an antiarrhythmic agent such as digoxin immune fab (Digibind), helps to convert the irregular heart rhythm caused by digoxin toxicity to a more normal rhythm. This explanation provides a clear understanding of why the medication is being administered in cases of digoxin toxicity. It is important for the nurse to educate the patient about the purpose of the medication and how it will help manage the symptoms of digoxin toxicity.