An older client with heart failure (HF), coronary artery disease (CAD), and hypertension (HTN) is receiving these daily prescriptions: atenolol, furosemide, and enalapril. Which assessments should the nurse include in evaluating the effectiveness of the medications? (Select all that apply.)

Heart sounds.

Blood pressure.

Bowel sounds.

Daily weight.

Range of motion.

Answer and Explanation

Correct Answer : A

Choice A reason:

Heart sounds: Monitoring heart sounds is crucial for evaluating the effectiveness of medications in a client with heart failure and coronary artery disease. Changes in heart sounds, such as the presence of new murmurs or gallops, can indicate worsening heart failure or other cardiac complications1. Regular assessment helps in early detection and management of potential issues.

Choice B reason:

Blood pressure: Blood pressure monitoring is essential for clients with hypertension and those taking medications like atenolol and enalapril. These medications are used to manage blood pressure and reduce the workload on the heart. Regular monitoring ensures that the medications are effectively controlling blood pressure within the target range, typically less than 130/80 mm Hg.

Choice C reason:

Bowel sounds: While assessing bowel sounds is important for overall health, it is not directly related to evaluating the effectiveness of heart failure, CAD, or hypertension medications. Bowel sounds are more relevant in gastrointestinal assessments and do not provide specific information about the effectiveness of the prescribed cardiac medications.

Choice D reason:

Daily weight: Monitoring daily weight is a key assessment for clients with heart failure. Sudden weight gain can indicate fluid retention, which is a sign of worsening heart failure. Furosemide, a diuretic, helps manage fluid balance, and daily weight monitoring helps evaluate its effectiveness in preventing fluid overload.

Choice E reason:

Range of motion: Assessing range of motion is important for overall mobility and physical health but is not directly related to evaluating the effectiveness of medications for heart failure, CAD, or hypertension. It is more relevant in musculoskeletal assessments and rehabilitation.

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Correct Answer is C

Explanation

Choice A reason: Administering potassium is not the primary action for treating digoxin toxicity. While hypokalemia can exacerbate digoxin toxicity, the initial step is to assess and stabilize the patient’s overall condition, including acid-base and electrolyte balance. Potassium administration may be considered if hypokalemia is present, but it is not the first-line treatment.

Choice B reason: Cardioversion is not typically used to treat digoxin toxicity. Digoxin toxicity can cause various arrhythmias, but the treatment focuses on stabilizing the patient and addressing the toxicity itself2. Cardioversion may be considered in life-threatening arrhythmias, but it is not the primary intervention.

Choice C reason: Checking acid-base and electrolyte values is crucial in managing digoxin toxicity. Digoxin toxicity can lead to electrolyte imbalances, particularly hyperkalemia, which can be life-threatening. Assessing and correcting these imbalances is essential for stabilizing the patient and preventing further complications.

Choice D reason: Giving digoxin by another route to slow absorption is not an appropriate action. The primary treatment for digoxin toxicity involves stopping the medication and administering digoxin-specific antibody fragments (Fab) if necessary. These antibodies bind to digoxin, neutralizing its effects and allowing for its excretion.

A. Irritable bowel syndrome. B. Coronary artery disease. C. Seasonal allergic rhinitis. D. Type 2 diabetes mellitus.

Correct Answer is B

Explanation

Choice A reason:

Irritable bowel syndrome (IBS) is not a primary concern when administering sumatriptan succinate. While IBS can cause significant discomfort and affect the quality of life, it does not pose a direct contraindication to the use of sumatriptan. Sumatriptan is primarily metabolized in the liver and excreted by the kidneys, and its use is not significantly impacted by gastrointestinal conditions like IBS1.

Choice B reason:

Coronary artery disease (CAD) is a critical consideration before administering sumatriptan succinate. Sumatriptan is a selective serotonin receptor agonist that causes vasoconstriction of cranial blood vessels to relieve migraine symptoms. However, it can also cause vasoconstriction in coronary arteries, which can be dangerous for clients with CAD. This can lead to serious cardiovascular events such as myocardial infarction or angina. Therefore, it is essential to assess for any history of CAD or other significant cardiovascular conditions before administering this medication.

Choice C reason:

Seasonal allergic rhinitis is not a significant concern when administering sumatriptan succinate. While allergic rhinitis can cause symptoms such as nasal congestion, sneezing, and itching, it does not interact with the pharmacological action of sumatriptan. Therefore, it is not a contraindication for the use of this medication.

Choice D reason:

Type 2 diabetes mellitus is not a primary concern when administering sumatriptan succinate. Although diabetes can increase the risk of cardiovascular disease, the presence of diabetes alone does not contraindicate the use of sumatriptan. However, it is important to consider the overall cardiovascular risk profile of the client, including any complications related to diabetes.

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An older client with heart failure (HF), coronary artery disease (CAD), and hypertension (HTN) is receiving these daily prescriptions: atenolol, furosemide, and enalapril. Which assessments should the nurse include in evaluating the effectiveness of the medications? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

Correct Answer is C

Explanation

Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client’s history includes which problem?

Correct Answer is B

Explanation

An older client with heart failure (HF), coronary artery disease (CAD), and hypertension (HTN) is receiving these daily prescriptions: atenolol, furosemide, and enalapril. Which assessments should the nurse include in evaluating the effectiveness of the medications? (Select all that apply.)

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