A nurse is reviewing data for a client who receives clonidine daily.
Which of the following findings indicates the nurse should withhold the next dose?
Urine output 600 mL in 8 hr.
Blood pressure 88/50 mm Hg.
Heart rate 110/min.
Blood glucose 70 mg/dL.
The Correct Answer is B
Choice A rationale:
A urine output of 600 mL in 8 hours is within the normal range. The average urine output for adults is about 1 to 2 liters per day.
Choice B rationale:
Clonidine is an antihypertensive medication. If the client’s blood pressure is already low (88/50 mm Hg), administering clonidine could further lower the blood pressure and cause hypotension.
Choice C rationale:
A heart rate of 110/min is slightly high, but it’s not a direct indication to withhold clonidine. Clonidine can actually help lower an elevated heart rate by reducing the levels of certain chemicals in your blood.
Choice D rationale:
A blood glucose level of 70 mg/dL is at the lower end of the normal range (70-100 mg/dL) However, clonidine does not directly affect blood glucose levels, so this would not be a reason to withhold the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
While it’s important for the client to maintain a balanced diet, consuming a lot of protein with each meal does not specifically benefit a person taking levodopa/carbidopa for Parkinson’s disease.
Choice B rationale:
Levodopa/carbidopa can cause side effects such as uncontrolled muscle movements in the face, arms, legs, or trunk. Therefore, monitoring for an increase in unusual movements is a sign of understanding the potential side effects of the medication.
Choice C rationale:
Levodopa/carbidopa helps manage the symptoms of Parkinson’s disease but does not prevent the disease from progressing.
Choice D rationale:
While levodopa/carbidopa can help reduce symptoms such as stiffness and tremors, it does not typically result in a rapid improvement in condition.
Correct Answer is B
Explanation
Choice A rationale:
While a tuberculin syringe can be used for insulin administration, it’s not necessary when mixing NPH and regular insulin. Insulin syringes are typically used for this purpose.
Choice B rationale:
Injecting air into each vial before withdrawing insulin helps equalize pressure and makes it easier to draw up the insulin. This should be done before withdrawing any insulin.
Choice C rationale:
Withdrawing NPH insulin first contradicts the standard practice of drawing up insulins. The usual recommendation is to draw up short-acting (regular) insulin before intermediate-acting (NPH) insulin.
Choice D rationale:
Shaking the regular insulin vial is unnecessary and could potentially create bubbles, making it harder to draw up the correct dose of insulin.
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