Nokea
The emergency department nurse is caring for a client with an abdominal aortic aneurysm at risk of rupturing. The nurse will anticipate the primary healthcare provider (PHCP) to prescribe
- A. esmolol
- B. dexamethasone
- C. heparin
- D. pantoprazole
Correct Answer: A
Rationale: Esmolol, a short-acting beta-blocker, is used to control blood pressure and reduce aortic wall stress in an abdominal aortic aneurysm. Dexamethasone, heparin, and pantoprazole are not indicated.
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The nurse is preparing an educational in-service about valsartan. Which of the following information should the nurse include?
- A. Valsartan blocks the conversion of angiotensin I to angiotensin II.
- B. Valsartan antagonizes angiotensin II receptors.
- C. Valsartan stimulates alpha-2 adrenoceptors in the brainstem.
- D. Valsartan blocks response to beta1- and beta2-adrenergic stimulation.
Correct Answer: B
Rationale: Valsartan, an ARB, antagonizes angiotensin II receptors, reducing blood pressure. It does not block angiotensin conversion, stimulate alpha-2 receptors, or block beta-adrenergic responses.
The emergency department (ED) nurse is caring for a client with a hypertensive emergency. The nurse should obtain a prescription for intravenous
- A. dobutamine
- B. digoxin
- C. nicardipine
- D. amiodarone
Correct Answer: C
Rationale: Nicardipine, an IV calcium channel blocker, is used to rapidly lower blood pressure in a hypertensive emergency. Dobutamine (an inotrope), digoxin (a cardiac glycoside), and amiodarone (an antiarrhythmic) are not appropriate for this condition.
The nurse is preparing to administer prescribed bumetanide to a client. Which clinical finding would indicate a therapeutic outcome?
- A. Increase in central venous pressure (CVP)
- B. Reduced cardiac preload and wall tension
- C. Decreased glomerular filtration rate (GFR)
- D. Increase in systemic vascular resistance (SVR)
Correct Answer: B
Rationale: Bumetanide, a loop diuretic, reduces fluid volume, leading to decreased cardiac preload and wall tension, indicating a therapeutic outcome in conditions like heart failure. Increased CVP, decreased GFR, or increased SVR are not desired effects.
The nurse is caring for a client with heart failure. Which medication should the nurse clarify with the primary healthcare provider (PHCP)?
- A. lisinopril
- B. prednisone
- C. hydralazine
- D. carvedilol
Correct Answer: B
Rationale: Prednisone, a corticosteroid, can cause fluid retention and worsen heart failure, so it should be clarified. Lisinopril, hydralazine, and carvedilol are commonly used in heart failure management.
The nurse is caring for a client who is taking prescribed sildenafil. After reviewing the client's other medications, the nurse recognizes which medication would contraindicate sildenafil?
- A. furosemide
- B. isosorbide
- C. atorvastatin
- D. losartan
Correct Answer: B
Rationale: Sildenafil is contraindicated with nitrates like isosorbide due to the risk of severe hypotension. Furosemide, atorvastatin, and losartan do not have significant interactions with sildenafil.