Nokea
This nurse is caring for a client who is receiving prescribed hydralazine. Which of the following findings would indicate a therapeutic response?
- A. Blood pressure 120/70 mm Hg
- B. Pulse (P) 67/minute
- C. Total cholesterol 185 mg/dL [200 mg/dL]
- D. aPTT 45 seconds [30-40 seconds]
Correct Answer: A
Rationale: Hydralazine, a vasodilator, lowers blood pressure, so 120/70 mm Hg indicates a therapeutic response. Pulse, cholesterol, and aPTT are not directly affected.
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The nurse has taught a client who has been prescribed nitroglycerin transdermal. Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. It is okay for me to apply this patch to the area that has been shaven.
- B. This patch should be removed for 4 to 6 hours to avoid me developing a tolerance.
- C. It is okay for me to wear this patch while I shower.
- D. I should apply this patch below my knee to lessen my chance of getting a headache.
Correct Answer: A
Rationale: Applying a nitroglycerin transdermal patch to a shaved area ensures good adhesion and absorption, indicating correct understanding. Nitroglycerin patches are typically removed for 10-12 hours to prevent tolerance, not 4-6 hours. While water-resistant, applying below the knee is not standard and does not reduce headache risk.
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 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.
The nurse is preparing an educational in-service about valsartan. Which of the following information should the nurse include?
- A. Valsartan blocks the conversion of angiotensin I to angiotensin II.
- B. Valsartan antagonizes angiotensin II receptors.
- C. Valsartan stimulates alpha-2 adrenoceptors in the brainstem.
- D. Valsartan blocks response to beta1- and beta2-adrenergic stimulation.
Correct Answer: B
Rationale: Valsartan, an ARB, antagonizes angiotensin II receptors, reducing blood pressure. It does not block angiotensin conversion, stimulate alpha-2 receptors, or block beta-adrenergic responses.
The nurse reviews newly prescribed laboratory tests and medications for the following clients. Which of the laboratory tests and prescriptions should the nurse question?
- A. Liver function tests (LFTs) for a client prescribed atorvastatin
- B. International normalized ratio (INR) for a client prescribed rivaroxaban
- C. Serum creatinine level for a client prescribed lisinopril
- D. Glycosylated hemoglobin (HgbA1C) level for a client prescribed olanzapine
Correct Answer: B
Rationale: INR monitoring is not typically required for rivaroxaban, a direct oral anticoagulant, as it does not affect INR. LFTs for atorvastatin, creatinine for lisinopril, and HgbA1C for olanzapine are appropriate monitoring tests.