The earliest toxic symptom of chronic digitalis administration is

Correct Answer: C

Rationale: In the context of cardiovascular drugs pharmacology, understanding the toxic effects of chronic digitalis administration is crucial. The correct answer is C) Anorexia, nausea, vomiting. This is because the earliest toxic symptoms of digitalis toxicity often involve the gastrointestinal system. Anorexia, nausea, and vomiting are commonly observed due to the drug's effects on the chemoreceptor trigger zone in the brain, leading to disturbances in the gastrointestinal tract. Option A) Altered color vision is a known symptom of digitalis toxicity, but it typically occurs at higher and later stages of toxicity. It is not usually the earliest symptom to manifest. Option B) Psychic symptoms such as confusion, hallucinations, or changes in mood can occur with digitalis toxicity, but they also tend to present at a more advanced stage. Option D) Retrosternal pain is not a typical early symptom of digitalis toxicity. It is more commonly associated with other conditions like angina or myocardial infarction. Educationally, recognizing the early signs of drug toxicity is essential for healthcare providers involved in patient care. Understanding the progression of symptoms can aid in early detection and intervention to prevent serious complications. This knowledge is particularly vital in the management of patients on digitalis therapy to ensure their safety and well-being.

Correct Answer: C

Rationale: The correct answer is C) The client has developed thrombotic thrombocytopenia. Thrombotic thrombocytopenia is a rare but serious side effect associated with ADP receptor blockers, specifically clopidogrel. This condition is characterized by a low platelet count and the formation of blood clots in small blood vessels throughout the body. The development of hemorrhaging and a low platelet count in a patient taking an ADP receptor blocker should raise concerns about thrombotic thrombocytopenia. Option A is incorrect because a low platelet count is not an anticipated reaction to taking an ADP receptor blocker; it indicates a potential complication. Option B is incorrect because taking an ADP receptor blocker with aspirin is a common practice for dual antiplatelet therapy but does not directly relate to the development of thrombotic thrombocytopenia. Option D is incorrect because the development of thrombotic thrombocytopenia is not solely due to taking too much of the ADP receptor blocker, but rather an adverse reaction associated with the medication. Educationally, this question emphasizes the importance of recognizing potential serious side effects of cardiovascular drugs and the need for close monitoring of patients on these medications. Nurses need to be vigilant in assessing for signs and symptoms of adverse reactions to promptly intervene and prevent further complications in patients receiving cardiovascular pharmacotherapy.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Triamterene, which will have limited efficacy in managing the patient's uncontrolled hypertension. Triamterene is a potassium-sparing diuretic and is not typically used as a first-line agent for hypertension management. It is often used in combination with other diuretics to prevent potassium loss. In this case, a more potent antihypertensive agent would be needed to effectively lower the patient's blood pressure. A) Labetalol is a non-selective beta-blocker with alpha-1 blocking properties, making it effective in managing hypertension, especially in black patients. B) Methyldopa is a centrally acting alpha-2 adrenergic agonist commonly used in the treatment of hypertension, particularly in patients of African descent. C) Pindolol is a non-selective beta-blocker with intrinsic sympathomimetic activity, which can effectively lower blood pressure. In an educational context, it is important to understand the mechanism of action and appropriate use of different cardiovascular drugs to tailor treatment to individual patient characteristics, such as race, comorbidities, and medication history. This case highlights the need for selecting the most appropriate antihypertensive agent based on patient factors to achieve optimal blood pressure control and reduce cardiovascular risk.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Cocaine. Cocaine acts as an indirect-acting agonist of the adrenergic nervous system by blocking the uptake of norepinephrine into the presynaptic neuron. This mechanism leads to an accumulation of norepinephrine in the synaptic cleft, prolonging its action and enhancing adrenergic effects. Now, let's analyze why the other options are incorrect: B) Epinephrine and C) Isoproterenol are direct-acting adrenergic agonists that directly stimulate adrenergic receptors rather than affecting norepinephrine uptake. D) Norepinephrine itself is not a reuptake inhibitor; it is a neurotransmitter released by sympathetic nerve terminals. Norepinephrine's function is to bind to adrenergic receptors on target tissues to exert its effects. Educationally, understanding the pharmacological actions of cardiovascular drugs is crucial for healthcare professionals to make informed decisions when treating patients with cardiovascular conditions. Knowing how medications interact with the adrenergic nervous system helps in predicting their effects and potential side effects, ultimately contributing to safe and effective patient care.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Headache. Nitroglycerine is a vasodilator commonly used to relieve angina by dilating blood vessels, reducing the heart's workload, and improving blood flow to the heart. One of the most common side effects of nitroglycerine is a headache, which occurs due to the vasodilatory effect on blood vessels, including those in the brain. Option A) Dry skin is not a common side effect of nitroglycerine. It is more likely to be associated with other medications or conditions affecting the skin. Option B) Erectile dysfunction is also not a typical side effect of nitroglycerine. It is more commonly linked to other medications used to treat cardiovascular conditions or underlying health issues. Option D) Priapism, a prolonged and painful erection, is not a known side effect of nitroglycerine use. Priapism is more commonly associated with certain medications, medical conditions, or trauma. Educational Context: Understanding the side effects of cardiovascular drugs is crucial for healthcare providers to educate patients effectively. In this case, knowing that headache is a common side effect of nitroglycerine helps healthcare professionals prepare patients for potential experiences and manage their expectations. Patient education plays a vital role in medication adherence and overall treatment success.