Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a client who has heart failure and a new prescription for lisinopril.
For which of the following adverse effects should the nurse monitor when administering lisinopril?
A. Tinnitus.
Choice A is wrong because tinnitus, which means ringing or buzzing in the ears, is not a common or serious side effect of lisinopril. Tinnitus can be caused by other factors such as ear infections, loud noises, or medications such as aspirin or antibiotics.
B. Hypotension.
Lisinopril is an angiotensin converting enzyme (ACE) inhibitor that is used to treat high blood pressure and heart failure. It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart. However, one of the common side effects of lisinopril is hypotension, which means low blood pressure. Hypotension can cause dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position. Therefore, the nurse should monitor the client’s blood pressure when administering lisinopril and report any signs of hypotension to the doctor.
C. Hypokalemia.
Choice C is wrong because hypokalemia, which means low potassium levels in the blood, is not a common or serious side effect of lisinopril. In fact, lisinopril can cause hyperkalemia, which means high potassium levels in the blood, especially in patients with kidney problems or diabetes. Hyperkalemia can cause irregular heartbeats, muscle weakness, or numbness. Therefore, the nurse should monitor the client’s potassium levels when administering lisinopril and avoid giving potassium supplements or salt substitutes that contain potassium.
D. Bradycardia.
Choice D is wrong because bradycardia, which means slow heart rate, is not a common or serious side effect of lisinopril. Lisinopril does not affect the heart rate directly, but it can lower the blood pressure and improve the heart function. Bradycardia can be caused by other factors such as heart block, sinus node dysfunction, or medications such as beta blockers or calcium channel blockers.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Pharmacology 2019 Proctored Exam. Take the full exam now
Full Explanation
Lisinopril is an angiotensin converting enzyme (ACE) inhibitor that is used to treat high blood pressure and heart failure. It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart. However, one of the common side effects of lisinopril is hypotension, which means low blood pressure. Hypotension can cause dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position. Therefore, the nurse should monitor the client’s blood pressure when administering lisinopril and report any signs of hypotension to the doctor.
Choice A is wrong because tinnitus, which means ringing or buzzing in the ears, is not a common or serious side effect of lisinopril.
Tinnitus can be caused by other factors such as ear infections, loud noises, or medications such as aspirin or antibiotics.
Choice C is wrong because hypokalemia, which means low potassium levels in the blood, is not a common or serious side effect of lisinopril. In fact, lisinopril can cause hyperkalemia, which means high potassium levels in the blood, especially in patients with kidney problems or diabetes. Hyperkalemia can cause irregular heartbeats, muscle weakness, or numbness. Therefore, the nurse should monitor the client’s potassium levels when administering lisinopril and avoid giving potassium supplements or salt substitutes that contain potassium.
Choice D is wrong because bradycardia, which means slow heart rate, is not a common or serious side effect of lisinopril.
Lisinopril does not affect the heart rate directly, but it can lower the blood pressure and improve the heart function.
Bradycardia can be caused by other factors such as heart block, sinus node dysfunction, or medications such as beta blockers or calcium channel blockers.
Similar Questions
A nurse is caring for a client who has a prescription for amoxicillin. Which of the following findings indicates the client is experiencing an allergic reaction?
A. Laryngeal edema.
Laryngeal edema is a sign of a severe allergic reaction to amoxicillin that can cause difficulty breathing and may be life threatening. The nurse should stop the medication and call for emergency assistance.
B. Nausea.
Choice B is wrong because nausea is a common side effect of amoxicillin, not an allergic reaction.
C. Insomnia.
Choice C is wrong because insomnia is not related to amoxicillin use.
D. Cardiac dysrhythmia.
Choice D is wrong because cardiac dysrhythmia is not a typical symptom of an allergic reaction to amoxicillin. It may be caused by other factors, such as underlying heart disease or electrolyte imbalance.
Full Explanation
Laryngeal edema is a sign of a severe allergic reaction to amoxicillin that can cause difficulty breathing and may be life threatening.
The nurse should stop the medication and call for emergency assistance. Choice B is wrong because nausea is a common side effect of amoxicillin, not an allergic reaction.
Choice C is wrong because insomnia is not related to amoxicillin use. Choice D is wrong because cardiac dysrhythmia is not a typical symptom of an allergic reaction to amoxicillin.
It may be caused by other factors, such as underlying heart disease or electrolyte imbalance.
A nurse is preparing to administer enoxaparin to a client.
Which of the following actions should the nurse take?
A. Expel the air bubble from the syringe prior to injection.
The air bubble should not be expelled from the syringe before administering enoxaparin. The air bubble is included to ensure that the entire dose is administered and to help prevent leakage of the medication into the subcutaneous tissue, which can reduce bruising.
B. Apply firm pressure to the injection site following administration.
After administering enoxaparin, applying firm pressure (but not massaging) to the injection site helps minimize bruising and bleeding. It's important not to massage the site as this can increase the risk of bleeding.
C. Insert the syringe needle halfway into the client’s skin.
The needle should be inserted fully into the subcutaneous tissue at a 90-degree angle (or at a 45-degree angle if the client has little subcutaneous tissue). Inserting the needle halfway may result in improper administration.
D. Administer the medication into the client’s muscles.
Enoxaparin is a low-molecular-weight heparin that should be administered subcutaneously, not intramuscularly. Administering it intramuscularly could increase the risk of bleeding and is not the appropriate route for this medication.
Full Explanation
Choice A rationale:
The air bubble should not be expelled from the syringe before administering enoxaparin. The air bubble is included to ensure that the entire dose is administered and to help prevent leakage of the medication into the subcutaneous tissue, which can reduce bruising.
Choice B rationale:
After administering enoxaparin, applying firm pressure (but not massaging) to the injection site helps minimize bruising and bleeding. It's important not to massage the site as this can increase the risk of bleeding.
Choice C rationale:
The needle should be inserted fully into the subcutaneous tissue at a 90-degree angle (or at a 45-degree angle if the client has little subcutaneous tissue). Inserting the needle halfway may result in improper administration.
Choice D rationale:
Enoxaparin is a low-molecular-weight heparin that should be administered subcutaneously, not intramuscularly. Administering it intramuscularly could increase the risk of bleeding and is not the appropriate route for this medication.
A nurse is caring for a client who has breast cancer and reports pain 1 hr after administration of prescribed morphine 10 mg IV.
Which of the following medications should the nurse expect to administer?
A. Fentanyl transmucosal.
This is because fentanyl transmucosal is a fast-acting opioid that can be used for breakthrough pain in patients who are already receiving opioids for chronic pain. Breakthrough pain is a sudden and severe increase in pain that occurs despite the use of regular pain medication. Fentanyl transmucosal has a rapid onset of action (1-3 minutes) and a short duration of effect (1-2 hours), which makes it suitable for treating episodic pain.
B. Lidocaine patch.
Choice B. Lidocaine patch is wrong because lidocaine patch is a topical anesthetic that can be used for localized neuropathic pain, but not for acute or severe pain.
C. Morphine tablet.
Choice C. Morphine tablet is wrong because morphine tablet is a long-acting opioid that can be used for chronic pain, but not for breakthrough pain. Morphine tablet has a slow onset of action (30-60 minutes) and a long duration of effect (3-4 hours), which makes it unsuitable for treating episodic pain.
D. Naloxone IV.
Choice D. Naloxone IV is wrong because naloxone IV is an opioid antagonist that can reverse the effects of opioids, but not relieve pain. Naloxone IV can cause acute withdrawal symptoms in patients who are dependent on opioids.
Full Explanation
This is because fentanyl transmucosal is a fast-acting opioid that can be used for breakthrough pain in patients who are already receiving opioids for chronic pain. Breakthrough pain is a sudden and severe increase in pain that occurs despite the use of regular pain medication. Fentanyl transmucosal has a rapid onset of action (1-3 minutes) and a short duration of effect (1-2 hours), which makes it suitable for treating episodic pain.
Choice B. Lidocaine patch is wrong because lidocaine patch is a topical anesthetic that can be used for localized neuropathic pain, but not for acute or severe pain.
Choice C. Morphine tablet is wrong because morphine tablet is a long-acting opioid that can be used for chronic pain, but not for breakthrough pain. Morphine tablet has a slow onset of action (30-60 minutes) and a long duration of effect (3-4 hours), which makes it unsuitable for treating episodic pain.
Choice D. Naloxone IV is wrong because naloxone IV is an opioid antagonist that can reverse the effects of opioids, but not relieve pain.
Naloxone IV can cause