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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 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 to a client who has a new prescription for atenolol. Which of the following adverse effects should the nurse include in the teaching?
- A. Lightheadedness
- B. Tachycardia
- C. Dry mouth
- D. Bronchodilation
Correct Answer: A
Rationale: The correct answer is A: Lightheadedness. Atenolol is a beta-blocker that can cause a decrease in blood pressure, leading to lightheadedness due to reduced blood flow to the brain. Tachycardia (choice B) is not an adverse effect as atenolol actually slows down the heart rate. Dry mouth (choice C) is not a common adverse effect of atenolol. Bronchodilation (choice D) is not expected with atenolol as it can actually cause bronchoconstriction in some individuals.
A nurse is caring for a client who is receiving long-term treatment with oral doses of prednisone. For which of the following adverse effects should the nurse monitor?
- A. Hypoglycemia
- B. Hyperreflexia
- C. Osteoporosis
- D. Inflammatory bowel disease
Correct Answer: C
Rationale: The correct answer is C: Osteoporosis. Prednisone is a corticosteroid medication that can lead to bone loss and increase the risk of osteoporosis with long-term use. The rationale: Prednisone inhibits calcium absorption and bone formation, resulting in decreased bone density. Monitoring for osteoporosis is crucial to prevent fractures. Hypoglycemia (A) is not a common adverse effect of prednisone but hyperglycemia is. Hyperreflexia (B) is not typically associated with prednisone. Inflammatory bowel disease (D) is not an adverse effect of prednisone, as it is actually used to treat inflammatory conditions.
A nurse is providing teaching to a client who has chronic rheumatoid arthritis and a new prescription for hydroxychloroquine. The nurse should instruct the client to obtain which of the following diagnostic studies routinely?
- A. Eye examination
- B. Chest -ray
- C. Pancreatic enzyme levels
- D. Urinalysis screening
Correct Answer: A
Rationale: The correct answer is A: Eye examination. Hydroxychloroquine can cause retinal toxicity, so regular eye exams are essential to monitor for any ocular changes. This is crucial in preventing irreversible vision damage. Choices B, C, and D are not routinely necessary for monitoring hydroxychloroquine therapy and are not directly related to its potential side effects. A chest x-ray is not typically indicated unless specific symptoms or concerns arise. Pancreatic enzyme levels and urinalysis are not directly impacted by hydroxychloroquine use. Therefore, the most appropriate diagnostic study for this client would be an eye examination to monitor for potential retinal toxicity.
A nurse is preparing to administer ampicillin/sulbactam 15 g via intermittent IV bolus, Available is ampicillin-sulbactam 1.5 g in 0.9% sodium chloride 100 mL to infuse over 30 min. The nurse should set the IV infusion pump to deliver how many mL/h?
- A. 200 mL/h
Correct Answer: A
Rationale: The correct answer is A: 200 mL/h. To calculate the infusion rate, you first need to convert the total dose of ampicillin/sulbactam to mL. The concentration is 1.5 g in 100 mL, so 15 g would be in 1000 mL. The infusion time is 30 min, so you need to convert it to hours (30 min ÷ 60 = 0.5 hours). Next, divide the total volume (1000 mL) by the infusion time (0.5 hours) to get 2000 mL/h. Therefore, the nurse should set the IV pump to deliver 200 mL/h. Other choices are incorrect as they do not follow the correct calculations based on the given information.