A client taking long-term steroids also has ranitidine prescribed. The nurse provides which explanation as to why these drugs are given together?

Correct Answer: A

Rationale: The correct answer is A. Ranitidine is prescribed with long-term steroids to reduce the risk of ulcers associated with steroid therapy. Although steroids can increase the risk of ulcers due to their effect on the gastrointestinal system, ranitidine works by reducing stomach acid production, thus helping to prevent ulcer formation. Choices B, C, and D are incorrect as ranitidine is not given to decrease the risk of infection, reduce blood sugar elevations, or reduce sodium retention associated with steroid usage.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) It causes increased production of bradykinin. Enalapril is an angiotensin-converting enzyme (ACE) inhibitor, which works by blocking the conversion of angiotensin I to angiotensin II. This action leads to decreased levels of angiotensin II and increased levels of bradykinin. Bradykinin is a vasodilator and also plays a role in cough reflex sensitivity. Therefore, the persistent dry cough experienced by the client is due to the increased levels of bradykinin caused by enalapril. Option A) It reduces the production of angiotensin II is incorrect because ACE inhibitors like enalapril actually reduce the conversion of angiotensin I to angiotensin II. Option B) It increases the production of angiotensin II is incorrect as ACE inhibitors have the opposite effect, decreasing levels of angiotensin II. Option D) It increases the production of aldosterone is incorrect because ACE inhibitors actually decrease the production of aldosterone by preventing the formation of angiotensin II, which stimulates aldosterone release. Understanding the mechanism of action of medications like enalapril is crucial in pharmacology as it helps nurses anticipate and manage potential side effects, ensuring safe and effective patient care.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Dry mouth. Ipratropium is an anticholinergic medication commonly used in the treatment of COPD. Anticholinergic medications work by blocking the action of acetylcholine, a neurotransmitter that plays a role in various bodily functions. Dry mouth, also known as xerostomia, is a common side effect of anticholinergic medications like ipratropium due to their ability to reduce saliva production. Option A) Nausea is less likely to be a side effect of ipratropium. While gastrointestinal side effects can occur with some medications, dry mouth is more commonly associated with anticholinergic drugs like ipratropium. Option C) Cough is not a typical side effect of ipratropium. In fact, ipratropium is used to help relieve cough associated with COPD by dilating the airways and reducing bronchospasms. Option D) Palpitations are also not a common side effect of ipratropium. Palpitations, which refer to the sensation of feeling your heart beating rapidly or irregularly, are not typically associated with this medication. Educationally, understanding the side effects of medications is crucial for nurses and healthcare professionals to provide safe and effective care to their patients. Knowing the common side effects of medications allows for early recognition and intervention, ultimately improving patient outcomes and safety. In the case of ipratropium, being aware of the potential side effect of dry mouth can help nurses educate patients, monitor for adverse reactions, and provide appropriate interventions if needed.

Correct Answer: C

Rationale: When a client with chronic heart failure is prescribed furosemide, a diuretic, the nurse should be vigilant for potential adverse effects. Furosemide can lead to excessive fluid loss, resulting in dehydration. Dehydration is a significant concern as it can exacerbate heart failure symptoms. Additionally, furosemide can cause electrolyte imbalances, particularly affecting potassium and sodium levels. Monitoring for signs of dehydration and electrolyte disturbances is crucial to prevent complications and ensure the client's safety and well-being.

Correct Answer: A

Rationale: The correct answer is A: Bone marrow suppression. Methotrexate, commonly used in rheumatoid arthritis, can lead to bone marrow suppression, reducing the production of blood cells and increasing the risk of infection. Monitoring for signs of anemia, leukopenia, and thrombocytopenia is crucial to detect bone marrow suppression early and prevent complications.