A nurse is administering nicardipine to a client who has a BP of 180/120 mm Hg. Which of the following actions should the nurse take first?

Check for orthostatic hypertension.

Assist the client to make lifestyle changes.

Instruct the client to restrict sodium intake.

Monitor the client's BP every 5 minutes.

Answer and Explanation

The Correct Answer is D

A. Check for orthostatic hypotension. While important, checking for orthostatic hypotension is not the priority action in a hypertensive emergency, where rapid blood pressure reduction is necessary.

B. Assist the client to make lifestyle changes. Assisting the client with lifestyle changes is part of long-term blood pressure management but is not a priority action when administering nicardipine for acute hypertension.

C. Instruct the client to restrict sodium intake. Sodium restriction is a key component of managing hypertension but is not the priority action during an acute hypertensive crisis.

D. Monitor the client's BP every 5 minutes. In a hypertensive crisis, frequent monitoring of the client’s blood pressure is essential to ensure the medication is lowering blood pressure safely and effectively.

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Correct Answer is ["A","C"]

Explanation

A. Monitor your blood pressure on a regular basis: Regular monitoring of blood pressure is important for clients taking lisinopril to ensure the medication is effectively controlling hypertension.

B. Your cholesterol levels must be monitored monthly while taking this medication: Lisinopril does not typically require monthly cholesterol monitoring. This instruction is more relevant for statins or other lipid-lowering agents.

C. Report the development of a persistent dry cough.: A dry cough is a common side effect of ACE inhibitors like lisinopril. Clients should report this side effect as it may necessitate discontinuing the medication.

D. Your diet should include plenty of potassium-rich foods daily: Lisinopril can increase potassium levels, potentially causing hyperkalemia. Clients should be advised to avoid excessive potassium intake, not to increase it.

A. Count the apical pulsations for a full minute. B. Place the just under the mid-clavicular are of the left chest. C. Press the stethoscope firmly against the client's skin. D. Check the apical pulse with a Doppler device.

Correct Answer is A

Explanation

A. Count the apical pulsations for a full minute. The apical pulse should be counted for a full minute to ensure accuracy, especially in clients taking cardiovascular medications, as these may affect heart rhythm and rate.

B. Place the stethoscope just under the mid-clavicular area of the left chest. The apical pulse is typically located at the fifth intercostal space at the midclavicular line, not directly under the clavicle.

C. Press the stethoscope firmly against the client's skin. While the stethoscope needs to be in full contact with the skin, excessive pressure is not necessary and may distort the sound.

D. Check the apical pulse with a Doppler device. A Doppler is typically used when the pulse is difficult to palpate or auscultate, not as a first-line method for checking the apical pulse.

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A nurse is administering nicardipine to a client who has a BP of 180/120 mm Hg. Which of the following actions should the nurse take first?

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Naxlex Comprehensive Predictor Exams

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