Nokea
A client, aged 60 years, is receiving nitroprusside for hypertensive emergency. The nurse would be alert for the development of which of the following?
- A. Significant hypotension
- B. Rebound hypertension
- C. Blindness
- D. Stroke
Correct Answer: A
Rationale: An older adult client is at risk for significant hypotension when receiving nitroprusside. To prevent this, the dosage should be reduced during the initial period of therapy. Rebound hypertension, stroke, and blindness will not occur during nitroprusside therapy.
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A client has a nursing diagnosis of Activity Intolerance related to fatigue and weakness. Which of the following would be appropriate for the nurse to include in the client's plan of care?
- A. Encouraging ambulation as tolerated
- B. Maintaining bed rest as much as possible
- C. Mandating the use of assistive devices
- D. Encouraging activities early in the morning when fatigue is less
- E. Promoting rest periods throughout the day as necessary
Correct Answer: A,E
Rationale: The client is encouraged to walk and ambulate as he or she can tolerate. Assistive devices may be used if needed, but these should not be mandated for use. The client can gradually increase tolerance by increasing the daily amount of activity. Planning rest periods according to the individual's tolerance is appropriate. Rest can take many forms, such as sitting in a chair, napping, watching television, or sitting with legs elevated.
When teaching a client about the prescribed clonidine transdermal medication, which of the following would the nurse most likely include? Select all that apply.
- A. A new patch is applied daily.
- B. If the patch loosens, a new patch should be applied
- C. The use of the adhesive overlay is not necessary
- D. A different body area should be selected for each application.
- E. The patch should be applied to a hairless area
Correct Answer: D,E
Rationale: The patch is applied to a hairless area of intact skin on the upper arm or torso; the patch is kept in place for 7 days. The adhesive overlay is applied directly over the system to ensure the patch remains in place for the required time. A different body area is selected for each application. If the patch loosens before 7 days, the edges can be reinforced with nonallergenic tape.
A client with hypertension has a fungal infection and has been prescribed fluconazole for the fungal infection and losartan for hypertension. The nurse would be alert for which of the following?
- A. Increased risk of adverse effects of losartan
- B. Increased risk of hypersensitivity reaction
- C. Decreased hypotensive effect of losartan
- D. Increased risk of hypoglycemia
Correct Answer: A
Rationale: Increased risk of antihypertensive effects and adverse reactions are associated with the concomitant use of fluconazole and losartan. Decreased hypotensive effect of losartan is seen with use of indomethacin and does not occur with the concomitant use of these drugs. Increased risk of hypoglycemia and increased risk of hypersensitivity do not occur with the concomitant use of these drugs.
A client is prescribed clonidine as a transdermal patch. After instructing the client about this drug, the nurse determines that the teaching was successful when the client states that the patch should remain in place for how long?
- A. 24 hours
- B. 3 days
- C. 7 days
- D. 2 weeks
Correct Answer: C
Rationale: The nurse should ensure that the transdermal patch is intact for a period of 1 week. A clonidine transdermal patch should be applied to a hairless area over the torso for 1 week. If the patch loosens before 7 days, it has to be reinforced. The nurse has to mark the date of placement and the date of removal of the patch on the surface of the patch.
A nurse is educating a client with hypertension who is prescribed losartan about the drug's action. Which of the following would the nurse incorporate into the teaching about this drug?
- A. Blocking aldosterone receptors
- B. Preventing conversion of angiotensin I
- C. Blocking angiotensin II receptors
- D. Preventing renin secretion
Correct Answer: C
Rationale: Losartan is an angiotensin II receptor antagonist, acting to block the angiotensin II receptors. By blocking the angiotensin II receptor, the renin-angiotensin system is stopped and consequently blood pressure is reduced. Drugs such as captopril prevent the conversion of angiotensin I. Losartan does not prevent renin secretion. Losartan does not block aldosterone receptors.