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

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. Aortic regurgitation: Aortic regurgitation typically presents with a diastolic murmur, not a systolic click.

B. Mitral stenosis: Mitral stenosis presents with a diastolic murmur, often associated with an opening snap, rather than a systolic click.

C. Aortic stenosis: Aortic stenosis typically presents with a systolic ejection murmur, but not a systolic click.

D. Mitral valve prolapse: This is the correct answer. Mitral valve prolapse (MVP) is characterized by the displacement of the mitral valve leaflets into the left atrium during systole, often producing a systolic click. Symptoms associated with MVP can include atypical chest pain, palpitations, and exercise intolerance.

A. Serum amylase B. Unconjugated bilirubin C. Aspartate aminotransferase (AST). D. Troponin I

Correct Answer is D

Explanation

A. Serum amylase: Serum amylase is an enzyme associated with pancreatic function, and its elevation is not specific to myocardial infarction.

B. Unconjugated bilirubin: Elevation of unconjugated bilirubin is associated with liver function and hemolysis, not specifically with myocardial infarction.

C. Aspartate aminotransferase (AST): While AST may be elevated in conditions affecting the heart, it is not as specific or sensitive for myocardial infarction as troponin I.

D. Troponin I: This is the correct answer. Troponin I is a cardiac-specific biomarker released into the bloodstream when there is damage to cardiac muscle, such as during a myocardial infarction. Troponin I levels start to rise within 3-4 hours after the onset of myocardial infarction, making it a crucial marker for early detection.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is assessing a client who reports occasional atypical chest pain, palpitations, and exercise intolerance. On auscultation, the nurse notes a systolic click. The nurse should recognize this finding as a manifestation of which of the following conditions?

Correct Answer is D

Explanation

A nurse is reviewing the laboratory values of a client who had a myocardial infarction 3 hr ago. The nurse should expect which of the following laboratory values to be elevated?

Correct Answer is D

Explanation

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