Nokea
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.
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The nurse is caring for a client who is receiving prescribed cilostazol. Which of the following client findings would indicate a therapeutic response?
- A. Absence of pain while ambulating
- B. Decreased total cholesterol
- C. Increased visual acuity
- D. Improved focus and attention
Correct Answer: A
Rationale: Cilostazol is used to treat intermittent claudication, so the absence of pain while ambulating indicates a therapeutic response. It does not directly affect cholesterol, visual acuity, or focus.
A nurse is teaching a client about newly prescribed hydrochlorothiazide (HCTZ). Which of the following statements, if made by the client, indicates an effective understanding of the potential side effects?
- A. I should be cautious about prolonged sun exposure as HCTZ can increase photosensitivity.
- B. I may experience drowsiness and sedation due to the central nervous system depressant effect of HCTZ.
- C. HCTZ can cause hypocalcemia, so I need to increase my intake of foods high in calcium.
- D. I might develop taste disturbances or loss of appetite as a common side effect of HCTZ.
Correct Answer: A
Rationale: HCTZ can cause photosensitivity, increasing the risk of sunburn, so caution with sun exposure indicates correct understanding. HCTZ does not typically cause drowsiness, hypocalcemia, or taste disturbances.
The nurse is reviewing discharge teaching with a client who was newly prescribed digoxin. Which statement, if made by the client, would require follow-up? Select all that apply.
- A. I should take my pulse before taking each dose.
- B. This medication will require me to take my weight daily.
- C. This medication will require me to have periodic blood work.
- D. I will ensure I get plenty of potassium in my diet.
- E. If I notice visual changes, I will call my eye doctor.
Correct Answer: B,E
Rationale: Daily weighing (B) is not required for digoxin but for diuretics in heart failure. Visual changes (E) should be reported to the prescriber, not an eye doctor, as they indicate digoxin toxicity. Pulse monitoring, blood work, and potassium intake are appropriate.
The nurse is teaching a continuing education course regarding cardiovascular medications. It would be appropriate for the nurse to reinforce which condition is a contraindication to administering beta-blockers?
- A. Atrial fibrillation
- B. Myocardial infarction
- C. Congestive heart failure (CHF)
- D. Cardiogenic shock
Correct Answer: D
Rationale: Cardiogenic shock is a contraindication for beta-blockers due to their negative inotropic effects, which can worsen cardiac output. Beta-blockers may be used cautiously in atrial fibrillation, myocardial infarction, or CHF.
The emergency department nurse is caring for a client with an abdominal aortic aneurysm at risk of rupturing. The nurse will anticipate the primary healthcare provider (PHCP) to prescribe
- A. esmolol
- B. dexamethasone
- C. heparin
- D. pantoprazole
Correct Answer: A
Rationale: Esmolol, a short-acting beta-blocker, is used to control blood pressure and reduce aortic wall stress in an abdominal aortic aneurysm. Dexamethasone, heparin, and pantoprazole are not indicated.