The patient is discharged home and returns to the emergency department 4 days later. The patient is admitted to the ICU with acute decompensated HF with dyspnea at rest. The nurse anticipates administration of which medication?

Correct Answer: D

Rationale: Nesiritide, also known as Natrecor, is a medication commonly used in the treatment of acute decompensated heart failure (ADHF) with dyspnea at rest. It is a recombinant form of B-type natriuretic peptide (BNP) which helps to improve cardiac function and alleviate symptoms of heart failure, such as dyspnea. Nesiritide works by promoting vasodilation and increasing diuresis, which can help reduce the workload on the heart and improve cardiac output. Therefore, in the case of a patient with acute decompensated heart failure and dyspnea at rest, the nurse would anticipate the administration of Nesiritide to help improve the patient's condition.

Correct Answer: D

Rationale: Lidocaine is a local anesthetic drug that can lead to central nervous system (CNS) toxicity when given in excessive doses. Symptoms of lidocaine toxicity include drowsiness, confusion, visual disturbances, muscle twitching, seizures, and, in severe cases, cardiovascular collapse. Among the options provided, convulsions are the most concerning adverse effect associated with lidocaine toxicity. It is essential for the nurse to closely monitor the patient for any signs or symptoms of CNS toxicity and promptly report any concerning findings to the healthcare provider to prevent potentially serious complications.

Correct Answer: A

Rationale: The term "effervescent" refers to the process of a gas being released from a substance when added to water. This is commonly observed when certain tablets or powders are added to water, resulting in the production of bubbles or fizz. Mucilage refers to a thick, sticky substance, while spirits typically refer to alcoholic beverages. Collyria are eye drops, and collodion is a solution used in photography and medicine. Therefore, the correct term for the described process is "effervescent."

Correct Answer: B

Rationale: Cyclophosphamide can cause hemorrhagic cystitis, a serious side effect resulting from the irritation of the bladder lining by its metabolites. To prevent this, patients must maintain high fluid intake (at least 2 liters per day) to dilute the urine and flush out the bladder. While emptying the bladder regularly is important, it is secondary to ensuring adequate hydration. Limiting fluid intake is contraindicated, as it increases the risk of bladder toxicity. An indwelling urinary catheter is not routinely required unless the patient has urinary retention.

Correct Answer: B

Rationale: When converting a patient from IV heparin to oral warfarin (Coumadin) therapy, it is important to overlap the two therapies for at least 5 days. This is because warfarin takes time to reach its full anticoagulant effect, and the patient needs to be adequately anticoagulated during this transition period to prevent the risk of thrombosis. The INR should be closely monitored, and the IV heparin should be stopped once the INR is in the therapeutic range. Simply discontinuing IV heparin and starting oral warfarin immediately could result in a period of inadequate anticoagulation, which could be dangerous for the patient, especially when transitioning from treatment for a pulmonary embolus.