The client is a 54-year-old male with a history of hypertension and type 2 diabetes. He takes spironolactone 25 mg per day, metformin 500 mg twice a day, and 25 units of insulin glargine.

The nurse notifies the provider that the client is having trouble remembering to take his second dose of captopril.

Which ACE inhibitors can be given only once per day? Select all that apply

Captopril

Ramipril

Lisinopril

Quinapril

Trandolapril

Answer and Explanation

Correct Answer : B,C,D,E

ACE inhibitors are a class of medications used to treat conditions like hypertension and heart failure. Some ACE inhibitors are available in formulations that can be given once daily, which can improve compliance and convenience for patients. The ACE inhibitors listed above (Ramipril, Lisinopril, Quinapril, and Trandolapril) have once-daily dosing options. Captopril, on the other hand, is typically administered two to three times a day, so it is not a once-daily option.

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Correct Answer is A

Explanation

The over-the-counter medication that the home health nurse should encourage the client with a history of heart failure (HF) to discuss with the healthcare provider to relieve heartburn when lying down after dinner is:

A. Low sodium antacid.

Explanation: Heartburn is a common symptom of gastroesophageal reflux disease (GERD), and it can exacerbate symptoms in individuals with heart failure due to the discomfort and potential fluid retention associated with excessive sodium intake. Low sodium antacids can help relieve heartburn without exacerbating fluid retention, making them a better choice for individuals with heart failure.

B. Diphenhydramine:

Diphenhydramine is an antihistamine commonly used to relieve allergies and may cause drowsiness. It is not indicated for heartburn or GERD symptoms.

C. Acetaminophen:

Acetaminophen is a pain reliever and fever reducer. It is not used to address heartburn or GERD symptoms.

D. Low dose aspirin:

Aspirin is typically used to prevent cardiovascular events in individuals at risk for heart disease but is not used to treat heartburn or GERD symptoms. In fact, aspirin can irritate the stomach lining and potentially worsen heartburn symptoms.

A. Withhold this dose of the carbamazepine. B. Administer the carbamazepine as prescribed. C. Notify the healthcare provider of the carbamazepine level. D. Assess the client for side effects of carbamazepine. E. Assess the client for side effects of carbamazepine.

Correct Answer is B

Explanation

A. Withhold this dose of carbamazepine:

Withholding the dose is not warranted in this case, as the client's morning carbamazepine level is within the therapeutic range.

When the nurse notes that the client's morning carbamazepine level was 8.4 mcg/L, which is within the reference range of 4 to 12 mcg/mL, the appropriate action to take is:

B. Administer the carbamazepine as prescribed.

Explanation: The client's morning carbamazepine level falls within the reference range (4 to 12 mcg/mL), indicating that the medication is at a therapeutic level. Therefore, the nurse should proceed with administering the evening dose of carbamazepine as prescribed.

C. Notify the healthcare provider of the carbamazepine level:

Notifying the healthcare provider is not necessary when the client's drug level is within the therapeutic range. There are no indications of overmedication or toxicity based on the given drug level.

D. Assess the client for side effects of carbamazepine:

Assessing the client for side effects is a routine nursing responsibility when administering medications. However, there is no specific reason to suspect side effects solely based on the provided carbamazepine level, which is within the therapeutic range.

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Naxlex Comprehensive Predictor Exams

A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem?

Correct Answer is A

Explanation

Prior to administering the evening dose of carbamazepine, the nurse notes that the client's moming carbamazepine level was 8.4 mcg/l. (35.6 mmol/L), Which action should the nurse take? Reference Range Carbamazepine level [Reference Range: 4 to 12 mcg/mL or 16.9 to 50.8 mcmoVL]

Correct Answer is B

Explanation

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