The client’s heart rate is 96 beats per minute, blood pressure is 220/129 mmHg, and respiratory rate is 18 breaths per minute.
The client is complaining of a headache. Ibuprofen was given as ordered.
Furosemide 50 mg IV was also given.
What should be the next step in the client’s care?
Attach the client to a continuous cardiac monitor
Place an indwelling urinary catheter
Give a fluid bolus
Draw a basic metabolic panel (BMP)
The Correct Answer is A
Choice A rationale
Given the client’s high blood pressure and complaint of a headache, it is important to continuously monitor the client’s cardiac status to detect any changes that may indicate worsening condition.
Choice B rationale
Placing an indwelling urinary catheter is not the immediate next step in this client’s care. While it may be necessary in some cases, it is not directly related to the client’s current symptoms.
Choice C rationale
Giving a fluid bolus is not the immediate next step in this client’s care. While it may be necessary in some cases, it is not directly related to the client’s current symptoms.
Choice D rationale
Drawing a basic metabolic panel (BMP) could be helpful in assessing the client’s overall health and kidney function, but it is not the immediate next step in this client’s care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Benztropine is used as an adjunct therapy for the treatment of all forms of Parkinson’s disease3. It works by reducing the activity of acetylcholine, a neurotransmitter that nerve terminals release to make muscles contract3. One of the side effects of benztropine is dry mouth3. If a patient reports having a very dry mouth, the practical nurse should administer the scheduled medication and provide oral care to help alleviate the symptom3.
Correct Answer is D
Explanation
The correct answer is Choice D, Hold the medication until the meal tray arrives. Acarbose is an oral antidiabetic medication that works by slowing the digestion of carbohydrates in the small intestine, thereby reducing the rise in blood glucose after meals. It is important to take acarbose at the start of each main meal, as it works on the food that is consumed. If the meal is delayed, the medication should also be delayed.
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