The nurse prepares to administer a scheduled dose of labetalol PO to a client with hypertension. The client's vital signs are a temperature of 99° F (37.2° C), a heart rate of 48 beats/minute, respirations of 16 breaths/minute, and a blood pressure of 150/90 mm Hg. Which action should the nurse take?

Assess for orthostatic hypotension before administering the dose.

Administer the dose and monitor the client's blood pressure regularly.

Withhold the scheduled dose and notify the healthcare provider.

Apply a telemetry monitor before administering the dose.

Answer and Explanation

The Correct Answer is C

A) Assessing for orthostatic hypotension is important when administering medications that can lower blood pressure, but in this scenario, the vital signs indicate bradycardia (heart rate of 48 beats/minute), which may be a contraindication for administering labetalol. Therefore, withholding the dose and notifying the healthcare provider is the priority.

B) Administering the dose and monitoring the client's blood pressure regularly could potentially worsen bradycardia and hypotension, especially given the client's current vital signs. It is safer to withhold the dose and seek guidance from the healthcare provider.

C) Withholding the scheduled dose and notifying the healthcare provider is the most appropriate action in this situation. The client's bradycardia, along with the hypertension, raises concern about the safety of administering labetalol without further assessment and possible adjustment of the treatment plan.

D) Applying a telemetry monitor may be warranted if the client's bradycardia is of concern, but it does not address the potential risk associated with administering labetalol to a client with a heart rate of 48 beats/minute. The priority is to withhold the medication and inform the healthcare provider for further evaluation and guidance.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A) Sleeps soundly through the night: Zolpidem is a sedative-hypnotic medication commonly prescribed for the short-term treatment of insomnia in older adults. The desired outcome of administering zolpidem is improved sleep quality, including the ability to sleep soundly through the night. Documenting that the client sleeps soundly through the night indicates that the medication has achieved its intended effect of promoting sleep.

B) Exhibits fewer emotional outbursts: While zolpidem may indirectly contribute to emotional stability by improving sleep quality, it is not primarily indicated for reducing emotional outbursts. Therefore, this documentation does not specifically reflect the desired outcome of zolpidem administration.

C) Improved ability to concentrate: Zolpidem’s primary effect is on sleep induction rather than concentration. While improved sleep may indirectly enhance concentration in some cases, this documentation does not directly relate to the intended outcome of zolpidem therapy.

D) Decreased episodes of incontinence: Zolpidem is not indicated for the treatment of urinary incontinence, so documenting a decrease in episodes of incontinence would not reflect the desired outcome of zolpidem administration.

Therefore, the most appropriate documentation indicating that the desired outcome has been achieved when administering zolpidem to an older client is that the client “sleeps soundly through the night.” This reflects the medication’s primary purpose of improving sleep quality and duration.

A. Report any tendon pain or swelling to the healthcare provider immediately. B. Limit exposure to sunlight and avoid tanning beds. C. Crush and mix the tablets with pudding if you have trouble swallowing the tablets. D. Increase fluid intake while taking the medication. E. Use nonsteroidal anti-inflammatory drugs (NSAID) to relieve mild joint aches and pains caused by the medication.

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

Explanation

A) Tendon pain or swelling can be a sign of tendinitis or tendon rupture, which can be serious side effects of ciprofloxacin. Therefore, it is crucial for the client to report any tendon pain or swelling to the healthcare provider immediately.

B) Ciprofloxacin can increase sensitivity to sunlight, leading to an increased risk of sunburn. Therefore, clients should be advised to limit exposure to sunlight and avoid tanning beds while taking this medication.

C) Crushing or mixing ciprofloxacin tablets with pudding is not recommended, as it may alter the absorption and effectiveness of the medication. Clients should swallow the tablets whole with a full glass of water.

D) Increasing fluid intake while taking ciprofloxacin is generally recommended to prevent dehydration and help flush the medication through the kidneys. Adequate hydration can also help reduce the risk of crystalluria, a potential adverse effect of ciprofloxacin.

E) Using nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve joint aches and pains caused by ciprofloxacin is not recommended, as NSAIDs can increase the risk of tendon problems when used with ciprofloxacin. It is important for the client to report any joint aches or pains to the healthcare provider for proper evaluation and management.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?

Correct Answer is A

Explanation

The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets, which wore prescribed because of a suspected anthrax exposure. What instruction(s) should be included in the teaching plan? Select all that apply.

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

Explanation

A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?

During a home visit, the nurse assesses a client with Alzheimer's Di’ease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

The nurse is reviewing the client’s laboratory results. Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

The nurse is preparing to apply the client’s scheduled fentanyl transdermal patch. The nurse notes the previously applied patch is intact on the client’s upper back and the client reports no pain. Which action should the nurse take?

A client with a history of smoking cigarettes for many years arrives to the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?