The nurse reviews the newly written prescriptions for a client admitted with the diagnoses of coronary artery disease and hypertension. Which prescription should the nurse implement first?

Furosemide 40 mg PO daily for a client whose blood pressure is 123986.

Nitroglycerin 0.4 mg SL PRN for a client complaining of chest

Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats

Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min

Answer and Explanation

The Correct Answer is B

A) Furosemide 40 mg PO daily for a client whose blood pressure is 123/86: While furosemide is important for managing fluid status, the client's blood pressure is within a normal range, and this medication does not address any acute concerns.

B) Nitroglycerin 0.4 mg SL PRN for a client complaining of chest pain: This prescription should be implemented first because it addresses an immediate and potentially life-threatening symptom. Chest pain can indicate angina or myocardial infarction, making it critical to relieve this symptom promptly.

C) Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats: While metoprolol is important for managing heart rate and hypertension, a heart rate of 55 beats/minute is on the lower end and could warrant caution. The priority would be to assess the need for medication before administering it.

D) Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min: This medication is also important for managing heart rate and hypertension but is not the priority over addressing acute chest pain. The client’s heart rate is within a normal range, so this does not require immediate action compared to the nitroglycerin for chest pain.

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Correct Answer is B

Explanation

A. "will confirm a diagnosis of G6PD anemia": This statement is incorrect. The Schilling test is specifically used to evaluate vitamin B12 absorption and diagnose conditions like pernicious anemia, not G6PD deficiency.

B. "is a 24-hour urine specimen collection test": This statement is accurate. The Schilling test typically involves collecting a 24-hour urine specimen to measure the amount of radioactively labeled vitamin B12 excreted in the urine, which helps determine if the body is absorbing vitamin B12 properly.

C. "involves limiting intake of animal proteins": This statement is misleading. While dietary restrictions may be necessary for certain tests, the Schilling test primarily focuses on the absorption of vitamin B12 and does not require limiting animal protein intake.

D. "entails administration of methylcellulose prior to the test": This statement is incorrect. Methylcellulose is not involved in the Schilling test. The test typically includes administration of oral vitamin B12 with or without intrinsic factor to evaluate absorption.

A. Temperature elevation of 100.4 ORGAN B. Hemoglobin decrease from 128g/dl to 9.5g/dl C. Serum potassium increase from 3.5 mEq/L 4.5 mEq/L D. Gastrointestinal discomfort prior to eating breakfast E. Several areas of ecchymosis on upper and lower extremities

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

Explanation

A. Temperature elevation of 100.4°F: While a slight fever can indicate infection or inflammation, it is not an immediate concern related to aspirin use. It requires monitoring but is not as critical as other findings.

B. Hemoglobin decrease from 128 g/dL to 5.5 g/dL: This significant drop in hemoglobin indicates severe anemia, which is a major concern and may suggest gastrointestinal bleeding, a known risk of long-term aspirin use.

C. Serum potassium increase from 3.5 mEq/L to 4.5 mEq/L: This level is still within the normal range and does not indicate a significant clinical issue. Normal potassium levels do not raise immediate concern.

D. Gastrointestinal discomfort prior to eating breakfast: While gastrointestinal discomfort can be a side effect of aspirin, it is not immediately alarming unless associated with more severe symptoms like bleeding or ulceration.

E. Several areas of ecchymosis on upper and lower extremities: This finding is concerning as it may indicate bleeding issues due to thrombocytopenia or increased bleeding tendency associated with aspirin therapy.

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The nurse reviews the newly written prescriptions for a client admitted with the diagnoses of coronary artery disease and hypertension. Which prescription should the nurse implement first?

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Naxlex Comprehensive Predictor Exams

In preparation for a client having a Schilling test the nurse should explain that the test:

Correct Answer is B

Explanation

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

Explanation

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