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What is the common side effect that is normal with the initial therapy of Nitroglycerine due to increased vasodilation?
- A. Abdominal cramps
- B. Calf
- C. Headache
- D. Blurred vision
Correct Answer: C
Rationale: The most common side effect that is normal with the initial therapy of Nitroglycerine due to increased vasodilation is a headache. Nitroglycerine causes vasodilation of blood vessels, including the blood vessels in the head and brain. This can lead to headaches as a result of the increased blood flow and changes in blood vessel diameter. Headaches caused by Nitroglycerine are usually mild and transient. It is important to monitor patients for this expected side effect and educate them about it to ensure compliance with the medication regimen.
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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.
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.
A patient requires a nonopioid medication. The nurse knows that which medication will cause the least gastrointestinal distress?
- A. Aspirin
- B. Ketorolac
- C. Celecoxib
- D. Ibuprofen
Correct Answer: C
Rationale: Celecoxib is a selective COX-2 inhibitor, which means it primarily targets the COX-2 enzyme involved in inflammation and pain while sparing the COX-1 enzyme that protects the stomach lining. This selectivity reduces the risk of gastrointestinal distress, such as ulcers and bleeding, compared to non-selective NSAIDs like aspirin, ketorolac, and ibuprofen. Therefore, celecoxib is the best choice for patients who require a nonopioid medication with minimal gastrointestinal side effects. Nurses should consider this when selecting pain management options for patients with a history of gastrointestinal issues.
Which of the following should be monitored for patients taking diuretics? (select all that apply)
- A. Daily weight
- B. Intake and output
- C. Amount and location of edema
- D. Appetite
Correct Answer: A
Rationale: A. Daily weight should be monitored for patients taking diuretics because diuretics can cause fluid loss which may lead to weight changes. Fluctuations in weight can indicate changes in fluid balance and help determine the effectiveness of the diuretic therapy.
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.