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 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.
Correct Answer is D
Explanation
A. Remove the catheter: Removing the catheter may not be the immediate priority. The nurse should focus on preventing further air entry into the circulation and addressing the symptoms.
B. Replace the infusion system: While ensuring that the infusion system is intact is important, it is not the primary action needed to manage an air embolism.
C. Prepare for chest tube insertion: Chest tube insertion is not the primary intervention for an air embolism. The focus should be on preventing the progression of the embolism and providing supportive care.
D. Place the client on his left side in Trendelenburg position: This is the correct answer. Placing the client on the left side in Trendelenburg position is a maneuver used to trap air in the right atrium, preventing it from traveling to the pulmonary artery. The left side position helps to prevent the air from traveling to the right ventricle and into the pulmonary artery, reducing the risk of further complications.
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