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 C

Explanation

A. Your blood pressure reflects how strong your heart muscle contracts: This statement oversimplifies the complexities of blood pressure and doesn't directly address the client's misunderstanding about the implications of hypertension.

B. "If you feel good your medication is working properly": While this may be true, it fails to convey the importance of monitoring blood pressure, regardless of symptoms. It might lead the client to believe that feeling well means there are no health concerns.

C. "Even if you are feeling good, damage can occur to your heart and kidneys": This response is the most appropriate as it emphasizes that hypertension can cause silent damage over time, even in the absence of symptoms. It educates the client about the potential long-term consequences of uncontrolled hypertension.

D. "Have you told your doctor that you are feeling good?": While it encourages communication, it does not provide useful information or address the client’s misconceptions about hypertension and its risks.

A. restrain the client to prevent self-harm B. assist the client to identify the trigger situation and choose a coping strategy. C. send the client to the crisis intervention unit for 23 hours of observation. D. advise the client to take an anxiolytic to decrease their anxiety level.

Correct Answer is B

Explanation

A. Restraining the client to prevent self-harm: While safety is a priority, physical restraint should be a last resort and not the first action taken in this scenario. It may escalate the situation and lead to feelings of loss of control.
B. Assist the client to identify the trigger situation and choose a coping strategy: This is the best initial intervention. Helping the client understand their triggers and encouraging the development of coping strategies can empower them and promote healthier responses to distress. This approach aligns with therapeutic practices that support emotional regulation.

C. Send the client to the crisis intervention unit for 23 hours of observation: While observation may be necessary if the client is at imminent risk of self-harm, it is essential first to explore the underlying issues and coping mechanisms. This action may be considered if the client remains a danger to themselves after initial interventions.

D. Advise the client to take an anxiolytic to decrease their anxiety level: Medications may help with anxiety, but this approach does not address the root of the problem or provide the client with skills to manage their distress. It is more beneficial to focus on therapeutic techniques first.

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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?

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Naxlex Comprehensive Predictor Exams

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