A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug?

Hydrochlorothiazide (HydroDIURIL)

Furosemide (Lasix)

Mannitol (Osmitrol)

Spironolactone (Aldactone)

Answer and Explanation

The Correct Answer is B

Choice A reason: Hydrochlorothiazide is for chronic hypertension, not acute pulmonary edema. Furosemide acts rapidly to relieve fluid overload, so this is incorrect for emergency use.

Choice B reason: Furosemide is the drug of choice for pulmonary edema, rapidly reducing fluid overload and relieving symptoms like frothy sputum. This is the correct choice.

Choice C reason: Mannitol is used for cerebral edema, not pulmonary edema. Furosemide targets acute fluid overload in the lungs, so this is incorrect for this scenario.

Choice D reason: Spironolactone is for chronic heart failure, not acute pulmonary edema. Furosemide’s rapid diuresis is needed, so this is incorrect for immediate treatment.

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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.

A. Administer the captopril and monitor for adverse effects B. Request an order to administer fosinopril instead of captopril C. Hold the dose and notify the provider D. Reassure the patient that this is not a serious side effect

Correct Answer is C

Explanation

Choice A reason: Administering captopril risks angioedema, as the patient’s history of tongue and lip swelling with enalapril (another ACE inhibitor) suggests a class effect due to bradykinin accumulation. This is potentially life-threatening, requiring avoidance, not monitoring, making this choice unsafe and incorrect.

Choice B reason: Fosinopril, another ACE inhibitor, carries the same angioedema risk as captopril and enalapril due to similar bradykinin effects. Switching within the same drug class doesn’t address the patient’s history of adverse reactions, making this choice inappropriate and potentially dangerous.

Choice C reason: Holding captopril and notifying the provider is correct, as the patient’s history of angioedema with enalapril indicates a high risk with captopril, another ACE inhibitor. Alternative classes (e.g., ARBs) should be considered to avoid life-threatening reactions, making this the safest and correct action.

Choice D reason: Angioedema (tongue and lip swelling) is a serious, potentially fatal side effect of ACE inhibitors, not benign. Reassuring the patient minimizes the risk, which could delay intervention. The history warrants avoiding captopril and consulting the provider, making this choice incorrect and unsafe.

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A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct?

Correct Answer is C

Explanation

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