The nurse is getting ready to give medications to an eight-month-old infant diagnosed with heart failure.
The infant’s vital signs are as follows: blood pressure 114/66 mm Hg, apical pulse 88 beats/minute, and respirations 30 breaths/minute.
Which medication should the nurse hold and inform the health care provider?
Enalapril
Digoxin
Furosemide
Hydralazine
The Correct Answer is B
Choice A rationale
Enalapril is an angiotensin-converting enzyme (ACE) inhibitor commonly used in the treatment of heart failure. It works by widening blood vessels, which reduces the workload of the heart and helps keep heart failure from getting worse. In the given scenario, there is no specific indication to hold Enalapril based on the infant’s vital signs.
Choice B rationale
Digoxin is a medication that can help the heart beat stronger with a more regular rhythm. However, it is important to monitor the patient’s heart rate when administering Digoxin, as it can lower the heart rate. In this case, the infant’s apical pulse is 88 beats/minute, which is lower than the normal range for an eight-month-old infant (normal range: 100-160 beats/minute). Therefore, the nurse should hold the Digoxin and inform the healthcare provider.
Choice C rationale
Furosemide is a diuretic that helps the kidneys get rid of extra fluid that may build up in the body. It is often used in the treatment of heart failure to relieve symptoms such as fluid retention. In the given scenario, there is no specific indication to hold Furosemide based on the infant’s vital signs.
Choice D rationale
Hydralazine is a medication used to treat high blood pressure. It works by relaxing and widening blood vessels so blood can flow more easily. In the given scenario, there is no specific indication to hold Hydralazine based on the infant’s vital signs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While it’s true that TSH levels can influence thyroxine levels, this statement is misleading. High TSH levels do not cause low thyroxine levels. Instead, the pituitary gland produces more TSH when thyroxine levels are low in an attempt to stimulate the thyroid gland to produce more thyroxine.
Choice B rationale
Thyroxine levels in breastfeeding infants should be within the normal range. High thyroxine levels are not typical and could indicate a problem with the infant’s thyroid gland.
Choice C rationale
This statement is incorrect. The thyroid gland begins producing thyroxine before birth, and levels should be within the normal range shortly after birth.
Choice D rationale
This is the correct explanation. In congenital hypothyroidism, the thyroid gland does not produce enough thyroxine, leading to high levels of TSH. The pituitary gland produces more TSH in an attempt to stimulate the thyroid gland to produce more thyroxine.
Correct Answer is A
Explanation
Choice A rationale
It’s important to educate the adolescent about the risks and benefits associated with oral contraceptives. This includes potential side effects, effectiveness in preventing pregnancy, and the need for continued use of condoms to prevent sexually transmitted infections.
Choice B rationale
While it’s important to inform the client about how to obtain contraceptives, providing a variety of free oral contraceptives from the clinic may not be feasible or appropriate depending on the specific circumstances and regulations.
Choice C rationale
Encouraging the client to discuss her contraceptive needs with her parents could be beneficial, but it’s also important to respect her autonomy and confidentiality. In many places, adolescents have the right to access contraceptive services without parental consent.
Choice D rationale
The requirement for parental consent to receive contraceptives varies by location. In many places, adolescents can access contraceptive services without parental consent.
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