A patient is in the emergency department with new-onset atrial fibrillation. Which order for digoxin would most likely have the fastest therapeutic effect?

Correct Answer: D

Rationale: When a patient requires immediate treatment for atrial fibrillation with digoxin, the fastest way to achieve a therapeutic effect is through intravenous administration. Option D, Digoxin 1 mg IV push now; then 0.25 mg IV daily, is the most appropriate order in this scenario. Intravenous administration allows for rapid absorption and onset of action, making it the preferred route for urgent situations like atrial fibrillation. By giving an initial loading dose intravenously, followed by a lower maintenance dose IV daily or orally, the patient can quickly achieve therapeutic digoxin levels to help stabilize the heart rhythm. Option D provides the most rapid and effective way to manage new-onset atrial fibrillation with digoxin.

Correct Answer: A

Rationale: A. Assess lung sounds, Pulse, and Blood pressure before administering: It is important to assess the patient's baseline lung sounds, pulse rate, and blood pressure before administering Albuterol to monitor for any changes that may occur after administration. This is crucial in determining the effectiveness of the medication and detecting any potential side effects.

Correct Answer: D

Rationale: When a patient requires immediate treatment for atrial fibrillation with digoxin, the fastest way to achieve a therapeutic effect is through intravenous administration. Option D, Digoxin 1 mg IV push now; then 0.25 mg IV daily, is the most appropriate order in this scenario. Intravenous administration allows for rapid absorption and onset of action, making it the preferred route for urgent situations like atrial fibrillation. By giving an initial loading dose intravenously, followed by a lower maintenance dose IV daily or orally, the patient can quickly achieve therapeutic digoxin levels to help stabilize the heart rhythm. Option D provides the most rapid and effective way to manage new-onset atrial fibrillation with digoxin.

Correct Answer: B

Rationale: Topical corticosteroids can exacerbate viral infections, such as herpes simplex, by suppressing the immune response. They are contraindicated in the presence of viral infections to prevent worsening of the condition. Bacterial, parasitic, and spirochete infections are not absolute contraindications, although caution is advised.

Correct Answer: A

Rationale: The basis for pharmacotherapeutics lies in the selective action of drugs with regard to the diagnosis, prevention, and treatment of diseases. Pharmacotherapeutics involves the use of drugs to manage diseases and improve health outcomes. Drugs are carefully selected based on their mechanism of action, efficacy, safety profile, and suitability for a specific condition. The goal is to achieve optimal therapeutic effects while minimizing potential adverse effects. By understanding the selective action of drugs in targeting specific pathways or processes in the body, healthcare providers can customize treatment regimens to individual patients and achieve the best possible outcomes.

Correct Answer: C

Rationale: An acute allergic reaction to Penicillin can present with symptoms such as skin rash or hives. This is a common sign of an allergic reaction and can indicate the patient is having an adverse response to the medication. It is essential for the nurse to monitor the patient closely for any signs of allergic reactions, including hives, as they can quickly progress to more severe reactions such as anaphylaxis. Other adverse effects listed in the choices, such as blurred vision, tinnitus, and vomiting, are not typically associated with an acute allergic reaction to Penicillin.

Correct Answer: A

Rationale: A decoction is a liquid preparation made by boiling vegetable substances with water. This process helps extract the beneficial properties and compounds from the plant material into the liquid. Decoctions are commonly used in herbal medicine to prepare medicinal remedies by simmering roots, bark, or other plant parts in water for a period of time.

Correct Answer: A

Rationale: Spironolactone is a potassium-sparing diuretic, which means it inhibits sodium reabsorption in the kidneys, while saving potassium and hydrogen ions. It accomplishes this by acting as an aldosterone antagonist, blocking the action of aldosterone. Aldosterone is a hormone that normally promotes sodium reabsorption in the kidneys and leads to potassium and hydrogen ion excretion. By inhibiting aldosterone, spironolactone promotes sodium excretion while conserving potassium and hydrogen ions.

Correct Answer: D

Rationale: In the scenario described, the patient presents with acute decompensated heart failure (HF) with dyspnea at rest, indicating severe symptoms. Nesiritide, a recombinant B-type natriuretic peptide, is commonly used in the management of acute decompensated HF to improve symptoms of dyspnea and congestion. It acts as a vasodilator and promotes natriuresis and diuresis, helping to alleviate the symptoms of heart failure exacerbation. While other medications like Carvedilol (Coreg) and Lisinopril (Prinivil) are commonly used in chronic HF management, in this acute scenario with severe symptoms, Nesiritide would be the appropriate medication to anticipate for administration in the ICU setting. Atropine is not indicated for acute decompensated heart failure.