Nokea
The client is taking an ACE inhibitor. What is a contraindication to taking this drug?
- A. Hypertension
- B. Bronchospasm
- C. Renal artery stenosis
- D. Heart failure
Correct Answer: C
Rationale: The correct answer is C: Renal artery stenosis. ACE inhibitors can cause a decrease in renal blood flow, potentially worsening renal function in patients with renal artery stenosis. This is a contraindication because it can lead to further renal damage and potentially acute renal failure. Hypertension (Choice A) is actually an indication for ACE inhibitors as they help lower blood pressure. Bronchospasm (Choice B) is not a contraindication for ACE inhibitors. Heart failure (Choice D) is also not a contraindication, as ACE inhibitors are commonly used to treat heart failure by reducing the workload on the heart.
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A patient is suspected of having a decreased cardiac output due to dysrhythmias. Which of the following assessments would be included in a decreased cardiac output? Select all that apply
- A. Elevated jugular venous distention
- B. Polyuria
- C. Full and bounding pulses
- D. Diaphoresis
Correct Answer: A
Rationale: The correct answer is A: Elevated jugular venous distention. This is a classic sign of decreased cardiac output as it indicates increased central venous pressure due to the heart's inability to effectively pump blood. This results in blood backing up into the jugular veins, causing them to appear distended.
Explanation for why other choices are incorrect:
B: Polyuria is not typically associated with decreased cardiac output. Polyuria is excessive urination and is more commonly seen in conditions such as diabetes insipidus or diabetes mellitus.
C: Full and bounding pulses are not indicative of decreased cardiac output. In fact, decreased cardiac output often leads to weak and thready pulses due to reduced blood flow.
D: Diaphoresis, or excessive sweating, can occur in various conditions but is not a specific sign of decreased cardiac output. It can be seen in response to pain, anxiety, or fever.
The nurse suspects that the patient with stable angina is experiencing a side effect of the prescribed drug metoprolol (Lopressor) if the
- A. patient is restless and agitated.
- B. blood pressure is 90/54 mm Hg.
- C. patient complains about feeling anxious.
- D. heart monitor shows normal sinus rhythm.
Correct Answer: B
Rationale: The correct answer is B because low blood pressure (90/54 mm Hg) is a known side effect of metoprolol. Metoprolol is a beta-blocker that can cause hypotension. Restlessness, agitation, and anxiety are not typical side effects of metoprolol. A normal sinus rhythm on the heart monitor does not indicate a side effect of metoprolol. Low blood pressure is a common side effect of metoprolol due to its beta-blocking effects on the heart and blood vessels, leading to decreased cardiac output and vasodilation.
Which order should the nurse question?
- A. The addition of a loop diuretic with digoxin.
- B. The addition of a beta blocker with digoxin.
- C. A digoxin dose of 0.125 mg per day.
- D. The addition of an ACE inhibitor with digoxin.
Correct Answer: A
Rationale: The correct order for the nurse to question is A: The addition of a loop diuretic with digoxin. This is because loop diuretics can increase the risk of digoxin toxicity by causing hypokalemia. Digoxin toxicity is more likely to occur when potassium levels are low. Therefore, the nurse should question this order to prevent potential harm to the patient.
Summary:
- B: The addition of a beta blocker with digoxin: Beta blockers can also increase the risk of digoxin toxicity but it is not as directly related to potassium levels as loop diuretics.
- C: A digoxin dose of 0.125 mg per day: This is within the recommended therapeutic range for digoxin and does not directly impact the risk of toxicity with loop diuretics.
- D: The addition of an ACE inhibitor with digoxin: ACE inhibitors can also increase the risk of digoxin toxicity, but the priority in this case is
To prevent arterial trauma during the use of the IABP, the nurse should
- A. Reposition the patient every 2 hours
- B. Check the site for bleeding every hour
- C. Prevent hip flexion of the cannulated leg
- D. Cover the insertion site with an occlusive dressing
Correct Answer: C
Rationale: Because the IABP is inserted into the femoral artery and advanced to the descending thoracic aorta, compromised distal extremity circulation is common, and requires that the cannulated extremity be extended at all times.
In a patient experiencing an acute episode of chest pain, you would anticipate administration of: (Select one that doesn't apply)
- A. Atorvastatin.
- B. Supplemental oxygen.
- C. Aspirin.
- D. Nitroglycerin.
Correct Answer: A
Rationale: Supplemental oxygen improves oxygenation, aspirin reduces platelet aggregation, and nitroglycerin relieves chest pain by dilating coronary arteries.