The following are first-line drugs for hypertension in diabetics with proteinuria:
- A. Lisinopril
- B. Losartan
- C. Amlodipine
- D. Hydrochlorothiazide
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A client has a prescription for a Nitroglycerin transdermal patch. Which of the following instructions should be included by the healthcare provider?
- A. Apply the patch to a hairless area of the body.
- B. Remove the patch every 12 hours.
- C. Massage the patch after applying it.
- D. Place the patch over a hairless area of the body.
Correct Answer: D
Rationale: The correct instruction for a Nitroglycerin transdermal patch is to place it over a hairless area of the body. This is essential to ensure proper adhesion and consistent absorption of the medication. Hair can impede the patch's ability to stick to the skin and deliver the medication effectively. Therefore, choices A, B, and C are incorrect. Applying the patch to the same site every day (Choice A) may lead to skin irritation, removing the patch every 12 hours (Choice B) is not typically recommended for Nitroglycerin patches, and massaging the patch after applying it (Choice C) could alter its integrity and affect drug delivery.
A client has been prescribed Warfarin for atrial fibrillation. Which of the following instructions should the nurse include in the discharge teaching?
- A. Avoid foods high in vitamin K.
- B. Take this medication with food to prevent nausea.
- C. Monitor your heart rate daily before taking the medication.
- D. Limit your fluid intake to 1 liter per day.
Correct Answer: A
Rationale: The correct instruction for the nurse to include in the discharge teaching for a client prescribed Warfarin is to 'Avoid foods high in vitamin K.' Foods high in vitamin K can decrease the effectiveness of Warfarin by interfering with its anticoagulant effects, potentially leading to blood clotting issues. It is crucial for clients on Warfarin therapy to maintain a consistent intake of vitamin K-containing foods to ensure the stability of the medication's effects. Choices B, C, and D are incorrect because taking Warfarin with food, monitoring heart rate daily, or limiting fluid intake are not directly related to optimizing the effectiveness of Warfarin therapy.
A healthcare professional is preparing to administer IV Dantrolene to a client who has developed Malignant Hyperthermia during surgery. Which of the following actions should the healthcare professional take?
- A. Dilute the medication with sterile water and administer it rapidly.
- B. Store the medication in a refrigerator until use.
- C. Administer the medication through a large-bore IV catheter.
- D. Administer the medication via an infusion pump over 60 minutes.
Correct Answer: C
Rationale: Dantrolene should be administered through a large-bore IV catheter because it is highly irritating to tissues and can cause vein irritation or thrombophlebitis if administered through a small vein. Using a large-bore IV catheter helps to minimize the risk of tissue damage and ensures proper and safe administration of the medication in emergency situations like Malignant Hyperthermia. Choices A, B, and D are incorrect because diluting the medication with sterile water and administering it rapidly can lead to tissue damage, storing the medication in a refrigerator is not necessary, and administering the medication via an infusion pump over 60 minutes is not appropriate in emergency situations like Malignant Hyperthermia where rapid administration is crucial.
Assessing a patient after intravenous morphine administration, the nurse notes cold, clammy skin; a pulse of 40 beats/min; respirations of 10 breaths/min; and constricted pupils. Which medication will the patient likely need next?
- A. Naloxone
- B. Meloxicam
- C. Pentazocine
- D. Propoxyphene
Correct Answer: A
Rationale: The patient's symptoms—cold, clammy skin, bradycardia, respiratory depression, and constricted pupils—are classic signs of opioid overdose. Naloxone is the antidote for opioid overdose and should be administered immediately to reverse the life-threatening effects of morphine. Meloxicam, pentazocine, and propoxyphene are not appropriate in this situation. Nurses must recognize the signs of opioid toxicity and act quickly to administer naloxone, ensuring the patient's airway, breathing, and circulation are supported.
When administering medications to a 4-month-old infant, which of the following pharmacokinetic principles should be considered? (Select all that apply.)
- A. Infants have a more rapid gastric emptying time.
- B. Infants have immature liver function.
- C. Infants' blood-brain barrier is poorly developed.
- D. Infants have an increased ability to absorb topical medications.
Correct Answer: B
Rationale: When administering medications to a 4-month-old infant, the pharmacokinetic principle to consider is that infants have immature liver function until 1 year of age. This requires medications metabolized by the liver to be administered in smaller dosages. While infants do have a more rapid gastric emptying time, immature liver function is a more critical pharmacokinetic consideration in this context. Additionally, although infants have a poorly developed blood-brain barrier, this relates more to pharmacodynamic effects rather than pharmacokinetic principles. The statement about infants having an increased ability to absorb topical medications is not directly related to pharmacokinetic principles, making choice B the correct answer.