Nokea
The nurse is caring for a client with infective endocarditis. The nurse anticipates a prescription for which medication?
- A. Nitroglycerin
- B. Vancomycin
- C. Atorvastatin
- D. Aspirin
Correct Answer: B
Rationale: Vancomycin, an antibiotic, is used to treat infective endocarditis caused by bacterial infection. Nitroglycerin, atorvastatin, and aspirin are not indicated for this condition.
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The emergency department (ED) nurse is caring for a client with a hypertensive emergency. The nurse should obtain a prescription for intravenous
- A. dobutamine
- B. digoxin
- C. nicardipine
- D. amiodarone
Correct Answer: C
Rationale: Nicardipine, an IV calcium channel blocker, is used to rapidly lower blood pressure in a hypertensive emergency. Dobutamine (an inotrope), digoxin (a cardiac glycoside), and amiodarone (an antiarrhythmic) are not appropriate for this condition.
The clinic nurse is caring for a 38-year-old male
Item 3 of 6
Diagnostic Results
Basic Metabolic Panel (fasting)
• Serum calcium 9.6 mg/dL (2.39 mmol/l) [9.0-10.5 mg/dL (2.24 - 2.61 mmol/l)
• Serum chloride 94 mEq/l (94 mmol/l) 90 to 110 mEq/L (90 -110 mmol/l)
• Serum glucose 126 mg/dL (6.99 mmol/l) 70-110 mg/dL (3.88 - 6.10 mmol/l)
• Serum potassium 4.2 mEq/l (4.2 mmol/l) 3.5 to 5.0 mEq/l (3.5 to 5.0 mmol/l)
• Serum sodium 136 mEq/l (136 mmol/l) 135 to 145 mEq/l (135 to 145 mmol/l)
• Serum creatinine 0.9 mg/dl (79.5 mcmol/l) 0.6 to 1.1 mg/dl (53 to 106 mcmol/l)
• Blood urea nitrogen 19 mg/dl (6.78 mmol/l) 10 to 20 mg/dl (3.57 to 7.14 mmol/l)
Lipid Panel (fasting)
• Total cholesterol 235 mg/dl (6.07 mmol/l) [less than 200 mg/dl (<5.18 mmol/l)]
• High-density lipoprotein (HDL) 35 mg/dl (0.91 mmol/l) [more than 45 mg/dL (>0.75 mmol/L) for men; more than 55 mg/dL (>0.91 mmol/L) for women]
• Low-density lipoprotein (LDL) 135 mg/dl (3.49 mmol/l) [less than 130 mg/dL (< 3.36 mmo/l)]
• Triglycerides 299 mg/dL [Females: 35-135 mg/dL or 0.40-1.52 mmol/L; Males: 40-160 mg/dL or 0.45-1.81 mmol/L]
Thyroid Panel
• Triiodothyronine (T3) 87 ng/dL (1.3 nmol/L) [80-200 ng/dL (1.2-3 nmol/L)]
• Thyroxine (T4) 5.4 µg/dL (69 nmol/L) [5.4-11.5 (69-148 nmol/L)]
• Thyroid-stimulating hormone (TSH) 4.0 µIU/mL (4.0 mIU/L) [0.45-4.5 µIU/mL (0.45-4.5 mIU/L)]
Follow-up Nurses' Notes
1345 - Client presents for a one-week follow-up appointment to review his laboratory results. The client reports no acute complaints, denies pain, and states he has been checking his blood pressure while at the grocery store "with the top number being in the 150s". Oral temperature 98.6°F (37° C) Pulse 88 Respiratory Rate 16 Blood Pressure 143/91 mm Hg Pulse oximetry 95% on room air. Current weight 270 pounds (122.72 kilograms); Body Mass Index 29. 41 inches (102 cm) waist size.
The nurse completes and reviews the follow-up nurses' notes and the laboratory results.Complete the following sentence below from the list of options. Based on the clinical data, this client is at the highest risk of developing.............
- A. hypothyroidism
- B. metabolic syndrome
- C. renal insufficiency
- D. secondary hypertension
Correct Answer: B
Rationale: The client has elevated blood pressure (143/91 mm Hg), high fasting glucose (126 mg/dL), hyperlipidemia (high cholesterol, LDL, triglycerides, low HDL), and obesity (BMI 29, waist 41 inches), which are diagnostic criteria for metabolic syndrome.
While reviewing a client's medication list, the nurse understands which prescribed medication(s) is/are classified as calcium channel blockers. Select all that apply.
- A. Nifedipine
- B. Propranolol
- C. Verapamil
- D. Hydralazine
- E. Digoxin
Correct Answer: A,C
Rationale: Nifedipine and verapamil are calcium channel blockers used to treat hypertension and angina. Propranolol is a beta-blocker, hydralazine is a vasodilator, and digoxin is a cardiac glycoside.
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 teaching a client who has hypertension about the newly prescribed medication, furosemide. Which of the following should the nurse include in the teaching?
- A. Limit intake of bananas, cantaloupe, and potatoes.
- B. Avoid taking the medication with grapefruit juice.
- C. Take this medication in the early part of the day.
- D. A nagging cough can occur as a side effect of the medication.
Correct Answer: A,C
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, so limiting potassium-rich foods (bananas, cantaloupe, potatoes) is advised, and taking it early prevents nocturia. Grapefruit juice and cough are not concerns.