The nurse is reviewing the client's medication list. Calcium channel blockers have a significant drug-drug interaction with what?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Digoxin. Calcium channel blockers are known to have a significant drug-drug interaction with digoxin. This interaction can lead to increased levels of digoxin in the body, potentially causing toxicity due to decreased clearance. Let's analyze why the other options are incorrect: B) Theophylline: Calcium channel blockers do not have a significant drug interaction with theophylline. Theophylline is primarily metabolized by different pathways than calcium channel blockers, so there is no significant interaction between them. C) Hydrochlorothiazide: Hydrochlorothiazide, a diuretic, does not have a significant drug interaction with calcium channel blockers. These medications work through different mechanisms in the body and do not typically interfere with each other's actions. D) Fentanyl: There is no significant drug-drug interaction between calcium channel blockers and fentanyl. Fentanyl is a potent opioid analgesic and does not typically interact with calcium channel blockers in a clinically significant manner. Educationally, understanding drug interactions is crucial for nurses to ensure safe medication administration and prevent adverse effects in patients. This knowledge helps nurses make informed decisions when reviewing medication lists, administering medications, and educating patients about their drug therapy. It also highlights the importance of interdisciplinary communication to ensure comprehensive patient care.

Correct Answer: C

Rationale: The correct answer is C) Minoxidil. Minoxidil, when used as an antihypertensive medication, can cause a side effect of excessive hair growth (hypertrichosis). This occurs due to the vasodilatory effects of minoxidil stimulating hair follicles, leading to increased hair growth. Option A) Hydrochlorothiazide is a diuretic commonly used for hypertension but does not cause excessive hair growth as a side effect. Option B) Isosorbide dinitrate is a vasodilator used for angina but does not cause excessive hair growth. Option D) Nifedipine is a calcium channel blocker used for hypertension but does not cause excessive hair growth. In an educational context, understanding the side effects of medications is crucial for healthcare professionals to provide safe and effective care to patients. This question highlights the importance of recognizing side effects associated with specific drugs, enabling healthcare providers to make informed decisions when managing patient care.

Correct Answer: B

Rationale: The correct answer is B) Nicotine-induced vasoconstriction. This 54-year-old man, being a heavy smoker, likely experiences chest pain after smoking due to the vasoconstrictive effects of nicotine. Nicotine causes narrowing of blood vessels, including coronary arteries, leading to decreased blood flow to the heart muscle. This can result in chest pain, known as angina pectoris, especially when the heart's oxygen demand increases after smoking. Option A) Myocardial infarction is incorrect because chest pain after smoking does not necessarily indicate a heart attack, although chronic smoking can increase the risk of heart attacks. Option C) Pulmonary embolism is incorrect as it usually presents with symptoms like shortness of breath, chest pain, and cough, not specifically triggered by smoking. Option D) Stroke volume change is incorrect because chest pain after smoking is more likely related to the acute effects of nicotine on blood vessels rather than changes in stroke volume. Educationally, it is crucial for healthcare professionals to understand the cardiovascular effects of smoking, particularly nicotine-induced vasoconstriction, to recognize and manage symptoms like chest pain appropriately in smokers. Encouraging smoking cessation and addressing risk factors are essential in preventing cardiovascular complications in such individuals.

Correct Answer: A

Rationale: The correct answer is option A) Within 3 hours. Alteplase, also known as tissue plasminogen activator (tPA), is a thrombolytic medication used to dissolve blood clots in the treatment of stroke. Administering alteplase within the first 3 hours after the onset of stroke symptoms is crucial for maximizing its effectiveness in restoring blood flow to the brain and minimizing potential brain damage. Options B, C, and D are incorrect because the efficacy of alteplase significantly decreases as time passes after the onset of a stroke. Administering alteplase beyond the 3-hour window can increase the risk of complications such as hemorrhage without providing significant benefits in terms of stroke recovery. Therefore, timely administration of alteplase is critical to achieving the best possible outcomes for stroke patients. In an educational context, understanding the time-sensitive nature of administering thrombolytic agents like alteplase in the treatment of strokes is essential for healthcare professionals, particularly those working in acute care settings. This knowledge can help improve patient outcomes and reduce the long-term impact of strokes on individuals. Educating healthcare providers about the importance of prompt and accurate decision-making in stroke management can lead to better quality care and improved patient survival rates.

Correct Answer: C

Rationale: Intravenous furosemide is a loop diuretic commonly used to manage conditions like heart failure and hypertension. The correct answer, option C, states that furosemide has a direct vasodilator effect, which is incorrect. Furosemide primarily acts as a diuretic by inhibiting sodium and chloride reabsorption in the ascending loop of Henle in the kidneys, leading to increased urine output. Option A is correct as furosemide causes natriuresis, which is the excretion of sodium in the urine. Option B is also correct as furosemide causes kaliuresis, which is the excretion of potassium in the urine due to its mechanism of action. Option D is also correct as diuresis typically begins around 10-20 minutes after an intravenous dose of furosemide due to its rapid onset of action. Understanding the effects and mechanisms of action of furosemide is crucial in managing patients with cardiovascular conditions to ensure appropriate dosing and monitoring for potential electrolyte imbalances. It is essential for healthcare professionals to be knowledgeable about drug actions to optimize patient care and outcomes in clinical practice.