Nokea
The nurse is preparing to administer medications to assigned clients. Which prescription should the nurse clarify with the primary healthcare provider (PHCP)?
- A. warfarin to a client with an international normalized ratio (INR) of 1.8 seconds [0.9-1.2]
- B. digoxin to a client with a serum potassium level of 3.1 mEq/L [3.5-5 mEq/L, mmol/L]
- C. enoxaparin to a client with a platelet count of 155,000 mm3 [150-400 mm3, 130-380 × 10^9/L]
- D. lisinopril to a client with a serum creatinine level of 0.6 mg/dL [0.6-1.2 mg/dL, 30-250 IU/L]
Correct Answer: B
Rationale: Digoxin with low potassium (3.1 mEq/L) increases toxicity risk, so it should be clarified. Warfarin with INR of 1.8 may be subtherapeutic but not immediately dangerous, enoxaparin is safe with normal platelets, and lisinopril is safe with normal creatinine.
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A nurse is caring for a client receiving nitroglycerin. It is essential to monitor the client's
- A. heart tones.
- B. respirations.
- C. urinary output.
- D. blood pressure.
Correct Answer: D
Rationale: Nitroglycerin, a vasodilator, can cause hypotension, so monitoring blood pressure is essential. Heart tones, respirations, and urinary output are less critical.
The nurse is caring for a client receiving a continuous infusion of heparin and warfarin. Based on the client's laboratory data, the nurse should take which action? See the image below.
- A. Document the findings
- B. Stop the heparin infusion
- C. Hold future doses of the warfarin
- D. Obtain a prescription of Vitamin K
Correct Answer: B
Rationale: Without specific lab data, stopping heparin is likely if INR is therapeutic (e.g., 2-3 for warfarin), as concurrent heparin and warfarin are typically transitioned. Documenting, holding warfarin, or giving Vitamin K depend on specific INR values.
Cardiovascular Pharmacology NCLEX RN
The nurse is caring for a client newly diagnosed with an abdominal aortic aneurysm. The nurse should anticipate a prescription for which of the following medications?
- A. naproxen
- B. digoxin
- C. prednisone
- D. atenolol
Correct Answer: D
Rationale: Atenolol, a beta-blocker, is often prescribed to manage blood pressure and reduce stress on the aortic wall in clients with an abdominal aortic aneurysm to prevent rupture. Naproxen (an NSAID), digoxin (a cardiac glycoside), and prednisone (a corticosteroid) are not typically used for this condition.
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 assessing a client with systolic heart failure receiving prescribed carvedilol. Which of the following findings would indicate a therapeutic response?
- A. Increased urinary output
- B. Increased left-ventricular ejection fraction (EF)
- C. Increased left-ventricular remodeling
- D. Increased brain natriuretic peptide (BNP)
Correct Answer: B
Rationale: Carvedilol, a beta-blocker, improves left-ventricular ejection fraction in systolic heart failure, indicating a therapeutic response. Increased urinary output, remodeling, or BNP are not desired outcomes.