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

Exhibits

For each category below, click to specify the medication the nurse should anticipate the provider to prescribe. Each finding may support more than 1 potential medication prescription.

Finding

Potential Medication Description

Blood pressure

Losartan Misoprostol

Moexipril

Laboratory results

Mesalamine Metformin

Liraglutide

 

A.

Losartan

B.

Misoprostol

C.

Moexipril

D.

Mesalamine

E.

Metformin

F.

Liraglutide

Answer and Explanation

The Correct Answer is ["A","C","E","F"]

Rationale for Correct Choices:

  • Losartan: Losartan is an angiotensin II receptor blocker (ARB) used to lower blood pressure by relaxing blood vessels and reducing vascular resistance which is especially important for clients with high blood pressure.
  • Moexipril: Moexipril is an angiotensin-converting enzyme (ACE) inhibitor that reduces blood pressure by blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor.
  • Metformin: Metformin is a first-line oral medication for type 2 diabetes. It decreases hepatic glucose production and improves insulin sensitivity in peripheral tissues. It is commonly prescribed for elevated fasting blood glucose and HbA1c.
  • Liraglutide: Liraglutide is a GLP-1 receptor agonist that enhances glucose-dependent insulin secretion, slows gastric emptying, and promotes satiety. It is used to improve glycemic control and can aid in weight management in type 2 diabetes.

Rationale for Incorrect Choices:

  • Misoprostol: Misoprostol is a prostaglandin analog primarily used to prevent gastric ulcers in patients taking NSAIDs and to induce labor in obstetrics. It does not have a role in blood pressure management.
  • Mesalamine: Mesalamine is used to treat inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, and has no effect on blood glucose levels.


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Related Questions

Correct Answer is B

Explanation

A. Take the medication in the morning: Simvastatin is more effective when taken in the evening because cholesterol synthesis is higher at night. Taking it in the morning may reduce its lipid-lowering effect.

B. Report muscle tenderness: Muscle pain, tenderness, or weakness can indicate myopathy or rhabdomyolysis, serious adverse effects of statins. Clients should report these symptoms promptly for evaluation and possible medication adjustment.

C. This medication can cause kidney damage: Simvastatin primarily affects the liver and muscles. While rhabdomyolysis can indirectly impact kidney function, kidney damage is not a common direct effect of the medication.

D. Avoid drinking grapefruit juice for 3 hr after taking this medication: Grapefruit juice can inhibit metabolism of simvastatin, increasing the risk of toxicity. Avoiding grapefruit entirely, rather than timing it around the dose, is the recommended precaution.

Correct Answer is D

Explanation

A. Bradypnea: Opioid withdrawal typically causes an increase in respiratory rate rather than slowing. Bradypnea is more commonly associated with opioid intoxication, not withdrawal.

B. Constipation: While opioids cause constipation during use, withdrawal usually results in diarrhea and increased bowel motility rather than continued constipation.

C. Miosis: Pupil constriction occurs with opioid use. During withdrawal, pupils often dilate (mydriasis), so miosis is not expected.

D. Sneezing: Sneezing is a common manifestation of opioid withdrawal due to hyperactivity of the autonomic nervous system. Other signs include lacrimation, rhinorrhea, yawning, and generalized restlessness.

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