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A nurse is assessing a client who reports feeling dizzy while getting out of bed. The nurse suspects orthostatic hypotension related to a medication the client is taking Which of the following medications should the nurse identify as likely causing this adverse effect?
- A. Dabigatran
- B. Levothyroxine
- C. Isoproterenol
- D. Furosemide
Correct Answer: D
Rationale: The correct answer is D: Furosemide. Furosemide is a loop diuretic that works by causing increased urine production, leading to fluid loss and potential dehydration, which can result in orthostatic hypotension. This effect is more pronounced when the client changes positions quickly, such as getting out of bed.
A: Dabigatran is an anticoagulant and does not typically cause orthostatic hypotension.
B: Levothyroxine is a thyroid hormone replacement and does not usually cause orthostatic hypotension.
C: Isoproterenol is a beta-adrenergic agonist that can actually increase blood pressure, not cause orthostatic hypotension.
In summary, Furosemide is the correct answer because it is a diuretic that can lead to dehydration and orthostatic hypotension, while the other options do not typically cause this adverse effect.
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A nurse is planning care for a client who has a new prescription to receive a continuous infusion of total parenteral nutrition (TPN) Which of the following interventions should the nurse implement?
- A. Change the TPN infusion tubing once every 3 days
- B. Check the client's blood glucose level regularly
- C. Insert the peripheral IV catheter for administration
- D. Monitor the client's weight every 3 days
Correct Answer: B
Rationale: The correct answer is B: Check the client's blood glucose level regularly. This is essential as TPN is a high-calorie, nutrient-dense solution that can increase the risk of hyperglycemia. Monitoring blood glucose levels helps the nurse assess the client's response to TPN and adjust the infusion rate accordingly to prevent complications.
Option A is incorrect because changing the TPN infusion tubing once every 3 days is not a priority in this situation. Option C is incorrect as TPN should be administered through a central venous catheter, not a peripheral IV catheter. Option D is incorrect as monitoring the client's weight every 3 days is not as crucial as monitoring blood glucose levels when on TPN.
A nurse is caring for a client who is starting to take aspirin 81 mg daily. Which of the following findings should the nurse identify as a risk factor for the client's development of an aspirin-induced ulcer?
- A. The client has a history of alcohol use disorder but is currently sober
- B. The client recently had a norovirus infection
- C. The client smokes one pack of cigarette per day
- D. The client has a history of rheumatoid arthritis
Correct Answer: C
Rationale: The correct answer is C: The client smokes one pack of cigarette per day. Smoking is a known risk factor for the development of ulcers, and when combined with aspirin use, it further increases the risk. Smoking decreases the production of prostaglandins in the stomach lining, which can lead to increased susceptibility to ulcers. Choices A, B, and D are not directly related to an increased risk of aspirin-induced ulcers. Choice A indicates a previous history of alcohol use disorder, which may have implications for liver health but not directly related to ulcers caused by aspirin. Choice B mentions a recent norovirus infection, which is not a risk factor for aspirin-induced ulcers. Choice D states a history of rheumatoid arthritis, which may necessitate the use of aspirin but does not inherently increase the risk of ulcers when combined with it.
A nurse is preparing to administer dopamine 5 mcg/kg/min by continuous IV infusion to a client who weighs 220 lb. Available is 400 mg of dopamine in 250 mL of 0.9% sodium chloride. The nurse should set the IV pump to deliver how many mL/hr?
- A. 18.8 mL/hr
Correct Answer: A
Rationale: The correct answer is A: 18.8 mL/hr. To calculate the rate of dopamine infusion, we first need to convert the client's weight from pounds to kilograms by dividing it by 2.2 (220 lb / 2.2 = 100 kg). Next, we calculate the total daily dose of dopamine by multiplying the weight in kg by the ordered dose (100 kg x 5 mcg/kg/min x 60 min/hr x 24 hr/day = 720,000 mcg/day). Then, we convert the total daily dose to mL/hr by dividing it by the concentration of dopamine in the IV solution (720,000 mcg/day / 400 mg/250 mL x 1000 mcg/mg = 18.8 mL/hr). This calculation ensures the correct dosage is administered to the client. Other choices are incorrect as they do not follow the necessary conversion steps or include miscalculations in the dosage determination.
A nurse is caring for a client who is receiving meperidine. Which of the following is the nurse's priority assessment before administering the medication?
- A. Urinary retention
- B. Vomiting
- C. Respiratory rate
- D. Level of consciousness
Correct Answer: C
Rationale: The correct answer is C: Respiratory rate. Meperidine is an opioid analgesic that can cause respiratory depression. Therefore, assessing the client's respiratory rate before administering the medication is crucial to prevent potential respiratory compromise. This assessment helps the nurse ensure the client can safely tolerate the medication and intervene promptly if respiratory depression occurs.
Urinary retention (choice A) is a potential side effect of meperidine but is not the priority assessment compared to respiratory rate. Vomiting (choice B) may be a concern in terms of medication absorption but does not directly relate to the risk of respiratory depression. Level of consciousness (choice D) is important but may be influenced by respiratory status, making respiratory rate the priority assessment.
A nurse is providing teaching for a client who has a prescription for gentamicin. Which of the following should the nurse include as an adverse effect of this medication?
- A. Urinary frequency
- B. Constipation
- C. Hypertension
- D. Tinnitus
Correct Answer: D
Rationale: The correct answer is D: Tinnitus. Gentamicin is known to cause ototoxicity, including tinnitus, which is a ringing or buzzing sound in the ears. This adverse effect is important for the nurse to include in teaching to monitor for hearing changes. Urinary frequency (A), constipation (B), and hypertension (C) are not commonly associated with gentamicin use, so they are incorrect choices.