The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?

Carvedilol

Captopril

Isosorbide dinitrate

Fluticasone

Answer and Explanation

The Correct Answer is A

A. Carvedilol: Carvedilol is a non-selective beta-blocker that blocks both beta-1 and beta-2 adrenergic receptors. Beta-2 blockade can lead to bronchoconstriction, which can exacerbate asthma symptoms. Clarification is needed to see if a cardioselective beta-blocker (like metoprolol) would be safer.

B. Captopril: Captopril is an ACE inhibitor commonly used in heart failure to reduce blood pressure and decrease the workload on the heart. It does not have bronchoconstrictive effects and is safe for use in clients with asthma.

C. Isosorbide dinitrate: Isosorbide dinitrate is a nitrate used to manage heart failure by dilating blood vessels and reducing the workload of the heart. It has no effect on bronchial smooth muscle and is not contraindicated in asthma, so no clarification is needed.

D. Fluticasone: Fluticasone is an inhaled corticosteroid used to manage asthma by reducing inflammation in the airways. It is beneficial in clients with asthma and does not pose a risk to clients with heart failure. There is no need to clarify this medication.

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Correct Answer is B

Explanation

A. Myringotomy: Myringotomy is a procedure involving the insertion of tubes into the eardrum to treat conditions such as chronic ear infections. This procedure is not associated with a significant risk of deep-vein thrombosis.

B. Hip arthroplasty: Hip arthroplasty, or hip replacement surgery, is associated with an increased risk of deep-vein thrombosis due to factors such as immobility, surgical trauma, and alterations in blood flow. Prophylactic measures, such as anticoagulant medications and early ambulation, are often employed to reduce this risk.

C. Cataract extraction: Cataract extraction is a procedure to remove a cloudy lens from the eye. This surgery is not typically associated with a high risk of deep-vein thrombosis.

D. Laparoscopic appendectomy: Laparoscopic appendectomy, a minimally invasive procedure to remove the appendix, is generally associated with a lower risk of deep-vein thrombosis compared to major orthopedic surgeries like hip arthroplasty.

A. Administer enteric-coated acetaminophen. B. Administer ibuprofen. C. Obtain an EKG. D. Maintain oxygen saturations greater than or equal to 92%.

Correct Answer is C

Explanation

A. Administer enteric-coated acetaminophen: Acetaminophen is not typically used to address the symptoms described by the client, such as pain in the jaw, back, and shoulder, shortness of breath, and nausea. Moreover, an enteric-coated form of acetaminophen is not likely to address the acute symptoms.

B. Administer ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) and may not be appropriate for the reported symptoms, especially if they are indicative of a cardiac event.

C. Obtain an EKG: This is the correct answer. The client's symptoms, including pain in the jaw, back, and shoulder, shortness of breath, and nausea, are concerning for a possible cardiac event, such as a myocardial infarction (heart attack). An electrocardiogram (EKG) is a crucial diagnostic tool to assess for cardiac abnormalities and should be done promptly.

D. Maintain oxygen saturations greater than or equal to 92%: While maintaining adequate oxygen saturation is important in various clinical situations, the client's symptoms, especially when associated with potential cardiac issues, warrant an immediate EKG to assess for cardiac abnormalities.

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The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse on a medical-surgical unit is caring for four clients who are 24 to 36 hr postoperative. Which of the following surgical procedures places the client at risk for deep-vein thrombosis?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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