The nurse is preparing a staff education program about beta-...

The nurse is preparing a staff education program about beta-blockers and their function in the cardiovascular system. Which of the following information should the nurse include? Select all that apply.

A. block catecholamines from binding to the beta receptors.
B. reduce myocardial oxygen demand.
C. increase cardiac contractility.
D. increase cardiac output.
E. prevent sodium and water resorption by inhibiting aldosterone secretion.

Correct Answer: A,B

Rationale: Beta-blockers block catecholamines at beta receptors, reducing heart rate and myocardial oxygen demand. They do not increase contractility or cardiac output and are not involved in aldosterone secretion.

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A nurse is caring for a client receiving digoxin. The client's most recent digitalis level was 2.5 ng/mL (0.5-2 ng/mL). The nurse should take which action? Select all that apply.

A. Withhold the client's scheduled dose
B. Administer the dose, as prescribed
C. Assess the client's 24-hour urinary output
D. Assess the client's most recent sodium level
E. Assess the client's heart rate and rhythm
F. Obtain a prescription for an echocardiogram

Correct Answer: A,E

Rationale: A digitalis level of 2.5 ng/mL indicates toxicity, so the nurse should withhold the dose (A) and assess heart rate and rhythm (E) for signs like bradycardia. Urinary output, sodium levels, and echocardiograms are not directly related to immediate toxicity management.

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.

The nurse is reviewing prescriptions for assigned clients. Which prescriptions require follow-up with the primary healthcare provider? A client with

A. congestive heart failure prescribed diltiazem.
B. hypertension prescribed clonidine.
C. diabetes insipidus prescribed hydrocortisone.
D. pulmonary emboli prescribed clopidogrel.
E. atrial fibrillation prescribed amiodarone.
F. bacterial cystitis prescribed valacyclovir.

Correct Answer: C,F

Rationale: Hydrocortisone is not used for diabetes insipidus (desmopressin is typical), and valacyclovir (an antiviral) is incorrect for bacterial cystitis (requires antibiotics). Diltiazem, clonidine, clopidogrel, and amiodarone are appropriate for their respective conditions.

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 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.