Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is assessing a client who reports feeling dizzy while getting out of bed. The nurse suspects orthostatic hypotension related to a medication the client is taking Which of the following medications should the nurse identify as likely causing this adverse effect?
A. Dabigatran
Dabigatran (A) is an anticoagulant used to prevent blood clots and does not typically cause orthostatic hypotension as a side effect.
B. Levothyroxine
Levothyroxine (B) is a thyroid hormone replacement medication used to treat hypothyroidism. It does not usually cause orthostatic hypotension.
C. Isoproterenol
Isoproterenol (C) is a non-selective beta-adrenergic agonist that is primarily used for cardiac stimulation. It can cause tachycardia and palpitations, but orthostatic hypotension is not a common side effect.
D. Furosemide
Furosemide, a loop diuretic, is known to cause orthostatic hypotension as an adverse effect. It works by increasing urine output and reducing fluid volume, which can lead to a decrease in blood pressure when standing up, causing dizziness or lightheadedness.
This question is an excerpt from Nurse Dive's nursing test bank - RN VATI Pharmacology S 2019 Proctored Exam. Take the full exam now
Full Explanation
Furosemide, a loop diuretic, is known to cause orthostatic hypotension as an adverse effect. It works by increasing urine output and reducing fluid volume, which can lead to a decrease in blood pressure when standing up, causing dizziness or lightheadedness.
Dabigatran (A) is an anticoagulant used to prevent blood clots and does not typically cause orthostatic hypotension as a side effect.
Levothyroxine (B) is a thyroid hormone replacement medication used to treat hypothyroidism. It does not usually cause orthostatic hypotension.
Isoproterenol (C) is a non-selective beta-adrenergic agonist that is primarily used for cardiac stimulation. It can cause tachycardia and palpitations, but orthostatic hypotension is not a common side effect.
Similar Questions
A nurse is providing teaching to a client who has a history of diabetes mellitus and a new prescription for hydrochlorothiazide to treat uncontrolled hypertension. Which of the following information should the nurse include in the teaching?
A. "Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide
"Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide": This statement is not accurate. Hydrochlorothiazide does not directly affect the accuracy of blood glucose monitoring. However, it is essential for clients with diabetes to be aware of the potential impact of hydrochlorothiazide on their blood glucose levels.
B. "You might need to decrease your insulin dosage while taking hydrochlorothiazide."
"You might need to decrease your insulin dosage while taking hydrochlorothiazide": Hydrochlorothiazide can potentially elevate blood glucose levels, which may require adjustments in diabetes management, including insulin dosage. However, it is not accurate to state that all clients will need to decrease their insulin dosage while taking hydrochlorothiazide. Each client's response to the medication may vary, and adjustments to diabetes medications should be made under the guidance of their healthcare provider based on individual blood glucose monitoring.
C. Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes
The nurse should include in the teaching that hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. Hydrochlorothiazide is a diuretic commonly used to treat hypertension (high blood pressure). While it is effective in reducing blood pressure, it can sometimes cause adverse effects on blood glucose levels, particularly in individuals with diabetes mellitus. Hydrochlorothiazide can cause an increase in blood glucose levels by reducing insulin sensitivity, leading to potential hyperglycemia (high blood sugar) in some individuals. Clients with diabetes should closely monitor their blood glucose levels while taking hydrochlorothiazide and inform their healthcare provider if they notice significant changes.
D. Reducing sodium in your die whim taking your control your blood glucose."
"Reducing sodium in your diet can help control your blood glucose while taking hydrochlorothiazide": While reducing sodium in the diet is generally a beneficial recommendation for individuals with hypertension, it is not directly related to controlling blood glucose levels in clients with diabetes. The primary focus for individuals with diabetes taking hydrochlorothiazide should be on monitoring blood glucose levels and working with their healthcare provider to manage any changes related to the medication.
Full Explanation
The nurse should include in the teaching that hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. Hydrochlorothiazide is a diuretic commonly used to treat hypertension (high blood pressure). While it is effective in reducing blood pressure, it can sometimes cause adverse effects on blood glucose levels, particularly in individuals with diabetes mellitus.
Hydrochlorothiazide can cause an increase in blood glucose levels by reducing insulin sensitivity, leading to potential hyperglycemia (high blood sugar) in some individuals. Clients with diabetes should closely monitor their blood glucose levels while taking hydrochlorothiazide and inform their healthcare provider if they notice significant changes.
Let's go through the other options:
A. "Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide": This statement is not accurate. Hydrochlorothiazide does not directly affect the accuracy of blood glucose monitoring. However, it is essential for clients with diabetes to be aware of the potential impact of hydrochlorothiazide on their blood glucose levels.
B. "You might need to decrease your insulin dosage while taking hydrochlorothiazide": Hydrochlorothiazide can potentially elevate blood glucose levels, which may require adjustments in diabetes management, including insulin dosage. However, it is not accurate to state that all clients will need to decrease their insulin dosage while taking hydrochlorothiazide. Each client's response to the medication may vary, and adjustments to diabetes medications should be made under the guidance of their healthcare provider based on individual blood glucose monitoring.
D. "Reducing sodium in your diet can help control your blood glucose while taking hydrochlorothiazide": While reducing sodium in the diet is generally a beneficial recommendation for individuals with hypertension, it is not directly related to controlling blood glucose levels in clients with diabetes. The primary focus for individuals with diabetes taking hydrochlorothiazide should be on monitoring blood glucose levels and working with their healthcare provider to manage any changes related to the medication.
A nurse is providing teaching to a client who has a new prescription for atenolol. Which of the following adverse effects should the nurse include in the teaching?
A. Lightheadedness
The nurse should include lightheadedness as an adverse effect in the teaching for a client who has a new prescription for atenolol. Atenolol is a beta-blocker medication used to treat various conditions, including hypertension and certain heart conditions. One of the common side effects of beta-blockers is orthostatic hypotension, which can cause lightheadedness or dizziness when the client stands up from a sitting or lying position.
B. Tachycardia
Tachycardia: Tachycardia is not an adverse effect of atenolol. In fact, atenolol is used to treat tachycardia by slowing down the heart rate.
C. Dry mouth
Dry mouth: Dry mouth is not a typical adverse effect of atenolol. Dry mouth is more commonly associated with anticholinergic medications rather than beta-blockers like atenolol.
D. Branchodilation
Bronchodilation: Bronchodilation is not an adverse effect of atenolol. In contrast, atenolol can cause bronchoconstriction (narrowing of the airways) in some individuals, particularly those with asthma or chronic obstructive pulmonary disease (COPD).
Full Explanation
The nurse should include lightheadedness as an adverse effect in the teaching for a client who has a new prescription for atenolol. Atenolol is a beta-blocker medication used to treat various conditions, including hypertension and certain heart conditions. One of the common side effects of beta-blockers is orthostatic hypotension, which can cause lightheadedness or dizziness when the client stands up from a sitting or lying position.
Let's go through the other options:
B. Tachycardia: Tachycardia is not an adverse effect of atenolol. In fact, atenolol is used to treat tachycardia by slowing down the heart rate.
C. Dry mouth: Dry mouth is not a typical adverse effect of atenolol. Dry mouth is more commonly associated with anticholinergic medications rather than beta-blockers like atenolol.
D. Bronchodilation: Bronchodilation is not an adverse effect of atenolol. In contrast, atenolol can cause bronchoconstriction (narrowing of the airways) in some individuals, particularly those with asthma or chronic obstructive pulmonary disease (COPD).
A nurse is caring for a client who has anxiety and a prescription for oral lorazepam PRN. Which of the following is the correct way to transcribe the prescription into the electronic medical record?
A. Lorazepam 2.5mg PO qhs before bed
This transcription suggests a fixed dose to be taken before bed (qhs = every bedtime), which does not align with the "as needed" or PRN (pro re nata) instruction for anxiety.
B. Lorazepam 2.5 mg PO QD at hs
This suggests that the medication should be taken once daily (QD) at bedtime (hs = at hour of sleep), which again is not appropriate for as-needed (PRN) use in anxiety.
C. Lorazepam 2.5 mg PO every 8 hours as needed for anxiety
This transcription correctly indicates that the lorazepam is to be taken as needed for anxiety, with a dose of 2.5 mg. However, this also suggests it can be taken every 8 hours, which is more of a standard timing than PRN use. But, it is still the most accurate option for a PRN order.
D. Lorazepam 2.50 mg PO Q 8 hours for anxiety
This prescription is incorrect because it implies the medication should be taken every 8 hours regardless of need, which conflicts with the as-needed (PRN) nature of the order.
Full Explanation
A. Lorazepam 2.5mg PO qhs before bed: This transcription suggests a fixed dose to be taken before bed (qhs = every bedtime), which does not align with the "as needed" or PRN (pro re nata) instruction for anxiety.
B. Lorazepam 2.5 mg PO QD at hs: This suggests that the medication should be taken once daily (QD) at bedtime (hs = at hour of sleep), which again is not appropriate for as-needed (PRN) use in anxiety.
C. Lorazepam 2.5 mg PO every 8 hours as needed for anxiety: This transcription correctly indicates that the lorazepam is to be taken as needed for anxiety, with a dose of 2.5 mg. However, this also suggests it can be taken every 8 hours, which is more of a standard timing than PRN use. But, it is still the most accurate option for a PRN order.
D. Lorazepam 2.50 mg PO Q 8 hours for anxiety: This prescription is incorrect because it implies the medication should be taken every 8 hours regardless of need, which conflicts with the as-needed (PRN) nature of the order.