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 ["125"]
Explanation
To calculate the rate at which the nurse should set the IV pump to deliver dextrose 5% in 0.45% sodium chloride over 24 hours, we can use the following steps:
Given:
Total IV fluid volume: 3 L
Infusion duration: 24 hours
Step 1: Convert the total IV fluid volume from liters (L) to milliliters (mL)
Total volume = 3 L × 1000 mL/L
Total volume = 3000 mL
Step 2: Calculate the rate of infusion per hour
Rate = Total volume / Infusion duration
Rate = 3000 mL / 24 hr
Rate ≈ 125 mL/hr
Rounding to the nearest whole number:
Rate ≈ 125 mL/hr
Therefore, the nurse should set the IV pump to deliver approximately 125 mL/hr for the infusion of dextrose 5% in 0.45% sodium chloride over 24 hours.
Correct Answer is ["0.75 mL"]
Explanation
To calculate the amount of heparin to administer, we can use the following formula:
Amount to administer (mL) = (Desired dose (units) / Available dose (units/mL))
Plugging in the given values:
Amount to administer (mL) = (7,500 units / 10,000 units/mL)
Now, let's solve for the amount to administer:
Amount to administer (mL) = (7,500 / 10,000) = 0.75 mL
So, the nurse should administer 0.75 mL of heparin subcutaneously.
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