A nurse is reviewing the medical record of a client who received medications 1 hour ago and reports having chest pain. The nurse should recognize that chest pain can be an adverse effect of which of the following medications?
Albuterol
Furosemide
Digoxin
Atenolol
The Correct Answer is A
Rationale:
A. Albuterol: This is a bronchodilator that can cause side effects such as increased heart rate and chest pain due to its stimulant effect on the cardiovascular system.
B. Furosemide: This diuretic is unlikely to cause chest pain directly; however, it may lead to electrolyte imbalances that can indirectly affect cardiac function.
C. Digoxin: While digoxin has several potential side effects, chest pain is not commonly recognized as a direct adverse effect of this medication.
D. Atenolol: This medication is a beta-blocker used to manage hypertension and is unlikely to cause chest pain; rather, it may help alleviate angina symptoms.
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Correct Answer is B
Explanation
Rationale:
A. Hydrochlorothiazide does not prevent angiotensin II from binding with receptor sites; this action is typically associated with ACE inhibitors or angiotensin receptor blockers.
B. Hydrochlorothiazide decreases the reabsorption of sodium and water in the distal renal tubule, which leads to increased urine output and decreased blood volume, effectively lowering blood pressure.
C. Hydrochlorothiazide does not block beta receptors; this is the mechanism of action for beta-blockers.
D. Hydrochlorothiazide does not promote the movement of extravascular fluids into the vascular compartment; instead, it reduces blood volume by promoting diuresis.
Correct Answer is A
Explanation
Rationale:
A. Requesting a serum trough level blood draw for 60 minutes after the completion of the infusion is appropriate for monitoring the therapeutic levels of vancomycin and ensuring it is within the desired range to prevent toxicity.
B. Changing the infusion site after each dose administration is not necessary unless there is an issue such as infiltration or phlebitis; typically, the site can be used for multiple doses if it remains patent and functional.
C. Contacting the provider for prescription clarification is not needed unless there are specific concerns about the medication or the administration protocol; in this case, the order is clear and standard.
D. Requesting a serum peak level to be drawn 30 minutes prior to infusion is incorrect, as the peak level should be drawn 30 minutes after the completion of the infusion, not before the next dose.