A nurse is caring for a client who has a new diagnosis of atrial fibrillation. Despite medication therapy aimed at correcting the dysrhythmia, the patient has consistently remained in atrial fibrillation for several days. Which of the following interventions would the nurse expect to be ordered for this client?

Emergency defibrillation

Coronary artery bypass graft (CABG)

Anticoagulant therapy

Diuretic therapy

Answer and Explanation

The Correct Answer is C

A.   Defibrillation is not typically indicated for atrial fibrillation. Atrial fibrillation involves disorganized electrical activity in the atria rather than a shockable rhythm like ventricular fibrillation or ventricular tachycardia. Therefore, emergency defibrillation is not appropriate for a client with persistent atrial fibrillation.
B.   CABG is a surgical procedure used to improve blood flow to the heart muscle by bypassing blocked coronary arteries. It is primarily indicated for clients with significant coronary artery disease that cannot be managed effectively with medications or less invasive
C.   Anticoagulant therapy, such as with medications like warfarin or direct oral anticoagulants (DOACs), is crucial for clients with atrial fibrillation. AFib predisposes individuals to an increased risk of stroke due to the potential formation of blood clots in the atria. Anticoagulants help prevent clot formation and reduce the risk of stroke.
D.   Diuretics are medications that increase urine output and are often used to manage fluid overload or congestion in conditions such as heart failure or volume overload. However, diuretic therapy alone does not address the underlying rhythm abnormality of atrial fibrillation.

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Correct Answer is B

Explanation

A. This option is not directly related to preventing exacerbations in COPD. While managing fluid intake may be important for individuals with certain cardiovascular or renal conditions, it is not a recognized strategy for preventing COPD exacerbations.
B. Influenza vaccination is highly recommended for individuals with COPD. Respiratory infections, such as influenza (flu), can trigger exacerbations in COPD. By receiving an annual influenza vaccine, the client can reduce the risk of developing influenza-related exacerbations and complications.
C. Pursed-lip breathing is a breathing technique that can help improve ventilation and decrease the work of breathing for individuals with COPD. It can be beneficial during exacerbations or episodes of dyspnea (shortness of breath). While it does not directly prevent exacerbations, it is a useful technique to manage symptoms and potentially reduce the severity of exacerbations.
D. The tripod position, where a person leans forward with hands supported on their knees or another surface, can help COPD patients during exacerbations by allowing better chest expansion and improving breathing mechanics. It can relieve dyspnea and help stabilize breathing. While it does not prevent exacerbations, it is a helpful technique during episodes of increased respiratory distress.

A. "Carbidopa crosses the blood-brain barrier where it is then converted to dopamine." B. "It may take weeks to begin seeing the effects of this medication." C. “You will remain on the same dosage of this medication for the rest of your life." D. "Levodopa protects carbidopa, preventing carbidopa from being broken down before it reaches the brain."

Correct Answer is B

Explanation

A. Carbidopa itself does not cross the blood-brain barrier. Its primary role in Sinemet is to inhibit the peripheral breakdown of levodopa (the precursor of dopamine) into dopamine before it reaches the brain.
B. It is true that it may take a few weeks to see the full effects of this medication, as the body needs time to adjust to it.
C. Parkinson's disease is progressive, and as the disease advances, the dosage and frequency of levodopa with carbidopa may need to be adjusted to maintain symptom control. Over time, higher doses or additional medications may be required to manage symptoms effectively.
D. Levodopa does not protect Carbidopa; rather, Carbidopa protects Levodopa from early conversion to dopamine outside the brain, which would make it less effective.

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Naxlex Comprehensive Predictor Exams

A nurse is discussing treatments and interventions with a client who has chronic obstructive pulmonary disease (COPD). Which of the following would assist in preventing exacerbations?

Correct Answer is B

Explanation

A client with Parkinson's disease is started on Levodopa with Carbidopa (Sinemet). What should the nurse include in the patient teaching?

Correct Answer is B

Explanation

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