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What is the primary action of amlodipine when prescribed to a patient with hypertension?
- A. Increase heart rate
- B. Reduce blood pressure
- C. Lower cholesterol levels
- D. Decrease blood sugar levels
Correct Answer: B
Rationale: The primary action of amlodipine is to reduce blood pressure by relaxing and dilating blood vessels, leading to improved blood flow and lower blood pressure. This is achieved by blocking calcium channels in the blood vessels. Increasing heart rate (A), lowering cholesterol levels (C), and decreasing blood sugar levels (D) are not the primary actions of amlodipine and are not directly related to its mechanism of action in treating hypertension.
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A patient with rheumatoid arthritis is taking prednisone. What is an important side effect for the nurse to monitor?
- A. Hyperglycemia
- B. Bradycardia
- C. Hypotension
- D. Hyperkalemia
Correct Answer: A
Rationale: The correct answer is A: Hyperglycemia. Prednisone is a corticosteroid that can cause an increase in blood glucose levels by promoting gluconeogenesis and decreasing insulin sensitivity. Monitoring for hyperglycemia is crucial as it can lead to serious complications such as diabetic ketoacidosis. Bradycardia (B) and hypotension (C) are not typical side effects of prednisone, as it tends to cause fluid retention and hypertension. Hyperkalemia (D) is also unlikely as prednisone can actually cause hypokalemia due to increased renal potassium excretion.
A client is admitted with a diagnosis of acute pancreatitis. Which laboratory value should the nurse monitor closely?
- A. Serum amylase.
- B. Serum sodium.
- C. Serum calcium.
- D. Serum potassium.
Correct Answer: A
Rationale: The correct answer is A: Serum amylase. In acute pancreatitis, there is inflammation of the pancreas leading to elevated serum amylase levels. Amylase is an enzyme produced by the pancreas, and increased levels indicate pancreatic injury. Monitoring serum amylase helps in diagnosing and assessing the severity of pancreatitis.
Choice B: Serum sodium, and Choice D: Serum potassium may be affected in pancreatitis due to fluid shifts, but they are not specific markers for pancreatitis.
Choice C: Serum calcium may also be affected in pancreatitis, but monitoring serum calcium is not as crucial as monitoring serum amylase for diagnosing and managing acute pancreatitis.
Aspirin is prescribed for a 9-year-old child with rheumatic fever to control the inflammatory process, promote comfort, and reduce fever. What intervention is most important for the nurse to implement?
- A. Instruct the parents to hold the aspirin until the child has first had a tepid sponge bath.
- B. Administer the aspirin with at least two ounces of water or juice.
- C. Notify the healthcare provider if the child complains of ringing in the ears.
- D. Advise the parents to question the child about seeing yellow halos around objects.
Correct Answer: C
Rationale: The correct answer is C: Notify the healthcare provider if the child complains of ringing in the ears. This is important because ringing in the ears can be a sign of salicylate toxicity, a potential side effect of aspirin use in children with rheumatic fever. It is crucial to monitor for this symptom to prevent serious complications.
A: Instructing the parents to hold the aspirin until the child has a tepid sponge bath is not the most important intervention. Managing salicylate toxicity takes precedence over comfort measures.
B: Administering the aspirin with at least two ounces of water or juice is a general guideline for medication administration but not the most critical intervention in this scenario.
D: Advising the parents to question the child about seeing yellow halos around objects is not directly related to the potential side effects of aspirin in this case. Monitoring for salicylate toxicity through symptoms like ringing in the ears is more crucial.
A patient with epilepsy is prescribed phenytoin. What is the primary side effect the nurse should monitor for?
- A. Hypotension
- B. Gingival hyperplasia
- C. Bradycardia
- D. Hyperkalemia
Correct Answer: B
Rationale: The correct answer is B: Gingival hyperplasia. Phenytoin is known to cause gingival overgrowth as a side effect. This is due to its effect on fibroblasts in the gums, leading to increased connective tissue production. Hypotension (A), bradycardia (C), and hyperkalemia (D) are not common side effects of phenytoin. Monitoring for gingival hyperplasia is crucial to prevent complications such as difficulty in eating, speaking, and maintaining oral hygiene.
A patient with rheumatoid arthritis is prescribed methotrexate. What is an important teaching point for the nurse to provide?
- A. Take folic acid supplements as prescribed.
- B. Avoid alcohol completely.
- C. Expect to see immediate results.
- D. Limit fluid intake to 1 liter per day.
Correct Answer: A
Rationale: The correct answer is A: Take folic acid supplements as prescribed. Methotrexate can lead to folic acid deficiency, causing side effects. Supplementing with folic acid can help manage these side effects. It is crucial for the nurse to emphasize the importance of taking folic acid as prescribed to prevent adverse effects.
Summary of Incorrect Choices:
B: Avoid alcohol completely - While alcohol should be limited or avoided due to potential liver toxicity with methotrexate, complete avoidance may not be necessary for all patients.
C: Expect to see immediate results - Methotrexate takes time to work, and patients should not expect immediate results. Patience is necessary.
D: Limit fluid intake to 1 liter per day - There is no specific guideline to limit fluid intake with methotrexate. Adequate hydration is important for overall health.