A patient has been started on therapy of a continuous infusion of lidocaine after receiving a loading dose of the drug. The nurse will monitor the patient for which adverse effect?

Correct Answer: D

Rationale: Lidocaine is a local anesthetic drug that can lead to central nervous system (CNS) toxicity when given in excessive doses. Symptoms of lidocaine toxicity include drowsiness, confusion, visual disturbances, muscle twitching, seizures, and, in severe cases, cardiovascular collapse. Among the options provided, convulsions are the most concerning adverse effect associated with lidocaine toxicity. It is essential for the nurse to closely monitor the patient for any signs or symptoms of CNS toxicity and promptly report any concerning findings to the healthcare provider to prevent potentially serious complications.

Correct Answer: C

Rationale: MIMS stands for Monthly Index of Medical Specialties. It is a comprehensive drug database and medical reference resource widely used by healthcare professionals around the world. MIMS provides essential information on prescription and over-the-counter drugs, medical news, disease management guidelines, medical directories, and more. The term "Monthly" in MIMS highlights that the information is regularly updated on a monthly basis to ensure healthcare professionals have access to the most current and reliable information relevant to their practice.

Correct Answer: A

Rationale: Warfarin is an anticoagulant medication commonly used to prevent and treat blood clots, specifically thromboembolic events. It works by inhibiting the production of certain clotting factors in the liver, thereby reducing the risk of clot formation in blood vessels. Warfarin is often prescribed for conditions such as atrial fibrillation, deep vein thrombosis, and pulmonary embolism to help prevent strokes, heart attacks, and other complications associated with blood clots. It is not used for suppressing seizure activity, causing laxative action, or relieving anginal attacks.

Correct Answer: C

Rationale: Administering 50% dextrose solution directly to a 1-year-old child is unsafe due to the risk of hyperosmolar injury to veins and tissues. Diluting it 1:1 with sterile water reduces the concentration to 25%, making it safer for pediatric administration. Using a filter needle (A) or tuberculin syringe (B) is not necessary for this preparation. Shaking the solution (D) is inappropriate and could introduce air bubbles.

Correct Answer: A

Rationale: Spironolactone is a potassium-sparing diuretic, which belongs to the aldosterone receptor antagonists. It works by inhibiting aldosterone activity in the distal convoluted tubule and collecting ducts of the kidney. Aldosterone promotes sodium reabsorption in exchange for potassium and hydrogen ions. By blocking aldosterone, Spironolactone allows for increased excretion of sodium while retaining potassium and hydrogen ions, making it a suitable choice for patients who need to maintain potassium levels or are at risk for hypokalemia.

Correct Answer: A

Rationale: Adverse effects of amiodarone include QT prolongation and gray coloring of the skin on the face, arms, and neck.

Correct Answer: C

Rationale: Levothyroxine is a synthetic form of the thyroid hormone thyroxine (T4). It is primarily used for the treatment of hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormone. By providing exogenous levothyroxine, the medication helps to restore the normal hormonal balance in the body. This can alleviate symptoms such as fatigue, weight gain, cold intolerance, and other issues related to an underactive thyroid gland. Levothyroxine is not used for the suppression of seizure activity, decreased frequency of migraines, or treatment of ulcers.

Correct Answer: B

Rationale: When converting a patient from IV heparin to oral warfarin (Coumadin) therapy, it is important to overlap the two therapies for at least 5 days. This is because warfarin takes time to reach its full anticoagulant effect, and the patient needs to be adequately anticoagulated during this transition period to prevent the risk of thrombosis. The INR should be closely monitored, and the IV heparin should be stopped once the INR is in the therapeutic range. Simply discontinuing IV heparin and starting oral warfarin immediately could result in a period of inadequate anticoagulation, which could be dangerous for the patient, especially when transitioning from treatment for a pulmonary embolus.

Correct Answer: D

Rationale: Nesiritide, also known as Natrecor, is a medication commonly used in the treatment of acute decompensated heart failure (ADHF) with dyspnea at rest. It is a recombinant form of B-type natriuretic peptide (BNP) which helps to improve cardiac function and alleviate symptoms of heart failure, such as dyspnea. Nesiritide works by promoting vasodilation and increasing diuresis, which can help reduce the workload on the heart and improve cardiac output. Therefore, in the case of a patient with acute decompensated heart failure and dyspnea at rest, the nurse would anticipate the administration of Nesiritide to help improve the patient's condition.