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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "Increasing my intake of foods containing trans-fatty acids can lower my risk." - This statement is incorrect. Trans-fatty acids are associated with an increased risk of cardiovascular disease. The client should be advised to reduce or eliminate the consumption of foods containing trans fats.
B. "Adding foods containing omega-3 fatty acids to my diet can lower my risk." - This statement is correct. Omega-3 fatty acids, found in fish and certain plant sources, have been associated with a decreased risk of cardiovascular disease.
C. "A weight loss program can decrease my LDL cholesterol level." - This statement is correct. Weight loss, especially in the context of a healthy diet and regular exercise, can contribute to a decrease in LDL (low-density lipoprotein) cholesterol levels.
D. "Exercising regularly will increase HDL cholesterol levels." - This statement is correct. Regular exercise is associated with an increase in HDL (high-density lipoprotein) cholesterol, which is considered beneficial for heart health.
Correct Answer is B
Explanation
A. Foot ulcers: Foot ulcers are more commonly associated with the later stages of peripheral arterial disease (PAD) when there is significant impairment of blood flow to the extremities, leading to tissue damage and delayed wound healing.
B. Intermittent claudication: This is the correct answer. Intermittent claudication is a classic symptom of PAD in the early stage. It is characterized by cramping leg pain or discomfort that occurs during physical activity, such as walking, and is relieved by rest. It is caused by insufficient blood flow to meet the demands of the muscles during exercise.
C. Rest pain: Rest pain is typically a symptom of more advanced PAD. It occurs when blood flow is severely compromised even at rest, leading to pain in the affected extremity that is not relieved by activity.
D. Dependent rubor: Dependent rubor is a sign of severe PAD and occurs when the foot or leg becomes red or flushed when in a dependent position. It is associated with compromised arterial blood flow.
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