The patient is prescribed an ACE inhibitor. What primary mechanism of ACE inhibitors will the nurse understand as the therapeutic action?

Correct Answer: C

Rationale: The primary mechanism of ACE inhibitors is to inhibit the production of angiotensin II, a potent vasoconstrictor that also stimulates the release of aldosterone. By inhibiting angiotensin II production, ACE inhibitors decrease aldosterone secretion. Aldosterone is a hormone that plays a key role in regulating blood pressure and fluid balance in the body. Inhibiting aldosterone secretion helps to reduce blood pressure by decreasing sodium and water retention, ultimately leading to vasodilation and lower blood pressure levels.

Correct Answer: B

Rationale: In this situation, the nurse's first priority should be to apply pressure to the site with a gauze pad. Bleeding from the antecubital area where venous lab work was drawn can be due to the effect of the thrombolytic drug, particularly in a patient who is already at risk for bleeding due to the acute MI. Applying pressure to the site will help control the bleeding and prevent any further complications. Once the bleeding is controlled, the nurse should monitor the site closely for any signs of increased bleeding or other complications. Slowing the rate of infusion or stopping the infusion of the thrombolytic drug may be considered depending on the severity of the bleeding and the patient's overall condition, but the immediate response should be to apply pressure to the site.

Correct Answer: D

Rationale: Phenylbutazone is a nonsteroidal anti-inflammatory drug (NSAID) known for its potential to cause bone marrow depression. Bone marrow depression is a serious side effect that can lead to decreased production of blood cells, including white blood cells, red blood cells, and platelets. This can result in an increased risk of infections, anemia, and bleeding disorders. Therefore, phenylbutazone should be used cautiously and under close monitoring to avoid this complication. Aspirin, Colchicine, Ibuprofen, and Acetaminophen are not typically associated with causing bone marrow depression as a side effect.

Correct Answer: C

Rationale: Mucositis, inflammation of the mucous membranes, is a common side effect of chemotherapy. Using alcohol-based mouthwash can exacerbate mucositis by causing further irritation and dryness. The patient should be taught to use gentle, non-alcoholic mouth rinses, such as saline or baking soda solutions, to soothe the mucosa. Ice pops, ice chips, and a soft toothbrush are appropriate measures to manage mucositis. The nurse should provide additional teaching to correct the misconception about alcohol-based mouthwash and emphasize the importance of gentle oral care.

Correct Answer: C

Rationale: Amiodarone is the drug of choice for treating severe ventricular dysrhythmias, such as those seen in patients with acute myocardial infarction. It is effective in treating both ventricular tachycardia and ventricular fibrillation. Amiodarone works by prolonging the action potential duration and refractory period in cardiac tissues, thereby helping to stabilize the heart's electrical activity. Diltiazem and Verapamil are calcium channel blockers that are not typically used for treating ventricular dysrhythmias. Adenosine is primarily used for treating supraventricular tachycardias.