The nurse noted a patient's heart rate decreasing from 45 to 38 while administering atropine 0.3 mg IV. What is the most likely explanation?

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Question 1 of 5

The nurse noted a patient's heart rate decreasing from 45 to 38 while administering atropine 0.3 mg IV. What is the most likely explanation?

Correct Answer: D

Rationale: Atropine is a parasympatholytic drug that blocks the action of the vagus nerve on the heart, typically increasing heart rate. However, in rare cases, atropine can cause an initial paradoxical slowing of the heart rate before the expected increase. This occurs because atropine may initially stimulate the vagus nerve at low doses before blocking its effects. The dose of 0.3 mg IV is relatively low, which could explain this phenomenon. The other options are incorrect because atropine does not stimulate the vagus nerve (A), the dose is not necessarily too low (B), and adenosine is not indicated for bradycardia (C).

Question 2 of 5

A patient is admitted to the hospital with an acute gout attack. The nurse expects that which medication will be ordered to treat acute gout?

Correct Answer: A

Rationale: Colchicine is the medication of choice for treating acute gout attacks due to its anti-inflammatory properties. It works by inhibiting microtubule polymerization, which reduces the migration of neutrophils to the inflamed joint, thereby alleviating pain and swelling. Allopurinol and probenecid are used for long-term management of gout to prevent future attacks by lowering uric acid levels, but they are not effective during an acute attack. Sulfinpyrazone is another uricosuric agent used for chronic management. Therefore, colchicine is the most appropriate medication for acute gout treatment, and nurses should be familiar with its use and monitoring.

Question 3 of 5

Epinephrine is administered to a female patient. The nurse should expect this agent to rapidly affect:

Correct Answer: A

Rationale: Epinephrine is a potent agonist of adrenergic receptors, which are part of the sympathetic nervous system. It rapidly affects alpha and beta-adrenergic receptors, leading to increased heart rate, vasoconstriction, and bronchodilation. Muscarinic and cholinergic receptors are part of the parasympathetic nervous system and are not directly activated by epinephrine. Nicotinic receptors are found in the neuromuscular junction and autonomic ganglia but are not the primary target of epinephrine. The rapid action of epinephrine makes it a critical drug in emergencies such as anaphylaxis.

Question 4 of 5

A client with osteoporosis is asking the nurse regarding the use of Salmon calcitonin (Miacalcin) nasal spray. The nurse tells the client to do the following, except?

Correct Answer: B

Rationale: Repeating the dose if the spray is not felt is incorrect and can lead to overdose. The delivery system is designed for 30 doses, and unused solution should be discarded. Miacalcin is typically administered as one spray daily in one nostril. Vitamin D supplementation may be recommended to support bone health, but it is not a direct instruction for using Miacalcin.

Question 5 of 5

Methylergonovine (Methergine) is prescribed to a patient who is having postpartum bleeding. Prior to giving the medication, the nurse contacts the physician who prescribed the medication if which of the following condition is documented in the patient’s chart?

Correct Answer: C

Rationale: Methylergonovine (Methergine) is contraindicated in patients with ischemic heart disease because it can cause vasoconstriction, increasing the risk of myocardial infarction or other cardiac complications. Hypotension is not a contraindication, and uterine atony is the indication for the medication. Acute gastroenteritis is unrelated to the use of methylergonovine. Therefore, ischemic heart disease is the condition that requires the nurse to contact the physician.

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