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NurseDive Free Nursing Practice Question
The nurse reviews the newly written prescriptions for a client admitted with the diagnoses of coronary artery disease and hypertension. Which prescription should the nurse implement first?
A. Furosemide 40 mg PO daily for a client whose blood pressure is 123986.
Furosemide 40 mg PO daily for a client whose blood pressure is 123/86: While furosemide is important for managing fluid status, the client's blood pressure is within a normal range, and this medication does not address any acute concerns.
B. Nitroglycerin 0.4 mg SL PRN for a client complaining of chest
Nitroglycerin 0.4 mg SL PRN for a client complaining of chest pain: This prescription should be implemented first because it addresses an immediate and potentially life-threatening symptom. Chest pain can indicate angina or myocardial infarction, making it critical to relieve this symptom promptly.
C. Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats
Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats: While metoprolol is important for managing heart rate and hypertension, a heart rate of 55 beats/minute is on the lower end and could warrant caution. The priority would be to assess the need for medication before administering it.
D. Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min
Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min: This medication is also important for managing heart rate and hypertension but is not the priority over addressing acute chest pain. The client’s heart rate is within a normal range, so this does not require immediate action compared to the nitroglycerin for chest pain.
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Full Explanation
A) Furosemide 40 mg PO daily for a client whose blood pressure is 123/86: While furosemide is important for managing fluid status, the client's blood pressure is within a normal range, and this medication does not address any acute concerns.
B) Nitroglycerin 0.4 mg SL PRN for a client complaining of chest pain: This prescription should be implemented first because it addresses an immediate and potentially life-threatening symptom. Chest pain can indicate angina or myocardial infarction, making it critical to relieve this symptom promptly.
C) Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats: While metoprolol is important for managing heart rate and hypertension, a heart rate of 55 beats/minute is on the lower end and could warrant caution. The priority would be to assess the need for medication before administering it.
D) Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min: This medication is also important for managing heart rate and hypertension but is not the priority over addressing acute chest pain. The client’s heart rate is within a normal range, so this does not require immediate action compared to the nitroglycerin for chest pain.
Similar Questions
The nurse has obtained assessment data for a client who is scheduled for a cardiac angiogram (catheterization). Which information must the nurse report to the health care provider prior to the procedure?
A. Pedal pulses are +1 bilaterally
Pedal pulses are +1 bilaterally: While this may indicate decreased perfusion, it is not an immediate concern that typically requires reporting before a cardiac angiogram. This finding should be monitored but does not usually contraindicate the procedure.
B. Client has multiple food allergies
Client has multiple food allergies: This information is critical to report prior to the procedure, especially if any of the allergies pertain to medications or contrast agents used during the angiogram. Knowing about allergies can help prevent potential allergic reactions during the procedure.
C. Admission blood pressure is 110/70
Admission blood pressure is 110/70: This blood pressure reading is within an acceptable range for most patients. While the healthcare provider should be aware of baseline vitals, this alone does not necessitate immediate reporting.
D. Client is slightly anxious
Client is slightly anxious: While anxiety is important to acknowledge and may require intervention, it is common for clients undergoing procedures. This does not typically need to be reported urgently to the healthcare provider prior to the angiogram.
Full Explanation
A) Pedal pulses are +1 bilaterally: While this may indicate decreased perfusion, it is not an immediate concern that typically requires reporting before a cardiac angiogram. This finding should be monitored but does not usually contraindicate the procedure.
B) Client has multiple food allergies: This information is critical to report prior to the procedure, especially if any of the allergies pertain to medications or contrast agents used during the angiogram. Knowing about allergies can help prevent potential allergic reactions during the procedure.
C) Admission blood pressure is 110/70: This blood pressure reading is within an acceptable range for most patients. While the healthcare provider should be aware of baseline vitals, this alone does not necessitate immediate reporting.
D) Client is slightly anxious: While anxiety is important to acknowledge and may require intervention, it is common for clients undergoing procedures. This does not typically need to be reported urgently to the healthcare provider prior to the angiogram.
The nurse is working collaboratively with the physical therapist to develop an exercise program for a client recently diagnosed with hypertension. Which intervention would be best to assist the client in maintaining the exercise program?
A. Reassuring the client that they will be able to do the exercise program
Reassuring the client that they will be able to do the exercise program: While reassurance is important for motivation, it does not provide practical support or help the client engage effectively in the program.
B. Explaining the exercise program to the client's spouse
Explaining the exercise program to the client's spouse: While involving the spouse can be beneficial, the primary focus should be on ensuring the client understands and can engage in the program themselves.
C. Providing the client with specific details of how to perform the exercises
Providing the client with specific details of how to perform the exercises: While it's important for the client to understand the exercises, simply giving details may not address the client's personal preferences or limitations, which are crucial for adherence.
D. Adapting the program to the client's needs and abilities
Adapting the program to the client's needs and abilities: This intervention is the best approach to help the client maintain the exercise program. By tailoring the exercise regimen to fit the client's individual abilities, preferences, and any physical limitations, the client is more likely to feel confident, motivated, and able to stick with the program long-term.
Full Explanation
A) Reassuring the client that they will be able to do the exercise program: While reassurance is important for motivation, it does not provide practical support or help the client engage effectively in the program.
B) Explaining the exercise program to the client's spouse: While involving the spouse can be beneficial, the primary focus should be on ensuring the client understands and can engage in the program themselves.
C) Providing the client with specific details of how to perform the exercises: While it's important for the client to understand the exercises, simply giving details may not address the client's personal preferences or limitations, which are crucial for adherence.
D) Adapting the program to the client's needs and abilities: This intervention is the best approach to help the client maintain the exercise program. By tailoring the exercise regimen to fit the client's individual abilities, preferences, and any physical limitations, the client is more likely to feel confident, motivated, and able to stick with the program long-term.
The nurse is reviewing the laboratory test results of a client with long standing hypertension. Which result would be of most concern to the nurse?
A. Blood urea nitrogen (BUN) 20 mg/d
Blood urea nitrogen (BUN) 20 mg/dL: While this BUN level is slightly elevated, it is not as concerning as the creatinine level. Elevated BUN can indicate dehydration or other issues but does not necessarily signal acute kidney injury.
B. Creatinine 2.6 mg/dl
Creatinine 2.6 mg/dL: This result is the most concerning because it indicates impaired kidney function. Normal creatinine levels are typically between 0.6 and 1.2 mg/dL. An elevated creatinine level suggests that the kidneys are not filtering waste effectively, which is a significant concern for a client with long-standing hypertension.
C. Hemoglobin 12.8 g/dl
Hemoglobin 12.8 g/dL: This hemoglobin level is within the normal range for adults and does not present an immediate concern.
D. Potassium 3.8 mEq/L
Potassium 3.8 mEq/L: This potassium level is also within the normal range (3.5 to 5.0 mEq/L) and does not raise any alarms in terms of electrolyte imbalances.
Full Explanation
A) Blood urea nitrogen (BUN) 20 mg/dL: While this BUN level is slightly elevated, it is not as concerning as the creatinine level. Elevated BUN can indicate dehydration or other issues but does not necessarily signal acute kidney injury.
B) Creatinine 2.6 mg/dL: This result is the most concerning because it indicates impaired kidney function. Normal creatinine levels are typically between 0.6 and 1.2 mg/dL. An elevated creatinine level suggests that the kidneys are not filtering waste effectively, which is a significant concern for a client with long-standing hypertension.
C) Hemoglobin 12.8 g/dL: This hemoglobin level is within the normal range for adults and does not present an immediate concern.
D) Potassium 3.8 mEq/L: This potassium level is also within the normal range (3.5 to 5.0 mEq/L) and does not raise any alarms in terms of electrolyte imbalances.