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 D

Explanation

A. A room that is within view of the nurses' station: While visibility to the nurses' station is advantageous for monitoring the client, it is not the most critical consideration for a client with active tuberculosis. The priority is to prevent the spread of infectious droplets to other clients and healthcare workers.

B. A room in the ICU: Placing a client with active tuberculosis in the ICU may not be necessary unless there are specific medical reasons requiring intensive care. However, the room assignment should prioritize infection control measures.

C. A room with another nonsurgical client: It is not advisable to place a client with active tuberculosis in a room with another nonsurgical client due to the risk of spreading the infection to a potentially vulnerable individual.

D. A room with air exhaust directly to the outdoor environment: This is the correct answer. The preferred room assignment for a client with active tuberculosis is one with proper ventilation that allows air to be exhausted directly to the outdoor environment. Negative pressure rooms with high-efficiency particulate air (HEPA) filtration are often used to minimize the risk of airborne transmission.

A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

Correct Answer is C

Explanation

pH 7.22: Indicates acidosis (normal range: 7.35-7.45).

PaCO2 68 mm Hg: Elevated partial pressure of carbon dioxide, suggesting respiratory acidosis (normal range: 35-45 mm Hg).

Base excess -2: Indicates a mild metabolic acidosis.

PaO2 78 mm Hg: Within the normal range (80-100 mm Hg), indicating adequate oxygenation.

Saturation 80%: Below the normal range (95-100%), suggesting some degree of hypoxemia.

Bicarbonate 26 mEq/L: Elevated bicarbonate levels, suggesting metabolic compensation for the respiratory acidosis.

Therefore, the client is experiencing respiratory acidosis with partial metabolic compensation (mild metabolic acidosis).

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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 is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client?

Correct Answer is D

Explanation

A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22 PaCO2 68 mm Hg Base excess -2 PaO2 78 mm Hg Saturation 80% Bicarbonate 26 mEq/L

Correct Answer is C

Explanation

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