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 ["25"]
Explanation
To calculate the IV flow rate in drops per minute (gtt/min) for the administration of clindamycin, we can follow these steps:
First, we need to determine the total number of minutes for the infusion, which is given as 1 hour:
1 hour × 60 minutes/hour = 60 minutes
Next, we calculate the total number of drops needed for the infusion:
The total volume to be infused is 100 mL.
The drop factor is 15 gtt/mL.
100 mL × 15 gtt/mL = 1500 gtt
Calculate the IV flow rate in drops per minute:
1500 gtt ÷ 60 min = 25 gtt/min
Rounding to the nearest whole number, the nurse should set the IV flow rate to deliver 25 gtt/min.
Correct Answer is D
Explanation
Choice A reason: This is incorrect because spironolactone does not affect the heart rate. Checking the heart rate before each dose is not necessary.
Choice B reason: This is incorrect because spironolactone does not interact with acetaminophen. Taking acetaminophen with spironolactone will not cause bleeding.
Choice C reason: This is incorrect because spironolactone does not cause dry cough or increase blood sugar. These are not signs of adverse effects of spironolactone.
Choice D reason: This is correct because spironolactone can cause hyperkalemia, which is a high level of potassium in the blood. Bananas, cantaloupe, and spinach are high-potassium foods that should be avoided by clients taking spironolactone.
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