Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A. Expect to gain weight while taking this medication.
Expecting to gain weight while taking this medication is not a correct instruction, as it may discourage the client from adhering to the treatment and may worsen the hypertension. Captopril is an angiotensin-converting enzyme (ACE) inhibitor that lowers the blood pressure by preventing the formation of angiotensin II, a potent vasoconstrictor. Captopril does not cause significant weight gain, but it may cause fluid retention or edema in some cases. The nurse should advise the client to monitor the weight daily and report any sudden or excessive increase to the provider.
B. Do not use salt substitutes while taking this medication.
Not using salt substitutes while taking this medication is a correct instruction, as it may prevent the risk of hyperkalemia, a potentially life-threatening condition. Captopril may increase the potassium level in the blood by reducing the secretion of aldosterone, a hormone that regulates the sodium and potassium balance. Salt substitutes may contain potassium chloride, which may further elevate the potassium level. The nurse should advise the client to avoid salt substitutes and high-potassium foods, such as bananas, oranges, or tomatoes, and to have regular blood tests to check the electrolyte levels.
C. Count your pulse rate before taking the medication.
Counting the pulse rate before taking the medication is not a necessary instruction, as it may not reflect the effect of the medication on the blood pressure. Captopril does not affect the heart rate significantly, but it may lower the blood pressure too much, especially in the first few weeks of treatment or after a dose increase. This may cause hypotension, dizziness, or fainting. The nurse should advise the client to monitor the blood pressure regularly and report any symptoms of hypotension to the provider.
D. Take the medication with food.
Taking the medication with food is not a correct instruction, as it may reduce the absorption and effectiveness of the medication. Captopril should be taken on an empty stomach, at least one hour before or two hours after a meal, to ensure optimal bioavailability. The nurse should advise the client to take the medication at the same time every day and to avoid skipping or doubling the doses.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Pharmacology Proctored Exam 2. Take the full exam now
Full Explanation
Choice A reason: Expecting to gain weight while taking this medication is not a correct instruction, as it may discourage the client from adhering to the treatment and may worsen the hypertension. Captopril is an angiotensin-converting enzyme (ACE) inhibitor that lowers the blood pressure by preventing the formation of angiotensin II, a potent vasoconstrictor. Captopril does not cause significant weight gain, but it may cause fluid retention or edema in some cases. The nurse should advise the client to monitor the weight daily and report any sudden or excessive increase to the provider.
Choice B reason: Not using salt substitutes while taking this medication is a correct instruction, as it may prevent the risk of hyperkalemia, a potentially life-threatening condition. Captopril may increase the potassium level in the blood by reducing the secretion of aldosterone, a hormone that regulates the sodium and potassium balance. Salt substitutes may contain potassium chloride, which may further elevate the potassium level. The nurse should advise the client to avoid salt substitutes and high-potassium foods, such as bananas, oranges, or tomatoes, and to have regular blood tests to check the electrolyte levels.
Choice C reason: Counting the pulse rate before taking the medication is not a necessary instruction, as it may not reflect the effect of the medication on the blood pressure. Captopril does not affect the heart rate significantly, but it may lower the blood pressure too much, especially in the first few weeks of treatment or after a dose increase. This may cause hypotension, dizziness, or fainting. The nurse should advise the client to monitor the blood pressure regularly and report any symptoms of hypotension to the provider.
Choice D reason: Taking the medication with food is not a correct instruction, as it may reduce the absorption and effectiveness of the medication. Captopril should be taken on an empty stomach, at least one hour before or two hours after a meal, to ensure optimal bioavailability. The nurse should advise the client to take the medication at the same time every day and to avoid skipping or doubling the doses.
Similar Questions
A nurse is assessing a client who is receiving a unit of packed red blood cells. Which of the following findings is a manifestation of acute hemolytic reaction?
A. Distended neck veins
Distended neck veins is not a manifestation of acute hemolytic reaction, but it may indicate fluid overload, which is another possible complication of blood transfusion. Fluid overload may occur when the blood volume or rate of infusion exceeds the client's circulatory capacity. Fluid overload may manifest as dyspnea, crackles, edema, hypertension, or tachycardia.
B. Client report of low back pain
Client report of low back pain is a manifestation of acute hemolytic reaction, which is a life-threatening condition that occurs when the donor blood is incompatible with the recipient's blood. Acute hemolytic reaction may occur within minutes or hours of the transfusion and may cause the destruction of the transfused red blood cells. Acute hemolytic reaction may manifest as fever, chills, low back pain, hemoglobinuria, hypotension, or shock.
C. A productive cough
A productive cough is not a manifestation of acute hemolytic reaction, but it may indicate a respiratory infection, which is a potential risk of blood transfusion. Blood transfusion may transmit infectious agents, such as bacteria, viruses, or parasites, from the donor to the recipient. A productive cough may also be a sign of pulmonary edema, which may result from fluid overload or transfusion-related acute lung injury (TRALI).
D. Client report of tinnitus
Client report of tinnitus is not a manifestation of acute hemolytic reaction, but it may indicate ototoxicity, which is a possible adverse effect of some medications, such as aminoglycosides, loop diuretics, or salicylates. Ototoxicity may damage the inner ear or the auditory nerve and cause hearing loss, tinnitus, or vertigo. The nurse should assess the client's medication history and monitor the client's hearing function.
Full Explanation
Choice A reason: Distended neck veins is not a manifestation of acute hemolytic reaction, but it may indicate fluid overload, which is another possible complication of blood transfusion. Fluid overload may occur when the blood volume or rate of infusion exceeds the client's circulatory capacity. Fluid overload may manifest as dyspnea, crackles, edema, hypertension, or tachycardia.
Choice B reason: Client report of low back pain is a manifestation of acute hemolytic reaction, which is a life-threatening condition that occurs when the donor blood is incompatible with the recipient's blood. Acute hemolytic reaction may occur within minutes or hours of the transfusion and may cause the destruction of the transfused red blood cells. Acute hemolytic reaction may manifest as fever, chills, low back pain, hemoglobinuria, hypotension, or shock.
Choice C reason: A productive cough is not a manifestation of acute hemolytic reaction, but it may indicate a respiratory infection, which is a potential risk of blood transfusion. Blood transfusion may transmit infectious agents, such as bacteria, viruses, or parasites, from the donor to the recipient. A productive cough may also be a sign of pulmonary edema, which may result from fluid overload or transfusion-related acute lung injury (TRALI).
Choice D reason: Client report of tinnitus is not a manifestation of acute hemolytic reaction, but it may indicate ototoxicity, which is a possible adverse effect of some medications, such as aminoglycosides, loop diuretics, or salicylates. Ototoxicity may damage the inner ear or the auditory nerve and cause hearing loss, tinnitus, or vertigo. The nurse should assess the client's medication history and monitor the client's hearing function.
A nurse is caring for a client who has a new prescription for propranolol. The nurse should monitor the client for which of the following severe reactions to this medication?
A. Ototoxicity
Ototoxicity is not a severe reaction to propranolol, but it may occur with some other medications, such as aminoglycosides, loop diuretics, or salicylates. Ototoxicity may damage the inner ear or the auditory nerve and cause hearing loss, tinnitus, or vertigo. The nurse should assess the client's medication history and monitor the client's hearing function.
B. Hypokalemia
Hypokalemia is not a severe reaction to propranolol, but it may occur with some other medications, such as thiazide diuretics, corticosteroids, or insulin. Hypokalemia may cause muscle weakness, cramps, arrhythmias, or cardiac arrest. The nurse should advise the client to eat foods rich in potassium, such as bananas, oranges, or potatoes, and to have regular blood tests to check the electrolyte levels.
C. Tachycardia
Tachycardia is not a severe reaction to propranolol, but it may be a sign of overdose, withdrawal, or rebound effect. Propranolol is a beta-blocker that lowers the heart rate and blood pressure by blocking the effects of epinephrine and norepinephrine. Propranolol may cause bradycardia, not tachycardia, as a side effect. The nurse should monitor the client's vital signs and advise the client to take the medication as prescribed and not to stop it abruptly.
D. Postural hypotension
Postural hypotension is a severe reaction to propranolol, as it may cause dizziness, fainting, or falls. Postural hypotension occurs when the blood pressure drops significantly when the client changes position, such as from lying to sitting or standing. Propranolol may cause postural hypotension by reducing the vascular tone and the cardiac output. The nurse should instruct the client to change position slowly and to report any symptoms of postural hypotension to the provider.
Full Explanation
Choice A reason: Ototoxicity is not a severe reaction to propranolol, but it may occur with some other medications, such as aminoglycosides, loop diuretics, or salicylates. Ototoxicity may damage the inner ear or the auditory nerve and cause hearing loss, tinnitus, or vertigo. The nurse should assess the client's medication history and monitor the client's hearing function.
Choice B reason: Hypokalemia is not a severe reaction to propranolol, but it may occur with some other medications, such as thiazide diuretics, corticosteroids, or insulin. Hypokalemia may cause muscle weakness, cramps, arrhythmias, or cardiac arrest. The nurse should advise the client to eat foods rich in potassium, such as bananas, oranges, or potatoes, and to have regular blood tests to check the electrolyte levels.
Choice C reason: Tachycardia is not a severe reaction to propranolol, but it may be a sign of overdose, withdrawal, or rebound effect. Propranolol is a beta-blocker that lowers the heart rate and blood pressure by blocking the effects of epinephrine and norepinephrine. Propranolol may cause bradycardia, not tachycardia, as a side effect. The nurse should monitor the client's vital signs and advise the client to take the medication as prescribed and not to stop it abruptly.
Choice D reason: Postural hypotension is a severe reaction to propranolol, as it may cause dizziness, fainting, or falls. Postural hypotension occurs when the blood pressure drops significantly when the client changes position, such as from lying to sitting or standing. Propranolol may cause postural hypotension by reducing the vascular tone and the cardiac output. The nurse should instruct the client to change position slowly and to report any symptoms of postural hypotension to the provider.
A nurse is reviewing laboratory results of a client who has atrial fibrillation and is taking warfarin. For which of the following results should the nurse notify the provider?
A. Platelets 190,000/mm3
Platelets 190,000/mm3 is within the normal range of 150,000 to 450,000/mm3. This result does not indicate a bleeding risk or a need to adjust the warfarin dose.
B. Hct 44%
Hct 44% is within the normal range of 37% to 47% for females and 42% to 52% for males. This result does not indicate anemia or polycythemia, which could affect the warfarin therapy.
C. PT 45 seconds
PT 45 seconds is above the normal range of 11 to 13.5 seconds. This result indicates that the blood is taking too long to clot, which increases the risk of bleeding. The nurse should notify the provider and expect a decrease in the warfarin dose.
D. Hgb 16 g/dL
Hgb 16 g/dL is within the normal range of 12 to 16 g/dL for females and 14 to 18 g/dL for males. This result does not indicate anemia or polycythemia, which could affect the warfarin therapy.
Full Explanation
Choice A reason: Platelets 190,000/mm3 is within the normal range of 150,000 to 450,000/mm3. This result does not indicate a bleeding risk or a need to adjust the warfarin dose.
Choice B reason: Hct 44% is within the normal range of 37% to 47% for females and 42% to 52% for males. This result does not indicate anemia or polycythemia, which could affect the warfarin therapy.
Choice C reason: PT 45 seconds is above the normal range of 11 to 13.5 seconds. This result indicates that the blood is taking too long to clot, which increases the risk of bleeding. The nurse should notify the provider and expect a decrease in the warfarin dose.
Choice D reason: Hgb 16 g/dL is within the normal range of 12 to 16 g/dL for females and 14 to 18 g/dL for males. This result does not indicate anemia or polycythemia, which could affect the warfarin therapy.