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.

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Free Nursing Study Resources

Correct Answer is ["A","C","E"]

Explanation

A. Drink 3 L of fluids daily: Increasing fluid intake helps flush bacteria from the urinary tract and dilutes urine, reducing the risk of infection. Adequate hydration also promotes more frequent urination, which prevents bacterial colonization in the bladder.

B. Take a warm bubble bath daily: Bubble baths can introduce irritants and disrupt the normal vaginal flora, increasing the risk of urinary tract infections. Soaking in bathwater containing soap or fragrances can also promote bacterial growth and irritation of the urethra.

C. Drink low-fructose cranberry juice: Cranberry juice contains compounds that help prevent bacteria, particularly Escherichia coli, from adhering to the bladder wall. Low-fructose options are preferred to minimize excessive sugar intake, which can contribute to bacterial growth.

D. Void every 6 hr during the day: Holding urine for long periods allows bacteria to multiply in the bladder, increasing the risk of infection. Voiding every 2 to 4 hours is recommended to promote bladder emptying and reduce bacterial colonization.

E. Wipe the perineal area from front to back after urinating: Wiping from front to back prevents the transfer of bacteria from the anal region to the urethra. This simple hygiene practice helps reduce the risk of E. coli contamination, a leading cause of urinary tract infections.

A. Insulin aspart and NPH insulin B. Insulin degludec and NPH insulin. C. Insulin glargine and insulin detemir D. Insulin lispro and regular insulin

Correct Answer is A

Explanation

A. Insulin aspart and NPH insulin: Insulin aspart is a rapid-acting insulin, and NPH is an intermediate-acting insulin. These can be mixed in the same syringe to provide both immediate and prolonged glucose control, with aspart covering postprandial spikes and NPH maintaining basal levels.

B. Insulin degludec and NPH insulin: Insulin degludec is an ultra-long-acting insulin and should not be mixed with any other insulin, as mixing can alter its absorption and effectiveness.

C. Insulin glargine and insulin detemir: Both glargine and detemir are long-acting insulins and should not be mixed with any other insulin, as this can interfere with their mechanism of providing a steady release.

D. Insulin lispro and regular insulin: Insulin lispro is a rapid-acting insulin, and regular insulin is short-acting. These insulins should not be mixed because they have different onset and peak times, which can lead to unpredictable glucose control.

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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

A nurse is teaching about measures to prevent recurring urinary tract infections with a female client. Which of the following information should the nurse include in the teaching? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

A nurse is teaching a client who is newly diagnosed with type 2 diabetes mellitus about insulin therapy. Which of the following insulin combinations should the nurse instruct the client to mix?

Correct Answer is A

Explanation

A nurse is caring for a client who has an evisceration of an abdominal incision. Which of the following actions should the nurse take first?

A nurse is assessing a client who is receiving radiation therapy to the head and neck. Which of the following findings should the nurse expect?

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 is experiencing seizures secondary to meningitis. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

A nurse is caring for a client who has chronic kidney failure. The client received hemodialysis 1 hr ago. The nurse should identify that which of the following findings is a manifestation of a complication related to the procedure?

A home health nurse is assessing the home environment of a client who has cystic fibrosis. Which of the following equipment should the nurse plan to recommend?

A nurse is reviewing the laboratory results of a group of clients. Which of the following client conditions requires reporting to the local health department?

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.

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.