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 C
Explanation
Choice A reason: This is incorrect because labetalol is a safe and effective medication for treating hypertension in pregnancy. Labetalol is a beta-blocker that lowers blood pressure by reducing the heart rate and the force of contraction. It does not affect the blood flow to the placenta or the fetus.
Choice B reason: This is incorrect because labetalol is not contraindicated for smokers. However, smoking is a risk factor for cardiovascular disease and should be discouraged by the nurse. Smoking can increase blood pressure, heart rate, and the risk of blood clots.
Choice C reason: This is correct because labetalol is contraindicated for clients with a history of uncontrolled asthma. Labetalol is a non-selective beta-blocker that can block the beta-2 receptors in the lungs and cause bronchoconstriction. This can worsen asthma symptoms and trigger an asthma attack.
Choice D reason: This is incorrect because labetalol is a suitable medication for clients who had a myocardial infarction. Labetalol can prevent further damage to the heart muscle by reducing the oxygen demand and the workload of the heart. It can also prevent arrhythmias and angina.
Correct Answer is ["4"]
Explanation
To determine how many capsules of rifampin the nurse should administer per dose, we can follow these steps:
Convert the client's weight from pounds to kilograms:
132 lb ÷ 2.2 = 59.9 kg (rounded to one decimal place)
Calculate the total daily dose of rifampin:
20 mg/kg/day × 59.9 kg = 1198 mg/day
Divide the total daily dose into two equal doses for administration:
1198 mg/day ÷ 2 = 599 mg per dose
Calculate the number of capsules needed per dose:
150 mg per capsule
599 mg per dose ÷ 150 mg per capsule = 3.9933...
Rounding to the nearest whole number, the nurse should administer 4 capsules per dose.
Therefore, the nurse should administer 4 capsules of rifampin per dose.
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