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The client's vital signs are T 99.2°F, AP 59, R 20, and BP 108/72. Which medication would the nurse question administering?
- A. Theo-Dur, a bronchodilator.
- B. Inderal, a beta blocker.
- C. Ampicillin, an antibiotic.
- D. Cardizem, a calcium channel blocker.
Correct Answer: B
Rationale: Inderal (propranolol) slows HR; an apical pulse of 59 warrants holding it, per guidelines, to avoid bradycardia. Other meds are unaffected by HR.
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A 68-year-old man has been diagnosed as having Parkinson's disease. He is started on Cogentin 0.5 mg PO daily. Which nursing action is most essential at this time?
- A. Monitor his BP and pulse
- B. Encourage cold beverages and hard candies
- C. Observe for rashes
- D. Monitor his stools for fluid loss
Correct Answer: B
Rationale: Cogentin, an anticholinergic, causes dry mouth; encouraging cold beverages and hard candies helps manage this side effect.
The nurse is administering a.m. medications. Which medication should the nurse administer first?
- A. The daily digoxin to the client diagnosed with congestive heart failure.
- B. The loop diuretic to the client with a serum potassium level of 3.1 mEq/L.
- C. The mucosal barrier Carafate to the client diagnosed with peptic ulcer disease.
- D. Solu-Medrol IVP to a client diagnosed with chronic lung disease.
Correct Answer: C
Rationale: Carafate (sucralfate) forms a protective barrier and must be given on an empty stomach, 30–60 minutes before other meds, to be effective for PUD.
The nurse administers 18 units of Humulin N, an intermediate-acting insulin, at 1630. Which priority intervention should the nurse implement?
- A. Monitor the client's hemoglobin A1c.
- B. Make sure the client eats the evening meal.
- C. Check the a.c. blood glucometer reading.
- D. Ensure the client eats a snack.
Correct Answer: B
Rationale: Humulin N peaks in 4–12 hours; evening meal prevents hypoglycemia during peak action. A1c, a.c. checks, or snacks are less immediate.
The client is diagnosed with essential hypertension and is receiving a calcium channel blocker. Which assessment data would warrant the nurse holding the client's medication?
- A. The client's oral temperature is 102°F.
- B. The client complains of a dry, nonproductive cough.
- C. The client's blood pressure reading is 106/76.
- D. The client complains of being dizzy when getting out of bed.
Correct Answer: D
Rationale: Dizziness on standing suggests orthostatic hypotension, a calcium channel blocker side effect, warranting holding the dose to prevent falls. Fever, cough, or BP are less critical.
The nurse is administering an intramuscular (IM) injection to a client. When the nurse aspirates, there is a blood return. What is the most appropriate action for the nurse to take?
- A. Continue to administer the medication
- B. Withdraw the needle and administer in another site
- C. Withdraw the needle, discard the medication, and start over
- D. Change the needle before administering the medication in another site
Correct Answer: C
Rationale: The nurse should not inject medication that has blood in it. Blood may interact with the medication and cause an adverse response.