Question 9
The nurse is preparing medications for a client with a history of hypertension that is post-op day 3 following hip replacement.
Meds: Atenolol 25 mg PO, Captopril 10 mg PO, Glipizide 5 mg PO, Atorvastatin 20 mg PO, and Enoxaparin 40 mg SQ.
Vital signs: blood pressure 138/90, heart rate 82, respiratory rate 18, temperature 99.7, O2 saturation 96% on room air.
Today's labs: sodium- 143 meq/L, potassium 6.2 mmol/L, hemoglobin 11.1 gm/dL, platelets 104,000, white blood count 10.8, blood glucose 130.
Which medication would be a priority for the nurse to hold?
Atorvastatin
Captopril
Atenolol
Glipizide
The Correct Answer is B
Choice A reason: This statement is false. Atorvastatin is not a medication that the nurse should hold, as it is used to lower cholesterol and prevent cardiovascular events. It does not have a significant effect on blood pressure, heart rate, or blood glucose.
Choice B reason: This statement is true. Captopril is a medication that the nurse should hold, as it is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure and prevents kidney damage. However, it can also cause hyperkalemia, which is a condition where the potassium level is too high. The client has a high potassium level, which can cause cardiac arrhythmias or muscle weakness. The nurse should hold the captopril and notify the prescriber.
Choice C reason: This statement is false. Atenolol is not a medication that the nurse should hold, as it is a beta-blocker that lowers blood pressure and heart rate. It can also prevent angina and reduce the risk of heart attack. The client has a normal heart rate and a slightly elevated blood pressure, which can be expected after surgery. The nurse should monitor the client's vital signs and administer the atenolol as ordered.
Choice D reason: This statement is false. Glipizide is not a medication that the nurse should hold, as it is an oral antidiabetic drug that lowers blood glucose by stimulating the release of insulin from the pancreas. The client has a normal blood glucose level, which can be maintained by taking the glipizide as ordered. The nurse should also encourage the client to follow a balanced diet and exercise regimen.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This statement is false. The client does not need to avoid taking acetaminophen with spironolactone, as there is no known interaction between these two drugs. Acetaminophen is a pain reliever and fever reducer that does not affect the blood clotting or the liver function. Spironolactone is a potassium sparing diuretic that reduces the fluid retention and the blood pressure. It does not increase the risk of bleeding or liver damage.
Choice B reason: This statement is false. The client does not need to report dry cough or blood sugar over 80 with spironolactone, as these are not common or serious side effects of this drug. Dry cough is more likely to occur with angiotensin converting enzyme (ACE) inhibitors, which are another class of blood pressure medications. Blood sugar over 80 is not a sign of hyperglycemia, which is a condition where the blood sugar is too high. Hyperglycemia can be caused by diabetes, steroids, or some other drugs, but not by spironolactone.
Choice C reason: This statement is true. The client should avoid bananas, cantaloupe, and spinach with spironolactone, as these are foods that are high in potassium. Spironolactone is a potassium sparing diuretic that prevents the loss of potassium in the urine. However, it can also cause hyperkalemia, which is a condition where the potassium level is too high. High potassium can cause muscle weakness, irregular heartbeat, or cardiac arrest. Therefore, the client should limit the intake of potassium rich foods and have their blood potassium level checked regularly.
Choice D reason: This statement is false. The client does not need to check their heart rate before each dose of spironolactone, as spironolactone does not affect the heart rate significantly. Spironolactone is a potassium sparing diuretic that reduces the fluid retention and the blood pressure. It can lower the heart rate slightly, but not to a dangerous level. However, the client should monitor their blood pressure and weight regularly and report any changes to their doctor..
Correct Answer is B
Explanation
Choice A reason: This statement is false. If the client develops facial swelling, which is a sign of angioedema, she should stop taking the medication and seek emergency care. Reducing the dose will not prevent a life-threatening reaction.
Choice B reason: This statement is true. Captopril is an angiotensin-converting enzyme (ACE) inhibitor, which can cause fetal harm or death if taken during pregnancy. The client should use effective contraception and inform the provider if she plans to conceive or suspects pregnancy.
Choice C reason: This statement is false. Captopril can be taken with or without food, but it should not be taken with milk or dairy products, as they can reduce its absorption and effectiveness.
Choice D reason: This statement is false. Captopril may cause a dry cough, hypotension, hyperkalemia, or renal impairment, but it is unlikely to cause anaphylaxis. An epi pen is not indicated for this medication.
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