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

Answer and Explanation

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

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Correct Answer is B

Explanation

A Furosemide is likely to cause hypotension rather than hypertension.

B. Limiting salt intake is highly recommended while on furosemide because excess sodium can cause the body to retain water, which can worsen fluid retention and undermine the effectiveness of the diuretic.

C. Checking the pulse is important for certain medications that can affect heart rate, like beta-blockers. However, furosemide is not typically associated with major effects on pulse rate.

D. While increasing potassium-rich foods such as cantaloupe can be beneficial in managing electrolyte balance, it does not specifically address a potential adverse effect of the medication.

A. Bruising around the incisional site B. Pallor in the affected extremity C. Urine output 150 mL over 4 hr D. Temperature of 37.9° C (100.2° F)

Correct Answer is B

Explanation

B. Pallor suggests potential compromised arterial blood flow or perfusion issues, which require immediate assessment and intervention to ensure the viability of the revascularized artery and the extremity.

A Bruising can be a common finding after surgery, especially involving vascular procedures. It is typically due to minor bleeding into the tissues around the surgical site.

C. Postoperative oliguria (low urine output) can indicate inadequate renal perfusion, which may result from hypovolemia or impaired cardiac output. 150ml in 4 hours does not immediately indicate a need for urgent intervention

D. A mild increase in temperature is common in the immediate postoperative period and can be due to the body's normal response to surgical stress.

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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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who is to start furosemide therapy for heart failure. Which of the following statements indicates that the client understands a potential adverse effect of this medication?

Correct Answer is B

Explanation

A nurse is assessing a client who is 4 hr postoperative following arterial revascularization of the left femoral artery. Which of the following findings should the nurse report to the provider immediately?

Correct Answer is B

Explanation

A nurse is caring for a client who has diabetes mellitus and has been following a treatment plan for 3 months. Which of the following laboratory results should the nurse monitor to determine long- term glycemic control?

A nurse is caring for a client who is postoperative and develops respiratory depression after receiving morphine for pain control. Which of the following medications should the nurse expect the provider to prescribe?

A nurse on a medical-surgical unit is planning care for a client who has dementia and a history of wandering. Which of the following actions should the nurse plan to implement?

A nurse is monitoring an older adult client who has an exacerbation of chronic lymphocytic leukemia. The nurse notes petechiae on the client's skin. Which of the following actions should the nurse take?

A nurse is caring for a client who is postoperative following a total knee arthroplasty Exhibits The client is at highest risk for dropdown as evidenced by the dropdown

Exhibits

For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.