A nurse is collecting data from a client prior to administering a calcium channel blocker (CCB) for treatment of hypertension. For which of the following findings should the nurse contact the provider?
Heart rate of 66/min
BP of 148/94 mm Hg
Peripheral edema of the ankles
A digoxin level of 1.2 ng/mL.
The Correct Answer is C
(a) Heart rate of 66/min:
A heart rate of 66/min is within the normal range (60-100 bpm) and does not typically require contacting the provider before administering a calcium channel blocker. CCBs can affect heart rate, but this finding alone is not a contraindication for their use.
(b) BP of 148/94 mm Hg:
A blood pressure reading of 148/94 mm Hg indicates hypertension, which is an appropriate indication for the use of calcium channel blockers. This finding supports the use of the medication rather than requiring the provider to be contacted.
(c) Peripheral edema of the ankles:
Peripheral edema is a known side effect of calcium channel blockers. If the client is already experiencing edema, administering the medication could potentially worsen this condition. The nurse should contact the provider to discuss this finding before proceeding with the medication administration.
(d) A digoxin level of 1.2 ng/mL:
A digoxin level of 1.2 ng/mL is within the therapeutic range (0.5-2.0 ng/mL). This finding does not necessitate contacting the provider before administering a calcium channel blocker, as it does not indicate toxicity or a contraindication for CCB use
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Expert opinions: While expert opinions can provide valuable insights, they are considered lower in the hierarchy of evidence. They do not undergo the rigorous testing and peer review that higher levels of evidence, such as systematic reviews and randomized controlled trials, do.
B. Credible websites: Credible websites can be a good source of information, but they are not considered the highest level of evidence. The information on websites can vary greatly in quality and may not be peer-reviewed.
C. Qualitative studies: Qualitative studies can provide in-depth information about specific topics, but they are not considered the highest level of evidence. They often involve smaller sample sizes and do not provide the same level of quantitative data as systematic reviews or randomized controlled trials.
D. Systematic review: This is correct. Systematic reviews are considered the highest level of evidence in the hierarchy. They involve a comprehensive search of multiple databases to identify all relevant studies on a particular topic, followed by a rigorous assessment of the quality of each study. The results are then synthesized to provide a comprehensive overview of the current evidence.
Correct Answer is D
Explanation
(A) Increased bowel sounds
At the end of life, decreased bowel sounds or even absent bowel sounds are more common due to reduced gastrointestinal activity as the body begins to shut down. Increased bowel sounds are not typically expected.
(B) Hypertension
Hypertension is not typically expected at the end of life. Instead, hypotension (low blood pressure) is more common as the heart and other systems begin to fail.
(C) Moist mucous membranes
At the end of life, mucous membranes are often dry due to decreased fluid intake and systemic dehydration. Moist mucous membranes would not be an expected finding.
(D) Mottled skin
Mottled skin is a common and expected finding at the end of life. It occurs as circulation diminishes and the skin takes on a blotchy, purplish appearance, typically starting in the extremities and moving centrally. This is a sign that the body is shutting down and approaching death.
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