Difficulty: Medium
Average Score: 88%
Simulated
Passage / Scenario
History and PhysicalThe client is a 54-year-old male with a history of hypertension and type 2 diabetes. He takes spironolactone 25 mg per day, metformin 500 mg twice a day, and 25 units of insulin glargine.
Orders
ÔÇó prescription of captopril 25mg by mouth twice a day
Laboratory Test
Hemoglobin A1C:
ÔÇó Result- 6.8%
ÔÇó Reference Range- 4 to 5.9%
For each instruction, click to indicate whether the instructions given by the nurse are indicated or contraindicated to prepare for the clientÔÇÖs first dose of captopril.
Rationale
Holding spironolactone reduces hyperkalemia risk with captopril, lying down manages hypotension, and monitoring blood pressure ensures safety. Increasing insulin or limiting fluids lacks rationale and risks hypoglycemia or dehydration.