A nurse is reviewing the medical record of a client who has a new prescription for verapamil. Which of the following findings in the client's medical record should the nurse identify as a contraindication for the administration of verapamil?

History of asthma

History of heart failure

Systolic BP 110 mm Hg

Blood creatinine 1.0 mg/dl

Answer and Explanation

The Correct Answer is B

A. History of asthma: Verapamil is a calcium channel blocker and does not affect the airways or cause bronchospasm, unlike beta-blockers, which can exacerbate asthma.

B. History of heart failure: Verapamil has negative inotropic effects, meaning it decreases the strength of heart contractions. This can exacerbate heart failure, particularly in clients with reduced ejection fraction (systolic heart failure). It is generally contraindicated in clients with severe heart failure as it can worsen symptoms.

C. Systolic BP 110 mm Hg: While verapamil can cause a drop in blood pressure due to its vasodilatory effects, a systolic blood pressure of 110 mm Hg is not an absolute contraindication.

D. A blood creatinine level of 1.0 mg/dL is within the normal range (approximately 0.6–1.2 mg/dL for adults). Verapamil is not contraindicated in clients with normal renal function.

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Correct Answer is D

Explanation

The nurse should report a creatinine level of 2 mg/dl to the provider as a potential adverse effect of captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat congestive heart failure and hypertension. One of the side effects of ACE inhibitors, including captopril, is the potential to cause kidney problems, leading to an increase in serum creatinine levels.

An increase in serum creatinine may indicate impaired kidney function, and it is essential to monitor kidney function regularly in clients taking ACE inhibitors. Elevated creatinine levels can suggest reduced glomerular filtration rate (GFR) and impaired kidney function, which may require adjustments in medication dosage or further evaluation and management.

Let's go through the other options:

A. Absolute neutrophil count (ANC) 4.000/ mm^3: An absolute neutrophil count of 4.000/ mm^3 is within the normal range, so it is not an adverse effect of captopril that requires immediate reporting.

B. Brain natriuretic peptide (BNP) 90 ng/L: A brain natriuretic peptide (BNP) level of 90 ng/L is used to assess heart failure severity. While BNP levels can be helpful in managing congestive heart failure, a BNP level of 90 ng/L is not an adverse effect of captopril that requires immediate reporting.

C. Sodium 140 mEq/l: A sodium level of 140 mEq/L is within the normal range, so it is not an adverse effect of captopril that requires immediate reporting.

A. Thyroid-stimulating hormone B. Hemoglobin C. Blood glucose D. Alanine aminotransferase E. Iron

Correct Answer is ["B","E"]

Explanation

The nurse should monitor the following laboratory tests to determine the effectiveness of epoetin alfa:

B. Hemoglobin: Epoetin alfa is a medication used to treat anemia by stimulating red blood cell production. Monitoring hemoglobin levels can help assess if the medication is effectively increasing red blood cell production and improving anemia.

E. Iron: Iron is essential for red blood cell production. Monitoring iron levels can help determine if the client has adequate iron stores to support the increased production of red blood cells stimulated by epoetin alfa.

The other options listed, A. Thyroid-stimulating hormone, C. Blood glucose, and D. Alanine aminotransferase, are not directly related to the effectiveness of epoetin alfa in treating anemia. Thyroid-stimulating hormone is related to thyroid function, blood glucose is related to blood sugar control, and alanine aminotransferase is related to liver function. While these tests may be important for monitoring the overall health of the client, they are not specific indicators of the effectiveness of epoetin alfa.

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A nurse is reviewing the medical record of a client who has a new prescription for verapamil. Which of the following findings in the client's medical record should the nurse identify as a contraindication for the administration of verapamil?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has congestive heart failure and is taking captopril. Which of the following laboratory values should the nurse report to the provider as a potential adverse effect of captopril?

Correct Answer is D

Explanation

A nurse is reviewing the medical record of a client who is taking epoetin alfa. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication? (Select all that apply.)

Correct Answer is ["B","E"]

Explanation

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