Which of the following clients is most at risk for developing a deep-vein thrombosis?

Correct Answer: C

Rationale: The correct answer is C because smoking and oral contraceptive use are both risk factors for developing deep-vein thrombosis (DVT). Smoking increases the risk of blood clot formation, while oral contraceptives can also contribute to blood clot formation. The combination of these two factors significantly increases the likelihood of developing DVT. Choice A is less likely to develop DVT as being young and postpartum does not carry as high a risk compared to the other options. Choice B, although on anticoagulant therapy, is at a lower risk compared to Choice C due to the specific risk factors mentioned. Choice D, having undergone laparoscopic cholecystectomy, has a lower risk compared to Choice C as surgery alone is not as significant a risk factor for DVT as smoking and oral contraceptive use.

Correct Answer: C

Rationale: The correct answer is C: Atrial flutter. Atrial flutter typically presents with a saw-tooth appearance of P waves at a rate of around 250-350 beats per minute. This rhythm is characterized by regular, rapid atrial depolarizations originating from a single ectopic focus in the atria. In contrast, Paroxysmal atrial tachycardia (PAT) is usually faster with rates above 150 bpm, Premature atrial contractions (PACs) are isolated premature beats, and Atrial fibrillation is irregularly irregular with no defined P waves. Therefore, the saw-toothed P waves at a rate of 300 bpm align with the characteristics of atrial flutter.

Correct Answer: B

Rationale: The correct answer is B because calcium channel blockers decrease the velocity of electrical activity on the AV node, leading to a decreased heart rate and reduced conduction through the AV node. This results in a negative chronotropic effect, slowing down the heart rate. The other choices are incorrect because: A: Calcium channel blockers do not increase preload on the heart. They may actually reduce preload by dilating blood vessels. C: Calcium channel blockers do not block sodium channels in the heart muscle; they specifically target calcium channels. D: Calcium channel blockers do not cause vasoconstriction of coronary arteries; they often have vasodilatory effects on coronary arteries.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) For hemostasis. Alpha agonists are vasoconstrictors that work by constricting blood vessels to help control bleeding. This is especially useful in situations where hemostasis, or the stopping of bleeding, is crucial, such as during surgery, traumatic injuries, or to manage conditions like epistaxis. Option B) To dilate the arteries is incorrect because alpha agonists actually cause vasoconstriction, not dilation. Option C) To dilate the veins is incorrect as well since alpha agonists primarily target arteries for vasoconstriction. Option D) To decrease afterload is incorrect because while some alpha agonists may indirectly affect afterload due to their vasoconstrictive effects, their primary purpose is not to decrease afterload. Educationally, understanding the pharmacological actions of alpha agonists is important for healthcare professionals, especially nurses and doctors, as it allows them to make informed decisions when prescribing or administering these medications. Knowing the specific uses and effects of alpha agonists can improve patient outcomes and safety in various clinical settings.

Correct Answer: A

Rationale: The correct answer is A: Digoxin. Calcium channel blockers can increase digoxin levels, leading to toxicity. Digoxin and calcium channel blockers both affect heart function, so combining them can cause arrhythmias. The other choices do not have a significant interaction with calcium channel blockers. Theophylline interacts with beta-blockers, hydrochlorothiazide interacts with lithium, and fentanyl interacts with other CNS depressants.