Nokea
To detect and treat the most common complication of MI, what should the nurse do?
- A. Measure hourly urine output
- B. Auscultate the chest for crackles
- C. Use continuous cardiac monitoring
- D. Take vital signs every 2 hours for the first 8 hours
Correct Answer: C
Rationale: Continuous monitoring detects dysrhythmias.
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The client on spironolactone (Aldactone) should avoid which type of food?
- A. Foods high in potassium
- B. Foods high in sodium
- C. Foods high in calcium
- D. Foods high in chloride
Correct Answer: A
Rationale: The correct answer is A: Foods high in potassium. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium. Consuming foods high in potassium while on spironolactone can lead to hyperkalemia, which is an elevated level of potassium in the blood. This can result in serious health complications such as irregular heartbeats and muscle weakness. Therefore, it is crucial for clients on spironolactone to avoid foods high in potassium to prevent these adverse effects. Choices B, C, and D are incorrect because spironolactone does not specifically interact with sodium, calcium, or chloride in a way that necessitates avoiding foods high in these electrolytes.
The client is on dobutamine. Adverse effects of Dobutrex (dobutamine) include the following: Select all that apply.
- A. Heart failure
- B. Bradycardia
- C. Tachycardia
- D. Respiratory distress
Correct Answer: C
Rationale: Step-by-step rationale:
1. Dobutamine is a beta-1 adrenergic agonist, which increases heart rate.
2. Tachycardia is a common adverse effect due to increased heart rate.
3. Bradycardia is the opposite effect and not expected with dobutamine.
4. Heart failure is a condition that dobutamine is used to treat, not cause.
5. Respiratory distress is not a typical adverse effect of dobutamine.
Summary:
Choice C (Tachycardia) is correct because dobutamine increases heart rate. Choices A, B, and D are incorrect because dobutamine does not cause heart failure, bradycardia, or respiratory distress.
Which heart chamber receives oxygenated blood from the four pulmonary veins and serves as a reservoir during ventricular systole?
- A. Right atrium
- B. Left atrium
- C. Right ventricle
- D. Left ventricle
Correct Answer: B
Rationale: The correct answer is B: Left atrium. The left atrium receives oxygenated blood from the pulmonary veins, acting as a reservoir during ventricular systole. This blood is then pumped into the left ventricle for distribution to the body. The right atrium receives deoxygenated blood from the body via the vena cavae. The right ventricle pumps this blood to the lungs for oxygenation. The left ventricle is responsible for pumping oxygenated blood to the rest of the body. Therefore, the left atrium is the correct choice based on its role in receiving oxygenated blood from the pulmonary veins.
Which of the following is a central vasodilator and peripheral vasoconstrictor?
- A. Sympathetic nervous system
- B. Parasympathetic nervous system
- C. Norepinephrine
- D. Acetylcholine
Correct Answer: A
Rationale: The correct answer is A: Sympathetic nervous system. The sympathetic nervous system releases norepinephrine, which acts as a central vasodilator by dilating blood vessels in the heart and skeletal muscles. It also acts as a peripheral vasoconstrictor by constricting blood vessels in other areas to redirect blood flow to vital organs during fight-or-flight responses.
B: Parasympathetic nervous system is incorrect as it primarily promotes rest and digestion, not vasodilation or vasoconstriction.
C: Norepinephrine is incorrect as it acts as a peripheral vasoconstrictor, not a central vasodilator.
D: Acetylcholine is incorrect as it primarily functions in the parasympathetic nervous system and is not associated with central vasodilation or peripheral vasoconstriction.
The nurse is caring for a client on enalapril (Vasotec). What is the most important side effect to monitor?
- A. Cough
- B. Hyperkalemia
- C. Hypotension
- D. Dizziness
Correct Answer: A
Rationale: The correct answer is A: Cough. Enalapril is an ACE inhibitor that can cause a dry, persistent cough as a common side effect. It is important to monitor for this because it can indicate a potentially serious adverse reaction called angioedema. Hyperkalemia (B) is a possible side effect of enalapril but is typically not as urgent to monitor as cough. Hypotension (C) is a common side effect but is usually monitored during the initial dose titration. Dizziness (D) is a less common side effect and is often transient. Monitoring for cough is crucial to detect and manage any potential angioedema promptly.