Which of the following drugs is most effective in converting a patient with atrial fibrillation into sinus rhythm?

Correct Answer: B

Rationale: Converting atrial fibrillation (AF) to sinus rhythm requires cardioversion or antiarrhythmics. Digoxin controls rate, not rhythm, ineffective for conversion. Atenolol, a beta-blocker, and diltiazem, a calcium channel blocker, manage rate, not rhythm restoration. Lidocaine treats ventricular arrhythmias. Amiodarone, a class III antiarrhythmic, prolongs repolarization, effectively converting AF to sinus rhythm, especially in acute settings, outperforming others. Its broad-spectrum action is key in AF management, balancing efficacy and safety.

Correct Answer: D

Rationale: Valproate is an anticonvulsant medication commonly used to treat seizures, epilepsy, and bipolar disorder. It works by increasing levels of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the brain and also affects other neurotransmitters. Therefore, the expected outcome of taking Valproate is to decrease seizure activity by stabilizing abnormal electrical activity in the brain.

Correct Answer: B

Rationale: The correct time to take doxapram (Dopram) is not at bedtime. Doxapram is a respiratory stimulant medication that is usually taken during waking hours to help improve breathing. Taking it at bedtime may interfere with regular sleep patterns and could potentially cause side effects like restlessness or insomnia. It is important for the client to take the medication as directed by their healthcare provider, typically before meals or as prescribed, and not at bedtime.

Correct Answer: A

Rationale: Epoetin alfa (Epogen, Procrit) is an example of a medication used to elicit a more rapid bone marrow recovery. It is a form of erythropoietin, which stimulates the production of red blood cells in the bone marrow. By stimulating red blood cell production, epoetin alfa can help in faster recovery from myelosuppression, a condition characterized by low blood cell counts. This medication is commonly used in patients undergoing chemotherapy or those with chronic kidney disease to manage anemia and improve overall quality of life. Therefore, epoetin alfa is the correct answer in this scenario as it specifically addresses the issue of bone marrow recovery.

Correct Answer: D

Rationale: Mean effective dose (ED50) affects 50% of a population, but individuals vary-some need more or less due to metabolism, weight, or genetics, a clinical reality. Severe side effects aren't 50%-that's toxicity. Ethnic differences influence response, but dose variation is broader. No effect in 50% misreads ED50. Dose adjustment reflects individual pharmacokinetics, key to practice.

Correct Answer: D

Rationale: When a patient has been taking a benzodiazepine for an extended period, abruptly stopping the medication can lead to withdrawal symptoms. These symptoms may include anxiety, irritability, agitation, insomnia, tremors, sweating, and in severe cases, seizures. To avoid these withdrawal effects, the nurse will recommend tapering the dose gradually under medical supervision. This approach allows the body to adjust slowly and reduces the likelihood of experiencing withdrawal symptoms. It is essential to follow a tapering schedule under the guidance of a healthcare provider to ensure a smooth transition off the medication and minimize the risk of withdrawal.

Correct Answer: B

Rationale: When administering packed red blood cells, it is recommended to use 0.9% sodium chloride, also known as normal saline solution, as the preferred solution. Normal saline is isotonic and compatible with blood products, making it the most suitable solution for transfusion with packed red blood cells. It helps maintain the osmotic pressure and prevents hemolysis of red blood cells, ensuring the safe delivery of the blood product to the patient. Lactated Ringer's solution, D5W, and 0.45% sodium chloride are not ideal choices for administering packed red blood cells due to their electrolyte compositions and potential risks of adverse reactions.

Correct Answer: B

Rationale: Cetirizine treats seasonal allergies (itchy eyes, runny nose) by inhibiting H1 receptors . This blocks histamine, relieving symptoms without sedation, ideal for his job. β2 inhibition or stimulation affects airways. α1 stimulation vasoconstricts. H1 inhibition (E) isn't stimulatory. Cetirizine's action ensures efficacy and safety.

Correct Answer: B

Rationale: Converting atrial fibrillation (AF) to sinus rhythm requires cardioversion or antiarrhythmics. Digoxin controls rate, not rhythm, ineffective for conversion. Atenolol, a beta-blocker, and diltiazem, a calcium channel blocker, manage rate, not rhythm restoration. Lidocaine treats ventricular arrhythmias. Amiodarone, a class III antiarrhythmic, prolongs repolarization, effectively converting AF to sinus rhythm, especially in acute settings, outperforming others. Its broad-spectrum action is key in AF management, balancing efficacy and safety.