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Questions 164

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Extract:


Question 1 of 5

A client is receiving digoxin (Lanoxin) 0.25 mg. Daily. The health care provider has written a new order to give metoprolol (Lopressor) 25 mg. B.I.D. In assessing the client prior to administering the medications, which of the following should the nurse report immediately to the health care provider?

Correct Answer: A

Rationale: Both medications decrease the heart rate. Metoprolol affects blood pressure.
Therefore, the heart rate and blood pressure must be within normal range (HR 60-100 BPM; systolic B/P over 100) in order to safely administer both medications.

Extract:

Laboratory results
Hematocrit
Male: 42%–52%
(0.42-0.52)

Female: 37%–47%
(0.37–0.47) 30%
(0.30)
Activated PTT
Baseline: 30–40 sec 110 sec
Platelets
150,000–400,000/mm3
(150–400 × 109/L) 80,000/mm3
(80 x 109/L)
PT
11–12.5 sec 11 sec


Question 2 of 5

The nurse is reinforcing teaching for a client who is prescribed acyclovir for genital herpes. Which statement should be included by the nurse?

Correct Answer: A

Rationale: Heparin is an anticoagulant that helps prevent further clot formation. It is titrated based on activated partial
thromboplastin time (aPTT). The therapeutic aPTT target is 1.5-2.0 times the normal reference range of 30-40
seconds. A aPTT value >100 seconds would be considered critical and could result in life-threatening side
effects. Common sentinel events that result from heparin drips include epistaxis, hematuria, and gastrointestina
bleeds (Option 1).
(Option 2) A normal hematocrit for a female is 37%-47% (0.37-0.47). In a client with a history of chronic
anemia, a hematocrit of 30% (0.30) may be an expected finding.
(Option 3) A normal platelet count is 150,000-400,000/mm* (150-400 x 10%L). In a client with a history of liver
cirrhosis, a platelet count of 80,000/mmª (80 x 10%/L) would be anticipated. An episode of bleeding rarely occurs
with a platelet count >50,000 mm* (50 x 10%/L).
(Option 4) A normal prothrombin time is 11-12.5 seconds, and so a level of 11 seconds would not be
concerning.

Extract:


Question 3 of 5

An adult is prescribed lovastatin (Mevacor). The nurse should teach the client that while he is taking lovastatin (Mevacor), he must avoid:

Correct Answer: B

Rationale: Grapefruit juice inhibits CYP3A4, increasing lovastatin levels and risking toxicity, such as myopathy. Apples, aspirin, and ibuprofen do not have significant interactions with lovastatin.

Question 4 of 5

A patient has recently been prescribed Lidocaine Hydrochloride. Which of the following symptoms may occur with over dosage?

Correct Answer: B

Rationale: Lidocaine Hydrochloride can cause fatigue and confusion if an over dosage occurs.

Question 5 of 5

A client with gout who was started on allopurinol a week ago calls the health care provider’s office with several concerns. The nurse should recognize which report by the client as being significant and requiring immediate follow-up?

Correct Answer: C

Rationale: A rash (
C) may indicate a hypersensitivity reaction to allopurinol, potentially progressing to severe conditions like Stevens-Johnson syndrome, requiring immediate follow-up. Ibuprofen (
A), urination (
B), and nausea (
D) are less urgent.

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