Client #1: 45-year-old male admitted to the hospital for migraine and dehydration Client reports a history of hypertension and has an allergy to codeine
Client #2: 68-year-old client admitted to the hospital with influenza. Client has a history of chronic stable angina
Client #3: 39 year old client admitted to the hospital for spinal surgery. Client has a history of chronic hypertension
Client #4: 54 year old client admitted to the hospital with acute myocardial infarction (MI). Client has allergy to lisinopril.
The nurse is caring for a group of clients with orders for calcium channel blocker. For which client should the nurse question the order?
Client #1
Client #2
Client #3
Client # 4
The Correct Answer is D
A. Client #1: A 45-year-old male with migraine, dehydration, and a history of hypertension could safely receive a calcium channel blocker if indicated for blood pressure management. No contraindications are present in his profile that would make the order unsafe.
B. Client #2: A 68-year-old with influenza and chronic stable angina may benefit from a calcium channel blocker to manage angina symptoms. There are no absolute contraindications based on his current condition or history.
C. Client #3: A 39-year-old post-spinal surgery with chronic hypertension could be prescribed a calcium channel blocker for blood pressure control. His surgical status does not contraindicate the use of this medication unless there are specific hemodynamic concerns.
D. Client #4: A 54-year-old with acute MI and a lisinopril allergy should raise concern because calcium channel blockers, particularly non-dihydropyridines (like verapamil or diltiazem), may interact with ACE inhibitors and affect cardiac function. Post-MI clients require careful selection of antihypertensive therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"C"}
Explanation
• Hypertension: Benazepril is an angiotensin-converting enzyme (ACE) inhibitor used to lower blood pressure by blocking the conversion of angiotensin I to angiotensin II. This results in vasodilation and reduced aldosterone secretion, which lowers systemic vascular resistance. It is commonly prescribed as first-line or adjunct therapy for chronic hypertension.
• Hyperkalemia: ACE inhibitors decrease aldosterone secretion, leading to reduced potassium excretion by the kidneys. In clients with existing hyperkalemia, benazepril can further elevate potassium levels, increasing the risk of dangerous cardiac dysrhythmias. Serum potassium must be monitored closely in clients receiving this medication.
• Breastfeeding: Benazepril can be excreted into breast milk and may affect neonatal renal function and blood pressure regulation. Infants exposed to ACE inhibitors are at risk for hypotension and renal impairment. Because of these potential effects, benazepril is contraindicated during breastfeeding.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
• Sitting: The sitting position promotes optimal lung expansion and helps the client achieve maximum inhalation of the medication. Proper posture ensures that the airways are open and reduces the risk of aspiration or ineffective drug delivery. Sitting upright also enhances coordination between actuation and inhalation.
• Shake the inhaler: Shaking the metered dose inhaler mixes the medication and propellant evenly, ensuring a consistent and accurate dose is delivered. Failing to shake the inhaler can result in uneven dosing, reducing the effectiveness of therapy and potentially worsening the client’s respiratory symptoms.
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