Nokea
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.
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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 nurse is preparing to administer a prescribed dose of digoxin to an infant. The nurse should assess the apical heart rate to ensure it is at least
- A. 70 beats-per-minute
- B. 60 beats-per-minute
- C. 90 beats-per-minute
- D. 50 beats-per-minute
Correct Answer: C
Rationale: For infants, digoxin should be withheld if the apical heart rate is below 90-100 beats per minute to prevent toxicity, so 90 beats per minute is the minimum threshold.
The nurse is caring for a three-year-old who is receiving digoxin for congestive heart failure. Which of the following manifestations is an early sign of digoxin toxicity?
- A. dizziness
- B. tachycardia
- C. vomiting
- D. failure to thrive
Correct Answer: C
Rationale: Vomiting is an early sign of digoxin toxicity in children. Dizziness is less common in young children, tachycardia is not typical, and failure to thrive is a chronic issue, not an early sign.
The following scenario applies to the next 1 items.
The medical-surgical nurse is performing an admission assessment
Item 1 of 1
Current Medications
losartan 25 mg by mouth daily
spironolactone 25 mg by mouth daily
multivitamin 1 tablet by mouth daily
acetaminophen 500 mg by mouth daily, as needed for pain
pantoprazole 40 mg by mouth daily
warfarin 2 mg by mouth daily
aspirin 81 mg by mouth daily
The nurse performs medication reconciliation for this client. Which four (4) medications does the nurse recognize as a potential drug interaction?
- A. losartan
- B. spironolactone
- C. multivitamin
- D. acetaminophen
- E. pantoprazole
- F. warfarin
- G. aspirin
Correct Answer: A,B,F,G
Rationale: Losartan and spironolactone can increase hyperkalemia risk when combined. Warfarin and aspirin together increase bleeding risk due to their anticoagulant and antiplatelet effects, respectively. Multivitamin, acetaminophen, and pantoprazole are less likely to cause significant interactions in this context.
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.