The nurse reviews the newly written prescriptions for a client admitted with the diagnoses of coronary artery disease and hypertension. Which prescription should the nurse implement first?

Furosemide 40 mg PO daily for a client whose blood pressure is 123986.

Nitroglycerin 0.4 mg SL PRN for a client complaining of chest

Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats

Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min

Answer and Explanation

The Correct Answer is B

A) Furosemide 40 mg PO daily for a client whose blood pressure is 123/86: While furosemide is important for managing fluid status, the client's blood pressure is within a normal range, and this medication does not address any acute concerns.

B) Nitroglycerin 0.4 mg SL PRN for a client complaining of chest pain: This prescription should be implemented first because it addresses an immediate and potentially life-threatening symptom. Chest pain can indicate angina or myocardial infarction, making it critical to relieve this symptom promptly.

C) Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats: While metoprolol is important for managing heart rate and hypertension, a heart rate of 55 beats/minute is on the lower end and could warrant caution. The priority would be to assess the need for medication before administering it.

D) Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min: This medication is also important for managing heart rate and hypertension but is not the priority over addressing acute chest pain. The client’s heart rate is within a normal range, so this does not require immediate action compared to the nitroglycerin for chest pain.

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

Explanation

A. "What were you doing when the pain started?" This question helps identify potential triggers or activities that may have precipitated the chest pain, which is crucial for understanding the context of the pain.

B. "How long has the pain lasted?" Knowing the duration of the pain is vital in assessing the urgency of the situation and determining whether it may be related to a serious condition like angina or myocardial infarction.

C. "How would you describe the pain?" This question allows the client to characterize the pain (e.g., sharp, dull, squeezing), which can provide insights into the potential causes and the nature of the chest pain.

D. "How has the pain affected your relationship with your spouse?" While this question might provide some psychosocial context, it is less directly related to the immediate assessment of the chest pain itself and can be considered secondary.

E. "Can you rate the pain on a 0-10 scale with 10 being the worst?" Pain rating is essential in assessing the severity of the pain, which can help guide treatment and interventions.

A. Tinnitus B. Constipation C. Visual disturbances D. Vertigo

Correct Answer is C

Explanation

A) Tinnitus: While tinnitus can be concerning, it is not a classic side effect of digoxin. It may indicate other issues such as hearing problems or medication interactions, but it does not typically warrant immediate communication with the healthcare provider in the context of digoxin use.

B) Constipation: Although constipation can occur in some patients taking digoxin, it is generally not considered a critical side effect that requires urgent attention. Patients are encouraged to manage this symptom through dietary changes or over-the-counter remedies unless it becomes severe.

C) Visual disturbances: Experiencing visual disturbances, such as seeing halos around lights or blurred vision, can be a sign of digoxin toxicity. Since these symptoms can indicate an elevated level of the drug in the bloodstream, it is crucial for the patient to contact their healthcare provider promptly to assess the situation and prevent further complications.

D) Vertigo: While vertigo can occur in various medical conditions and may be a side effect of other medications, it is not specifically linked to digoxin. If a patient experiences vertigo, they should monitor it but are not necessarily required to contact their healthcare provider immediately unless it is severe or persistent.

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The nurse reviews the newly written prescriptions for a client admitted with the diagnoses of coronary artery disease and hypertension. Which prescription should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is performing an admission assessment of a client complaining of chest pain. Which question(s) should the nurse ask in the assessment regarding the chief complaint? (SELECT ALL THAT APPLY)

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

Explanation

The nurse should teach the client who is taking digoxin 0.125 mg PO daily to call the healthcare provider if which side effect is experienced?

Correct Answer is C

Explanation

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