The nurse prepares to administer a scheduled dose of labetalol PO to a client with hypertension. The client's vital signs are a temperature of 99° F (37.2° C), a heart rate of 48 beats/minute, respirations of 16 breaths/minute, and a blood pressure of 150/90 mm Hg. Which action should the nurse take?

Assess for orthostatic hypotension before administering the dose.

Administer the dose and monitor the client's blood pressure regularly.

Withhold the scheduled dose and notify the healthcare provider.

Apply a telemetry monitor before administering the dose.

Answer and Explanation

The Correct Answer is C

A) Assessing for orthostatic hypotension is important when administering medications that can lower blood pressure, but in this scenario, the vital signs indicate bradycardia (heart rate of 48 beats/minute), which may be a contraindication for administering labetalol. Therefore, withholding the dose and notifying the healthcare provider is the priority.

B) Administering the dose and monitoring the client's blood pressure regularly could potentially worsen bradycardia and hypotension, especially given the client's current vital signs. It is safer to withhold the dose and seek guidance from the healthcare provider.

C) Withholding the scheduled dose and notifying the healthcare provider is the most appropriate action in this situation. The client's bradycardia, along with the hypertension, raises concern about the safety of administering labetalol without further assessment and possible adjustment of the treatment plan.

D) Applying a telemetry monitor may be warranted if the client's bradycardia is of concern, but it does not address the potential risk associated with administering labetalol to a client with a heart rate of 48 beats/minute. The priority is to withhold the medication and inform the healthcare provider for further evaluation and guidance.

Nursing Test Bank

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Free Nursing Study Resources

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

Explanation

A) Tendon pain or swelling can be a sign of tendinitis or tendon rupture, which can be serious side effects of ciprofloxacin. Therefore, it is crucial for the client to report any tendon pain or swelling to the healthcare provider immediately.

B) Ciprofloxacin can increase sensitivity to sunlight, leading to an increased risk of sunburn. Therefore, clients should be advised to limit exposure to sunlight and avoid tanning beds while taking this medication.

C) Crushing or mixing ciprofloxacin tablets with pudding is not recommended, as it may alter the absorption and effectiveness of the medication. Clients should swallow the tablets whole with a full glass of water.

D) Increasing fluid intake while taking ciprofloxacin is generally recommended to prevent dehydration and help flush the medication through the kidneys. Adequate hydration can also help reduce the risk of crystalluria, a potential adverse effect of ciprofloxacin.

E) Using nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve joint aches and pains caused by ciprofloxacin is not recommended, as NSAIDs can increase the risk of tendon problems when used with ciprofloxacin. It is important for the client to report any joint aches or pains to the healthcare provider for proper evaluation and management.

A. pH. B. Calcium. C. Potassium. D. Phosphate.

Correct Answer is D

Explanation

pH: Calcium acetate is not directly related to changes in blood pH. Therefore, monitoring pH levels would not indicate the effectiveness of the medication for CKD.

B) Calcium: Calcium levels may be affected by calcium acetate, but the primary goal of using calcium acetate in CKD is to reduce phosphate levels, not calcium levels. Therefore, monitoring calcium levels would not directly indicate the effectiveness of the medication.

C) Potassium: Calcium acetate is not typically used to affect potassium levels. Monitoring potassium levels would not indicate the effectiveness of calcium acetate for CKD.

D) Phosphate: This is the correct answer. Calcium acetate is a phosphate binder commonly used in CKD to help lower elevated phosphate levels. A decrease in phosphate levels in the blood would indicate that the medication is having the desired effect in controlling phosphate levels, which is important in managing CKD and preventing complications associated with hyperphosphatemia. Therefore, monitoring phosphate levels is essential to assess the effectiveness of calcium acetate therapy in CKD.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets, which wore prescribed because of a suspected anthrax exposure. What instruction(s) should be included in the teaching plan? Select all that apply.

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

Explanation

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

Correct Answer is D

Explanation

A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is a “Risk for injury and this is based on which etiology?

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 10%)]

During a home visit, the nurse assesses a client with Alzheimer's Di’ease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?

The nurse is preparing to apply the client’s scheduled fentanyl transdermal patch. The nurse notes the previously applied patch is intact on the client’s upper back and the client reports no pain. Which action should the nurse take?

The nurse is providing discharge instructions for a client with metastatic cancer who is proscribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

A peak and trough level was obtained from a client receiving an aminoglycoside IV every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?