Before a patient receives triptans for the treatment of migraines, the nurse will assess for the presence of which condition, which is a contraindication if present?

Correct Answer: D

Rationale: The correct answer is D: Cardiovascular disease. Triptans can cause vasoconstriction, potentially worsening cardiovascular conditions. Assessing for cardiovascular disease is crucial to prevent adverse effects. A: Hypotension is not a contraindication for triptans. B: Renal disease does not directly interact with triptans. C: Liver damage is not a direct contraindication for triptans.

Correct Answer: B

Rationale: The correct answer is B: Osmotic diuretics. Osmotic diuretics, like mannitol, are commonly used in the neurologic ICU to reduce intracranial pressure by drawing water out of the brain tissue and into the bloodstream, thus decreasing cerebral edema. Loop diuretics (A) are more commonly used for conditions like heart failure and kidney disease, not specifically for cerebral edema. Thiazide diuretics (C) are primarily used for conditions like hypertension and edema related to heart failure, not for reducing intracranial pressure. Vasodilators (D) work by dilating blood vessels and are not typically used as the first-line treatment for cerebral edema.

Correct Answer: A

Rationale: Step-by-step rationale for why choice A is correct: Hydrophilic agents have low ability to penetrate through cell membrane lipids due to their polar nature. Lipids are hydrophobic, causing repulsion. This prevents direct diffusion of hydrophilic molecules across the lipid bilayer. This leads to the correct answer, A. Summary of why other choices are incorrect: B: Endocytosis involves engulfing particles into cells, not typical for small hydrophilic molecules. C: The blood-brain barrier is selective and restricts the passage of hydrophilic substances. D: High reabsorption in renal tubules would apply to hydrophobic agents that can pass through lipid membranes easily, not hydrophilic agents.

Correct Answer: C

Rationale: Step-by-step rationale: 1. G-proteins are signaling proteins that transmit signals from cell surface receptors to effector elements. 2. G-proteins do not directly change the activity of effector elements like cAMP and cGMP do. 3. cAMP and cGMP are second messengers that mediate intracellular signaling processes. 4. Calcium ions act as second messengers by regulating various cellular functions. Summary: Choice C (G-protein) is the correct answer as it does not belong to second messengers category and does not directly change the activity of effector elements. Choices A, B, and D are incorrect as they are all second messengers that modulate cellular responses.

Correct Answer: B

Rationale: The correct answer is B: Lidocaine. Lidocaine is a Class Ib antiarrhythmic agent that stabilizes cell membranes by blocking sodium channels, reducing excitability and conduction velocity in cardiac tissue. It is commonly used to treat ventricular arrhythmias. Cocaine (A) is a local anesthetic but not typically used as an antiarrhythmic. Bupivacaine (C) and Ropivacaine (D) are long-acting local anesthetics and are not commonly used as antiarrhythmics due to their mechanism of action.