Nokea
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.
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The nurse is providing discharge instructions to a client prescribed lisinopril. Which of the following instructions should the nurse include? Select all that apply.
- A. You will need to take your pulse for one minute before each dose.
- B. You may notice the need to go to the bathroom more often.
- C. Limit your intake of foods such as avocados and apricots.
- D. You may notice a decrease in your ability to taste foods.
- E. The goal of this medication is to lower your cholesterol.
Correct Answer: B,C
Rationale: Lisinopril, an ACE inhibitor, may increase urination due to its blood pressure-lowering effects and requires limiting potassium-rich foods (e.g., avocados, apricots) to prevent hyperkalemia. Pulse monitoring, taste changes, and cholesterol reduction are not associated with lisinopril.
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.
The following scenario applies to the next 1 items
The nurse in the emergency department (ED) is caring for a client with septic shock
Item 1 of 1
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 teaching a client who has hypertension about the newly prescribed medication, diltiazem. Which of the following should the nurse include in the teaching?
- A. A nagging cough can occur as a side effect of the medication.
- B. This medication may cause you to go to the bathroom more often.
- C. Avoid taking the medication with grapefruit juice.
- D. You will need to increase your dietary intake of potassium-rich foods.
Correct Answer: C
Rationale: Diltiazem, a calcium channel blocker, interacts with grapefruit juice, which can increase drug levels. Cough, increased urination, and potassium intake are not associated with diltiazem.
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.