Which of the following medications is commonly used for afterload reduction in critical care?

Nitroglycerin

Metoprolol

Furosemide

Epinephrine

Answer and Explanation

The Correct Answer is A

A. Nitroglycerin is a vasodilator commonly used to reduce preload and afterload in critical care settings. By dilating blood vessels, nitroglycerin decreases systemic vascular resistance (afterload), which reduces the workload on the heart and improves cardiac output. It is often used to manage conditions such as acute heart failure, hypertensive emergencies, and acute coronary syndromes.

B. Metoprolol is a beta-blocker that primarily acts to reduce heart rate and myocardial contractility. While it can indirectly reduce afterload by lowering blood pressure, its primary mechanism of action is not targeted at afterload reduction. Metoprolol is commonly used in critical care for various indications, including hypertension, myocardial infarction, and heart failure, but it is not primarily used for afterload reduction.

C. Furosemide is a loop diuretic commonly used to manage volume overload and reduce preload in critical care settings. By promoting diuresis, furosemide decreases circulating blood volume, venous return, and preload, which indirectly reduces afterload. However, its primary mechanism of action is not targeted at afterload reduction but rather at reducing volume overload.

D. Epinephrine is a potent sympathomimetic agent that acts on alpha and beta-adrenergic receptors. While it can increase systemic vascular resistance (afterload) at higher doses due to its alpha-adrenergic effects, it is not commonly used for afterload reduction in critical care settings. Epinephrine is primarily used as a vasopressor to increase blood pressure and cardiac output in patients with shock or cardiac arrest.

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Correct Answer is B

Explanation

B. Endotracheal intubation and positive pressure ventilation are indicated in patients with respiratory failure who are unable to maintain adequate oxygenation or ventilation with non-invasive interventions. Intubation allows for the delivery of positive pressure ventilation, oxygenation, and airway protection. It also facilitates the clearance of secretions and administration of medications. Given the patient's severe hypoxemia, impending respiratory distress, and deteriorating condition, endotracheal intubation and positive pressure ventilation are the most appropriate interventions to ensure adequate oxygenation and prevent further deterioration.

A. CPAP is a non-invasive ventilation modality that provides a continuous positive pressure to the airways throughout the respiratory cycle. While CPAP may be beneficial in certain cases of respiratory failure, it may not be sufficient for a patient with severe hypoxemia (SpO2 of 80%) and impending respiratory distress. CPAP is typically indicated for patients with conditions such as obstructive sleep apnea or mild to moderate respiratory failure.

C. Mini-tracheostomy may be considered in certain cases of upper airway obstruction or inadequate airway clearance. However, in this scenario, the patient's hypoxemia is likely due to severe respiratory failure rather than upper airway obstruction. While suctioning may be necessary to clear secretions, it does not address the underlying cause of hypoxemia or provide ventilatory support.

D. While administration of supplemental oxygen is important in the management of hypoxemia, a non- rebreather mask may not be sufficient for a patient with severe hypoxemia and impending respiratory distress. Non-rebreather masks can deliver high concentrations of oxygen but may not provide adequate positive pressure support or airway protection. In this case, endotracheal intubation and positive pressure ventilation are more appropriate to ensure adequate oxygenation and ventilation.

A. First-degree AV block B. Sinus tachycardia C. Atrial fibrillation D. Sinus bradycardia

Correct Answer is C

Explanation

C Atrial fibrillation (AF) is characterized by rapid, irregular electrical activity in the atria, leading to an irregularly irregular ventricular response. AF often results in palpitations, fatigue, and dizziness due to the irregular heart rhythm and inefficient cardiac output. A significant pulse deficit may also be present due to the irregularity of the ventricular response compared to the atrial activity. Given the sudden onset of irregular palpitations, fatigue, dizziness, and a significant pulse deficit, atrial fibrillation is a likely dysrhythmia in this scenario.

A First-degree AV block is characterized by a prolonged PR interval on the electrocardiogram (ECG), indicating delayed conduction between the atria and ventricles. While it can indicate conduction system abnormalities, it typically does not result in rapid or irregular palpitations, fatigue, or dizziness.

Therefore, it is less likely to be the cause of the client's symptoms.

B Sinus tachycardia is characterized by a rapid heart rate originating from the sinus node, typically with a regular rhythm. While sinus tachycardia can cause palpitations and fatigue, it is less likely to result in an irregular heart rate with a significant pulse deficit. Therefore, it is less likely to be the cause of the client's symptoms.

D Sinus bradycardia is characterized by a slow heart rate originating from the sinus node. While sinus bradycardia can cause fatigue and dizziness, it typically does not result in a rapid or irregular heart rate. Therefore, it is less likely to be the cause of the client's symptoms.

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Which of the following medications is commonly used for afterload reduction in critical care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with respiratory failure has a respiratory rate of 26 breaths/min and an oxygen saturation (SpO2) of 80%. The patient is increasingly pale and restless but follows commands. Which intervention will the nurse anticipate?

Correct Answer is B

Explanation

A nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse finds a rapid and irregular heart rate with a significant pulse deficit. Which of the following dysrhythmias should the nurse expect to find on the ECG?

Correct Answer is C

Explanation

A nurse is caring for a client who reports heart palpitations. An ECG confirms the client is experiencing ventricular tachycardia (VT). The nurse should anticipate the need for taking which of the following actions?

A client with acute respiratory distress syndrome (ARDS) shows no improvement despite increases in concentration in oxygen administered. What intervention should the nurse attempt which may improve ventilation-perfusion matching?

The nurse is caring for a client who has heart failure with an EF of 40%. The client has a BP of 170/67 with an HR of 60. He currently is in normal sinus rhythm and has an amber urine output of 45ml in the last 3 hours. Which medication would the nurse expect to give first?

A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation?

A nurse is caring for a client who is receiving positive-pressure mechanical ventilation. Which of the following interventions should the nurse implement to prevent complications? (Select all that apply.)

Which statement by the nurse when explaining the purpose of positive end-expiratory pressure (PEEP) to the patient's caregiver is accurate?

Which of the following medications is commonly used for afterload reduction in critical care?