NURS MISCComprehensive 1
1. A client with asthma receives a prescription for high blood pressure during
a clinic visit. Which prescription should the nurse anticipate the client to
receive that is least likely to exacerbate asthma?
Pindolol (Visken).
Carteolol
(Ocupress).
Metoprolol tartrate (Lopressor). Correct
Propranolol hydrochloride (Inderal).
The best antihypertensive agent for clients with asthma is metoprolol (Lopressor)
(C), a beta2 blocking agent which is also cardioselective and less likely to cause
bronchoconstriction.
Pindolol (A) is a beta2 blocker that can cause bronchoconstriction and increase
asthmatic symptoms. Although carteolol (B) is a beta blocking agent and an
effective antihypertensive agent used in managing angina, it can increase a client's
risk for bronchoconstriction due to its nonselective beta blocker action. Propranolol
(D) also blocks the beta2 receptors in the lungs, causing bronchoconstriction, and
is not indicated in clients with asthma and other obstructive pulmonary disorders.
2. A male client who has been taking propranolol (Inderal) for 18 months tells
the nurse that the healthcare provider discontinued the medication because
his blood pressure has been normal for the past three months. Which
instruction should the nurse provide?
Report any uncomfortable symptoms after stopping the
medication. Stop the medication and keep an accurate
record of blood pressure.
Ask the healthcare provider about tapering the drug dose over the next week.
Correct Obtain another antihypertensive prescription to avoid withdrawal
symptoms.
Although the healthcare provider discontinued the propranolol, measures to
prevent rebound cardiac excitation, such as progressively reducing the dose over
one to two weeks (C), should be recommended to prevent rebound tachycardia,
hypertension, and ventricular dysrhythmias. Abrupt cessation (A and B) of the beta-
blocking agent may precipitate tachycardia and rebound hypertension, so gradual
weaning should be recommended. (D) is not indicated.
3. A client who is taking clonidine (Catapres, Duraclon) reports
drowsiness. Which additional assessment should the nurse make?
How long has the client been taking the medication?
,NURS MISCComprehensive 1
Correct Does the client use any tobacco products?
Has the client experienced constipation
recently? Did the client miss any doses of
the medication?
,NURS MISCComprehensive 1
Drowsiness can occur in the early weeks of treatment with clonidine and with
continued use becomes less intense, so the length of time the client has been on
the medication (A) provides information to direct additional instruction. (B, C, and
D) are not relevant.
4. The nurse is preparing to administer atropine, an anticholinergic, to a client
who is scheduled for a cholecystectomy. The client asks the nurse to explain
the reason for the prescribed medication. What response is best for the
nurse to provide?
Provide a more rapid induction of anesthesia.
Decrease the risk of bradycardia during surgery.
Correct Induce relaxation before induction of
anesthesia.
Minimize the amount of analgesia needed postoperatively.
Atropine may be prescribed preoperatively to increase the automaticity of the
sinoatrial node and prevent a dangerous reduction in heart rate (B) during surgical
anesthesia. (A, C and D) do not address the therapeutic action of atropine use
perioperatively.
5. An 80-year-old client is given morphine sulphate for postoperative pain.
Which concomitant medication should the nurse question that poses a
potential development of urinary retention in this geriatric client?
Insulin.
Antacid
s.
Tricyclic antidepressants. Correct
Nonsteroidal antiinflammatory
agents.
Drugs with anticholinergic properties, such as tricyclic antidepressants (C), can
exacerbate urinary retention associated with opioids in the older client. Although
tricyclic antidepressants and antihistamines with opioids can exacerbate urinary
retention, the concurrent use of (A and B) with opioids do not. Nonsteroidal
antiinflammatory agents (D) can increase the risk for bleeding, but do not increase
urinary retention with opioids (D).
6. A client with osteoarthritis is given a new prescription for a nonsteroidal
antiinflammatory drug (NSAID). The client asks the nurse, "How is this
medication different from the acetaminophen I have been taking?" Which
information about the therapeutic action of NSAIDs should the nurse
provide?
, NURS MISCComprehensive 1
Are less expensive.
Provide antiinflammatory response.
Correct Cause gastrointestinal
bleeding.
Increase hepatotoxic side effects.
1. A client with asthma receives a prescription for high blood pressure during
a clinic visit. Which prescription should the nurse anticipate the client to
receive that is least likely to exacerbate asthma?
Pindolol (Visken).
Carteolol
(Ocupress).
Metoprolol tartrate (Lopressor). Correct
Propranolol hydrochloride (Inderal).
The best antihypertensive agent for clients with asthma is metoprolol (Lopressor)
(C), a beta2 blocking agent which is also cardioselective and less likely to cause
bronchoconstriction.
Pindolol (A) is a beta2 blocker that can cause bronchoconstriction and increase
asthmatic symptoms. Although carteolol (B) is a beta blocking agent and an
effective antihypertensive agent used in managing angina, it can increase a client's
risk for bronchoconstriction due to its nonselective beta blocker action. Propranolol
(D) also blocks the beta2 receptors in the lungs, causing bronchoconstriction, and
is not indicated in clients with asthma and other obstructive pulmonary disorders.
2. A male client who has been taking propranolol (Inderal) for 18 months tells
the nurse that the healthcare provider discontinued the medication because
his blood pressure has been normal for the past three months. Which
instruction should the nurse provide?
Report any uncomfortable symptoms after stopping the
medication. Stop the medication and keep an accurate
record of blood pressure.
Ask the healthcare provider about tapering the drug dose over the next week.
Correct Obtain another antihypertensive prescription to avoid withdrawal
symptoms.
Although the healthcare provider discontinued the propranolol, measures to
prevent rebound cardiac excitation, such as progressively reducing the dose over
one to two weeks (C), should be recommended to prevent rebound tachycardia,
hypertension, and ventricular dysrhythmias. Abrupt cessation (A and B) of the beta-
blocking agent may precipitate tachycardia and rebound hypertension, so gradual
weaning should be recommended. (D) is not indicated.
3. A client who is taking clonidine (Catapres, Duraclon) reports
drowsiness. Which additional assessment should the nurse make?
How long has the client been taking the medication?
,NURS MISCComprehensive 1
Correct Does the client use any tobacco products?
Has the client experienced constipation
recently? Did the client miss any doses of
the medication?
,NURS MISCComprehensive 1
Drowsiness can occur in the early weeks of treatment with clonidine and with
continued use becomes less intense, so the length of time the client has been on
the medication (A) provides information to direct additional instruction. (B, C, and
D) are not relevant.
4. The nurse is preparing to administer atropine, an anticholinergic, to a client
who is scheduled for a cholecystectomy. The client asks the nurse to explain
the reason for the prescribed medication. What response is best for the
nurse to provide?
Provide a more rapid induction of anesthesia.
Decrease the risk of bradycardia during surgery.
Correct Induce relaxation before induction of
anesthesia.
Minimize the amount of analgesia needed postoperatively.
Atropine may be prescribed preoperatively to increase the automaticity of the
sinoatrial node and prevent a dangerous reduction in heart rate (B) during surgical
anesthesia. (A, C and D) do not address the therapeutic action of atropine use
perioperatively.
5. An 80-year-old client is given morphine sulphate for postoperative pain.
Which concomitant medication should the nurse question that poses a
potential development of urinary retention in this geriatric client?
Insulin.
Antacid
s.
Tricyclic antidepressants. Correct
Nonsteroidal antiinflammatory
agents.
Drugs with anticholinergic properties, such as tricyclic antidepressants (C), can
exacerbate urinary retention associated with opioids in the older client. Although
tricyclic antidepressants and antihistamines with opioids can exacerbate urinary
retention, the concurrent use of (A and B) with opioids do not. Nonsteroidal
antiinflammatory agents (D) can increase the risk for bleeding, but do not increase
urinary retention with opioids (D).
6. A client with osteoarthritis is given a new prescription for a nonsteroidal
antiinflammatory drug (NSAID). The client asks the nurse, "How is this
medication different from the acetaminophen I have been taking?" Which
information about the therapeutic action of NSAIDs should the nurse
provide?
, NURS MISCComprehensive 1
Are less expensive.
Provide antiinflammatory response.
Correct Cause gastrointestinal
bleeding.
Increase hepatotoxic side effects.
