The nurse plans to administer the adult client’s prescriptions which are metoprolol, hydrochlorothiazide, enoxaparin and atorvastatin.

The current laboratory values are; Serum potassium 5.2 mmol/L, Platelet Count 98,000/mm, Serum cholesterol 250 mg/dL and Serum Creatinine 1.2 mg/dL.
Which medication should the nurse hold and notify the prescriber?

Metoprolol.

Hydrochlorothiazide.

Enoxaparin.

Atorvastatin.

Answer and Explanation

The Correct Answer is B

The nurse should hold and notify the prescriber because hydrochlorothiazide is a diuretic that can lower the serum potassium level. The client already has a high serum potassium level of 5.2 mmol/L, which is above the normal range of 3.5 to 5.0 mmol/L.

Giving hydrochlorothiazide could worsen the client’s condition and cause hypokalemia.

Choice A is wrong because metoprolol is a beta-blocker that can lower the blood pressure and heart rate.

The client’s blood pressure and heart rate are not given, so there is no reason to hold metoprolol based on the information provided.

Choice C is wrong because enoxaparin is an anticoagulant that can prevent blood clots. The client has a low platelet count of 98,000/mm, which is below the normal range of 150,000 to 450,000/mm.

However, this does not contraindicate the use of enoxaparin, unless the client has signs of bleeding or bruising.

Choice D is wrong because atorvastatin is a statin that can lower the serum cholesterol

level. The client has a high serum cholesterol level of 250 mg/dL, which is above the desirable level of less than 200 mg/dL.

Giving atorvastatin could help reduce the client’s risk of cardiovascular complications.

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Correct Answer is ["A","C"]

Explanation

Choice A is correct because using a soft toothbrush can decrease the risk of bleeding from the gums, which is a common site of bleeding for people with hemophilia.

Choice C is correct because reporting excessive bleeding to the provider and using precautions to protect the head and joints are important aspects of home care for hemophilia.

Choice B is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can interfere with platelet function and increase bleeding tendency. People with hemophilia should avoid NSAIDs and use acetaminophen instead for pain relief.

Choice D is wrong because clotting factor treatments are not only needed when a bleed occurs but also as a preventive measure to reduce the frequency and severity of bleeding episodes. People with severe hemophilia need regular clotting factor replacement therapy for the rest of their lives.

Choice E is wrong because warm, painful joints are signs of joint bleeding, which is a serious complication of hemophilia that can lead to permanent joint damage.

People with hemophilia should not apply heat to their joints, but rather use ice packs, compression, elevation and rest to reduce swelling and pain. They should also seek medical attention and receive clotting factor replacement therapy as soon as possible.

A. Increased heart rate. B. Decreased blood pressure. C. Increased temperature. D. Hypoactive muscle responses. E. Alert and oriented.

Correct Answer is ["A","B"]

Explanation

A client with dehydration will have increased heart rate and decreased blood pressure due to the loss of fluid volume and the compensatory mechanisms to maintain cardiac output.

Choice C is wrong because dehydration does not cause increased temperature, but rather decreased temperature due to reduced blood flow to the skin.

Choice D is wrong because dehydration causes hyperactive muscle responses, such as muscle cramps, twitching, and tetany.

Choice E is wrong because dehydration can cause altered mental status, such as confusion, lethargy, or coma. Normal ranges for heart rate are 60-100 beats per minute, blood pressure is 120/80 mm Hg, and temperature is 36.5-37.5°C (97.7-99.5°F).

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client with newly diagnosed hemophilia about home care practices. What statements by the client indicate that teaching has been effective? Select all that apply.

Correct Answer is ["A","C"]

Explanation

A middle-aged adult client with nausea and vomiting for three days presents to the emergency room. Which findings should the nurse expect to assess in a client diagnosed with dehydration? Select all that apply.

Correct Answer is ["A","B"]

Explanation

Which older adult on bed rest is most at risk to develop skin breakdown? A client who:.

Following a uterine biopsy, a client asks a nurse, “Do you think I have cancer?” Which response by the nurse would most likely prompt the client to elaborate on their concerns?

Which interventionshouldthe nurse implement when planning to teach older adult clients?

A client has lorazepam prescribed before surgery and refuses the injection. If the nurse administers the scheduled injection despite the client’s lack of consent, which term best describes the nurse’s action?

Which statement best documents the situation when a client becomes extremely agitated after receiving a sedative?

A male client weighing 175 pounds is to receive an intramuscular injection into his deltoid of two milliliters (2 mL) of a viscous fluid. Which needle size should a nurse use?

A nurse is receiving a client from the post anesthesia unit after a colon resection. What is the first observation the nurse should perform?