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Questions and Answers

What is the primary mechanism of action of Ezetimibe?

Enhances renal excretion of cholesterol

Inhibits absorption of cholesterol in the small intestine (correct)

Inhibits cholesterol synthesis in the liver

Increases secretion of bile acids

What is a common side effect of Alirocumab?

Increased heart rate

Nausea and vomiting

Flu-like symptoms (correct)

Severe headaches

Which of the following medications is an example of an ACE inhibitor?

Lisinopril (correct)

Metoprolol

Losartan

Amlodipine

What is a contraindication for using Carvedilol?

Asthma Signup and view all the answers

What should be checked prior to administering a beta blocker and a glycoside?

BP and HR Signup and view all the answers

Which condition can cause Digoxin toxicity symptoms?

Hypokalemia Signup and view all the answers

What is a expected effect of Furosemide in heart failure management?

Removal of excess fluid Signup and view all the answers

What is a key nursing consideration when administering Milrinone?

Place patient on a cardiac monitor Signup and view all the answers

What are the common signs associated with right-sided heart failure?

Fluid retention Signup and view all the answers

Which condition is most commonly associated with left-sided heart failure?

Coronary artery disease Signup and view all the answers

What does preload refer to in the context of heart function?

The pressure in the heart before contraction Signup and view all the answers

What is the main mechanism of action for statins?

Inhibit HMG-CoA reductase Signup and view all the answers

What serious complication should be reported when taking statins?

Rhabdomyolysis Signup and view all the answers

What is the primary purpose of cholestyramine?

Limit bile acid reabsorption Signup and view all the answers

How long before or after medications should cholestyramine be taken?

2 hours before or 4 hours after Signup and view all the answers

What does gemfibrozil primarily help with?

Break down triglyceride particles Signup and view all the answers

What is the primary use of Ezetimibe?

To lower cholesterol Signup and view all the answers

Which of the following is a common side effect of Alirocumab?

Flu-like symptoms Signup and view all the answers

What condition is Carvedilol contraindicated in?

Asthma Signup and view all the answers

What should be monitored when administering Milrinone?

Blood pressure and heart rate Signup and view all the answers

What effect do Beta Blockers have on heart function?

Decrease blood pressure and slow heart rate Signup and view all the answers

How is Alirocumab administered?

Subcutaneously Signup and view all the answers

What type of drug is Digoxin classified as?

Cardiac glycoside Signup and view all the answers

Which symptoms may indicate Digoxin toxicity?

Nausea and vomiting Signup and view all the answers

What is a mechanism of action of ACE inhibitors?

Inhibit the conversion of angiotensin I to II Signup and view all the answers

What potential side effect could be associated with the use of Hydralazine and Isosorbide?

Reflex tachycardia Signup and view all the answers

What condition is most commonly associated with right-sided heart failure?

Fluid retention Signup and view all the answers

What is the primary cause of left-sided heart failure?

Coronary artery disease Signup and view all the answers

What is the effect of gemfibrozil on HDL and VLDL levels?

Increases HDL and reduces VLDL Signup and view all the answers

Which of the following is a common complication of statin use?

Rhabdomyolysis Signup and view all the answers

What does cholestyramine do in the gastrointestinal tract?

Binds to bile acids Signup and view all the answers

When should cholestyramine be administered in relation to other medications?

2 hours before or 4 hours after Signup and view all the answers

What is the mechanism of action of statins?

Inhibit HMG-CoA reductase Signup and view all the answers

What indicates a need to report potential statin complications?

Rust-colored urine Signup and view all the answers

What is the main effect of preload in the heart?

Involves the volume of blood in the ventricles Signup and view all the answers

What is the primary use of gemfibrozil?

Break down triglycerides Signup and view all the answers

What is a potential complication when taking gemfibrozil?

Gallstones Signup and view all the answers

Which medication requires evaluation of the apical pulse prior to administration?

Digoxin Signup and view all the answers

What is the primary action of alirocumab?

Binds to LDL receptors Signup and view all the answers

Which of the following medications should be given with food to prevent heartburn?

Gemfibrozil Signup and view all the answers

What is a significant adverse effect associated with amiodarone?

Pulmonary toxicity Signup and view all the answers

Which statement is true regarding rivaroxaban?

Antidote is andexanet alfa Signup and view all the answers

What must clients be educated about when taking metoprolol?

They should not drive until they know how it affects them Signup and view all the answers

What is the recommended route of administration for milrinone?

Intravenous Signup and view all the answers

What is the recommended dietary approach for clients suffering from heart failure?

Low sodium and monitoring fluid intake Signup and view all the answers

Which adverse effect is associated with atorvastatin?

Severe muscle pain and weakness Signup and view all the answers

What is the primary goal of anti-cholesterol drugs?

Lower LDL levels Signup and view all the answers

What is a crucial instruction for a nurse administering Furosemide?

Push slowly to avoid hearing loss Signup and view all the answers

What should be monitored before administering statin medications?

Lipid profile and liver enzymes Signup and view all the answers

Which medication is known to block the production of LDL cholesterol?

PCSK9 inhibitors Signup and view all the answers

What is a potential complication of IV crystalloid administration?

Fluid overload leading to heart failure Signup and view all the answers

What should clients newly diagnosed with hyperlipidemia be educated about regarding medication?

Lifestyle changes may reduce the need for medication Signup and view all the answers

What is the primary goal of parish nursing?

To provide holistic health to individuals and the community Signup and view all the answers

Which type of exposure falls under chemical environmental exposures?

Metals and pesticides Signup and view all the answers

What is the purpose of the Air Quality Index (AQI)?

To assess the level of air pollution Signup and view all the answers

Which component is NOT a part of primary care?

Promoting exclusive access to specialists Signup and view all the answers

What do Federally Qualified Health Centers (FQHCs) primarily provide?

Comprehensive services to underserved populations Signup and view all the answers

Which of the following best describes 'mixed' environmental exposures?

Combination of various agents ingested or inhaled Signup and view all the answers

What role do community collaborations play in nursing?

Partnering with individuals and organizations for public health change Signup and view all the answers

Which factor is crucial in exposure assessment?

Length of time and extent of exposure Signup and view all the answers

What is a key benefit of increasing the number of nurse practitioners in rural areas?

Improved patient to nurse ratio Signup and view all the answers

Which level of control focuses on early recognition of a disease in occupational health?

Secondary control Signup and view all the answers

What is the primary responsibility of Occupational Health Registered Nurses?

Detecting and assessing occupational hazards Signup and view all the answers

Which of the following is NOT part of the Five Levels of Control in occupational safety?

Employ comprehensive insurance Signup and view all the answers

What is the purpose of the Safety Data Sheet (SDS)?

To describe properties and hazards of substances Signup and view all the answers

What is one of the goals of community organizing in the context of health?

To achieve common goals for improving population health Signup and view all the answers

Which population is considered at greatest risk during disaster planning?

Children, elderly, and disabled individuals Signup and view all the answers

What role do school nurses have in health promotion for students?

Bridge healthcare and education Signup and view all the answers

Which of the following is an example of tertiary prevention in schools?

Screening for signs of abuse Signup and view all the answers

Which of these is a common health stressor in urban communities?

Decreased air quality Signup and view all the answers

What is one main function of the Employee Assistance Program (EAP)?

Discuss work or social issues confidentially Signup and view all the answers

What intervention is recommended to promote safe environments in schools?

Training staff in first aid and CPR Signup and view all the answers

How does telehealth contribute to addressing rural health disparities?

By facilitating remote healthcare consultations Signup and view all the answers

Which type of exposure involves physical threats that can affect health?

Physical Signup and view all the answers

What is the primary purpose of Federally Qualified Health Centers (FQHC)?

To serve underserved populations on a sliding scale Signup and view all the answers

What does the Air Quality Index (AQI) indicate?

The degree of air pollution in an area Signup and view all the answers

Which type of environmental exposure involves agents like bacteria and viruses?

Biological Signup and view all the answers

Which factor is NOT considered in exposure assessment?

Cost of treatment Signup and view all the answers

Which aspect is critical in the case management process?

Communication and resource promotion Signup and view all the answers

What is the primary goal of community organizing in health improvement?

Build relationships to achieve common health goals Signup and view all the answers

Which factor contributes to increased health disparities in rural areas?

Lower patient-to-PCP ratio Signup and view all the answers

Which of the following is considered a primary prevention activity in schools?

Providing mental health education Signup and view all the answers

What is an example of a tertiary prevention strategy?

Screening for abuse in students Signup and view all the answers

Which route of exposure involves the ingestion of harmful substances?

Gastrointestinal Signup and view all the answers

What is the role of OSHA regarding workplace safety?

Require record-keeping of workplace injuries Signup and view all the answers

Which of the following elements is NOT a part of the five levels of hazard control?

Increase employee workload Signup and view all the answers

What is the focus of the WSCC framework?

Fostering healthy lifestyle behaviors among students Signup and view all the answers

Which of the following statements about telehealth is correct in the context of rural healthcare?

It increases access to healthcare services for rural populations. Signup and view all the answers

Which population is considered to be at greater risk during disaster management?

Children and elderly individuals Signup and view all the answers

What should employers undertake to ensure employee safety regarding hazardous substances?

Provide access to Safety Data Sheets (SDS) Signup and view all the answers

Which of the following is a critical responsibility of school nurses?

Provide care coordination and health teaching Signup and view all the answers

Which is NOT an intended outcome of health promotion programs in schools?

Providing financial services Signup and view all the answers

What level of health care is a nurse practicing when developing an anti-smoking campaign?

Primary Signup and view all the answers

Which of the following is one of the most effective health promotion efforts in primary health care?

Administration of vaccines Signup and view all the answers

In planning a response to an E.coli contamination, which role does the public health nurse primarily take?

Disaster preparedness Signup and view all the answers

Which nursing action represents the role of a case manager when assisting a client with a substance abuse diagnosis?

Advocacy Signup and view all the answers

Establishing affordable housing options for low-income clients illustrates which nurse role?

Community partnership Signup and view all the answers

Which challenge is commonly faced in providing healthcare within rural communities?

Access to care Signup and view all the answers

What factor largely affects health disparities in rural communities?

Difficulty recruiting healthcare providers Signup and view all the answers

A public health nurse in a rural community would be least expected to assist with which role?

Social justice reform (laws) Signup and view all the answers

What nursing action is crucial for addressing health needs in a rural community?

Use of cultural competence Signup and view all the answers

Which factor does NOT influence health in an urban community according to public health nursing?

Access to green spaces Signup and view all the answers

What is the focus of a public health nurse working within the community to identify and implement common goals?

Coalition building Signup and view all the answers

What type of nursing is practiced within a faith community?

Parish nursing Signup and view all the answers

What recommendation should the school nurse make regarding this disaster response plan?

Practice the plan a number of times each year Signup and view all the answers

In the epidemiological triangle, what aspect would assist John in understanding the toxic exposure incidents?

When the exposure occurred Signup and view all the answers

Who serves as the best resource for community-based participatory research?

Public health nurse Signup and view all the answers

What type of environmental hazard is the patient experiencing after mixing household cleaning products?

Chemical hazard Signup and view all the answers

Which benefit is associated with care provided at a nurse-managed health center?

Affordable care Signup and view all the answers

What are the stress, pain, and anxiety experienced by the family after the weather event classified as?

Psychosocial factors Signup and view all the answers

What aspect of exposure is the nurse most concerned about when the patient has a long history of workplace toxin exposure but current levels are normal?

Bioaccumulation/Accumulation Signup and view all the answers

What term describes a source that contributes to decreased air quality in an industrial area?

Point source Signup and view all the answers

How should a nurse respond when told that the company is not required to maintain an OSHA 300 form?

That’s incorrect. The OSHA 300 logs should be kept when the company has 10 employees Signup and view all the answers

What level of prevention does the use of personal protective equipment (PPE) fall under?

Primary prevention Signup and view all the answers

What significant true statement can be made about the American workforce?

Approximately 43% of teenagers are employed and in their first job by the age of 19 years Signup and view all the answers

What health issue should be screened for among migrant workers in addition to routine health assessments?

Skin cancer Signup and view all the answers

Which of the following is a primary prevention method regarding bioterrorism?

Creating a bioterrorism response plan Signup and view all the answers

Which principle of environmental health is not relevant to nursing practice?

Implementing waste management practices Signup and view all the answers

What is the term used for the process that evaluates potential health effects from environmental exposure?

Exposure risk assessment Signup and view all the answers

Which factor should not be included in the assessment of a client affected by a hazardous substance?

If the substance reaches susceptible organs Signup and view all the answers

Which of the following is a significant health issue related to severe weather caused by climate change?

Malnutrition Signup and view all the answers

What is considered the most effective level of control in the hierarchy of controls to prevent workplace hazards?

Elimination/substitution Signup and view all the answers

Which component should be included in the initial assessment of an environmental health history?

Time and location of exposure Signup and view all the answers

Which organization is responsible for enforcing federal guidelines in workplace environments to protect public health?

Occupational Safety and Health Administration (OSHA) Signup and view all the answers

What is an example of a tertiary prevention measure in a workplace?

Providing psychological support after incidents Signup and view all the answers

Which type of health impact does frostbite from cold exposure fall under?

Physical Signup and view all the answers

What intervention can help reduce workplace stress effectively?

Meditation and relaxation techniques Signup and view all the answers

What is a criterion for a client to be considered disabled?

Physical or mental impairment that limits life activities Signup and view all the answers

Which action demonstrates cultural competence while assisting underrepresented clients?

Utilizing cultural competence in care planning Signup and view all the answers

Which method is effective in assessing emergency preparedness in workplaces?

Identifying levels of emergency supplies needed Signup and view all the answers

Which of the following actions represents an example of local regulation in the school system?

Hearing and vision screening must be completed for each student prior to the start of the school year Signup and view all the answers

What is a key step a school nurse should take when preparing for a potentially life-threatening event in the school?

Training staff in CPR Signup and view all the answers

How does a school nurse contribute to addressing the issue of cyberbullying among students?

Providing treatment for cyberbullying victims Signup and view all the answers

What type of prevention is represented by a community-wide program aimed at raising awareness about nicotine use and supporting teens to quit smoking?

Health promotion Signup and view all the answers

Which approach does a public health initiative take when encouraging unvaccinated patients to get vaccinated?

Primary health prevention focused on health promotion Signup and view all the answers

In the medical home model, which of the following elements does not fit?

Specialized focused care Signup and view all the answers

What is the primary characteristic of collaboration within a healthcare setting?

The nurse partners with key individuals and organizations Signup and view all the answers

Which of the following is not a characteristic need of a rural population?

Higher life expectancy compared to urban populations Signup and view all the answers

What action could a nurse take to effectively serve a community where the patient load is increasing but time is limited?

Set up a telehealth system for basic inquiries Signup and view all the answers

What describes the effort when community members repair broken windows and maintain buildings?

Community organization Signup and view all the answers

Which activity is specific to the role of a parish nurse?

Improving spiritual health through practices such as grief counseling Signup and view all the answers

Which component does not belong in the Whole School, Whole Community, Whole Child (WSSC) model?

Comprehensive academic programs Signup and view all the answers

What does health protection cover in the context of school nursing?

Administering STI vaccines Signup and view all the answers

How should a new school nurse handle established scoliosis screening procedures in the school?

Consult state guidelines regarding required screenings Signup and view all the answers

Study Notes

Heart Failure (HF)

Right-sided HF is characterized by dependent edema, vein distention, and fluid retention. This condition arises from left ventricular dysfunction, such as a myocardial infarction (MI), hypertension, coronary artery disease (CAD), or cardiomyopathy. Blood backs up into the left atrium and pulmonary veins, causing pulmonary congestion.
Left-sided HF (more common) is due to blood backing up into the left atrium and pulmonary veins, leading to pulmonary congestion. This condition occurs from problems like MI, hypertension, CAD, or cardiomyopathy.
Preload: The precontraction pressure in the heart as the volume of blood builds up.
Afterload: The resistance to blood ejection from the ventricle.
Statins work by inhibiting HMG-CoA reductase, reducing low-density lipoprotein (LDL) production in the liver. Common side effects include hepatotoxicity, rhabdomyolysis, and muscle aches.
Cholestyramine binds bile acids, limiting their reabsorption in the gastrointestinal tract. This action reduces serum cholesterol and LDL. It must be taken with 60-80 ml of liquid.
Gemfibrozil breaks down triglycerides (TG) particles, increasing high-density lipoprotein (HDL) and reducing very-low-density lipoprotein (VLDL). Potential side effects are gallstones, gastrointestinal distress, and liver function issues.
Ezetimibe inhibits cholesterol absorption in the small intestine, lowering cholesterol levels. Potential side effects include elevations in liver enzymes and GI issues.
Alirocumab is an example of a PCSK9 inhibitor. It reduces LDL by binding to the low-density lipoprotein (LDL) receptors in the liver. Given subcutaneously. Possible adverse events include flu-like symptoms.
ACE-I Inhibitors (Captopril, Lisinopril, Enalapril) and ARBs (Losartan) reduce blood pressure by reducing afterload and preload, which helps improve cardiac output. Potential side effects include dizziness, orthostatic hypotension, and cough.
Diuretics (such as Furosemide, Thiazides, Spironolactone) help remove excess fluid, a key aspect in managing HF.
Beta-blockers (Metoprolol, Carvedilol) slow heart rate and decrease blood pressure. Carvedilol is contraindicated with severe asthma or bronchospastic issues.
Digoxin increases heart contractions and force, which lowers heart rate. Potential adverse effects include visual disturbances, nausea, vomiting. Check heart rate and blood pressure before administering with other heart medications. Digoxin toxicity includes visual halos and anorexia.
Vasodilators such as Hydralazine and Isosorbide help relax blood vessels, reducing blood pressure. Milrinone is typically given intravenously for acute HF management. Adverse effects of milrinone include dysrhythmias.
Dysrhythmias: Irregular heartbeats. Monitor ECG and assess vitals

Other Medications

Procainamide and Lidocaine: Sodium channel blockers used to treat ventricular arrhythmias. Procainamide has a black box warning for bone marrow suppression. Lidocaine can cause toxicity such as confusion and fever.
Amiodarone: Antiarrhythmic drug. Possible side effects include pulmonary toxicity, bradycardia, and hypotension
Calcium Channel Blockers: (Diltiazem, Verapamil) slow AV node conduction, decrease contractility, and are used to treat hypertension, angina, and certain types of cardiac arrhythmias. These drugs are typically given to lower heart rate and slow conduction through AV node.
Adenosine: Decreases contractility and conduction through AV node. This medication is given intravenously and can be used to manage supraventricular tachycardia (SVT).
Digoxin: Digitalis glycoside used to treat HF by increasing heart contractility.
Anticoagulants: Heparin, Enoxaparin, Warfarin, Dabigatran, and Rivaroxaban. Used to prevent blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE).
Antiplatelets: Aspirin, Clopidogrel, Eptifibatide, and Tirofiban prevent platelet aggregation, preventing clot formation.
Thrombolytics: Alteplase, Reteplase, Streptokinase, and Tenecteplase dissolve or break down clots.
Hemostatics: Desmopressin(DDAVP). Prevents or stops bleeding.

Nursing Considerations

Monitor weight, input/output, and oxygen saturation (SpO2).

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