Which of the following drugs was most likely administered to the patient with a chief complaint of palpitations for the past 3 hours?

Correct Answer: B

Rationale: The correct answer is B: Adenosine. Adenosine is commonly used for treating supraventricular tachycardias, which can cause palpitations. It works by slowing electrical conduction in the heart, helping to restore normal heart rhythm. Mexiletine (A) is a sodium channel blocker used for ventricular arrhythmias. Sotalol (C) is a beta-blocker used for atrial and ventricular arrhythmias. Verapamil (D) is a calcium channel blocker used for atrial arrhythmias but not typically for palpitations due to supraventricular tachycardias.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Ibutilide. Ibutilide is a class III antiarrhythmic agent that is effective in the acute management of atrial fibrillation or atrial flutter of recent onset. Ibutilide exerts its antiarrhythmic effects by prolonging the cardiac action potential and refractory period, thereby helping to restore normal sinus rhythm in patients with atrial fibrillation or flutter. Its mechanism of action involves blocking the rapid component of the delayed rectifier potassium current (IKr), leading to prolongation of the repolarization phase of the cardiac action potential. Now, let's analyze why the other options are incorrect: A) Bretylium: Bretylium is a class II antiarrhythmic agent that is primarily used for the management of ventricular arrhythmias. It is not typically used for the acute management of atrial fibrillation or flutter. C) Metoprolol: Metoprolol is a beta-blocker, which is classified as a class II antiarrhythmic agent. While beta-blockers are commonly used for rate control in atrial fibrillation, they are not typically used for the acute conversion of atrial fibrillation or flutter. D) Disopyramide: Disopyramide is a class I antiarrhythmic agent, specifically a class IA antiarrhythmic. It is more commonly used for the management of ventricular arrhythmias and is not typically used for acute management of atrial fibrillation or flutter. In an educational context, understanding the classification of antiarrhythmic drugs is crucial for healthcare professionals, especially nurses, who may encounter patients with various cardiac arrhythmias. It is essential to know the mechanism of action and appropriate use of each class of antiarrhythmic drugs to provide safe and effective care to patients with cardiac rhythm disturbances.

Correct Answer: A

Rationale: In the acute management of angina pectoris, the agent given sublingually is Glyceryl trinitrate (Option A). Rationale: 1. **Correct Answer**: Glyceryl trinitrate is a fast-acting vasodilator that helps to dilate coronary arteries, increasing blood flow to the heart. Administered sublingually, it quickly enters the bloodstream, providing rapid relief from angina symptoms. 2. **Incorrect Options**: - B) Amyl nitrite: While also a vasodilator, it is typically used in the past for angina attacks but is not commonly used today. - C) Erythrital tetranitrate: This drug is not a commonly used medication for acute angina attacks. - D) Pentoerythritol tetranitrate: This medication is not typically administered sublingually for acute angina treatment. 3. **Educational Context**: Understanding the appropriate medications for the management of acute conditions like angina pectoris is crucial for healthcare providers, especially nurses. By knowing the correct medication and route of administration, nurses can promptly and effectively manage patients experiencing angina attacks, potentially preventing serious complications like myocardial infarction. In conclusion, Glyceryl trinitrate is the preferred choice for sublingual administration in acute angina attacks due to its rapid onset of action and effectiveness in relieving symptoms. Nurses must be well-versed in the appropriate use of cardiovascular drugs to provide optimal care to patients in various clinical settings.

Correct Answer: D

Rationale: Rationale: The correct answer is D) It is a competitive inhibitor of the rate-limiting step in cholesterol synthesis. Lovastatin is a member of the statin drug class, which works by inhibiting HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis. By blocking this enzyme, lovastatin reduces the production of cholesterol in the liver, leading to decreased levels of LDL (bad) cholesterol in the bloodstream. This mechanism of action makes option D the correct statement about lovastatin. Option A is incorrect because lovastatin primarily affects cholesterol levels, especially LDL cholesterol, rather than triglycerides. Statins are more effective in lowering LDL cholesterol than triglycerides. Option B is incorrect as lovastatin is not typically used in conjunction with gemfibrozil for type III hyperlipoproteinemia. Statins are the first-line treatment for elevated cholesterol levels, while fibric acid derivatives like gemfibrozil are more commonly used for high triglyceride levels. Option C is also incorrect as lovastatin is effective in treating hypercholesterolemia, including in patients with diabetes. In fact, statins are recommended for diabetic patients due to their proven benefits in reducing cardiovascular risk in this population. In an educational context, understanding the mechanism of action of cardiovascular drugs like lovastatin is crucial for healthcare professionals, especially nurses, to make informed decisions regarding drug therapy for patients with dyslipidemia. Knowing how lovastatin works allows nurses to educate patients on medication adherence, potential side effects, and lifestyle modifications to optimize treatment outcomes.

Correct Answer: B

Rationale: In the scenario where a client is toxic on heparin, the appropriate antidote to use is Protamine, making option B the correct answer. Protamine works by binding to heparin, forming a stable complex that neutralizes the anticoagulant effects of heparin. This action helps to reverse the effects of heparin and prevent further bleeding complications. Option A, giving vitamin K, is not the correct choice in this situation as vitamin K is used to reverse the effects of warfarin, another type of anticoagulant. Option C, giving warfarin, is also incorrect as warfarin is not the antidote for heparin toxicity. Option D, giving platelets, is not the appropriate intervention for heparin toxicity as platelets are not effective in reversing the anticoagulant effects of heparin. In an educational context, it is crucial for nurses to be knowledgeable about antidotes for common medications, especially anticoagulants like heparin. Understanding the actions of antidotes and their specific indications is essential for providing safe and effective patient care. This knowledge helps nurses intervene promptly in situations of medication toxicity, like heparin overdose, to prevent adverse outcomes and ensure patient safety.