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The nurse has provided medication instruction to a client who has been prescribed enalapril. Which of the following statements, if made by the client, would indicate a correct understanding of the teaching?
- A. I will notify my prescriber if I develop swelling of the face.
- B. I will need to weigh myself every day while taking this medication.
- C. I should eat foods high in potassium while I am taking this medication.
- D. I will need lab work done every so often to evaluate my liver function.
Correct Answer: A
Rationale: Enalapril can cause angioedema, so notifying the prescriber about facial swelling indicates correct understanding. Daily weighing, high potassium intake, and liver function monitoring are not typically required.
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The nurse is caring for a client who is receiving prescribed cilostazol. Which of the following client findings would indicate a therapeutic response?
- A. Absence of pain while ambulating
- B. Decreased total cholesterol
- C. Increased visual acuity
- D. Improved focus and attention
Correct Answer: A
Rationale: Cilostazol is used to treat intermittent claudication, so the absence of pain while ambulating indicates a therapeutic response. It does not directly affect cholesterol, visual acuity, or focus.
The nurse is caring for a client with the following clinical data. Based on the vital signs, which medications would the nurse clarify with the primary healthcare provider (PHCP) prior to administration? See the exhibit. Select all that apply.
- A. Atenolol 50 mg PO Daily
- B. Spironolactone 50 mg PO Daily
- C. Albuterol 2.5 mg via nebulizer Daily
- D. Fentanyl 50 mcg IV Push q 6 hours PRN Pain
- E. Modafinil 100 mg PO Daily
Correct Answer: A
Rationale: Without specific vital signs provided, atenolol (a beta-blocker) may need clarification if the client has low heart rate (bradycardia) or low blood pressure, as it can exacerbate these conditions. Spironolactone, albuterol, fentanyl, and modafinil are less likely to require clarification based solely on vital signs unless specific contraindications (e.g., severe hypotension or respiratory distress) are present.
A nurse is caring for a client receiving digoxin. The client's most recent digitalis level was 2.5 ng/mL (0.5-2 ng/mL). The nurse should take which action? Select all that apply.
- A. Withhold the client's scheduled dose
- B. Administer the dose, as prescribed
- C. Assess the client's 24-hour urinary output
- D. Assess the client's most recent sodium level
- E. Assess the client's heart rate and rhythm
- F. Obtain a prescription for an echocardiogram
Correct Answer: A,E
Rationale: A digitalis level of 2.5 ng/mL indicates toxicity, so the nurse should withhold the dose (A) and assess heart rate and rhythm (E) for signs like bradycardia. Urinary output, sodium levels, and echocardiograms are not directly related to immediate toxicity management.
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.
The following scenario applies to the next 1 items.
The medical-surgical nurse is performing an admission assessment
Item 1 of 1
Current Medications
losartan 25 mg by mouth daily
spironolactone 25 mg by mouth daily
multivitamin 1 tablet by mouth daily
acetaminophen 500 mg by mouth daily, as needed for pain
pantoprazole 40 mg by mouth daily
warfarin 2 mg by mouth daily
aspirin 81 mg by mouth daily
The nurse performs medication reconciliation for this client. Which four (4) medications does the nurse recognize as a potential drug interaction?
- A. losartan
- B. spironolactone
- C. multivitamin
- D. acetaminophen
- E. pantoprazole
- F. warfarin
- G. aspirin
Correct Answer: A,B,F,G
Rationale: Losartan and spironolactone can increase hyperkalemia risk when combined. Warfarin and aspirin together increase bleeding risk due to their anticoagulant and antiplatelet effects, respectively. Multivitamin, acetaminophen, and pantoprazole are less likely to cause significant interactions in this context.