Exhibits
For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.
Metoprolol 5 mg every 2 to 3 min up to three doses
Oxygen at 2 L/min via nasal cannula
Draw electrolytes along with Hgb and Hct
Morphine 6 mg IV bolus every 3 hr as needed for pain
Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses
Obtain daily weight
Atropine 0.5 mg IV bolus every 5 min up to 2 mg
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"},"G":{"answers":"C"}}
Metoprolol 5 mg every 2 to 3 min up to three doses
Nonessential: Metoprolol is a beta-blocker used to reduce heart rate and blood pressure. However, in this scenario, the client already has a history of irregular heart rate and is currently tachycardic. Starting metoprolol at this frequency and dose without knowing the client's response or stability could exacerbate their condition. Therefore, it is considered nonessential until further assessment and stabilization.
Oxygen at 2 L/min via nasal cannula
Anticipated: The client's oxygen saturation dropped to 89% at 1015 and improved to 92% with oxygen supplementation by 1200. Given the client's symptoms and fluctuating oxygen saturation, supplemental oxygen is necessary to ensure adequate tissue oxygenation and is anticipated to support respiratory function.
Draw electrolytes along with Hgb and Hct
Nonessential: While electrolyte levels (such as potassium) are important to monitor, they are not immediately critical in the management of acute myocardial infarction or unstable angina. They can be drawn later for comprehensive assessment but are not urgently needed in the acute phase of care.
Morphine 6 mg IV bolus every 3 hr as needed for pain
Anticipated: Morphine is indicated for managing severe pain, such as chest pain associated with myocardial infarction. The client reported significant chest pain (7/10 initially), and morphine is appropriate to alleviate discomfort and reduce myocardial oxygen demand.
Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses
Anticipated: Nitroglycerin is a vasodilator that helps relieve chest pain associated with angina or myocardial infarction by dilating coronary arteries. Given the client's chest pain and the protocol for administering nitroglycerin, it is anticipated to be effective in managing symptoms and improving coronary blood flow.
Obtain daily weight
Nonessential: Daily weight monitoring is useful for assessing fluid status in some conditions, but it is not immediately necessary in the acute management of myocardial infarction or unstable angina unless there are signs of fluid overload or heart failure, which are not evident in this case.
Atropine 0.5 mg IV bolus every 5 min up to 2 mg
Contraindicated: Atropine is used to treat bradycardia (slow heart rate). However, the client in this scenario is tachycardic (rapid heart rate), and atropine would exacerbate this condition. Therefore, it is contraindicated and should not be administered.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A Structured activities are important for clients with Alzheimer's disease because they can help provide a sense of routine, purpose, and control. Engaging the client in meaningful activities that are simple and appropriate for their cognitive level can help prevent boredom, restlessness, and agitation.
B. Keeping the client's room dark during the day is not recommended as it can disrupt the client's sleep- wake cycle. Instead, maintaining a regular sleep schedule, promoting natural light exposure during the day, and ensuring a quiet, calm environment at night are more effective strategies.
C. While displaying a calendar can be helpful for some individuals with Alzheimer's, it doesn't directly address the need for structured activities or engagement throughout the day.
D. Providing excessive stimulation can overwhelm individuals with Alzheimer's disease. It's important to create a calm, predictable environment with familiar objects and routines to minimize confusion and agitation.
Correct Answer is C
Explanation
C. An increase in uric acid levels (hyperuricemia) is a hallmark finding in acute gout. Elevated uric acid levels predispose to the formation and deposition of urate crystals in joints, leading to the inflammatory response seen in gout attacks.
A While CK levels can increase in conditions affecting muscles (like rhabdomyolysis), it is not specifically associated with acute gout.
C Uric acid levels are typically elevated during acute gout attacks. This is because gout results from the deposition of urate crystals in the joints due to elevated serum uric acid levels. Therefore, during an acute gout attack, uric acid levels in the blood are often higher than normal.
D. Chloride is an electrolyte and its levels can vary based on hydration status, acid-base balance, and kidney function. It is not directly associated with acute gout, so its levels would not necessarily increase in this condition.
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