Nokea
The nurse is teaching a client who is receiving newly prescribed enalapril. Which of the following information should be a priority for the nurse to include?
- A. This medication may cause you to develop a dry cough.
- B. If you notice swelling of your face, lips, or eyes, report this to your doctor.
- C. You may notice that the taste of foods is different.
- D. You will need to obtain periodic lab work while taking this medication.
Correct Answer: B
Rationale: Enalapril, an ACE inhibitor, can cause angioedema, a potentially life-threatening swelling of the face, lips, or eyes, making this the priority teaching point. Dry cough, taste changes, and lab monitoring are relevant but less urgent.
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The nurse is caring for a client experiencing polyarthritis associated with rheumatic fever. The nurse anticipates a prescription for which medication?
- A. Prazosin
- B. Naproxen
- C. Verapamil
- D. Furosemide
Correct Answer: B
Rationale: Naproxen, an NSAID, is used to reduce inflammation and pain in polyarthritis associated with rheumatic fever. Prazosin, verapamil, and furosemide are not indicated for this condition.
The nurse is teaching a client who has hypertension about the newly prescribed medication, furosemide. Which of the following should the nurse include in the teaching?
- A. Limit intake of bananas, cantaloupe, and potatoes.
- B. Avoid taking the medication with grapefruit juice.
- C. Take this medication in the early part of the day.
- D. A nagging cough can occur as a side effect of the medication.
Correct Answer: A,C
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, so limiting potassium-rich foods (bananas, cantaloupe, potatoes) is advised, and taking it early prevents nocturia. Grapefruit juice and cough are not concerns.
The nurse is caring for a client who is taking prescribed sildenafil. After reviewing the client's other medications, the nurse recognizes which medication would contraindicate sildenafil?
- A. furosemide
- B. isosorbide
- C. atorvastatin
- D. losartan
Correct Answer: B
Rationale: Sildenafil is contraindicated with nitrates like isosorbide due to the risk of severe hypotension. Furosemide, atorvastatin, and losartan do not have significant interactions with sildenafil.
This nurse is caring for a client who is receiving prescribed amlodipine. Which of the following findings would indicate a therapeutic response?
- A. Hemoglobin A1C 5.6% (5.7%)
- B. Blood pressure 119/79 mm Hg
- C. Capillary blood glucose 88 mg/dL (70-110 mg/dL)
- D. Total cholesterol 190 (<200 mg/dL)
Correct Answer: B
Rationale: Amlodipine, a calcium channel blocker, is used to treat hypertension. A blood pressure of 119/79 mm Hg indicates a therapeutic response. Hemoglobin A1C, blood glucose, and cholesterol are not directly affected by amlodipine.
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.