Patient Data

Exhibits

Click to mark whether the assessment finding represents a therapeutic result of the minoxidil administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

Blood glucose 218 mg/dL (12.1 mmol/L)

Dizziness while sitting up

Blood pressure 162/111 mm Hg

Pain rated at 1 on a 0 to 10 scale

Urine output 600 mL

Answer and Explanation

The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"C"}}

Blood glucose 218 mg/dL (12.1 mmol/L)

Classification: Unrelated Finding
Rationale: Minoxidil does not influence blood glucose levels. This elevated blood glucose is likely related to the patient’s known history of type 2 diabetes mellitus. It's not a side effect or intended therapeutic action of minoxidil.

Dizziness while sitting up

Classification: Nontherapeutic Side Effect
Rationale: Minoxidil is a vasodilator that can cause a rapid drop in blood pressure, particularly when changing positions (orthostatic hypotension). Dizziness is a common side effect due to decreased cerebral perfusion when blood pressure drops too quickly or too much.

Blood pressure 162/111 mm Hg

Classification: Therapeutic Result
Rationale: On admission, the patient’s BP was dangerously high at 203/166 mm Hg. A subsequent reading of 162/111 mm Hg shows a significant drop, indicating that minoxidil is having the desired therapeutic effect of lowering blood pressure, even though it's still above target.

Pain rated at 1 on a 0 to 10 scale

Classification: Unrelated Finding
Rationale: Minoxidil is not a pain medication and does not impact pain perception. A low pain score of 1 is likely due to an unrelated mild discomfort or pre-existing condition and has no connection to minoxidil's effects.

Urine output 600 mL

Classification: Unrelated Finding
Rationale: Minoxidil may cause fluid retention, but 600 mL urine output is within the normal range over a few hours (depending on timing and context). This measurement alone does not indicate a therapeutic or side effect of the drug, and without signs of oliguria or diuresis, it remains unrelated.

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Correct Answer is C

Explanation

A. When using the discus, have the client breathe out rapidly into the mouthpiece: Clients should exhale away from the mouthpiece before inhaling the medication. Breathing out into the mouthpiece can blow away the powdered medication, making the dose ineffective.

B. Offer the discus to the client for use during an acute asthma attack: Fluticasone and salmeterol are used for long-term control of asthma, not for immediate relief during an acute attack. A short-acting bronchodilator like albuterol is needed for acute symptom management.

C. Explain that the client should not use the discus more than twice daily: The fluticasone/salmeterol combination is typically prescribed for use twice daily. Exceeding the recommended frequency increases the risk of side effects such as throat irritation, infections, and cardiovascular effects.

D. Clients using the discus may experience decreased blood pressure: While beta-agonists can sometimes have cardiovascular effects, salmeterol is a long-acting beta-agonist primarily targeting the airways. Decreased blood pressure is not a common or expected side effect of fluticasone/salmeterol inhalers. Increased heart rate or palpitations are more potential cardiovascular effects, but significant hypotension is unlikely.

A. Hold both medications until contacting the healthcare provider (HCP). B. Hold the calcitriol, but administer the calcium carbonate as scheduled. C. Hold the calcium carbonate, but administer the calcitriol as scheduled. D. Administer both prescribed medications as scheduled.

Correct Answer is A

Explanation

A. Hold both medications until contacting the healthcare provider (HCP): A total calcium level of 14 mg/dL is critically high and indicates hypercalcemia. Continuing calcitriol or calcium carbonate could worsen the hypercalcemia, so both medications should be held and the HCP contacted immediately for further orders.

B. Hold the calcitriol, but administer the calcium carbonate as scheduled: Calcium carbonate increases serum calcium levels, and administering it would exacerbate the already dangerously high calcium level. It should not be given until the situation is reassessed.

C. Hold the calcium carbonate, but administer the calcitriol as scheduled: Calcitriol promotes intestinal absorption of calcium, which could further elevate serum calcium levels. Giving calcitriol would be unsafe until the client’s calcium status is re-evaluated.

D. Administer both prescribed medications as scheduled: Administering both medications would significantly increase the risk of severe hypercalcemia complications, such as cardiac arrhythmias or neurologic changes, and must be avoided until new instructions are received.

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Patient Data Exhibits Click to mark whether the assessment finding represents a therapeutic result of the minoxidil administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?

Correct Answer is C

Explanation

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?Reference Range:Calcium [8.5 to 10.5 mg/dL (2.25 to 2.75 mmol/L]

Correct Answer is A

Explanation

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Patient Data

Exhibits

Click to mark whether the assessment finding represents a therapeutic result of the minoxidil administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.