The nurse is preparing medications for a client with a history of hypertension who is post-op day 3 following hip replacement.
Meds: Atenolol 25 mg PO, Captopril 10 mg PO, Atorvastatin 40 mg PO, and Warfarin 4 mg PO.
Vital signs: blood pressure 138/90, heart rate 52, respiratory rate 18, temperature 99.7, O2 saturation 96% on room air.
Today’s labs: sodium- 143 meq/L, potassium 4.6 mmol/L, Hemoglobin 11.1 gm/dL, white blood count 10.8, INR 2.2
Which medication will the nurse hold?
Atenolol
Captopril
Warfarin
Glipizide
The Correct Answer is A
Choice A reason: Atenolol is a beta blocker that lowers blood pressure and heart rate. The nurse should hold atenolol for this client because the client's heart rate is already low (52 beats per minute), and giving atenolol could cause bradycardia (slow heart rate), which can lead to dizziness, fainting, or heart failure. The nurse should notify the provider and monitor the client's vital signs and cardiac rhythm.
Choice B reason: Captopril is an ACE inhibitor that lowers blood pressure and prevents kidney damage. The nurse should not hold captopril for this client because the client's blood pressure is still high (138/90 mmHg), and captopril could help lower it to the target range. The nurse should administer captopril as prescribed and monitor the client's blood pressure and renal function.
Choice C reason: Warfarin is an anticoagulant that prevents blood clots and reduces the risk of stroke. The nurse should not hold warfarin for this client because the client's INR (a measure of blood clotting time) is within the therapeutic range (2.0 to 3.0), and warfarin could help prevent post-operative complications such as deep vein thrombosis or pulmonary embolism. The nurse should administer warfarin as prescribed and monitor the client's INR and bleeding signs.
Choice D reason: Glipizide is not a medication for this client. Glipizide is an oral hypoglycemic agent that lowers blood sugar levels in people with diabetes. This client does not have diabetes and does not need glipizide. The nurse should check the medication order and the client's medical history and clarify any discrepancies with the provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is incorrect. INR level is a measure of blood clotting time and is not directly affected by digoxin. It is more relevant for patients who are taking anticoagulants, such as warfarin.
Choice B reason: This is incorrect. Temperature is not a priority assessment for a patient receiving digoxin. It may indicate an infection or inflammation, but it is not related to the action or toxicity of digoxin.
Choice C reason: This is correct. Apical heart rate is the priority assessment for a patient receiving digoxin. Digoxin is a cardiac glycoside that increases the force and efficiency of the heart contractions, but also slows down the heart rate. The nurse should monitor the apical pulse for one full minute before administering digoxin and withhold the dose if the pulse is below 60 beats per minute for adults or below the age-specific normal range for children. A low or irregular pulse may indicate digoxin toxicity, which can be life-threatening.
Choice D reason: This is incorrect. Blood pressure is not a priority assessment for a patient receiving digoxin. Digoxin does not have a direct effect on blood pressure, although it may improve the cardiac output and reduce the fluid retention in patients with heart failure. Blood pressure should be monitored regularly, but it is not as critical as the apical heart rate.
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: Maintaining a healthy weight is important for lowering cholesterol levels and reducing the risk of cardiovascular disease. Obesity is associated with higher levels of LDL-cholesterol (the "bad" cholesterol) and lower levels of HDL-cholesterol (the "good" cholesterol). Losing weight can improve these ratios and lower blood pressure. ¹
Choice B reason: Avoiding cigarettes and other nicotine products is essential for preventing cardiovascular disease. Smoking damages the blood vessels and increases the risk of atherosclerosis, which is the buildup of plaque in the arteries. Smoking also lowers HDL-cholesterol and raises triglycerides, another type of fat in the blood. Quitting smoking can improve cholesterol levels and lower the risk of heart attack and stroke. ²
Choice C reason: Importance of regular exercise is another key factor for improving cholesterol levels and cardiovascular health. Exercise helps to lower LDL-cholesterol and raise HDL-cholesterol, as well as lower blood pressure and blood sugar. Exercise also strengthens the heart muscle and improves blood flow. The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, or a combination of both. ³
Choice D reason: Positive stress management techniques are not directly related to cholesterol levels or statin medications, but they may have some benefits for cardiovascular health. Stress can increase blood pressure and heart rate, and may trigger unhealthy behaviors such as smoking, drinking, or overeating. Stress can also affect the immune system and inflammation, which may contribute to atherosclerosis. Learning to cope with stress in healthy ways, such as meditation, yoga, breathing exercises, or counseling, may help to lower the risk of cardiovascular disease. ⁴
Choice E reason: Healthy low fat diet options are an important part of lowering cholesterol levels and preventing cardiovascular disease. A diet that is high in saturated fat, trans fat, and cholesterol can raise LDL-cholesterol and lower HDL-cholesterol. A diet that is low in fat and high in fiber, fruits, vegetables, whole grains, and lean protein can lower LDL-cholesterol and raise HDL-cholesterol. Some foods, such as oats, nuts, soy, and fish, may have additional benefits for cholesterol levels. .
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