A nurse is caring for a client who has a demand pacemaker inserted with the rate set at 72/min. Which of the following findings should the nurse expect?

Correct Answer: A

Rationale: The correct answer is A because a demand pacemaker only paces when the client's heart rate falls below the set rate (in this case, 72/min). Telemetry monitoring showing QRS complexes occurring at a rate of 74/min with no pacing spikes indicates that the client's intrinsic heart rate is above the set rate, so the pacemaker is not pacing. Choices B, C, and D are incorrect because they do not align with the expected outcome of a demand pacemaker set at 72/min. Choice B shows the QRS rate below the set rate with pacing spikes, choice C shows the QRS rate at the set rate with constant spikes, and choice D indicates bradycardia with pacing spikes, all of which are not in line with the functioning of a demand pacemaker.

Correct Answer: D

Rationale: The correct answer is D: Aspirin. Aspirin is an acetylated salicylate because it contains acetylsalicylic acid, which is a derivative of salicylic acid. The acetylation of salicylic acid forms aspirin, making it an acetylated salicylate. Choline trilisalicylate (A) is a salt form of salicylic acid, not acetylated. Salsalate (B) is an ester of salicylic acid, not acetylated. Sodium salicylate (C) is the sodium salt of salicylic acid, not acetylated. Thus, aspirin (D) is the only option that fits the description of an acetylated salicylate.

Correct Answer: A

Rationale: The correct answer is A: Development of lymphomas or other cancers. Black box warnings are the most serious warnings issued by the FDA for medications. Tumor necrosis factor blockers are associated with an increased risk of developing lymphomas or other cancers due to their immunosuppressive effects. This risk is well-documented in clinical studies and post-marketing surveillance. The other choices, B, C, and D, are not typically associated with tumor necrosis factor blockers. GI bleeding is more commonly associated with NSAIDs, renal failure with certain medications like ACE inhibitors or NSAIDs, and CNS effects with medications that directly affect the central nervous system.

Correct Answer: A

Rationale: The correct answer is A: Probenecid. Probenecid is a uricosuric agent that works by increasing the excretion of uric acid in the urine, thereby reducing its levels in the blood. This helps in the treatment of gout and hyperuricemia. Allopurinol (B) and Febuxostat (C) are xanthine oxidase inhibitors that work by reducing the production of uric acid. Colchicine (D) is used to relieve gout flares by reducing inflammation and pain, but it is not a uricosuric agent.

Correct Answer: A

Rationale: The correct answer is A: Hydroxychloroquine. It is used to reduce inflammation in rheumatoid arthritis by inhibiting the immune response. Hydroxychloroquine is a disease-modifying anti-rheumatic drug (DMARD) that helps control symptoms and slow the progression of the disease. Methotrexate (B) and Leflunomide (C) are also DMARDs used in RA treatment, but they have different mechanisms of action. Adalimumab (D) is a biologic drug that targets specific proteins in the immune system and is used for more severe cases of RA.