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?

Administer the captopril and monitor for adverse effects

Request an order to administer fosinopril instead of captopril

Hold the dose and notify the provider

Reassure the patient that this is not a serious side effect

Answer and Explanation

The Correct Answer is C

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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Correct Answer is B

Explanation

Choice A reason: For 40 mg at 25 mg/mL: 40 ÷ 25 = 1.6 mL. Choice A (0.6 mL) delivers 15 mg (0.6 × 25), underdosing Benadryl, which could fail to relieve allergic symptoms or sedation needs, making this choice incorrect for the prescribed dose.

Choice B reason: Calculating 40 mg ÷ 25 mg/mL = 1.6 mL accurately delivers the ordered 40 mg of Benadryl (diphenhydramine) for allergy or sedation. This ensures therapeutic efficacy without overdose, aligning with safe administration for intramuscular delivery, making this the correct choice.

Choice C reason: For 40 mg, the volume is 40 ÷ 25 = 1.6 mL. Choice C (2 mL) delivers 50 mg (2 × 25), overdosing Benadryl, risking excessive sedation or anticholinergic effects like dry mouth or confusion, making this choice incorrect and potentially unsafe.

Choice D reason: The correct volume is 1.6 mL (40 ÷ 25). Choice D (1 mL) delivers 25 mg (1 × 25), underdosing Benadryl, which may not achieve therapeutic effects for allergies or sedation, making this choice inadequate for the prescribed dose.

A. Renal artery ligation stenosis B. Bronchial asthma C. Diabetes mellitus D. Coronary artery disease

Correct Answer is B

Explanation

Choice A reason: Renal artery ligation stenosis is affected by beta-blockers’ renin reduction, but asthma’s bronchoconstriction risk is more immediate. Respiratory effects are critical, so this is incorrect.

Choice B reason: Nonselective beta-blockers can cause bronchospasm in asthma by blocking beta-2 receptors. This is a major concern, making it the correct disease to prioritize.

Choice C reason: Diabetes mellitus may mask hypoglycemia with beta-blockers, but asthma’s acute airway risk is more severe. Respiratory issues take precedence, so this is incorrect.

Choice D reason: Coronary artery disease benefits from beta-blockers’ cardiac effects. Asthma’s bronchoconstriction risk is more concerning, so this is incorrect for the primary concern.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The healthcare provider orders Benadryl 40 mg IM now. The available concentration is 25 mg/mL. How many mL will the patient receive?

Correct Answer is B

Explanation

A patient with hypertension is prescribed a nonselective beta-blocker. The nurse reviewing this patient’s chart before administering the medication will be most concerned about which other disease process?

Correct Answer is B

Explanation

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