Nokea
The nurse is administering a beta blocker to the client diagnosed with essential hypertension. Which data would cause the nurse to question administering the medication?
- A. The client's BP is 110/70.
- B. The client's potassium level is 3.4 mEq/L.
- C. The client has a barky cough.
- D. The client's apical pulse is 56.
Correct Answer: D
Rationale: Beta blockers slow heart rate; an apical pulse of 56 (D) may indicate bradycardia, warranting caution. BP 110/70 (A) is acceptable, K+ 3.4 (B) is low but unrelated, and cough (C) is not a contraindication.
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The nurse is caring for a client who is receiving heparin therapy intravenously. Which assessment data would indicate to the nurse the client is developing heparin-induced thrombocytopenia (HIT)? Select all that apply.
- A. The client has spontaneous bleeding from around the IV site.
- B. The client complains of chest pain on inspiration and has become restless.
- C. The client’s platelet count on admission was 420 (103) and now is 200 (103).
- D. The client complains that the gums bleed when brushing the teeth.
- E. The client has developed skin lesions at the IV site.
Correct Answer: A,C,D
Rationale: HIT causes thrombocytopenia and bleeding: IV site bleeding (A), platelet drop from 420 to 200 (C), and gum bleeding (D) are signs. Chest pain/restlessness (B) suggests PE, and skin lesions (E) are not typical.
The client with cardiomyopathy is prescribed a beta-blocker. What is the primary purpose of this medication?
- A. Increase heart rate
- B. Reduce cardiac workload
- C. Prevent blood clots
- D. Remove excess fluid
Correct Answer: B
Rationale: Beta-blockers reduce heart rate and myocardial oxygen demand, decreasing cardiac workload.
When assessing the client's lower leg, which findings characteristic of venous stasis ulcers is the nurse most likely to find? Select all that apply.
- A. Purulent drainage from lesions
- B. Blanched patches around open areas
- C. Dark brown, dry, and crusty skin
- D. Fluid-filled blisters
- E. Edema in the lower legs
- F. Fine red rash below the knee
Correct Answer: C,E
Rationale: Venous stasis ulcers are typically characterized by dark brown, dry, crusty skin due to hemosiderin deposition and edema in the lower legs due to venous insufficiency.
The client with heart failure is prescribed digoxin. Which finding should the nurse report immediately?
- A. Heart rate of 58 beats per minute
- B. Potassium level of 3.2 mEq/L
- C. Blood pressure of 130/85 mmHg
- D. Respiratory rate of 18 breaths per minute
Correct Answer: B
Rationale: Hypokalemia (low potassium) increases the risk of digoxin toxicity, requiring immediate reporting.
The nurse is assessing a client with pericarditis. Which finding is most characteristic?
- A. Chest pain relieved by leaning forward
- B. Swelling in the ankles
- C. Fever above 103°F
- D. Bradycardia
Correct Answer: A
Rationale: Pericarditis causes chest pain that is typically relieved by leaning forward, reducing pressure on the inflamed pericardium.