A nurse is preparing to administer verapamil to a client who is 2 days post-myocardial infarction. The nurse should monitor the client for which of the following outcomes as a therapeutic response to the medication?
Increased heart rate
Increased blood pressure
Decreased pulmonary congestion
Decreased anginal pain
The Correct Answer is D
Rationale:
A. Verapamil is a calcium channel blocker that typically decreases heart rate rather than increases it. Therefore, an increased heart rate would not be a therapeutic response to this medication.
B. Verapamil works to lower blood pressure by inhibiting calcium influx into the vascular smooth muscle. An increase in blood pressure would not be an expected therapeutic outcome.
C. While verapamil may help with heart function, the primary therapeutic response is not specifically measured by decreased pulmonary congestion. This outcome may not be directly observable in the early treatment phases post-myocardial infarction.
D. Verapamil is effective in reducing anginal pain by decreasing myocardial oxygen demand through lowering heart rate and contractility. Thus, a decrease in anginal pain would be a direct therapeutic response to the medication.
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Correct Answer is B
Explanation
Rationale:
A. Diazepam is a benzodiazepine used for anxiety and sedation but is not effective for treating malignant hyperthermia.
B. Dantrolene is the specific antidote for malignant hyperthermia, and the nurse should expect to administer it to help reduce the severe muscle contractions and hypermetabolism associated with this condition.
C. Cyclobenzaprine is a muscle relaxant used for muscle spasms but is not indicated for malignant hyperthermia.
D. Metaxalone is also a muscle relaxant, but like cyclobenzaprine, it is not effective for managing malignant hyperthermia and would not be used in this situation.
Correct Answer is B
Explanation
Rationale:
A. Hydrochlorothiazide does not prevent angiotensin II from binding with receptor sites; this action is typically associated with ACE inhibitors or angiotensin receptor blockers.
B. Hydrochlorothiazide decreases the reabsorption of sodium and water in the distal renal tubule, which leads to increased urine output and decreased blood volume, effectively lowering blood pressure.
C. Hydrochlorothiazide does not block beta receptors; this is the mechanism of action for beta-blockers.
D. Hydrochlorothiazide does not promote the movement of extravascular fluids into the vascular compartment; instead, it reduces blood volume by promoting diuresis.
