Nokea
The nurse is caring for a client prescribed a calcium channel blocker to treat primary hypertension. When providing education about medication administration, which of these foods will the nurse advise the client to avoid?
- A. Eggs
- B. Milk
- C. Grapefruit
- D. Bananas
Correct Answer: C
Rationale: Grapefruit juice can inhibit the metabolism of calcium channel blockers, increasing drug levels and toxicity risk. Eggs, milk, and bananas do not interact significantly.
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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 with an exacerbation of congestive heart failure (CHF). The client has generalized edema, dyspnea, and jugular venous distention. The nurse should anticipate a prescription for which medication?
- A. Mannitol
- B. Furosemide
- C. Diltiazem
- D. Verapamil
Correct Answer: B
Rationale: Furosemide, a loop diuretic, is used to treat fluid overload in CHF, addressing edema, dyspnea, and jugular venous distention. Mannitol, diltiazem, and verapamil are not appropriate.
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 following scenario applies to the next 6 items
The clinic nurse is caring for a 38-year-old male
Item 1 of 6
Nurses' Notes
1456 - 38-year-old male reports to the clinic for an annual physical examination and to establish care. The client reports no acute concerns but does admit to gaining a few pounds over the past several months. The client reports having decreased physical activity. He reports his dietary habits have changed because of his job, where he relies on fast food for breakfast and lunch. On assessment, the client is alert and completely oriented to person, place, and situation. The skin is warm and dry—patches of darkening and thickening of the skin around the skin folds. Lung sounds are clear; S1/S2 heart tones are auscultated. Peripheral pulses palpable, 2+. Bowel sounds are active in all quadrants. He denies any dysuria and reports his sex drive has decreased over the past several months. He reports occasional constipation, which causes him to use stool softeners. He reported no medical or surgical history besides an appendectomy four years ago. His parents are living, his mother is being treated for ovarian cancer, and his father has hypothyroidism and had a myocardial infarction two years ago. He recently started taking daily over-the-counter aspirin because of his father's cardiovascular disease. He takes a multivitamin 'when he remembers.' He is separated from his wife and currently going through what he describes as a bitter divorce which has been 'stressing him out.' He has one child. He denies using tobacco products but drinks one to two glasses of wine weekly. Current weight 269 pounds (122.27 kilograms); Body Mass Index 29; 40 inches (102 cm) waist size. Oral temperature 98.6°F (37° C) Pulse 92 Respiratory Rate 17 Blood Pressure 141/92 mm Hg Pulse oximetry 96% on room air
Select the client findings that require follow-up. Select all that apply.
- A. respiratory rate
- B. blood pressure
- C. pulse
- D. waist size
- E. body mass index (BMI)
- F. dietary habits
- G. darkening patches in the skin folds
Correct Answer: B,D,E,F,G
Rationale: Blood pressure (141/92 mm Hg) indicates hypertension, waist size (40 inches) and BMI (29) suggest obesity, dietary habits (fast food reliance) contribute to cardiovascular risk, and darkening skin patches (acanthosis nigricans) may indicate insulin resistance, all requiring follow-up. Respiratory rate (17) and pulse (92) are within normal limits.
The nurse is caring for a client receiving a continuous infusion of norepinephrine. The nurse should plan to monitor which of the following for the client? Select all that apply.
- A. Blood pressure
- B. Intracranial pressure
- C. Intravenous site
- D. Urine output
- E. Blood glucose
Correct Answer: A,C,D,E
Rationale: Norepinephrine, a vasopressor, requires monitoring blood pressure (to assess efficacy), IV site (for extravasation risk), urine output (to evaluate perfusion), and blood glucose (as it can cause hyperglycemia). Intracranial pressure is not typically monitored unless neurological issues are present.