The nurse notes a client with a prescription for glipizide is confused, diaphoretic, and tachycardic. What is the nurse’s priority assessment?
Blood glucose
Apical heart rate
INR level
Last bowel movement
The Correct Answer is A
Choice A reason: This choice is correct because blood glucose is the priority assessment for a client with a prescription for glipizide who is confused, diaphoretic, and tachycardic. Glipizide is a medicine that lowers blood sugar levels in the body. It can cause side effects such as anxiety, diarrhea, nausea, and low blood sugar. Low blood sugar (hypoglycemia) can cause confusion, sweating, fast heart rate, dizziness, hunger, and seizures. The nurse should check the client's blood glucose level and treat hypoglycemia as soon as possible.
Choice B reason: This choice is incorrect because apical heart rate is not the priority assessment for a client with a prescription for glipizide who is confused, diaphoretic, and tachycardic. Apical heart rate is the number of heartbeats per minute that can be heard at the apex of the heart. It can be affected by many factors, such as age, activity, stress, and medication. Tachycardia is a condition where the heart beats faster than normal, which can be a sign of low blood sugar, dehydration, infection, or heart problems. The nurse should check the apical heart rate after assessing and treating the blood glucose level.
Choice C reason: This choice is incorrect because INR level is not the priority assessment for a client with a prescription for glipizide who is confused, diaphoretic, and tachycardic. INR stands for international normalized ratio, which is a measure of how long it takes the blood to clot. It is used to monitor the effect of anticoagulant drugs, such as warfarin, that prevent blood clots. Glipizide does not affect the INR level, and the client's symptoms are not related to bleeding or clotting. The nurse should check the INR level only if the client is taking anticoagulant drugs and has signs of bleeding or clotting.
Choice D reason: This choice is incorrect because the last bowel movement is not the priority assessment for a client with a prescription for glipizide who is confused, diaphoretic, and tachycardic. The last bowel movement is the time and nature of the client's most recent defecation. It can be affected by many factors, such as diet, fluid intake, activity, medication, and bowel habits. Glipizide can cause diarrhea or constipation, which can affect the frequency and consistency of the bowel movement. The nurse should check the last bowel movement after assessing and treating the blood glucose level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
Explanation
To calculate the amount of ampicillin the nurse should administer per dose in milliliters (mL) for a 500 mg IM dose, we can use the following steps:
Given:
Ampicillin dose: 500 mg
Available concentration after reconstitution: 250 mg/mL
Volume of sterile water to be added: 1.8 mL
Step 1: Calculate the amount of ampicillin to be administered per dose in mL
First, we need to reconstitute the ampicillin vial to yield the desired concentration of 250 mg/mL.
The concentration after reconstitution is 250 mg/mL, and the total dose required is 500 mg. Therefore, the nurse needs to administer:
Volume = Ampicillin dose / Concentration
Volume = 500 mg / 250 mg/mL
Volume = 2 mL
Rounding to the nearest whole number:
Volume = 2 mL
Therefore, the nurse should administer 2 mL of the reconstituted ampicillin solution per dose.
Correct Answer is ["A","B","E"]
Explanation
Choice A reason: Captopril is an ACE inhibitor, which means it blocks the enzyme that converts angiotensin I to angiotensin II, a hormone that constricts blood vessels and raises blood pressure. Captopril is used to treat high blood pressure, heart failure, diabetic kidney disease, and some types of heart attack. ¹
Choice B reason: Lisinopril is also an ACE inhibitor, with similar effects and uses as captopril. Lisinopril may be preferred over captopril because it has a longer duration of action and fewer side effects. ²
Choice C reason: Atenolol is not an ACE inhibitor, but a beta blocker, which means it blocks the receptors for adrenaline and noradrenaline, hormones that increase heart rate and blood pressure. Atenolol is used to treat high blood pressure, angina, irregular heartbeat, and prevent heart attack and stroke. ³
Choice D reason: Labetalol is also not an ACE inhibitor, but a combination of alpha and beta blocker, which means it blocks both the receptors for adrenaline and noradrenaline, and the receptors for angiotensin II. Labetalol is used to treat high blood pressure, especially in pregnancy and hypertensive emergencies.
Choice E reason: Ramipril is another ACE inhibitor, with similar effects and uses as captopril and lisinopril. Ramipril may have additional benefits in preventing cardiovascular events and kidney damage in high-risk patients..
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