Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants Que And Ans

A patient is admitted with severe hypertensive crisis. The nurse will anticipate administering which medication? a. Captopril PO b. Hydralazine [Apresoline] 25 mg PO c. Minoxidil 20 mg PO d. Sodium nitroprusside [Nitropress] IV - ANS ANS: D Sodium nitroprusside is the drug of choice for hypertensive emergencies and is given intravenously. ACE inhibitors, such as captopril, are not used. Hydralazine maybe used but should be given IV. Minoxidil is effective, but its severe side effects make it a second-line drug.DIF: Cognitive Level: ApplicationREF: pp. 373 TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies .A patient who took an overdose of verapamil has been treated with gastric lavage and a cathartic. The emergency department nurse assesses the patient and notes a heart rate of 50 beats/minute and a blood pressure of 90/50 mm Hg. The nurse will anticipate: a. administering intravenous norepinephrine (NE) and atropine and glucagon. b. assisting with direct-current (DC) cardioversion. c. placing the patient in an upright position. d. preparing to administer a beta blocker. - ANS ANS: A Verapamil toxicity can cause bradycardia and hypotension. Atropine and glucagon should be given to treat bradycardia and NE for hypotension. DC cardioversion is indicated for ventricular tachydysrhythmias, which this patient does not have. Patients with hypotension should be placed in Trendelenburg position. Beta blockers will only exacerbate these effects.DIF: Cognitive Level: ApplicationREF: pp. 366TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential A 5-year-old patient seen in an outpatient clinic is noted to have hypertension on three separate visits. Ambulatory blood pressure monitoring confirms that the child has hypertension. As an initial intervention with the child's parents, the nurse will expect to: a. perform a detailed health history on the child. b. provide teaching about antihypertensive medications. c. reassure the parents that their child may outgrow this condition. d. teach the parents about lifestyle changes and a special diet. - ANS ANS: A Because the incidence of secondary hypertension is much higher in children than in adults, it is important to obtain an accurate health history to help uncover primary causes. Once the type of hypertension is established, the teaching interventions may be useful. Hypertension must be treated, and it is incorrect to reassure parents that their child may just outgrow the condition.DIF: Cognitive Level: ApplicationREF: pp. 386TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation A 12-year-old female patient is admitted to the hospital before sinus surgery. The nurse preparing to care for this patient notes that the admission hemoglobin is 10.2 gm/dL, and the hematocrit is 32%. The nurse will ask the child's parents which question about their daughter? a. "Does she eat green, leafy vegetables?" b.