A client receiving enalapril reports a persistent dry cough. The nurse should explain that this side effect is related to which medication action?
- A. It reduces the production of angiotensin II.
- B. It increases the production of angiotensin II.
- C. It causes increased production of bradykinin.
- D. It increases the production of aldosterone.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A client who takes metformin for diabetes mellitus type 2 is taking nothing by mouth (NPO) for surgery. What pre-op prescription should the practical nurse (PN) anticipate for this client's glucose management?
- A. NPO except for metformin and regular snacks
- B. NPO except for oral antidiabetic agent
- C. Novolin-N insulin subcutaneously twice daily
- D. Regular insulin subcutaneously per sliding scale
Correct Answer: D
Rationale: When a client taking metformin for diabetes mellitus type 2 is NPO for surgery, it is essential to manage their glucose levels effectively. In this scenario, the best approach is to prescribe regular insulin subcutaneously according to a sliding scale based on the client's blood glucose levels. This method allows for precise adjustment of insulin doses to maintain blood glucose within the target range while the client is unable to take oral medications.
How do you determine if the medication is effective for a client with anemia secondary to chronic kidney disease (CKD)?
- A. Food diary shows increased consumption of iron-rich foods
- B. Reports of increased energy levels and decreased fatigue
- C. Hemoglobin level increased to 12 grams/dL
- D. Takes concurrent iron therapy without adverse effects
Correct Answer: C
Rationale: To assess the effectiveness of the medication for anemia in a client with CKD, monitoring hemoglobin levels is crucial. Hemoglobin levels serve as a direct indicator of the response to treatment and improvement in the condition. An increase in hemoglobin level to 12 grams/dL suggests that the medication is effectively addressing the anemia associated with CKD.
The healthcare provider is assessing the effectiveness of the drug amiodarone. Which client statement best indicates that the drug has been effective?
- A. I have not had as many spells of angina.
- B. I have not had as much swelling in my ankles lately.
- C. My doctor told me my cholesterol levels were improving with each visit.
- D. I do not notice as many irregular heartbeats as before I started taking this medication.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with a history of hypertension is prescribed hydrochlorothiazide. The practical nurse should monitor the client for which potential adverse effect?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hypernatremia
- D. Hyponatremia
Correct Answer: B
Rationale: Hydrochlorothiazide is a diuretic that can lead to potassium loss, resulting in hypokalemia. Monitoring for hypokalemia is essential because it can cause various complications such as cardiac dysrhythmias. Therefore, the practical nurse should closely watch for signs and symptoms of low potassium levels in clients taking hydrochlorothiazide.
A client has been diagnosed with open-angle glaucoma. The health care provider prescribes pilocarpine 1% eye drops. The nurse explains that which action of this drug makes it a useful treatment for the client's condition?
- A. The ciliary muscle contracts increasing the outflow of aqueous humor in the eye.
- B. Ciliary muscles are paralyzed to decrease accommodation.
- C. Bilateral mydriasis with cycloplegia is accomplished.
- D. The production of aqueous humor in the eyes is decreased.
Correct Answer: A
Rationale: Pilocarpine, a cholinergic agent, stimulates the ciliary muscle to contract, which opens the trabecular meshwork and facilitates the outflow of aqueous humor, reducing intraocular pressure. This mechanism helps in managing open-angle glaucoma by improving drainage and lowering pressure within the eye.