Nokea
The nurse is caring for a client diagnosed with atrial fibrillation. The nurse should anticipate a prescription for which of the following medications? Select all that apply.
- A. diltiazem
- B. nitroglycerin
- C. clonidine
- D. atorvastatin
- E. warfarin
Correct Answer: A,E
Rationale: Diltiazem (rate control) and warfarin (anticoagulation) are used in atrial fibrillation. Nitroglycerin, clonidine, and atorvastatin are not typically indicated.
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The following scenario applies to the next 1 items
The nurse in the emergency department (ED) is caring for a client with septic shock
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Nurses' Notes
1400: Follow-up assessment after the infusion of 30 mL/kg of 0.9% saline bolus (1850 mL total) was infused. Vital signs: T 103.4° F (39.7° C), P 104, RR 22, BP 90/61, pulse oximetry reading 95% on room air.
1410: The physician was notified of the vital signs, and a verbal order for a dopamine drip was received for 5 mcg/kg/minute to titrate to a MAP of 65 mm Hg. The order was read back and verified.
1415: Dopamine infusion started in the client's right antecubital peripheral vascular access device.
1445: The client reports 'stinging' pain at the vascular access site. The site had erythema, swelling, and tenderness when touched. The infusion was stopped.
The nurse reviewed all nursing note entries and notified the physician of the vascular access device assessment findings. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress
- A. Obtain a prescription for phentolamine, Flush the vascular access device, Aspirate any residual medication, Restart the infusion at a lower rate.
- B. Extravasation, Hematoma, Infiltration, Phlebitis.
- C. Urinary output, Neurovascular status of affected extremity, Drainage at vascular access site, Pain level.
Correct Answer: B, A, C
Rationale: The client is experiencing extravasation (B) due to dopamine causing stinging, erythema, and swelling. Actions include obtaining phentolamine (A, an antidote for vasopressor extravasation) and aspirating residual medication (A). Monitor neurovascular status (C) and pain level (C) to assess progress.
The nurse is answering phones in the general practice clinic and receives a call from a client who is experiencing leg pain after starting atorvastatin. Which of the following should the nurse advise the client to do?
- A. Continue taking the medication as this is an expected side effect.
- B. Discontinue the medication and schedule an appointment for the next week.
- C. Stretch for 20 minutes or take a warm shower.
- D. Discontinue the medication and go to the emergency room as soon as possible.
Correct Answer: D
Rationale: Leg pain with atorvastatin may indicate myopathy or rhabdomyolysis, a serious side effect requiring immediate discontinuation and emergency evaluation.
The nurse is presenting at a staff development conference about medications used to treat heart failure. The nurse recognizes which medications are used to treat heart failure. Select all that apply.
- A. furosemide
- B. metformin
- C. lisinopril
- D. digoxin
- E. warfarin
- F. metoprolol
Correct Answer: A,C,D,F
Rationale: Furosemide (diuretic), lisinopril (ACE inhibitor), digoxin (cardiac glycoside), and metoprolol (beta-blocker) are used in heart failure. Metformin and warfarin are not standard treatments.
A nurse is caring for a client receiving nitroglycerin. It is essential to monitor the client's
- A. heart tones.
- B. respirations.
- C. urinary output.
- D. blood pressure.
Correct Answer: D
Rationale: Nitroglycerin, a vasodilator, can cause hypotension, so monitoring blood pressure is essential. Heart tones, respirations, and urinary output are less critical.
The nurse is caring for a client with the following clinical data. Which medication would the nurse clarify with the primary healthcare provider (PHCP) before administration based on the vital signs?
- A. Atenolol 50 mg PO Daily
- B. Simvastatin 40 mg PO Daily
- C. Albuterol 2.5 mg via nebulizer Daily
- D. Spironolactone 25 mg PO Daily
Correct Answer: A
Rationale: Atenolol, a beta-blocker, may need clarification if the client has bradycardia or hypotension, as it can exacerbate these conditions. Simvastatin, albuterol, and spironolactone are less affected by vital signs.