The practical nurse (PN) is caring for a client who has been taking ibuprofen for arthritic pain. Which action should the PN include in the client’s plan of care (POC)?

Choice A reason: Conferring with the charge nurse is unnecessary, as a blood pressure of 120/72 mm Hg is within normal range for a client on maintenance antihypertensive therapy. Maintenance doses prevent hypertension recurrence, and this reading does not indicate a need to alter the schedule.

Choice B reason: Advising the client to report rising blood pressure symptoms is general education, not an action addressing the current situation. The blood pressure is normal, and the maintenance dose is indicated to sustain control, making this choice irrelevant for immediate action.

Choice C reason: Withholding the medication and rechecking in an hour risks blood pressure spikes, as maintenance therapy prevents hypertension. A normal reading of 120/72 mm Hg indicates effective control, and stopping the dose could destabilize the client’s condition, making this choice inappropriate.

Choice D reason: Administering the scheduled antihypertensive dose is correct, as 120/72 mm Hg indicates effective blood pressure control. Maintenance therapy sustains normotension by regulating vascular tone or fluid balance, preventing hypertensive episodes, ensuring cardiovascular stability, and aligning with the prescription’s intent.

Choice A reason: A color change during a chemical reaction indicates the formation of new substances with altered molecular structures, affecting light absorption. For instance, iron reacting with oxygen forms iron oxide, shifting from silver to reddish-brown. This reflects a chemical transformation where new compounds with distinct optical properties are produced, confirming a reaction at the molecular level.

Choice B reason: Precipitate formation signifies a chemical reaction as soluble reactants produce an insoluble solid. In a double displacement reaction, such as silver nitrate combining with sodium chloride, silver chloride precipitates. This occurs due to ion exchange, forming a new compound with low solubility, providing visible evidence of a chemical change driven by molecular restructuring.

Choice C reason: Gas release during a reaction indicates a chemical change, as new gaseous products form from reactants. For example, sodium bicarbonate reacting with acetic acid produces carbon dioxide gas. This results from molecular bond rearrangement, where reactants break and reform into new molecules, including a gas, confirming a chemical transformation.

Choice D reason: Temperature changes often accompany chemical reactions, reflecting energy shifts. Exothermic reactions, like combustion, release heat, increasing temperature, while endothermic reactions absorb heat, decreasing it. These changes occur as chemical bonds break and form, redistributing energy. This energy dynamic is a hallmark of chemical reactions, indicating molecular-level transformations.

Choice E reason: This choice is correct as all listed signs—color change, precipitate formation, gas release, and temperature change—are indicators of chemical reactions. Each reflects molecular rearrangements, such as new compound formation or energy shifts. By encompassing all these observable phenomena, this option accurately represents the diverse physical manifestations of chemical changes.