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 C

Explanation

A) Cholesterol 200 mg/dL, HDL 50 mg/dL, triglycerides 140 mg/dL: While the total cholesterol level is at the borderline (200 mg/dL), the HDL level is within a reasonable range, and triglycerides are also normal. This set does not immediately indicate a need for dietary modifications.

B) Cholesterol 165 mg/dL, HDL 54 mg/dL, triglycerides 160 mg/dL: All values are within acceptable ranges. The total cholesterol is below 200 mg/dL, and the HDL and triglycerides are also in normal ranges, indicating that dietary modifications may not be necessary.

C) Cholesterol 200 mg/dL, HDL 35 mg/dL, triglycerides 190 mg/dL: The total cholesterol is at the upper limit, but the low HDL (35 mg/dL) is concerning, as it is below the desirable level of 40 mg/dL. Low HDL is associated with increased cardiovascular risk, indicating a strong need for dietary modifications to improve heart health.

D) Cholesterol 180 mg/dL, HDL 40 mg/dL, triglycerides 220 mg/dL: While the total cholesterol is within a normal range, the triglycerides are elevated (above 150 mg/dL), which indicates a risk factor for coronary artery disease. Dietary modifications may be warranted, but the HDL is at the lower end of normal.

A. Baked chicken, baked beans, french fries, and cake B. Grilled steak, fresh green beans, mashed potatoes, and ice cream C. Tomato soup, fried flounder, white rice and an apple D. Baked salmon, fresh broccoli, brown rice and fresh fruit

Correct Answer is D

Explanation

A) Baked chicken, baked beans, french fries, and cake: While baked chicken and baked beans may have some nutritional benefits, the inclusion of french fries and cake adds unhealthy fats and sugars, which are not recommended for a client with hypertension. High sodium levels in processed foods can also be problematic.

B) Grilled steak, fresh green beans, mashed potatoes, and ice cream: Grilled steak can be high in saturated fat, and mashed potatoes may be loaded with butter or cream. Ice cream adds excessive sugar and fat, which are not ideal for managing hypertension.

C) Tomato soup, fried flounder, white rice, and an apple: Fried flounder is high in unhealthy fats, and white rice can be high in carbohydrates without the fiber found in whole grains. While the apple is a healthy choice, the overall menu does not support hypertension management effectively.

D) Baked salmon, fresh broccoli, brown rice, and fresh fruit: This option is the most appropriate for a client with hypertension. Baked salmon is rich in omega-3 fatty acids, fresh broccoli provides fiber and vitamins, brown rice offers whole grains, and fresh fruit adds essential nutrients without excessive sugars. This combination supports heart health and helps manage blood pressure effectively.

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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

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Explanation

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Correct Answer is D

Explanation

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