A patient with chronic heart failure is prescribed furosemide. What is the primary action of this medication?

Correct Answer: B

Rationale: The correct answer is B: Reduce fluid retention. Furosemide is a loop diuretic that works by increasing urine production, leading to the removal of excess fluid and sodium from the body. This helps reduce fluid volume overload in conditions like heart failure. Choice A is incorrect because while reducing fluid retention may indirectly improve cardiac output by reducing preload, furosemide itself does not directly increase cardiac output. Choice C is incorrect as furosemide does not have a direct effect on heart rate. Choice D is incorrect because while furosemide may lower blood pressure as a result of reducing fluid volume, its primary action is to reduce fluid retention, not specifically lower blood pressure.

Correct Answer: D

Rationale: The correct answer is D: No palpable pulse. Ventricular fibrillation is a life-threatening arrhythmia where the heart quivers and doesn't effectively pump blood. This results in the absence of a palpable pulse. The nurse should anticipate this finding as it indicates a severe cardiac emergency requiring immediate intervention. Choices A, B, and C are incorrect because ventricular fibrillation leads to ineffective heart contractions, causing a lack of pulse rather than bounding, irregular, or thready pulses. It is crucial for the nurse to recognize the absence of a palpable pulse to initiate prompt resuscitative measures.

Correct Answer: B

Rationale: The correct answer is B: Report any weight gain of more than 2 pounds in a day. This instruction is crucial for a client with heart failure taking furosemide as sudden weight gain can indicate fluid retention, which can worsen heart failure. Monitoring weight daily can help detect early signs of fluid overload. A: Taking the medication before bedtime is not a critical instruction for furosemide as it is usually taken in the morning to prevent nocturia. C: Increasing intake of high-sodium foods contradicts the purpose of furosemide, which is a diuretic used to reduce fluid retention by promoting diuresis. D: Limiting fluid intake to less than 1 liter per day can lead to dehydration and electrolyte imbalances, which can be harmful for a client with heart failure.

Correct Answer: B

Rationale: The correct answer is B: Suppress thyroid hormone production. PTU is an antithyroid medication used to inhibit the synthesis of thyroid hormones, effectively suppressing their production. This helps to manage hyperthyroidism by reducing excessive levels of thyroid hormones in the body. Choices A, C, and D are incorrect as PTU does not aim to increase hormone production, enhance iodine absorption, or stimulate the thyroid gland. Understanding the mechanism of action of PTU is crucial in recognizing its primary purpose in treating hyperthyroidism.

Correct Answer: B

Rationale: The correct answer is B: Diminished cough effort. In myasthenia gravis, muscle weakness can affect the muscles involved in coughing, leading to diminished cough effort. This can result in ineffective airway clearance, putting the client at high risk for respiratory complications. Pain during coughing (choice A) may occur but is not the primary cause of ineffective airway clearance in myasthenia gravis. Thick, dry secretions (choice C) and excessive inflammation (choice D) may contribute to airway clearance issues but are not as directly related to the underlying muscle weakness seen in myasthenia gravis.

Correct Answer: C

Rationale: Insulin glargine is a long-acting insulin due to its slow and consistent release, providing basal insulin coverage for about 24 hours. This steady release mimics the body's natural basal insulin secretion pattern. Rapid-acting insulins (A) work quickly to control postprandial glucose levels. Intermediate-acting insulins (B) have a slower onset and last for a moderate duration. Short-acting insulins (D) act quickly but have a shorter duration of action compared to long-acting insulins.

Correct Answer: C

Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.

Correct Answer: A

Rationale: The correct answer is A: Take folic acid supplements as prescribed. Methotrexate can lead to folic acid deficiency, causing side effects. Supplementing with folic acid can help manage these side effects. It is crucial for the nurse to emphasize the importance of taking folic acid as prescribed to prevent adverse effects. Summary of Incorrect Choices: B: Avoid alcohol completely - While alcohol should be limited or avoided due to potential liver toxicity with methotrexate, complete avoidance may not be necessary for all patients. C: Expect to see immediate results - Methotrexate takes time to work, and patients should not expect immediate results. Patience is necessary. D: Limit fluid intake to 1 liter per day - There is no specific guideline to limit fluid intake with methotrexate. Adequate hydration is important for overall health.

Correct Answer: D

Rationale: The correct answer is D: Reduce anxiety. Alprazolam is a benzodiazepine that acts on the central nervous system to enhance the effects of a neurotransmitter called GABA, which helps to calm the brain and reduce anxiety. This medication does not increase energy levels (choice A), induce sedation (choice B), or elevate mood (choice C). Alprazolam's primary action is to target and alleviate the symptoms of anxiety by promoting relaxation and reducing excessive brain activity associated with anxiety disorders.