A nurse is caring for a client in the emergency department (ED)
Drag 1 medication and 1 client finding to fill in each blank in the following sentence.
The nurse should anticipate a provider prescription for
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}
Rationale for Correct Choices:
- Diltiazem: Diltiazem is a calcium channel blocker commonly used to control ventricular rate in atrial fibrillation. The client’s ECG confirms atrial fibrillation with rapid ventricular response, making rate control a priority to prevent hemodynamic instability.
- Cardiac rhythm: The rapid, irregular heart rate documented on ECG is the primary finding necessitating medication intervention to prevent further complications such as decreased cardiac output or thromboembolism.
Rationale for Incorrect Choices:
- Dopamine: Dopamine is a vasopressor used to support blood pressure in hypotension or shock. While the client’s BP is mildly decreased, the immediate concern is rapid atrial fibrillation rather than hypotensive crisis.
- Furosemide: Furosemide treats fluid overload and edema but does not directly address the acute arrhythmia causing tachycardia and hemodynamic compromise.
- Albuterol nebulizer: Albuterol is used for bronchospasm and respiratory distress related to airway constriction. The client has clear lung sounds, so this is not indicated.
- Alprazolam: Alprazolam can reduce anxiety but does not manage the underlying atrial fibrillation or prevent cardiovascular complications.
- Edema, blood pressure, anxiety, dyspnea: While these are relevant assessments, they are secondary to the urgent need to control the cardiac rhythm in acute atrial fibrillation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "I will notify your provider of your decision.": Informing the provider ensures that the client’s refusal is documented and that the healthcare team can discuss alternatives or address potential risks. This approach respects client autonomy while maintaining safety.
B. "Most people feel better after they have taken these medications.": This statement attempts to persuade the client rather than explore their reasons for refusal, which may not address underlying concerns or promote informed decision-making.
C. "If you do not take your medications, you will not recover.": Using scare tactics can create fear or mistrust and is not an effective way to encourage adherence. It does not support patient-centered care.
D. "Why are you refusing your medications?": Asking "why" can come across as judgmental and may make the client defensive. Open-ended, nonjudgmental questions are more effective for understanding the client’s perspective.
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.
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