The nurse is preparing medications for a client with a history of hypertension who is post-op day 3 following hip replacement.
Meds: Atenolol 25 mg PO, Captopril 10 mg PO, Atorvastatin 40 mg PO, and Warfarin 4 mg PO.
Vital signs: blood pressure 138/90, heart rate 52, respiratory rate 18, temperature 99.7, O2 saturation 96% on room air.
Today’s labs: sodium- 143 meq/L, potassium 4.6 mmol/L, Hemoglobin 11.1 gm/dL, white blood count 10.8, INR 2.2
Which medication will the nurse hold?
Atenolol
Captopril
Warfarin
Glipizide
The Correct Answer is A
Choice A reason: Atenolol is a beta blocker that lowers blood pressure and heart rate. The nurse should hold atenolol for this client because the client's heart rate is already low (52 beats per minute), and giving atenolol could cause bradycardia (slow heart rate), which can lead to dizziness, fainting, or heart failure. The nurse should notify the provider and monitor the client's vital signs and cardiac rhythm.
Choice B reason: Captopril is an ACE inhibitor that lowers blood pressure and prevents kidney damage. The nurse should not hold captopril for this client because the client's blood pressure is still high (138/90 mmHg), and captopril could help lower it to the target range. The nurse should administer captopril as prescribed and monitor the client's blood pressure and renal function.
Choice C reason: Warfarin is an anticoagulant that prevents blood clots and reduces the risk of stroke. The nurse should not hold warfarin for this client because the client's INR (a measure of blood clotting time) is within the therapeutic range (2.0 to 3.0), and warfarin could help prevent post-operative complications such as deep vein thrombosis or pulmonary embolism. The nurse should administer warfarin as prescribed and monitor the client's INR and bleeding signs.
Choice D reason: Glipizide is not a medication for this client. Glipizide is an oral hypoglycemic agent that lowers blood sugar levels in people with diabetes. This client does not have diabetes and does not need glipizide. The nurse should check the medication order and the client's medical history and clarify any discrepancies with the provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2.8"]
Explanation
Convert the patient's weight from pounds to kilograms:
154 lb ÷ 2.2 = 70 kg
Calculate the dose of pentamidine:
4 mg/kg × 70 kg = 280 mg
Determine the volume to be administered:
We have 100 mg/mL concentration of pentamidine.
280 mg ÷ 100 mg/mL = 2.8 mL
Therefore, the nurse should administer 2.8 mL of pentamidine to the client.
Correct Answer is ["2"]
Explanation
To calculate the amount of ampicillin the nurse should administer per dose in milliliters (mL) for a 500 mg IM dose, we can use the following steps:
Given:
Ampicillin dose: 500 mg
Available concentration after reconstitution: 250 mg/mL
Volume of sterile water to be added: 1.8 mL
Step 1: Calculate the amount of ampicillin to be administered per dose in mL
First, we need to reconstitute the ampicillin vial to yield the desired concentration of 250 mg/mL.
The concentration after reconstitution is 250 mg/mL, and the total dose required is 500 mg. Therefore, the nurse needs to administer:
Volume = Ampicillin dose / Concentration
Volume = 500 mg / 250 mg/mL
Volume = 2 mL
Rounding to the nearest whole number:
Volume = 2 mL
Therefore, the nurse should administer 2 mL of the reconstituted ampicillin solution per dose.
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