Page 1802 - Saunders Comprehensive Review For NCLEX-RN

3. 0.9 ng/mL (1.14 nmol/L)
4. 2.2 ng/mL (2.8 nmol/L)
628. A client is being treated with procainamide for a cardiac dysrhythmia.
Following intravenous administration of the medication, the client complains
of dizziness. What intervention should the nurse take first?
1. Obtain a 12-lead electrocardiogram.
2. Check the client’s fingerstick blood glucose level.
3. Auscultate the client’s apical pulse and blood pressure.
4. Measure the QRS interval duration on the rhythm strip.
629. The nurse is monitoring a client with hypertension who is taking
propranolol. Which assessment finding indicates a potential adverse
complication associated with this medication?
1. Report of infrequent insomnia
2. Development of expiratory wheezes
3. A baseline blood pressure of 150/80 mm Hg followed by a blood
pressure of 138/72 mm Hg after 2 doses of the medication
4. A baseline resting heart rate of 88 beats per minute followed by a
resting heart rate of 72 beats per minute after 2 doses of the
medication
630. A client with valvular heart disease who has a clot in the right atrium is
receiving a heparin sodium infusion at 1000 units/hr and warfarin sodium
7.5 mg at 5:00 p.m. daily. The morning laboratory results are as follows:
activated partial thromboplastin time (aPTT), 32 seconds; international
normalized ratio (INR), 1.3. The nurse should take which action based on the
client’s laboratory results?
1. Collaborate with the primary health care provider (PHCP) to
discontinue the heparin infusion and administer the warfarin
sodium as prescribed.
2. Collaborate with the PHCP to obtain a prescription to increase the
heparin infusion and continue the warfarin sodium as prescribed.
3. Collaborate with the PHCP to withhold the warfarin sodium since
the client is receiving a heparin infusion and the aPTT is within
the therapeutic range.
4. Collaborate with the PHCP to continue the heparin infusion at the
same rate and to discuss use of dabigatran etexilate in place of
warfarin sodium.
631. A client is diagnosed with an ST segment elevation myocardial infarction
(STEMI) and is receiving a tissue plasminogen activator, alteplase. Which
action is a priority nursing intervention?
1. Monitor for kidney failure.
2. Monitor psychosocial status.
3. Monitor for signs of bleeding.
4. Have heparin sodium available.
632. The nurse is monitoring a client for adverse effects of medications. Which
findings are characteristic of adverse effects of hydrochlorothiazide? Select
all that apply.

1. Sulfa allergy

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