Patient Data

Select from Word Choices to complete the sentence.

The thiazide diuretic works to decrease the client's blood pressure by

, and the angiotensin converting enyzme (ACE) inhibitor works to decrease the client's blood pressure by

and
_

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D","dropdown-group-3":"A"}

Increasing heart rate: Increasing heart rate is not the mechanism of thiazide diuretics or ACE inhibitors. It would raise blood pressure by increasing cardiac workload. Effective antihypertensives aim to lower or stabilize heart rate, not increase it.
Reducing stroke volume: Thiazide diuretics reduce stroke volume by lowering blood volume through sodium and water excretion. This decreases cardiac output and helps lower blood pressure, particularly in volume-sensitive hypertension.
Suppressing the appetite: Suppressing appetite is unrelated to the action of thiazide diuretics or ACE inhibitors. These drugs target fluid balance and vascular tone, not the central nervous system mechanisms that regulate hunger.
Decreasing serum sodium levels: Both thiazide diuretics and ACE inhibitors contribute to decreased serum sodium levels, which helps lower blood volume. This reduction supports blood pressure control but must be monitored to avoid hyponatremia.
Reducing systemic vascular resistance: ACE inhibitors lower blood pressure by reducing systemic vascular resistance through vasodilation. Blocking angiotensin II prevents arterial constriction, easing the workload on the heart and lowering afterload.

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Correct Answer is ["A","C","F"]

Explanation

A. Have a manual resuscitation bag at the bedside: Because morphine can cause respiratory depression, it is critical to have emergency resuscitation equipment readily available in case the client requires assisted ventilation during an adverse reaction.

B. Suction the client to clear the airway: Routine suctioning is not necessary unless the client has secretions impairing airway patency. It is not a standard precaution for clients receiving IV morphine without signs of airway obstruction.

C. Ask the client about other medications she takes: Morphine can interact dangerously with other medications, particularly sedatives, benzodiazepines, and other central nervous system depressants. Knowing the client’s full medication list helps prevent additive respiratory depression.

D. Perform a 12-lead electrocardiogram: A 12-lead ECG is not a standard requirement when starting morphine therapy unless there are cardiac symptoms. Continuous cardiorespiratory monitoring is already ordered, and that level of cardiac surveillance is sufficient unless new cardiac concerns arise.

E. Restrain the client with soft restraints: Restraints are not appropriate unless the client becomes a danger to herself or others. Administering morphine does not justify the prophylactic use of restraints and would violate ethical care standards.

F. Take an initial respiratory rate: An initial baseline respiratory rate is critical before starting or continuing morphine, as the drug’s main risk is respiratory depression. Ongoing respiratory assessments will be essential during PCA therapy.

A. Observe the client for the presence of pain behaviors before the next analgesic dose is due. B. Review the client's laboratory values for a change in the peak and trough levels of the analgesic C. Prolong the interval between analgesic medication doses and monitor the client's vital signs. D. Ask family members to report behaviors suggesting that the client's pain has returned.

Correct Answer is A

Explanation

A. Observe the client for the presence of pain behaviors before the next analgesic dose is due: In a nonverbal client, observing for pain behaviors such as grimacing, restlessness, moaning, or changes in vital signs is crucial. If these behaviors increase before the next scheduled dose, it may suggest that the current analgesic regimen is becoming less effective, indicating tolerance.

B. Review the client's laboratory values for a change in the peak and trough levels of the analgesic: Peak and trough levels are useful for monitoring therapeutic ranges for certain medications but are not reliable indicators of analgesic tolerance. Tolerance is a clinical observation based on pain behavior, not solely on drug concentration measurements.

C. Prolong the interval between analgesic medication doses and monitor the client's vital signs: Extending the interval between doses risks undertreating the client’s pain and causing unnecessary suffering. Tolerance assessment should focus on evaluating pain control, not withholding medication to observe physiological responses.

D. Ask family members to report behaviors suggesting that the client's pain has returned: While family members can provide valuable insight, their observations should supplement, not replace, the nurse's direct clinical assessment. Family members may miss subtle signs of pain or misinterpret behaviors unrelated to pain.

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Patient Data Select from Word Choices to complete the sentence. The thiazide diuretic works to decrease the client's blood pressure by ______, and the angiotensin converting enyzme (ACE) inhibitor works to decrease the client's blood pressure by ________ and _______

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Which actions should the nurse take to assure safety during morphine administration? Select all that apply.

Correct Answer is ["A","C","F"]

Explanation

Which action should the nurse take to assess for analgesic tolerance in a client who is unable to communicate?

Correct Answer is A

Explanation

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Patient Data

Select from Word Choices to complete the sentence.

The thiazide diuretic works to decrease the client's blood pressure by

, and the angiotensin converting enyzme (ACE) inhibitor works to decrease the client's blood pressure by

and
_