Nokea
While providing medications to clients on the cardiac unit, the nurse anticipates that hydralazine hydrochloride and isosorbide dinitrate (BiDil) would most likely be prescribed for which of the following clients?
- A. A 48-year-old Caucasian male diagnosed with atrial fibrillation
- B. A 55-year-old African American female diagnosed with hypertension
- C. A 63-year-old Caucasian female diagnosed with sick sinus syndrome
- D. A 64-year-old African American male diagnosed with heart failure
Correct Answer: D
Rationale: BiDil (hydralazine/isosorbide) is FDA-approved specifically for heart failure in African Americans , showing improved outcomes in this population.
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Jim is having a hip replacement surgery and would like to self-donate blood for the surgery. In addition to being prescribed epogen alpha he should also be prescribed:
- A. Folic acid to prevent megaloblastic anemia
- B. Iron, to start when the epogen starts
- C. An antihypertensive to counter the adverse effects of epogen
- D. Vitamin B12 to prevent pernicious anemia
Correct Answer: B
Rationale: Iron supports erythropoiesis with epoetin alfa; antihypertensives manage side effects, not prophylaxis.
Piroxicam has a particularly long half-life (50 hours) as it undergoes enterohepatic recycling.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Piroxicam's long half-life is due to enterohepatic recycling, prolonging its presence in the body.
A nurse is caring for a client who has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, the nurse should advise the client to do which of the following?
- A. Avoid the use of acetaminophen for headaches.
- B. Restrict intake of foods rich in sodium.
- C. Decrease fluid intake to less than 1,500 mL daily
- D. Limit aerobic activity in hot weather
Correct Answer: D
Rationale: Limiting activity in hot weather prevents dehydration, which increases lithium levels and risk of toxicity.
Which example best demonstrates safe drug administration by the nurse?
- A. Administering an oral medication with the patient sitting upright
- B. Asking children to say their name before administering the medication
- C. Leaving the medications on the bedside stand after verifying patient identification
- D. Returning the unused portion of a medication to a stock supply bottle
Correct Answer: A
Rationale: Sitting the patient upright for oral medications is safe medication practice. Children should never be asked their names as a means of positive identification. Remaining with a patient until the drug is swallowed is safe practice. Returning an unused portion of medication to the stock supply bottle is not safe medication practice.
The following drugs reduce mortality in congestive cardiac failure EXCEPT:
- A. Captopril
- B. Carvedilol
- C. Digoxin
- D. Enalapril
Correct Answer: C
Rationale: Digoxin improves symptoms but does not reduce mortality in heart failure.