Which drugs are most commonly used to treat hypertensive crises?

Correct Answer: D

Rationale: In the treatment of hypertensive crises, the most commonly used drugs are fenoldopam (Corlopam) and sodium nitroprusside (Nipride) as indicated by option D. Fenoldopam is a selective dopamine receptor agonist that promotes vasodilation, helping to reduce blood pressure quickly. Sodium nitroprusside is a potent vasodilator that acts on both arteries and veins, rapidly lowering blood pressure in emergency situations. Option A, Esmolol and captopril, are not typically used in hypertensive crises. Esmolol is a beta-blocker that acts more for long-term blood pressure control, while captopril is an ACE inhibitor that may take longer to show its full effect. Option B, Enalaprilat and minoxidil, are also not the first-line agents for hypertensive crises. Enalaprilat is an ACE inhibitor, similar to captopril, and minoxidil is a potent vasodilator that is more commonly used for chronic hypertension. Option C, Labetalol and bumetanide, are used in hypertensive emergencies, but they are not the most commonly used drugs for this purpose. Labetalol is a combined alpha and beta-blocker, and bumetanide is a loop diuretic, which are not the primary choices for immediate blood pressure reduction. It is crucial for healthcare professionals to be well-versed in the appropriate medications for hypertensive crises to ensure prompt and effective management of potentially life-threatening situations. Understanding the mechanisms of action and indications of each drug is essential for providing optimal patient care in emergency situations.

Correct Answer: A

Rationale: In the context of thrombolytic therapy for myocardial infarction (MI), it is crucial for the nurse to recognize signs indicating treatment failure. The correct answer, option A, "Continues to have chest pain," signifies unsuccessful thrombolysis. Chest pain persistence suggests ongoing myocardial ischemia due to inadequate clot dissolution, necessitating further interventions like rescue angioplasty. This outcome highlights the importance of prompt recognition and action in managing MI. Option B, "Has a marked increase in CK enzyme levels within 3 hours of therapy," is incorrect as elevated CK levels are expected after MI and thrombolysis due to myocardial damage, not necessarily indicating treatment failure. Option C, "Develops major GI or GU bleeding during treatment," is also incorrect as bleeding is a known side effect of thrombolytic therapy but does not inherently denote treatment failure. Option D, "Develops premature ventricular contractions and ventricular tachycardia during treatment," is incorrect as these arrhythmias can occur post-MI and are not specific indicators of thrombolytic therapy failure. Educationally, understanding the nuances of post-MI care, including thrombolytic therapy outcomes, is crucial for nurses caring for cardiac patients. This rationale emphasizes the importance of clinical vigilance, prompt assessment, and appropriate response to patient responses to therapy to optimize outcomes and prevent complications.

Correct Answer: D

Rationale: In the field of cardiovascular health, understanding the indications for pneumonectomy is crucial for healthcare professionals. A pneumonectomy is the surgical removal of a lung, and it is typically indicated in cases where the lung is severely compromised and cannot function properly. The correct answer, option D) "All of the above," is the correct choice because a pneumonectomy may be indicated for a variety of conditions, including a malignant lung tumor, severe lung infections that are unresponsive to other treatments, and traumatic injuries to the lung that cannot be managed conservatively. Option A) "Malignant tumor" is a common indication for a pneumonectomy because removing the affected lung lobe can help prevent the spread of cancer to other parts of the body. Option B) "Severe lung infection" may require a pneumonectomy if the infection is localized and cannot be controlled with antibiotics or other therapies. Option C) "Trauma" can also necessitate a pneumonectomy if the lung is severely damaged and cannot be repaired. Educationally, understanding the indications for pneumonectomy is essential for healthcare professionals working in cardiovascular and thoracic surgery, oncology, pulmonology, and critical care. It is important to be able to recognize when a patient may benefit from this surgical intervention and to understand the potential risks and benefits associated with the procedure. Healthcare providers must weigh the indications for pneumonectomy against the potential impact on the patient's quality of life and overall prognosis.

Correct Answer: C

Rationale: Congestive heart failure (CCF) is a complex condition that requires a comprehensive approach to management. The correct answer, option C (Both A and B), is the most appropriate choice because the medical and nursing management of CCF typically involves a combination of medications and lifestyle changes. Medications play a crucial role in managing CCF by addressing underlying causes, reducing symptoms, and improving heart function. Common medications include ACE inhibitors, beta-blockers, diuretics, and vasodilators. These medications help to reduce the workload on the heart, control blood pressure, and prevent fluid retention. On the other hand, lifestyle changes are equally important in managing CCF. Patients with CCF benefit from adopting a heart-healthy lifestyle, which includes maintaining a balanced diet low in sodium, engaging in regular physical activity, quitting smoking, managing stress, and monitoring weight and fluid intake. These lifestyle modifications can help improve heart function, reduce symptoms, and enhance overall quality of life. Option A (Medications) alone is incorrect because managing CCF solely with medications without addressing lifestyle factors may not lead to optimal outcomes. Similarly, option B (Lifestyle changes) alone is insufficient as lifestyle modifications alone may not be able to address the underlying physiological imbalances seen in CCF. In an educational context, understanding the multifaceted approach to managing CCF is crucial for healthcare professionals. By comprehensively addressing both medications and lifestyle changes, healthcare providers can optimize patient outcomes, reduce hospital readmissions, and improve quality of life for individuals living with CCF. This integrated approach underscores the importance of a holistic and patient-centered care model in managing chronic cardiovascular conditions.

Correct Answer: A

Rationale: The correct answer is option A) Take his blood pressure in his right arm while he is sitting and resting. This is the most appropriate nursing action because measuring blood pressure in a standardized and consistent manner is crucial for accurate assessment. Taking the blood pressure in a specific arm while the patient is sitting and at rest allows for a reliable baseline measurement. This is important for monitoring trends and making informed decisions about treatment. Option B is incorrect because it is not the nurse's role to diagnose or prescribe medication. It is essential to follow proper protocols and consult with a healthcare provider for diagnosis and treatment decisions. Option C is also incorrect as immediate referral to a physician may not be necessary based solely on one high blood pressure reading. Nurses play a critical role in initial assessment and monitoring before escalating care. Option D is incorrect because it is not appropriate to reassure a patient that elevated blood pressure is normal. It is essential to address high blood pressure with further assessment and potential interventions to prevent complications. In an educational context, understanding the correct procedure for measuring blood pressure and the role of the nurse in initial assessment is fundamental for nursing practice. This question highlights the importance of accurate assessment and appropriate nursing actions in managing patients with high blood pressure.