A nurse is preparing to give routine medications to a client with a history of hypertension. The nurse recognizes the need to assess the clients blood pressure before and after administering which of the following medications?

Simvastatin

Metoprolol

Acetylsalicylic. Acid (Aspirin)

Metformin

Answer and Explanation

The Correct Answer is B

A) Simvastatin: Simvastatin is a medication used to lower cholesterol levels and does not typically require monitoring of blood pressure before or after administration. While statins may have some indirect cardiovascular benefits, blood pressure is not directly affected by this medication, so it is not necessary to assess blood pressure before or after administering simvastatin.

B) Metoprolol: This is the correct answer. Metoprolol is a beta-blocker commonly used to treat hypertension and other cardiovascular conditions. It works by reducing heart rate and blood pressure. Therefore, it is important to assess the client's blood pressure both before and after administering metoprolol to ensure the medication is having the desired effect and to detect any adverse changes, such as hypotension or bradycardia.

C) Acetylsalicylic Acid (Aspirin): Aspirin is primarily used for its antiplatelet effect, such as for preventing heart attacks or strokes, and it does not have a significant direct impact on blood pressure. While aspirin can have side effects, such as gastrointestinal irritation or bleeding, blood pressure monitoring is generally not necessary before or after administering aspirin.

D) Metformin: Metformin is used to manage type 2 diabetes by helping control blood glucose levels. It does not directly affect blood pressure, so routine blood pressure assessment is not required before or after giving metformin. However, monitoring for side effects like gastrointestinal distress or lactic acidosis is important, but blood pressure is not a priority for this medication.

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Correct Answer is A

Explanation

A) pH 7.25, CO2 40, HCO3- 16:
In metabolic acidosis, the pH is decreased indicating acidemia. The bicarbonate level is low which is a hallmark of metabolic acidosis. The CO2 level of 40 is within the normal range suggesting that the body is not compensating for the acidosis through respiratory compensation yet. In metabolic acidosis, the body will often try to compensate by increasing respiratory rate to blow off CO2, but this takes time.

B) pH 7.5, CO2 35, HCO3- 30:
In metabolic alkalosis, the pH is increased above 7.45, and the bicarbonate level (HCO3-) is elevated both of which are seen here. The CO2 level of 35 is within normal limits, and while respiratory compensation could increase CO2 in response to metabolic alkalosis,

C) pH 7.5, CO2 30, HCO3- 22:
The pH is increased above 7.45, and the bicarbonate level is within the normal range. The CO2 level of 30 is low, which is typical in respiratory alkalosis, where the body compensates for the increased pH by blowing off CO2.

D) pH 7.25, CO2 55, HCO3- 25:
The pH is low, but the bicarbonate level is normal. The CO2 level is elevated, which is indicative of hypoventilation or inadequate respiratory compensation, commonly seen in respiratory acidosis, where the lungs cannot excrete CO2 effectively

A. Positive Trousseau's sign B. Hypertension and headache C. Tachycardia and tachypnea D. Depressed deep tendon reflexes and lethargy

Correct Answer is D

Explanation

A. Positive Trousseau's sign:
A positive Trousseau's sign (spasms of the hand and forearm when a blood pressure cuff is inflated) is a sign of hypocalcemia, not hypermagnesemia. It indicates low calcium levels in the blood, not elevated magnesium levels. Therefore, this is not indicative of hypermagnesemia.

B. Hypertension and headache:
Hypertension and headache are more commonly associated with hypomagnesemia (low magnesium levels), rather than hypermagnesemia. Elevated magnesium levels tend to cause vasodilation, which can lead to hypotension, not hypertension. Therefore, these symptoms are not consistent with hypermagnesemia.

C. Tachycardia and tachypnea:
Tachycardia and tachypnea are often signs of hypomagnesemia as well, where the body compensates for low magnesium by increasing heart rate and breathing rate. Hypermagnesemia, on the other hand, usually causes bradycardia (slowed heart rate) and respiratory depression. So, tachycardia and tachypnea are not indicative of hypermagnesemia.

D. Depressed deep tendon reflexes and lethargy:
This is the correct answer. Hypermagnesemia can lead to depressed deep tendon reflexes (DTRs) and lethargy, as magnesium is a central nervous system depressant. Elevated magnesium levels inhibit neuromuscular function, which can cause symptoms such as diminished reflexes, muscle weakness, and overall lethargy or drowsiness. This combination of findings is a key indicator of hypermagnesemia.

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A nurse is preparing to give routine medications to a client with a history of hypertension. The nurse recognizes the need to assess the clients blood pressure before and after administering which of the following medications?

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