Question

A nurse is caring for a patient taking a beta-blocker and a nitrate to treat angina. The nurse recognizes the need for careful monitoring due to which comorbidity?

Answer 1

Correct Answers:

Chronic obstructive pulmonary disease (COPD)

Rationale :

🫁Beta-blockers, especially nonselective agents, may block beta₂ receptors in the lungs and cause bronchoconstriction.

💨Patients with COPD may experience worsening wheezing, dyspnea, or reduced response to beta₂-agonist bronchodilators.

🩺The nurse should carefully monitor respiratory status, oxygen saturation, lung sounds, heart rate, and blood pressure.

💊When beta-blocker therapy is necessary, a cardioselective beta₁-blocker at the lowest effective dose is generally preferred and monitored cautiously.

📌Core Message

Patients with COPD require careful monitoring because beta-blockers may cause bronchoconstriction and interfere with bronchodilator effectiveness.

Answer 2

Correct Answers:

Confirming drug dosage calculation

Rationale :

⚖️Digoxin has a narrow therapeutic index, so small dosing errors can cause serious toxicity.

👶Infant doses are calculated carefully using the child’s weight and prescribed dosage parameters.

🧮The nurse must independently verify the dose calculation before administering the medication.

🚨An incorrect dose may cause bradycardia, dysrhythmias, vomiting, or other toxic effects.

📌Core Message

Because digoxin has a narrow therapeutic index, the nurse must verify the infant’s dose calculation before administration.

Answer 3

Correct Answers:

"When was your last menstrual period?"

Rationale :

🤰ARBs can cause severe fetal injury or death when taken during pregnancy.

🩺The last menstrual period helps assess whether the patient may currently be pregnant.

🧬These medications can impair fetal renal development, especially later in pregnancy.

⚠️The prescription must be questioned if pregnancy is suspected or confirmed.

📌Core Message

Determine possible current pregnancy before administering an ARB because it can cause serious fetal harm.

Answer 4

Correct Answers:

Administer digoxin immune fab as prescribed

Rationale :

☠️Severe digoxin toxicity can cause life-threatening cardiac dysrhythmias and hyperkalemia.

💉Digoxin immune fab binds circulating digoxin and neutralizes its toxic effects.

🧪Prompt antidote administration reduces the amount of active digoxin available to bind cardiac tissue.

❤️Continuous cardiac and electrolyte monitoring remains necessary during treatment.

📌Core Message

Severe digoxin toxicity requires prompt administration of digoxin immune fab to prevent fatal complications.

Answer 5

Correct Answers:

"The left ventricle needs to pump blood through the entire body."

Rationale :

🫀The left ventricle pumps blood into the systemic circulation through the aorta.

💪Its thicker muscular wall generates the high pressure needed to circulate blood throughout the body.

🌍Systemic circulation creates greater vascular resistance than pulmonary circulation.

🫁The right ventricle pumps blood only through the lower-pressure pulmonary circulation.

📌Core Message

The left ventricle is larger because it must generate enough pressure to supply the entire systemic circulation.

Answer 6

Correct Answers:

Assess the patient's blood pressure

Rationale :

💊Nifedipine causes arterial vasodilation, which can lower blood pressure.

📉Dizziness may indicate clinically significant hypotension.

😵The nurse must assess the patient before deciding whether to withhold medication or contact the provider.

🛡️Immediate assessment supports appropriate fall precautions and treatment decisions.

📌Core Message

When dizziness occurs after nifedipine, first assess blood pressure for medication-induced hypotension.

Answer 7

Correct Answers:

245

Rationale :

🧾The required volume is calculated as 671 mg ÷ 486 mg × 68 mL = 93.88 mL.

📐The infusion time of 23 minutes equals 23 ÷ 60 = 0.383 hour.

⏱️The rate is calculated as 93.88 mL ÷ 0.383 hour = 244.92 mL/hr.

📈Rounding to the nearest whole number produces 245 mL/hr.

📌Core Message

Infusing 93.88 mL over 23 minutes requires the pump to be set at 245 mL/hr.

Answer 8

Correct Answers:

1

Rationale :

⚖️The prescribed dose is 5 mg.

💠Each available tablet contains 5 mg.

✏️The calculation is 5 mg ÷ 5 mg/tablet = 1 tablet.

✅The nurse should therefore administer one tablet.

📌Core Message

Because the ordered and available doses are both 5 mg, administer one tablet.

Answer 9

Correct Answers:

Atrial fibrillation

Rationale :

🫶Dofetilide is a class III antiarrhythmic used to manage atrial fibrillation and atrial flutter.

⚡It prolongs cardiac repolarization by blocking potassium channels.

🔄The medication helps convert certain patients to normal sinus rhythm and maintain that rhythm.

📋Initiation requires close monitoring because it can prolong the QT interval.

📌Core Message

Dofetilide is primarily used to convert and maintain sinus rhythm in atrial fibrillation.

Answer 10

Correct Answers:

Release of renin

Rationale :

🫘Reduced renal blood flow stimulates the kidneys to release renin.

⬇️Renin activates the renin–angiotensin–aldosterone system in response to perceived low perfusion.

🧫Angiotensin II causes vasoconstriction, while aldosterone promotes sodium and water retention.

⬆️These effects increase circulating volume and blood pressure.

📌Core Message

Decreased renal blood flow triggers renin release, activating mechanisms that raise blood pressure.

1 :
A nurse is caring for a patient taking a beta-blocker and a nitrate to treat angina. The nurse recognizes the need for careful monitoring due to which comorbidity?

2 :
The nurse is preparing to administer digoxin to an infant. What is the nurse's priority intervention for this patient?

3 :
What is the nurse's priority assessment question before administering an angiotensin II receptor blocker (ARB) to a female patient?

4 :
A nurse is assessing a 78-year-old patient in the emergency department. The nurse determines the patient is experiencing severe digoxin toxicity. What is the nurse's priority action?

5 :
A patient asks the nurse to explain why the left ventricle is so much larger than the right ventricle. Which explanation will the nurse provide?

6 :
A patient diagnosed with angina has been prescribed nifedipine 15 mg PO three times a day. The patient has received the first two doses of the medication and reports dizziness. What is the nurse's PRIORITY action?

7 :
The client has an order for penicillin 671 mg IV to infuse over 23 minutes. The medication available is penicillin 486 mg/68 mL NS. At what nurse set the infusion? mL/hr (If needed, round to the nearest whole number)

8 :
The client has an order for methylphenidate (Ritalin) 5 mg orally. The medication available is methylphenidate 5 mg per scored tablet. How many tablets will the nurse administer?. needed, round to the nearest whole number.)

9 :
The nurse is reviewing the medication regimen of a newly admitted patient. The patient currently takes dofetilide 250 mcg PO twice a day. The patient's health history likely includes what diagnosis?

10 :
The nurse is caring for a patient with decreased blood flow to the kidneys. The patient's blood pressure has been in the range of 150/100 mmHg for several days. What is the most likely cause of this patient's hypertension?

1 : A nurse is caring for a patient taking a beta-blocker and a nitrate to treat angina. The nurse recognizes the need for careful monitoring due to which comorbidity?

2 : The nurse is preparing to administer digoxin to an infant. What is the nurse's priority intervention for this patient?

3 : What is the nurse's priority assessment question before administering an angiotensin II receptor blocker (ARB) to a female patient?

4 : A nurse is assessing a 78-year-old patient in the emergency department. The nurse determines the patient is experiencing severe digoxin toxicity. What is the nurse's priority action?

5 : A patient asks the nurse to explain why the left ventricle is so much larger than the right ventricle. Which explanation will the nurse provide?

6 : A patient diagnosed with angina has been prescribed nifedipine 15 mg PO three times a day. The patient has received the first two doses of the medication and reports dizziness. What is the nurse's PRIORITY action?

7 : The client has an order for penicillin 671 mg IV to infuse over 23 minutes. The medication available is penicillin 486 mg/68 mL NS. At what nurse set the infusion? mL/hr (If needed, round to the nearest whole number)

8 : The client has an order for methylphenidate (Ritalin) 5 mg orally. The medication available is methylphenidate 5 mg per scored tablet. How many tablets will the nurse administer?. needed, round to the nearest whole number.)

9 : The nurse is reviewing the medication regimen of a newly admitted patient. The patient currently takes dofetilide 250 mcg PO twice a day. The patient's health history likely includes what diagnosis?

10 : The nurse is caring for a patient with decreased blood flow to the kidneys. The patient's blood pressure has been in the range of 150/100 mmHg for several days. What is the most likely cause of this patient's hypertension?

1 :
A nurse is caring for a patient taking a beta-blocker and a nitrate to treat angina. The nurse recognizes the need for careful monitoring due to which comorbidity?

2 :
The nurse is preparing to administer digoxin to an infant. What is the nurse's priority intervention for this patient?

3 :
What is the nurse's priority assessment question before administering an angiotensin II receptor blocker (ARB) to a female patient?

4 :
A nurse is assessing a 78-year-old patient in the emergency department. The nurse determines the patient is experiencing severe digoxin toxicity. What is the nurse's priority action?

5 :
A patient asks the nurse to explain why the left ventricle is so much larger than the right ventricle. Which explanation will the nurse provide?

6 :
A patient diagnosed with angina has been prescribed nifedipine 15 mg PO three times a day. The patient has received the first two doses of the medication and reports dizziness. What is the nurse's PRIORITY action?

7 :
The client has an order for penicillin 671 mg IV to infuse over 23 minutes. The medication available is penicillin 486 mg/68 mL NS. At what nurse set the infusion? mL/hr (If needed, round to the nearest whole number)

8 :
The client has an order for methylphenidate (Ritalin) 5 mg orally. The medication available is methylphenidate 5 mg per scored tablet. How many tablets will the nurse administer?. needed, round to the nearest whole number.)

9 :
The nurse is reviewing the medication regimen of a newly admitted patient. The patient currently takes dofetilide 250 mcg PO twice a day. The patient's health history likely includes what diagnosis?

10 :
The nurse is caring for a patient with decreased blood flow to the kidneys. The patient's blood pressure has been in the range of 150/100 mmHg for several days. What is the most likely cause of this patient's hypertension?