Exhibits
For each instruction, click to indicate whether the instructions given by the nurse are indicated or contraindicated to prepare for the client's first dose of captopril.
Increase the lantus dose by 3 units the morning of the first dose.
Limit fluids for several days before the first dose.
Hold spironolactone for 3 days.
Lay down if the blood pressure drops quickly after the first dose.
Monitor blood pressure for several hours after the first dose.
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}
Indicated Instructions:
-
Hold spironolactone for 3 days (Choice D):
- Reasoning: Captopril, an ACE inhibitor, can increase potassium levels. Spironolactone is a potassium-sparing diuretic. Holding spironolactone helps prevent hyperkalemia (high potassium levels), which can be dangerous.
-
Lay down if the blood pressure drops quickly after the first dose (Choice E):
- Reasoning: Captopril can cause a significant drop in blood pressure, especially after the first dose. Lying down helps prevent dizziness and fainting (orthostatic hypotension) due to the sudden decrease in blood pressure.
Contraindicated Instructions:
-
Increase the lantus dose by 3 units the morning of the first dose (Choice B):
- Reasoning: Adjusting insulin (Lantus) dose is not related to the administration of captopril and could potentially cause blood sugar imbalances. Such a change should be based on blood glucose monitoring, not the initiation of captopril.
-
Limit fluids for several days before the first dose (Choice C):
- Reasoning: Limiting fluids can lead to dehydration, which can exacerbate the hypotensive effects of captopril. Maintaining adequate hydration is important to avoid severe drops in blood pressure.
-
Monitor blood pressure for several hours after the first dose (Choice B):
- Reasoning: Monitoring blood pressure ensures that any significant hypotensive response (drop in blood pressure) to the initial dose of captopril is identified and managed promptly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale: Hematemesis refers to the vomiting of blood and is a severe and potentially life-threatening adverse effect of ibuprofen. Ibuprofen belongs to the class of nonsteroidal anti-inflammatory drugs (NSAIDs), which can cause gastrointestinal bleeding and ulcerations.
Hematemesis indicates significant gastrointestinal irritation or bleeding, and it requires immediate attention from the healthcare provider to assess and manage the client's condition.
Choice B rationale: Nausea is a common side effect of ibuprofen and other NSAIDs. While it is important to monitor and address any adverse effects experienced by the client, nausea alone is not as urgent or critical as hematemesis, which can indicate a more severe complication.
Choice C rationale: Insomnia is not directly related to the use of ibuprofen. While sleep disturbances can occur as a side effect of some medications, it is not the most important finding to report to the healthcare provider in this context.
Choice D rationale: Dizziness can be a side effect of ibuprofen, but it is not the most concerning finding in this situation. Hematemesis, which indicates potential gastrointestinal bleeding, is a more critical symptom that requires immediate attention and reporting to the healthcare provider.
Correct Answer is B
Explanation
Choice A rationale: Tetracycline should generally be taken on an empty stomach, as certain food and beverages, including orange juice, can interfere with its absorption. The nurse should instruct the client to take tetracycline with water and on an empty stomach unless otherwise specified by the healthcare provider.
Choice B rationale: Tetracycline is an antibiotic that can make the skin more sensitive to sunlight, leading to an increased risk of sunburn and photosensitivity reactions. To prevent these adverse effects, the nurse should instruct the client to protect their skin from sunlight while taking the medication. This includes using sunscreen, wearing protective clothing, and avoiding prolonged sun exposure. It is essential to educate the client about this potential side effect to ensure their safety and minimize skin reactions during treatment.
Choice C rationale: Tetracycline does not require routine monitoring of serum drug levels. It is an antibiotic with a well-established dosing regimen, and monitoring drug levels is not necessary for its safe and effective use.
Choice D rationale: While taking tetracycline with milk or antacids may help reduce GI irritation, it can also interfere with the absorption of the medication. Therefore, it is generally recommended to take tetracycline with water and on an empty stomach to ensure optimal absorption and effectiveness.
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