The nurse is reviewing the client's medical record.

For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.

Metoprolol 5 mg every 2 to 3 min up to three doses

Oxygen at 2 L/min via nasal cannula

Draw electrolytes along with Hgb and Hct

Morphine 6 mg IV bolus every 3 hr as needed for pain

Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses

Obtain daily weight

Atropine 0.5 mg IV bolus every 5 min up to 2 mg

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"},"G":{"answers":"C"}}

Anticipated:

Metoprolol 5 mg every 2 to 3 min up to three doses
Oxygen at 2 L/min via nasal cannula
Draw electrolytes along with Hgb and Hct
Morphine 6 mg IV bolus every 3 hr as needed for pain
Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses

Nonessential:

Obtain daily weight

Contraindicated:

Atropine 0.5 mg IV bolus every 5 min up to 2 mg

Rationale:

Metoprolol 5 mg every 2 to 3 min up to three doses: Beta-blockers reduce myocardial oxygen demand by decreasing heart rate and blood pressure, making them beneficial in acute coronary syndrome. They should be used cautiously in patients with signs of heart failure or bradycardia.
Oxygen at 2 L/min via nasal cannula: Supplemental oxygen is recommended for clients with acute coronary syndrome when oxygen saturation is below 94% to optimize myocardial oxygen supply and prevent ischemia.
Draw electrolytes along with Hgb and Hct: Electrolytes are critical in evaluating myocardial function, and hemoglobin/hematocrit levels help assess perfusion and oxygen-carrying capacity.
Morphine 6 mg IV bolus every 3 hr as needed for pain: Morphine is used to relieve severe chest pain in myocardial infarction and reduce myocardial oxygen demand by decreasing anxiety and preload.
Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses: Nitroglycerin dilates coronary arteries, improving oxygen delivery to the myocardium, and reduces preload and afterload, alleviating chest pain. It is a first-line treatment for angina and myocardial infarction but should be avoided in cases of hypotension.
Obtain daily weight: Daily weight monitoring is primarily used for fluid balance assessment in conditions like heart failure rather than for acute myocardial infarction management.
Atropine 0.5 mg IV bolus every 5 min up to 2 mg: Atropine is used to treat bradycardia. However, the client is tachycardic, so atropine would worsen the condition and is contraindicated.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is ["B","D","E"]

Explanation

"The iron supplement might cause my stools to be black.": This statement is correct as one of the common side effects of iron supplementation is darkening of the stools. This occurs due to the unabsorbed iron and is generally harmless, but clients should be educated about this to avoid confusion with gastrointestinal bleeding.
"I should increase green leafy vegetables in my diet.": Green leafy vegetables are excellent sources of iron, particularly non-heme iron, which can help improve the client's iron levels. Encouraging a diet rich in iron-rich foods is essential for effective management of iron deficiency anemia, especially for clients on a vegan diet.
"I will take my iron supplement 1 hour before a meal.": Taking iron supplements on an empty stomach enhances absorption. Clients should be instructed to take the supplement ideally 1 hour before meals or 2 hours after meals for optimal efficacy, unless gastrointestinal discomfort occurs.

"I should expect to have swelling in my feet.": This statement is not appropriate. Swelling in the feet may indicate fluid retention or other medical issues that should be reported. It is not a typical or expected side effect of iron supplementation or iron deficiency anemia.
"The iron supplement might cause ringing in my ears.": Ringing in the ears (tinnitus) is not a common side effect of iron supplements. If a client experiences this symptom, it may be related to other factors or medications and should be investigated further.

A. "Your provider would not prescribe this treatment if it weren't necessary." B. "Chemotherapy is your best chance for survival." C. "It is your decision whether to continue chemotherapy." D. "Why don't you want to continue treatment?"

Correct Answer is C

Explanation

A. "Your provider would not prescribe this treatment if it weren't necessary.": While the provider recommends treatment based on medical necessity, the decision to continue or discontinue chemotherapy ultimately lies with the client. This response does not acknowledge the client’s autonomy.

B. "Chemotherapy is your best chance for survival.": This response focuses on treatment efficacy rather than addressing the client's emotional and personal concerns. It may also create pressure rather than supporting the client’s decision-making process.

C. "It is your decision whether to continue chemotherapy.": This response is appropriate as it acknowledges the client’s autonomy and right to make healthcare decisions. It validates the client’s concerns while offering support without imposing an opinion.

D. "Why don't you want to continue treatment?": Asking "why" may make the client feel defensive or pressured to justify their decision. A more open-ended approach, such as "Can you tell me more about your concerns?" would be a better way to explore the client’s feelings.

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The nurse is reviewing the client's medical record. For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for the client who has iron deficiency anemia. Which of the following statements indicate the client understands the instructions? Select the 3 statements that apply.

Correct Answer is ["B","D","E"]

Explanation

A nurse is caring for a client who has end-stage cancer and is receiving chemotherapy. The client tells the nurse, "I want to discontinue treatment, but my children insist I continue." Which of the following responses should the nurse make?

Correct Answer is C

Explanation

The nurse has reviewed the provider prescriptions at 1045. Which of the following actions should the nurse perform first?

A nurse is caring for a client who is postoperative following a total knee arthroplasty. Complete the following sentence by using the lists of options. The client is at the highest risk for ...... as evidenced by the client's ......

A nurse is assessing a client who is taking lisinopril. Which of the following findings should the nurse document in the client's medical record as an adverse effect?

A nurse is planning care for a client who has a new diagnosis of sepsis. Which of the following interventions is the nurse's priority?

A nurse is providing teaching to a client about an upcoming hysterosalpingography. Which of the following statements should the nurse include?

A nurse is preparing to administer a blood transfusion to a client. Which of the following actions should the nurse plan to take?

The nurse is reviewing the client's medical record. For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.

A nurse is teaching a client who has heart failure about self-management techniques. Which of the following statements by the client indicates an understanding of the teaching?

The nurse is reviewing the client's medical record.

For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.