What class of antiarrhythmic drugs blocks potassium channels prolonging phase 3 of the action potential and slowing the rate and conduction of the heart?
- A. I.
- B. IV.
- C. III.
- D. II.
Correct Answer: C
Rationale: The correct answer is C: Class III. Class III antiarrhythmic drugs block potassium channels, which prolongs phase 3 of the action potential by delaying repolarization. This action results in a longer refractory period, slowing the heart rate and conduction. Option A (Class I) blocks sodium channels, option B (Class IV) blocks calcium channels, and option D (Class II) are beta-blockers that work by blocking beta-adrenergic receptors. These classes do not have a direct effect on potassium channels and do not produce the same effect as Class III drugs.
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A patient is diagnosed as having elevated cholesterol level. The nurse is aware that plaque on the inner lumen of arteries begins as what?
- A. Platelets and fibrin.
- B. Fatty streaks.
- C. White blood cells (WBC).
- D. Foam cells.
Correct Answer: B
Rationale: The correct answer is B: Fatty streaks. Fatty streaks are the earliest visible signs of atherosclerosis and are primarily composed of lipid-laden macrophages within the arterial wall. Platelets and fibrin (A) are involved in clot formation, not the initial stages of plaque formation. White blood cells (C) and foam cells (D) are involved in the later stages of atherosclerosis. The other choices are irrelevant to the initial development of plaque.
A patient who has Parkinson's will begin taking carbidopa-levodopa. What information will the nurse include when teaching this patient about this medication?
- A. Discontinue the drug if you experience insomnia.
- B. Rise slowly from your bed or chair to avoid dizziness and falls.
- C. Call your health care provider immediately if your urine turns a dark color.
- D. Take the drug with foods high in protein to improve drug delivery.
Correct Answer: B
Rationale: The correct answer is B: Rise slowly from your bed or chair to avoid dizziness and falls. This is because carbidopa-levodopa can cause orthostatic hypotension, leading to dizziness and potential falls when standing up quickly. Instructing the patient to rise slowly can help prevent this adverse effect.
Choice A is incorrect because insomnia is not a common side effect of carbidopa-levodopa, so there is no need to discontinue the drug solely for this reason.
Choice C is incorrect as dark-colored urine is not a typical side effect of carbidopa-levodopa and does not warrant immediate medical attention.
Choice D is incorrect because taking carbidopa-levodopa with high-protein foods can actually decrease the absorption of the medication, potentially reducing its effectiveness.
Therefore, the most important information for the patient to remember is to rise slowly to prevent dizziness and falls.
Vitamin D plays an important part in the absorption of calcium by the body. Where is vitamin D activated into a form that promotes calcium absorption?
- A. Small intestine.
- B. Vitamin D is not activated into another form.
- C. Kidneys.
- D. Large intestine.
Correct Answer: C
Rationale: The correct answer is C: Kidneys. Vitamin D undergoes two hydroxylation steps for activation - first in the liver and then in the kidneys. The final active form of vitamin D, calcitriol, is produced in the kidneys. Calcitriol promotes the absorption of calcium in the intestines. The small intestine (Choice A) is where calcium is absorbed, but vitamin D is activated in the kidneys. Vitamin D does undergo activation into another form as mentioned above, so choice B is incorrect. The large intestine (Choice D) is primarily involved in water absorption, not vitamin D activation.
A nurse admits an older patient to the emergency room with reports of shortness of breath on exertion and a productive cough. The nurse reviews the patient's current medications and the patient says, “I take one pink pill every morning.†The nurse asks the name of the drug and the patient says she doesn't know. This happens with four other medications the patient says she takes. What is an appropriate nursing diagnosis for this patient?
- A. Ineffective health maintenance.
- B. Noncompliance.
- C. Acute confusion.
- D. Risk-prone health behavior.
Correct Answer: A
Rationale: The correct answer is A: Ineffective health maintenance. This diagnosis is appropriate because the patient's inability to identify their medications indicates a lack of understanding and engagement in managing their own health. The patient's confusion about their medications can lead to noncompliance and potential health risks. The other choices are not as appropriate because the patient's issue is related to a lack of knowledge and understanding rather than deliberate noncompliance (B), acute confusion (C), or a risky behavior (D). To address the issue, the nurse should focus on education and support to improve the patient's health maintenance skills.
What drug would the nurse administer to treat a patient diagnosed with bronchospasm associated with chronic obstructive pulmonary disease (COPD)?
- A. Glycopyrrolate.
- B. Ipratropium.
- C. Atropine.
- D. Flavoxate.
Correct Answer: B
Rationale: The correct answer is B: Ipratropium. Ipratropium is an anticholinergic bronchodilator that helps relax the muscles in the airways, making it effective in treating bronchospasm in COPD. Glycopyrrolate (A) is also an anticholinergic but not commonly used for bronchospasm. Atropine (C) is not typically used for COPD-related bronchospasm. Flavoxate (D) is a urinary antispasmodic and not indicated for bronchospasm.
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