Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is collecting data from a client prior to administering nifedipine.
For which of the following findings should the nurse contact the provider?.
A. BP of 148/94 mm Hg
A blood pressure of 148/94 mm Hg is elevated, but it is not an immediate contraindication for administering nifedipine. Nifedipine is often used to treat hypertension.
B. Peripheral edema of the ankles.
Peripheral edema is a common side effect of nifedipine and can indicate worsening fluid retention. The nurse should contact the provider to assess the need for adjusting the medication or implementing additional interventions.
C. Heart rate of 66/min.
A heart rate of 66/min is within the normal range (60-100/min) and does not require immediate action before administering nifedipine.
D. Increased alkaline phosphatase level.
An increased alkaline phosphatase level can indicate liver or bone disease, but it is not directly related to the administration of nifedipine. However, it should be monitored and discussed with the provider.
This question is an excerpt from Nurse Dive's nursing test bank - ATI PN Custom Cohert 6 Pharmacology Quiz 2 Proctored Exam. Take the full exam now
Full Explanation
The correct answer is choice B. Peripheral edema of the ankles.
Choice A rationale:
A blood pressure of 148/94 mm Hg is elevated, but it is not an immediate contraindication for administering nifedipine. Nifedipine is often used to treat hypertension.
Choice B rationale:
Peripheral edema is a common side effect of nifedipine and can indicate worsening fluid retention. The nurse should contact the provider to assess the need for adjusting the medication or implementing additional interventions.
Choice C rationale:
A heart rate of 66/min is within the normal range (60-100/min) and does not require immediate action before administering nifedipine.
Choice D rationale:
An increased alkaline phosphatase level can indicate liver or bone disease, but it is not directly related to the administration of nifedipine. However, it should be monitored and discussed with the provider.
Similar Questions
A nurse is reviewing the components of medication reconciliation with a newly licensed nurse.
Which of the following information should the nurse include in the teaching?.
A. "The list obtained from the client does not need to list medications that are not prescribed by the client's provider.”
A rationale: The list obtained from the client should include all medications the client is taking, regardless of who prescribed them.
B. "Complete the reconciliation process one time when the client is first admitted to the hospital.”.
B rationale: The reconciliation process should be completed at each transition of care, not just at admission.
C. "A comprehensive list of medications is provided for the client at the time of discharge.”.
C rationale: Providing a comprehensive list of medications at discharge is a key component of medication reconciliation.
D. "A nurse should write a verbal order in the medical record for medications the client was taking at home.”. .
D rationale: Nurses should not write verbal orders for medications. This is the responsibility of the provider.
Full Explanation
Choice A rationale:
The list obtained from the client should include all medications the client is taking, regardless of who prescribed them.
Choice B rationale:
The reconciliation process should be completed at each transition of care, not just at admission.
Choice C rationale:
Providing a comprehensive list of medications at discharge is a key component of medication reconciliation.
Choice D rationale:
Nurses should not write verbal orders for medications. This is the responsibility of the provider.
The nurse is preparing to administer ear drops to an adult client.
Which of the following actions should the nurse plan to take?.
A. Avoid applying pressure to the tragus of the ear
A rationale: Applying pressure to the tragus of the ear can help move the liquid in deeper. Therefore, this statement is incorrect.
B. Pull the pinna upward and backward.
B rationale: For adults, the pinna should be pulled upward and backward to straighten the ear canal. Therefore, this statement is correct.
C. Don sterile gloves to instill the medication.
C rationale: Sterile gloves are not necessary when administering ear drops. Therefore, this statement is incorrect.
D. Chill the otic solution prior to administration.
D rationale: Ear drops should be at room temperature. If they’re too cold or hot, they can make you feel dizzy and disoriented. Therefore, this statement is incorrect.
Full Explanation
Choice A rationale:
Applying pressure to the tragus of the ear can help move the liquid in deeper. Therefore, this statement is incorrect.
Choice B rationale:
For adults, the pinna should be pulled upward and backward to straighten the ear canal. Therefore, this statement is correct.
Choice C rationale:
Sterile gloves are not necessary when administering ear drops. Therefore, this statement is incorrect.
Choice D rationale:
Ear drops should be at room temperature. If they’re too cold or hot, they can make you feel dizzy and disoriented. Therefore, this statement is incorrect.
A nurse is reviewing the medication record of a client who has heart failure and has a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as a possible cause of the client's potassium level?.
A. Furosemide
A rationale: Furosemide is a diuretic that can cause your blood level of potassium to decrease, which is known as hypokalemia. Therefore, this statement is correct.
B. Spironolactone.
B rationale: Spironolactone is a potassium-sparing diuretic which conserves potassium, thereby balancing its levels in the body. Therefore, this statement is incorrect.
C. Metoprolol.
C rationale: Metoprolol does not significantly affect potassium levels. Therefore, this statement is incorrect.
D. Nitroglycerin.
D rationale: Nitroglycerin does not significantly affect potassium levels. Therefore, this statement is incorrect.
Full Explanation
Choice A rationale:
Furosemide is a diuretic that can cause your blood level of potassium to decrease, which is known as hypokalemia. Therefore, this statement is correct.
Choice B rationale:
Spironolactone is a potassium-sparing diuretic which conserves potassium, thereby balancing its levels in the body. Therefore, this statement is incorrect.
Choice C rationale:
Metoprolol does not significantly affect potassium levels. Therefore, this statement is incorrect.
Choice D rationale:
Nitroglycerin does not significantly affect potassium levels. Therefore, this statement is incorrect.