A patient is in the intensive care unit and receiving an infusion of milrinone (Primacor) for severe

Correct Answer: D

Rationale: Milrinone and furosemide are two medications that are known to interact when mixed together in the same intravenous line. Milrinone is a phosphodiesterase inhibitor that works to increase cardiac contractility and output, while furosemide is a loop diuretic used to promote diuresis. When mixed together, the pH level of the solution can become altered, leading to potential precipitation or inactivation of one or both drugs.

Correct Answer: B

Rationale: Acetaminophen overdose is hepatotoxic and can cause severe liver damage, leading to liver failure if not treated promptly. The liver metabolizes acetaminophen into a toxic metabolite, N-acetyl-p-benzoquinone imine (NAPQI), which depletes glutathione stores and causes cellular damage. Early administration of N-acetylcysteine (NAC) is critical to prevent irreversible liver damage. While kidney injury can occur, it is less common than liver damage.

Correct Answer: A

Rationale: Iron supplements are known to commonly cause gastrointestinal side effects, such as constipation, upset stomach, and nausea. Constipation is a common side effect of iron supplements due to the way iron can harden the stool and slow down bowel movements. Upset stomach and nausea can occur because iron supplements can irritate the stomach lining, leading to discomfort and feelings of queasiness. It is important for individuals taking iron supplements to be aware of these potential side effects and to speak with their healthcare provider if they are experiencing severe or persistent symptoms.

Correct Answer: C

Rationale: Propranolol is the drug that undergoes extensive first-pass hepatic metabolism. First-pass metabolism refers to the metabolism of a drug by the liver before it enters the systemic circulation. In the case of propranolol, a significant portion of the drug is metabolized by the liver before reaching the systemic circulation, leading to reduced bioavailability. This is why propranolol is often given in higher doses to achieve the desired therapeutic effect. Heparin, insulin, nitroglycerine, and warfarin do not undergo significant first-pass metabolism by the liver.

Correct Answer: D

Rationale: Nesiritide is a synthetic form of brain natriuretic peptide (BNP) that is used for the treatment of acutely decompensated heart failure (HF) in patients who have dyspnea at rest. It works by vasodilating veins and arteries, leading to decreased preload and afterload, thus improving the symptoms of HF such as dyspnea and edema. Nesiritide is typically reserved for patients who are hospitalized with acute decompensated HF and severe symptoms like dyspnea at rest. Patients needing initial treatment for HF or those with atrial fibrillation may not necessarily benefit from nesiritide therapy. Patients with reduced cardiac output may benefit from other therapies aimed at improving cardiac function rather than nesiritide alone.

Correct Answer: B

Rationale: - Antacids can reduce the absorption of tetracycline when taken together. It is recommended to separate the administration of tetracycline and antacids by at least 2-3 hours to minimize this interaction.

Correct Answer: A

Rationale: Tinnitus, or ringing in the ears, is a classic sign of aspirin toxicity, also known as salicylism. Aspirin can cause ototoxicity at high doses, leading to hearing disturbances. Patients taking aspirin for arthritis are often on long-term therapy, which increases the risk of toxicity. Seizures, sinusitis, and palpitations are not typically associated with aspirin use. Therefore, nurses should educate patients to report tinnitus immediately, as it may indicate the need for dose adjustment or discontinuation of the medication to prevent further complications.

Correct Answer: C

Rationale: Amiodarone is the drug of choice for treating severe ventricular dysrhythmias, such as those experienced by the patient in the intensive care unit with acute myocardial infarction. It is a class III antiarrhythmic medication that works by prolonging the action potential duration and refractory period, thereby helping to stabilize the electrical activity of the heart. Amiodarone is effective in treating various types of ventricular dysrhythmias, including ventricular tachycardia and ventricular fibrillation, making it a suitable choice in this scenario. Diltiazem and verapamil are calcium channel blockers primarily used for supraventricular arrhythmias and are not the first-line treatment for severe ventricular dysrhythmias. Adenosine is used for terminating supraventricular tachycardias, not ventricular dysrhythmias. Amiodarone

Correct Answer: D

Rationale: Kallidin is a peptide, specifically a kinin, and is not classified as an eicosanoid. Eicosanoids are a group of lipid mediators derived from arachidonic acid or other fatty acids, including prostaglandins, prostacyclin, thromboxane, and leukotrienes. Although kallidin also plays a role in inflammation and vasodilation like some eicosanoids, it is not part of the eicosanoid family.