The nurse administers IV push hydralazine (Apresoline) to a client with severe hypertension. Which assessment finding requires immediate action?

Correct Answer: B

Rationale: Hydralazine, a vasodilator, lowers blood pressure but triggers reflex tachycardia. A heart rate of 110 bpm indicates significant compensation, risking ischemia or strain, requiring immediate action (e.g., slowing infusion, notifying physician). BP of 140/90 is improved, not critical. Headache and flushing are expected from vasodilation, less urgent. Tachycardia's potential to destabilize circulation, especially in severe hypertension, aligns with hydralazine's pharmacology'arteriolar relaxation prompts sympathetic response. This finding demands swift intervention to prevent cardiovascular collapse, making B the priority over manageable side effects.

Correct Answer: D

Rationale: These are direct oral anticoagulants (DOACs), which do not require regular INR monitoring.

Correct Answer: A

Rationale: ACE inhibitors, such as enalapril and lisinopril, work by blocking the enzyme angiotensin-converting enzyme (ACE), which is responsible for converting angiotensin I into angiotensin II. By inhibiting this conversion, ACE inhibitors prevent the vasoconstrictor and aldosterone-stimulating effects of angiotensin II at the receptor sites. This leads to vasodilation, decreased blood pressure, and reduced aldosterone secretion. This mechanism of action makes ACE inhibitors an important class of medications for managing conditions such as hypertension, heart failure, and chronic kidney disease.

Correct Answer: B

Rationale: Hydralazine, a vasodilator, lowers blood pressure but triggers reflex tachycardia. A heart rate of 110 bpm indicates significant compensation, risking ischemia or strain, requiring immediate action (e.g., slowing infusion, notifying physician). BP of 140/90 is improved, not critical. Headache and flushing are expected from vasodilation, less urgent. Tachycardia's potential to destabilize circulation, especially in severe hypertension, aligns with hydralazine's pharmacology'arteriolar relaxation prompts sympathetic response. This finding demands swift intervention to prevent cardiovascular collapse, making B the priority over manageable side effects.

Correct Answer: A

Rationale: Dalfampridine treats MS by blocking potassium channels in demyelinated axons, enhancing nerve conduction and improving walking ability. Exposed potassium channels in MS leak current, impairing signal propagation; dalfampridine's blockade restores function. Donepezil boosts acetylcholine for Alzheimer's. Riluzole reduces glutamate in ALS. Bromocriptine, a dopamine agonist, manages Parkinson's. Dalfampridine's unique potassium channel action directly addresses MS's neurological deficit, supported by clinical evidence, making it the correct agent here.

Correct Answer: A

Rationale: The percentage of ionization of a weak acid or base can be estimated using the Henderson-Hasselbalch equation:

Correct Answer: C

Rationale: A common side effect of Heparin, which is an anticoagulant medication, is the risk of bleeding. Heparin works by preventing the formation of blood clots, which can lead to a bleeding risk as it inhibits the normal clotting process. Patients taking Heparin should be monitored closely for signs of bleeding, such as easy bruising, prolonged bleeding from minor cuts, or blood in the urine or stools. It is important for healthcare providers to closely monitor patients on Heparin therapy and adjust the dosage as needed to minimize the risk of excessive bleeding.

Correct Answer: A

Rationale: HRT increases clotting risk, making calf pain a priority due to potential DVT, a life-threatening side effect. Libido , back pain , and fatigue are less urgent. A ensures safety, aligning with HRT risks, making it the priority.

Correct Answer: D

Rationale: Transdermal nitroglycerin patches should be applied to clean, dry, hairless areas of the body to ensure proper absorption of the medication. Hair can interfere with the absorption of the medication through the skin. Commonly recommended areas for application include the chest, upper arm, or abdomen. It is important to rotate application sites to prevent skin irritation and to follow the specific instructions provided by the healthcare provider or pharmacist.