A nurse in a provider's office is caring for a client.

Exhibits

What actions should the nurse take?

Select all that apply.

Advise the client to take the medication before bedtime.

Advise the client to restrict potassium intake.

Advise the client to change positions slowly.

Monitor the client for dysrhythmias.

Check the client for orthostatic hypotension.

Answer and Explanation

Correct Answer : C,D,E

C. Thiazide diuretics like hydrochlorothiazide can cause orthostatic hypotension, which may contribute to the client's symptoms of dizziness and light-headedness upon standing. Advising the client to change positions slowly can help mitigate these symptoms by allowing the body time to adjust to changes in posture and blood pressure.
D. Thiazide diuretics can alter electrolyte levels, including potassium, which is critical for normal cardiac function. Although the client's potassium level (3.4 mEq/L) is within the normal range, ongoing

monitoring for potential dysrhythmias is prudent due to the electrolyte-altering effects of hydrochlorothiazide.
E. Given the client's report of dizziness and light-headedness upon standing, checking for orthostatic hypotension is important. Thiazide diuretics can cause volume depletion and subsequent orthostatic hypotension, especially in older adults. Assessing blood pressure and symptoms in supine and standing positions will help evaluate for orthostatic changes.
A. This is not typically recommended for hydrochlorothiazide. It is usually advised to take this medication in the morning to avoid nighttime diuresis and nocturia. Therefore, this action is not appropriate.
B. Hydrochlorothiazide is a thiazide diuretic that can cause potassium loss through increased urine output. Restricting potassium intake is not typically necessary unless potassium levels drop significantly below the normal range. Given that the client's potassium level is within the normal range (3.4 mEq/L), advising strict potassium restriction is not indicated at this time.

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Correct Answer is A

Explanation

A. Consulting the pharmacist is crucial to assess potential drug interactions between verapamil and newly ordered medications. Verapamil can potentiate the effects of other medications that affect cardiac conduction or blood pressure, leading to adverse effects or therapeutic failure if not managed properly.

B. While reporting client refusal is important for care coordination, it typically does not require immediate consultation with a pharmacist unless there are specific concerns about managing the client's refusal or exploring alternative treatment options.

C. Requesting a change in verapamil dosage should involve clinical assessment and may require collaboration with the healthcare provider to adjust therapy based on the client's response, side effects, or changes in clinical status. This decision typically involves the prescriber rather than the pharmacist.

D. Verifying the frequency of administration is important to ensure adherence to the prescribed regimen and optimize therapeutic outcomes. While this information can often be verified through standard references or electronic records, consulting the pharmacist may be necessary for specific clarification or if there are discrepancies.

A. Oxycodone inhibits prostaglandin synthesis. B. Oxycodone causes central nervous system depression. C. Oxycodone blocks the sodium channel suspending nerve conduction. D. Oxycodone promotes vasodilation of cranial arteries.

Correct Answer is B

Explanation

A. Oxycodone does not directly inhibit prostaglandin synthesis. Its primary mechanism of action is through binding to opioid receptors in the central nervous system (CNS), particularly the mu-opioid receptors. While prostaglandins play a role in pain perception and inflammation, they are not directly involved in oxycodone-induced respiratory depression.

B. Oxycodone binds to opioid receptors in the CNS, particularly in the brainstem, which houses the respiratory centers. Activation of these receptors leads to a reduction in neurotransmitter release, including those responsible for stimulating respiratory drive. As a result, the respiratory rate decreases, and if the depression is severe, it can lead to hypoventilation or respiratory arrest.

C. Oxycodone does not block sodium channels in the same manner as local anesthetics. Its effects are primarily mediated through opioid receptor binding and subsequent CNS depression, rather than by affecting nerve conduction through sodium channels.

D. Its effects are centrally mediated through opioid receptor binding, resulting in pain relief, sedation, and respiratory depression. Vasodilation of cranial arteries is not a known effect of oxycodone.

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A nurse in a provider's office is caring for a client. Exhibits What actions should the nurse take? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a history of cardiac arrhythmias and is taking verapamil. For which of the following reasons should the nurse consult the pharmacist?

Correct Answer is A

Explanation

A nurse is assessing a client who has received oxycodone. The nurse notes that the client's respiratory rate is 8/min. The nurse should identify that which of the following is the pathophysiology for the client's respiratory rate?

Correct Answer is B

Explanation

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A nurse is providing teaching to a client who has a new prescription for theophylline, a sustained-release capsule. Which of the following statements by the client indicates an understanding of the teaching?

A nurse in a provider's office is caring for a client. Exhibits What actions should the nurse take? Select all that apply.

A nurse is assessing a client prior to administering morphine. Which of the following findings indicates the nurse should withhold the morphine and contact the provider?

A nurse in a provider's office is caring for a client.

Exhibits

What actions should the nurse take?

Select all that apply.