Nokea
A client with hypertension asks the nurse to explain how amlodipine besylate (Norvasc) lowers her blood pressure. The nurse gives which explanation to the client?
- A. It prevents calcium from entering the smooth muscle, which relaxes the blood vessels to lower heart rate and blood pressure.
- B. It is a diuretic that works by removing extra sodium and water from the body through the kidneys, which helps lower blood pressure.
- C. It causes the body to produce less angiotensin, which allows blood vessels to relax and open up, therefore reducing blood pressure.
- D. It lowers blood pressure by lowering the heart rate and the workload of the heart, and decreases the amount of blood pumped out of the heart.
Correct Answer: A
Rationale: Amlodipine, a calcium channel blocker, prevents calcium entry into vascular smooth muscle, causing vasodilation and lowering blood pressure. It does not primarily affect heart rate (A is partially incorrect but closest), nor is it a diuretic (B), ACE inhibitor (C), or beta-blocker (D).
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Which instruction is correct for a client receiving lithium carbonate for bipolar disorder?
- A. breastfeeding may be done
- B. driving or using machinery is acceptable
- C. drugs containing ibuprofen should be avoided
- D. fluid intake should be limited to eight 8-oz glasses per day
Correct Answer: C
Rationale: Ibuprofen can increase lithium levels, risking toxicity, and should be avoided. Breastfeeding is contraindicated, driving may be unsafe due to side effects, and fluid intake should be adequate.
The night nurse is preparing to pull night medications for a client. Levofloxacin is scheduled to be given at 0030. The nurse will give this medication at which time?
- A. 1:30 a.m.
- B. 1:30 p.m.
- C. 11:30 p.m.
- D. 12:30 a.m.
- E. 12:30 p.m.
Correct Answer: D
Rationale: 0030 in 24-hour format is 12:30 a.m. (midnight plus 30 minutes), appropriate for a night shift medication.
The nurse is preparing to administer a calcium channel blocker to a client with hypertension. The nurse understands that the mechanism of action of these drugs is to
- A. cause vasodilation and increase total peripheral resistance.
- B. cause vasodilation and decrease total peripheral resistance.
- C. cause vasoconstriction and decrease total peripheral resistance.
- D. cause vasoconstriction and increase total peripheral resistance.
Correct Answer: B
Rationale: Calcium channel blockers cause vasodilation, reducing total peripheral resistance and lowering blood pressure.
A client with asthma has orders for terbutaline. Which finding in the medical history would the nurse be most concerned about?
- A. diabetes
- B. migraines
- C. osteoarthritis
- D. coronary artery disease
Correct Answer: D
Rationale: Terbutaline, a beta-2 agonist, can cause tachycardia and increased myocardial oxygen demand, posing a significant risk in coronary artery disease.