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A homecare nurse is visiting a patient for the first time and is reviewing the medication list prepared by the patient's daughter. The patient is diagnosed with heart failure and has a history of asthma and stage 2 kidney disease. Which finding on the medication list will be the priority for the nurse to address with the patient?

Atenolol 25 mg oral tablet with breakfast

Captopril 25 mg three times a day

Hydrochlorothiazide 25 mg twice a day

Aspirin 81 mg tablet every day

Digoxin 0.125 mg every other day

Furosemide 20 mg at bedtime

Multivitamin one tablet daily

Some doses of medication are missing

Some of the routes of medications are missing

Some medications are duplicated.

The medications have drug-drug interactions.

Answer and Explanation

The Correct Answer is K

Choice A reason: Atenolol 25 mg oral tablet with breakfast is a common beta-blocker used to manage heart conditions, but it does not indicate an immediate priority.

Choice B reason: Captopril 25 mg three times a day is an ACE inhibitor used to manage blood pressure and heart failure but is not an immediate priority unless there are contraindications.

Choice C reason: Hydrochlorothiazide 25 mg twice a day is a diuretic used to manage fluid retention and blood pressure. While important, it is not the immediate priority unless there are contraindications.

Choice D reason: Aspirin 81 mg tablet every day is a common medication for preventing blood clots but is not an immediate priority unless there are contraindications or interactions.

Choice E reason: Digoxin 0.125 mg every other day is used to manage heart conditions but is not the immediate priority unless there are contraindications or interactions.

Choice F reason: Furosemide 20 mg at bedtime is a diuretic used to manage fluid retention and blood pressure. While important, it is not the immediate priority unless there are contraindications.

Choice G reason: Multivitamin one tablet daily is a common supplement and is not the immediate priority.

Choice H reason: Some doses of medication are missing, which needs to be addressed, but it is not the immediate priority.

Choice I reason: Some routes of medications are missing, which needs to be addressed, but it is not the immediate priority.

Choice J reason: Some medications are duplicated, which is important but not the immediate priority unless it poses a risk to the patient.

Choice K reason: The medications have drug-drug interactions is the priority for the nurse to address. Drug-drug interactions can lead to adverse effects and complications, especially in a patient with multiple conditions such as heart failure, asthma, and kidney disease. Ensuring that medications are safe and do not interact negatively is crucial for patient safety.

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Correct Answer is C

Explanation

Choice A reason: Monitoring blood pressure weekly is important but does not directly help the patient accurately monitor their fluid balance. Daily weight monitoring provides more immediate feedback on fluid status changes.

Choice B reason: Limiting fluid intake to 3 liters per day may be appropriate for some patients but does not directly help the patient monitor their fluid balance. Accurate fluid monitoring involves tracking intake, output, and changes in body weight.

Choice C reason: Weighing yourself at the same time each day is crucial for accurately monitoring fluid balance. Daily weights provide consistent and immediate information about changes in fluid status, which is essential for managing hypervolemia in patients with chronic kidney disease.

Choice D reason: Increasing daily sodium intake is not appropriate for patients with hypervolemia, as it can lead to further fluid retention and worsen the condition. The focus should be on reducing sodium intake and monitoring fluid balance.

A. Bronchoconstriction B. Pulmonary edema C. Hemoptysis D. Pneumothorax

Correct Answer is A

Explanation

Choice A reason: Wheezing is a typical sound heard during bronchoconstriction, which occurs in conditions like asthma and COPD. It indicates that the airways are narrowed, causing the characteristic sound.

Choice B reason: Pulmonary edema typically presents with crackles or rales rather than wheezing. Wheezing would not be the primary indication of this condition.

Choice C reason: Hemoptysis refers to coughing up blood and does not typically present with wheezing. It might present with other sounds if there is an underlying lung issue, but wheezing is not specific to it.

Choice D reason: Pneumothorax generally presents with decreased or absent breath sounds on one side, not wheezing. It occurs when air enters the pleural space, causing lung collapse.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with a history of chronic kidney disease who was admitted with hypervolemia. As part of discharge planning, which instruction will the nurse provide to help the patient accurately monitor their fluid balance?

Correct Answer is C

Explanation

The nurse is assessing a patient with chronic obstructive pulmonary disease (COPD) who is reporting dyspnea. The nurse auscultates the patient's chest and hears wheezing throughout the lung fields. What does this finding indicate to the nurse about this patient?

Correct Answer is A

Explanation

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