The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?
Carvedilol
Captopril
Isosorbide dinitrate
Fluticasone
The Correct Answer is A
A. Carvedilol: Carvedilol is a non-selective beta-blocker that blocks both beta-1 and beta-2 adrenergic receptors. Beta-2 blockade can lead to bronchoconstriction, which can exacerbate asthma symptoms. Clarification is needed to see if a cardioselective beta-blocker (like metoprolol) would be safer.
B. Captopril: Captopril is an ACE inhibitor commonly used in heart failure to reduce blood pressure and decrease the workload on the heart. It does not have bronchoconstrictive effects and is safe for use in clients with asthma.
C. Isosorbide dinitrate: Isosorbide dinitrate is a nitrate used to manage heart failure by dilating blood vessels and reducing the workload of the heart. It has no effect on bronchial smooth muscle and is not contraindicated in asthma, so no clarification is needed.
D. Fluticasone: Fluticasone is an inhaled corticosteroid used to manage asthma by reducing inflammation in the airways. It is beneficial in clients with asthma and does not pose a risk to clients with heart failure. There is no need to clarify this medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
A. Montelukast: Montelukast is a leukotriene receptor antagonist commonly used in the management of asthma and allergic rhinitis. It is not part of the standard tuberculosis treatment regimen.
B. Rifampin: Rifampin is a key component of tuberculosis treatment and is effective against both active and latent tuberculosis.
C. Acyclovir is an antiviral medication primarily used for herpes simplex virus infections and is not part of the standard treatment for tuberculosis.
D. Isoniazid: Isoniazid is another essential drug in the treatment of tuberculosis, particularly for the prevention of latent tuberculosis progression to active disease.
E. Pyrazinamide: Pyrazinamide is part of the standard combination therapy for tuberculosis.
Correct Answer is D
Explanation
A. A friction rub:A friction rub is a sound caused by the rubbing of inflamed pericardial layers and is not classified as a heart sound like S1 or S2. It is unrelated to the sequence of heart sounds.
B. A split second heart sound S₂:A split S₂ occurs during the closure of the aortic and pulmonary valves and is heard after S1, not before.
C. The third heart sound (S3):S3, or the ventricular gallop, occurs shortly after S2 during early diastole and indicates rapid ventricular filling. It is not heard before S1.
D. The fourth heart sound (S4):S4, known as the "atrial gallop," occurs just before S1 during atrial contraction. It is associated with a stiff or hypertrophied ventricle and is often indicative of underlying heart disease, especially in older adults.
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