Critical Care Comprehensive Exam 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?
A. Carteolol (Ocupress).
B. Propranolol hydrochloride (Inderal).
C. Pindolol (Visken). Incorrect
D. Metoprolol tartrate (Lopressor). Correct
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?
A. Obtain another antihypertensive prescription to avoid withdrawal
symptoms.
B. Stop the medication and keep an accurate record of blood pressure.
C. Report any uncomfortable symptoms after stopping the medication.
D. Ask the healthcare provider about tapering the drug dose over the next
week. Correct
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
1 / 4
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?
A. Has the client experienced constipation recently?
B. Did the client miss any doses of the medication?
C. How long has the client been taking the medication? Correct
D. Does the client use any tobacco products?
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.
0 Comments