A clinic nurse has been assigned a 49-year-old female client who has a history of diabetes. A recent diagnosis of hypertension has been made, and the client has been prescribed a hydrochlorothiazide and metoprolol. The client will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the nurse will be to:

question the client about her dietary intake.

monitor the client's blood pressure.

weigh the client.

monitor the client's respiratory rate.

Answer and Explanation

The Correct Answer is B

A. While dietary intake is important, especially regarding sodium and fluid balance, it is not the highest priority compared to monitoring blood pressure.

B. Monitoring the client's blood pressure is essential to evaluate the effectiveness of the prescribed antihypertensive medications and to ensure the client is within the target range for managing her hypertension.

C. Weighing the client is important for monitoring fluid retention, especially with hydrochlorothiazide, but it is secondary to direct blood pressure monitoring.

D. Monitoring the respiratory rate is generally less critical in this scenario unless there are specific concerns related to medication side effects or respiratory conditions.

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Correct Answer is A

Explanation

A. A reduced plasma albumin level can lead to increased free drug levels in the bloodstream, raising the risk of drug toxicity, particularly for highly protein-bound medications.

B. Decreased therapeutic effects are less likely because the decrease in albumin can lead to higher free drug concentrations, which may actually increase effects rather than decrease them.

C. Altered drug absorption is generally not directly influenced by plasma albumin levels; it relates more to gastrointestinal factors.

D. Increased drug metabolism is not a direct consequence of lower albumin levels; instead, the concern is primarily about increased free drug concentrations and potential toxicity.

A. A 47-year-old female with hypertension B. A 52-year-old male with adult-onset diabetes C. A 17-year-old female with symptoms of an upper respiratory infection D. A 62-year-old male with gout

Correct Answer is A

Explanation

A. Phenylephrine is a decongestant that can raise blood pressure, making it contraindicated for individuals with hypertension. Advising a patient with hypertension to avoid phenylephrine is essential to prevent potential cardiovascular complications.

B. While patients with diabetes should be cautious about certain medications, phenylephrine is not specifically contraindicated in this condition.

C. A 17-year-old female with an upper respiratory infection typically does not have contraindications for phenylephrine unless there are underlying conditions not mentioned.

D. Gout does not have a direct contraindication for phenylephrine use, so the patient may not need to avoid it unless other health issues are present.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for

Correct Answer is A

Explanation

Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

Correct Answer is A

Explanation

The doctor orders a patient to take Fakelixir (mixturezole difakate) 350 mg PO BID. Based on the total volume amount (AFTER reconstitution), how many doses will this bottle of Fakelixir (mixturezole difakate) provide to the patient?

The nurse is caring for a client who is experiencing pulmonary edema. The client is treated with furosemide. What will the nurse monitor most closely?

The nurse is caring for a 38-year-old client who has been diagnosed with asthma and is prescribed albuterol. What assessment finding should the nurse most likely attribute to adverse medication effects?

What measure protects the nurse when preparing cytotoxic drugs?

Interpret and spell the abbreviation: tab

The nurse is teaching a client how to use nasal spray. What will the nurse include in the teaching plan? (Select all that apply.)

A client diagnosed with type 1 diabetes suddenly reports feeling weak, shaky, and dizzy. What should be the nurse's initial response?

The nurse would contact the health care provider before administering an adrenergic drug to a client who is also taking which drug?