A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. Which statement by the student indicates a need for further teaching?

“Beta blockers decrease the release of renin.”

“Beta blockers decrease peripheral vascular resistance.”

“Beta blockers decrease heart rate and contractility.”

“Beta blockers block the actions of angiotensin II.”

Answer and Explanation

The Correct Answer is B

Choice A reason: Beta blockers decrease renin release, reducing angiotensin II and aldosterone, which lowers blood pressure. This statement is accurate, reflecting correct understanding, so it does not indicate a need for further teaching.

Choice B reason: Beta blockers do not primarily decrease peripheral vascular resistance; they reduce heart rate and contractility. Peripheral resistance is more affected by alpha blockers or vasodilators, so this incorrect statement indicates a need for further teaching.

Choice C reason: Beta blockers reduce heart rate and myocardial contractility, decreasing cardiac output and blood pressure. This statement is correct, showing proper understanding, so it does not require additional teaching.

Choice D reason: While beta blockers do not directly block angiotensin II, they reduce its production by decreasing renin. The statement is imprecise but not entirely wrong, making it less indicative of a teaching need than choice B.

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Correct Answer is D

Explanation

Choice A reason: Respiratory alkalosis involves low PaCO2 (<35 mm Hg) due to hyperventilation, raising pH. Here, pH is 7.31 (acidic), PaCO2 is 41 mm Hg (normal), and HCO3- is 20 mEq/L (low), indicating a metabolic cause, not respiratory, making this choice incorrect.

Choice B reason: Respiratory acidosis requires elevated PaCO2 (>45 mm Hg), lowering pH. With PaCO2 at 41 mm Hg (normal) and low HCO3- (20 mEq/L), the acidosis stems from reduced bicarbonate, not CO2 retention, ruling out respiratory acidosis and making this choice incorrect.

Choice C reason: Metabolic alkalosis involves high HCO3- (>26 mEq/L) and elevated pH. Here, pH is 7.31 (acidic) and HCO3- is 20 mEq/L (low), indicating acidosis, not alkalosis. The low bicarbonate points to a metabolic cause, making this choice incorrect for the ABG values.

Choice D reason: pH 7.31 (acidic), PaCO2 41 mm Hg (normal), and HCO3- 20 mEq/L (low) indicate metabolic acidosis, likely from conditions like diabetic ketoacidosis or lactic acidosis. No respiratory compensation (normal PaCO2) confirms uncompensated metabolic acidosis, making this the correct choice for the imbalance.

A. 5 mL B. 6 mL C. 4 mL D. 2 mL

Correct Answer is D

Explanation

Choice A reason: To calculate volume, divide the ordered dose (40 mg) by the concentration (20 mg/mL): 40 ÷ 20 = 2 mL. Choice A (5 mL) delivers 100 mg (5 × 20), far exceeding the ordered dose, risking fluid and electrolyte imbalances, making it incorrect for safe administration.

Choice B reason: The correct volume is 40 mg ÷ 20 mg/mL = 2 mL. Choice B (6 mL) delivers 120 mg (6 × 20), significantly overdosing Lasix, which could cause severe dehydration, hypokalemia, or hypotension. This excessive dose is unsafe and incorrect for the prescribed administration.

Choice C reason: Calculating 40 mg ÷ 20 mg/mL yields 2 mL. Choice C (4 mL) delivers 80 mg (4 × 20), doubling the ordered dose. This could lead to excessive diuresis, electrolyte disturbances, or hypotension, making it an incorrect and potentially harmful choice for administration.

Choice D reason: Dividing the ordered dose (40 mg) by the concentration (20 mg/mL) gives 40 ÷ 20 = 2 mL. This volume accurately delivers the prescribed 40 mg of Lasix, ensuring effective diuresis for conditions like edema or heart failure while minimizing risks, making it the correct choice.

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A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. Which statement by the student indicates a need for further teaching?

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Naxlex Comprehensive Predictor Exams

Name the imbalance using the following Arterial Blood Gas (ABG) values: pH 7.31, PaCO2 41, HCO3- 20

Correct Answer is D

Explanation

The healthcare provider orders Lasix 40 mg IV now. The concentration available is Lasix 20 mg/mL. How many mL will the patient receive?

Correct Answer is D

Explanation

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