A client is wearing a continuous cardiac monitor, which begins to alarm at the nurse's station. The nurse sees no electrocardiographic complexes on the screen. What should the nurse do first?

Correct Answer: C

Rationale: The correct first action for the nurse to take is to check the client's status and lead placement. This step is crucial to ensure that the alarm is not triggered by a simple issue such as lead displacement. Calling a code blue (choice A) is premature without assessing the client first. Contacting the healthcare provider (choice B) can be done after ruling out basic causes for the alarm. Pressing the recorder button (choice D) is not as urgent as checking the client's status and lead placement in this scenario.

Correct Answer: D

Rationale: Choice D is correct because family history (genetic predisposition), mental health issues (self-medication), and peer pressure (social influence) are all established risk factors, per SAMHSA. Choice A is incorrect alone as it's one factor. Choice B is wrong by itself because mental health is just part. Choice C is incorrect solo since pressure is only one element.

Correct Answer: A

Rationale: Choice A is correct because VKORC1 variants alter warfarin's target enzyme, affecting its anticoagulant effect and requiring dose adjustments. Choice B is incorrect as codeine's action is CYP2D6-mediated, not VKORC1-related. Choice C is wrong because acetaminophen doesn't interact with VKORC1—it's unrelated to coagulation. Choice D is incorrect since only warfarin is impacted by VKORC1 genetics.

Correct Answer: B

Rationale: Choice B is correct because the second trimester involves growth, and tobacco restricts it via vasoconstriction, a key risk then. Choice A is incorrect as teratogens primarily affect organ development in the first trimester. Choice C is wrong because hypertension's placental effects are more third-trimester prominent. Choice D is incorrect since B is the specific second-trimester concern.

Correct Answer: D

Rationale: Choice D is correct because family history (genetic predisposition), mental health issues (self-medication), and peer pressure (social influence) are all established risk factors, per SAMHSA. Choice A is incorrect alone as it's one factor. Choice B is wrong by itself because mental health is just part. Choice C is incorrect solo since pressure is only one element.

Correct Answer: B

Rationale: The correct answer is B because levofloxacin has lower hepatic risk, safer for liver-damaged patients. Choices A, C, and D are incorrect (higher hepatic risk).

Correct Answer: A

Rationale: Choice A is correct because diphenhydramine has strong anticholinergic effects (e.g., confusion, dry mouth), risky in the elderly, per Beers Criteria. Choice B is incorrect as atenolol (beta blocker) lacks anticholinergic action. Choice C is wrong because lisinopril (ACE inhibitor) doesn't affect cholinergic systems. Choice D is incorrect since only diphenhydramine applies.

Correct Answer: B

Rationale: In a client with coronary artery disease (CAD) experiencing dyspnea at rest, the priority intervention should be to elevate the head of the bed to at least 45 degrees. This position helps reduce the work of breathing, optimizes lung expansion, and can alleviate symptoms of dyspnea by improving oxygenation and ventilation. Providing a walker for ambulation, monitoring oxygen saturation, and having an oxygen cannula at the bedside are important interventions but not the priority when the client is experiencing dyspnea at rest. Elevating the head of the bed is crucial to improve respiratory function and should be prioritized in this situation.

Correct Answer: A

Rationale: The correct answer is A because antacids change gastric pH, affecting drug absorption. Choice B is incorrect as distribution isn’t directly altered. Choice C is wrong since toxicity isn’t the primary concern here. Choice D is inaccurate as antacids typically reduce upset.