The nurse receives a new client from the emergency department with an order for propranolol (Inderal). Upon looking at the client's history. which diagnosis would make the nurse clarify this order?

Tachycardia

End-stage kidney failure

Hypertension

Asthma

Answer and Explanation

The Correct Answer is D

A) Tachycardia: Propranolol is often used to manage tachycardia by reducing heart rate and controlling excessive adrenergic activity. Therefore, this diagnosis would not warrant clarification of the order; it is an appropriate use of the medication.

B) End-stage kidney failure: While caution is necessary when administering medications in clients with renal impairment, propranolol is primarily metabolized by the liver, and its use is not contraindicated in end-stage kidney failure. However, renal function can affect dosing, so monitoring would be important, but this diagnosis alone wouldn't require clarification.

C) Hypertension: Propranolol is commonly prescribed to manage hypertension, making this diagnosis a valid reason for the medication order. The use of propranolol in this context would not need clarification.

D) Asthma: Propranolol is a non-selective beta-blocker, which can cause bronchoconstriction and exacerbate asthma symptoms. This diagnosis would require the nurse to clarify the order, as beta-blockers are generally contraindicated in clients with asthma due to the risk of respiratory complications. If the client has reactive airway disease, an alternative medication should be considered.

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Correct Answer is A

Explanation

A) Shiny, hairless lower extremities: In advanced peripheral arterial disease (PAD), the skin on the lower extremities often appears shiny and hairless due to reduced blood flow. The lack of hair growth and the shiny appearance are indicative of ischemia and poor circulation, making this a common finding in clients with advanced PAD.

B) Warm lower extremities: This finding is not typical in advanced PAD. Due to compromised blood flow, the lower extremities are more likely to feel cool or cold to the touch rather than warm. Warm skin can indicate good blood flow, which is usually absent in cases of significant arterial disease.

C) Thin toenails: In advanced PAD, toenails may become thin and brittle due to insufficient blood supply, which can lead to impaired nail growth. This change is consistent with the overall effects of reduced circulation and is an expected finding in clients with advanced PAD.

D) Lower extremity bilateral pulse 3+: A 3+ pulse indicates a strong and bounding pulse, which is not typically present in advanced PAD. In fact, patients with PAD often exhibit diminished or absent pulses in the affected extremities due to poor arterial circulation. Therefore, this finding does not align with the expected assessment results for advanced PAD.

A. Provide discharge instructions for a client who has a new skin graft. B. Weigh a client who is on fluid restriction. C. Check a blood product with another nurse prior to administration. D. Perform an admission assessment on a client. E. Ambulate an older adult client who has hypertension.

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

Explanation

A) Provide discharge instructions for a client who has a new skin graft: This task should not be delegated to an assistive personnel (AP) as it requires clinical judgment and knowledge about the specific care needs associated with a new skin graft. Discharge instructions must be provided by a qualified nurse.

B) Weigh a client who is on fluid restriction: This task can be delegated to an AP. Weighing a client is a straightforward procedure that does not require nursing judgment and is within the scope of practice for an AP.

C) Check a blood product with another nurse prior to administration: This task must be performed by a licensed nurse to ensure patient safety and compliance with protocols. Checking blood products requires knowledge of the client's specific needs and potential reactions.

D) Perform an admission assessment on a client: Admission assessments require nursing expertise and critical thinking. This task cannot be delegated to an AP, as it involves evaluating the client's condition and creating a care plan based on the assessment findings.

E) Ambulate an older adult client who has hypertension: This task can be delegated to an AP, provided the client is stable and there are no other complications. Assisting with ambulation is within the scope of practice for an AP, and it can help promote mobility and independence for the client.

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The nurse receives a new client from the emergency department with an order for propranolol (Inderal). Upon looking at the client's history. which diagnosis would make the nurse clarify this order?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing client with advanced peripheral arterial disease (PAD). Which of the following findings would the nurse expect?

Correct Answer is A

Explanation

A nurse is planning to assign tasks for a group of clients. Which of the following tasks should the nurse delegate to an assistive personnel (AP)? (Select all that apply.)

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

Explanation

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