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A mechanically ventilated client with ARDS has FiO₂ 0.60 and newly increased PEEP from 8 to 12 cm H₂O. The nurse anticipates this change primarily aims to:

A 71-year-old man with HFrEF presents with nausea, yellow-green visual halos, and new-onset ventricular ectopy. He has been compliant with his digoxin therapy and recently had his furosemide dose increased for volume overload. Labs: K⁺ = 2.8 mEq/L, Cr = 1.0 mg/dL. Which factor most likely precipitated his digoxin toxicity? 

A patient on chronic benzodiazepine therapy suddenly discontinues the drug. What is the most concerning complication? 

A 29-year-old man with a history of intravenous heroin use is brought to the ED unresponsive with shallow respirations (RR 6/min) and pinpoint pupils. He receives IV naloxone 0.4 mg, and within minutes he becomes alert but develops severe agitation, diaphoresis, piloerection, tachycardia, hypertension, and nausea. Which best explains this clinical presentation? 

A 60-year-old man had a cardiac stent placed 2 months ago for NSTEMI. He takes aspirin and clopidogrel. His dentist wants to do an elective tooth extraction, and he asks if he can stop clopidogrel. What should the NP recommend? 

A patient with moderate Alzheimer’s is prescribed memantine. Its mechanism is: 

A 48-year-old man with a 30–pack-year smoking history presents for help with quitting. He has no history of depression, seizures, or cardiovascular disease. He has attempted to quit twice in the past using willpower alone but relapsed within weeks due to strong cravings. He expresses high motivation to stop now, stating, “I’ll try whatever works best.” Which first-line pharmacologic intervention is most appropriate to recommend? 

A 69-year-old man with persistent atrial fibrillation has been maintained on amiodarone for rhythm control for the past 18 months. He presents to clinic for follow-up and reports mild dyspnea on exertion but no chest pain or palpitations. He is otherwise stable on warfarin and carvedilol. Which organ systems require routine baseline and ongoing monitoring in patients treated chronically with amiodarone? 

A 58-year-old man had a heart attack (STEMI) treated with stent placement 3 months ago. He now has frequent premature ventricular contractions (PVCs) on Holter monitoring. He asks if there is a medicine to “stop the extra beats.” Which drug class improves survival in this setting? 

After 5 years on levodopa, a patient develops involuntary writhing movements. This is most likely: