Cardiac 2
Which of the following indicates that a patient understands how to use sublingual nitroglycerin?
"I should feel a fizzing or burning sensation."
The nurse is preparing a patient for discharge who will receive a prescription for an beta-hydroxy-beta-methylglutaryl coenzyme A HMG-CoA)inhibitor What statement by the patient demonstrates that they have a clear understanding of the teaching provided
"Ishouldplantotakethisdrugbeforebedtimebecausemybodymakeslipids mostly at night'
The patient is receiving niacin. Although this drug is effective in lowering lipid levels, the patient complains of uncomfortable flushing. What is the best education by the nurse?
"Take one aspirin 30 minutes before you take your niacin."
A murse is teaching a client who has a new prescription for Clopidogrel (Plavix) an antiplatelet agent. Which of the following instructions should the nurse include?
"You might have to stop taking this medication 5 days before any planned surgeries"
The nurse is planning a teaching session for a client newly diagnosed with Hemophilia A. Which information should be included?
A substance that is part of the clotting process is missing.
The patient is taking a statin drug. Which assessment data would be a priority for the nurse to report immediately to the physician?
A. "My calves hurt, and I had a hard time walking to the bathroom."
A clinic nurse is developing a teaching handout for clients who are prescribed warfarin (Coumadin) therapy. Which statements should be included in this information? Select all that apply.
A. "Tell your dentist you are taking warfarin prior to any procedures." C. "Use a soft bristle toothbrush."
The client diagnosed with angina who is prescribed nitroglycerin (NTG) tells the nurse, "I don't understand why I can't take my sildenafil. I need to take it so that I can make love to my wife." Which statement is the nurse's best response?
A. If you take the medications together, they may cause you to have very low blood pressure.
Captopril is often used to treat heart failure. Which of the following best describes the mechanism of action of captopril?
A. It has an antagonistic effect on angiotensin-converting enzyme.
A nurse assessing a client on a heparin drip notes bloody drainage in the nasogastric tube and indwelling urinary catheter. A stat partial thromboplastin time (PTT) is drawn according to heparin protocol. The result is 224 seconds Which action by the nurse is
A. Notify the healthcare provider and prepare to administer protamine sulfate.
A client with chronic stable angina is reporting chest pain. The nurse notices that the transdermal nitroglycerin patch that was applied an hour ago has peeled off. The clients vital signs are stable. Look at the medication orders below. What is the nurses priority action? Med administration record: Medications Schedule Aspirin tablet: 81mg, PO, daily 0800 Metopero:l 25 mg, PO, every 12 hours 0800 and 2000 Nitroglycerin patch: 0.4mg, transdermal, daily, remove after 12 hours 0800 Morphine Sulfate: 2mg. IV push, every 6 hours PRN for pain Nitroglycerin tablets: 0.4 mg sublingual, q5 minutes PRN, up to 2 additional dose PRN
B. Administer PRN sublingual nitroglycerine
A healthcare professional is caring for a patient who is about to begin using transdermal nitroglycerin (Nitro-Dur) to treat angina pectoris. When talking with the patient about the drug, the healthcare professional should include which of the following instructions? (Select all that apply)
B. Apply the patch to a hairless area and rotate sites D. Apply a new patch each morning
A hospitalized client has been treated for the past 48 hours with a continuous heparin infusion for a deep vein thrombosis (DVT). When the nurse prepares to administer the evening dose of warfarin, the client's spouse says, "Wait My spouse can't have that! My spouse is already getting heparin for DVT. How should the nurse respond?
B. Both medications will be given for several days until the warfarin has time to take
A client diagnosed with myocardial infarction is prescribed thrombolytic therapy. The nurse recognizes that which is the goal of this therapy
B. Dissolve clots
A nurse is teaching a client who has a new prescription for Ferrous sulfate. Which of the following statements by the client indicates an understanding of the teaching?
B. I should expect dark,black-green stools
A healthcare professional is caring for a patient who is about to begin taking Simvastatin (Zocor) to treat hyperlipidemia.The healthcare professional should tell the patient to report which of the following indications of a serious adverse reaction which could warrant stopping drug therapy?
B. Muscle pain
The nurse is administering a loop diuretic. The nurse must monitor for which of the following adverse effects specific to the loop class of diuretics?
B. Ototoxicity
NGN: A nurse is admitting a client to a medical surgical unit following a fall at home. Which of the medications should the nurse question the provider about prior to administration. (select all that apply).
B. Spironolactone C. Ferrous sulfate
A patient is being discharged on cholestyramine (Questran). Patient teaching should include what about this medication?
B. Take other drugs 2 hours before or 4 hours after cholestyramine
The client who has had a gastric bypass surgery asks the nurse. "Why do I need to take vitamin B Injections? Which statement is the nurse's best response?
B. Your body cannot absorb the vitamins from the food you eat
A hospitalized client is prescribed warfarin (Coumadin). The nurse teaches the client to avoid which food on the lunch selection menu?
Broccoli salad
An adult client is brought to the emergency department (ED) and diagnosed with a thrombotic stroke. The team plans to administer alteplase (Activase). The client makes the following comments to a nurse. Which information is critical for the nurse to relay to the healthcare provider?
C. "I wonder if this was happening when I fell and hit my head last week."
A client is being treated for a thrombotic disorder. If the goal is to prevent clot formation, the nurse anticipates the client will be treated with which classifications of drug? Select all that apply.
C. Anticoagulants D. Antiplatelet agents
A client with deep vein thrombosis (DVT) is receiving a continuous infusion of heparin The client asks the nurse what the heparin is for. How should the nurse respond?
C. Heparin will keep the current clot from getting bigger and help prevent new clots from forming
A client is diagnosed with an ST-segment elevation myocardial infarction (STEM) and Is receiving tissue plasminogen activator ( TPA). Which action is a priority nursing intervention?
C. Monitor for signs of bleeding
The nurse is preparing to administer Clopidogrel to the client with coronary artery disease. The client asks the nurse, "Why am I getting this medication?" Which statement by the nurse is most appropriate?
C. This medication will help prevent your blood from clotting in the arteries
The client diagnosed with coronary artery disease is instructed to take 81mg of aspirin. Which statement best describes the scientific rationale for prescribing this medication?
C. This medication will prevent platelet aggregation
NGN: A nurse in a medical clinic is caring for a client who has come in for their annual BMI = 19 Client reports they started following a strict vegan diet one month ago. Hand grasps strong and equal bilaterally. Breath sounds clear and present throughout. Apical heart rate is regular and strong. Abdomen is flat and soft. Bowel sounds are present. Skin warm and dry, buccal mucosa pink, skin color is consistent with the client's genetic background Het 38% Hgb 13 g/dL Platelet 350.000/mm3 6 months after annual visit: Client made appointment today due to experiencing paresthesia of fingers and toes, muscle weakness, and fatigue. BMI = 18 Breath sounds clear and present throughout. Apical heart rate is strong, regular, and slightly tachycardic. No murmurs are auscultated. Skin cool, buccal mucosa pale. nailbeds are pale for the client's genetic background, tongue appears red and smooth Het 26% Hgb 8 g/dL Platelet 275,
C. Vitamin B12 anemia E. OralB-12supplements
The nurse is teaching the client diagnosed with angina about sublingual nitroglycerin (NTG). Which statement indicates the client needs more teaching?
C. if my pain is not relieved with one tablet. I will seek medical help
The nurse is administering iron dextran to a client diagnosed with iron-deficiency anemia. Which intervention should the nurse implement?
D. Administer the medication by the Z-track method
The client prescribed heparin therapy asks how the "blood thinner" works. Which response by the nurse is the most appropriate?
D. Heparin prevents clots from forming.
A client with stable angina is being discharged home with a prescription for a transdermal patch. The nurse reviewed discharge instructions on the medication with the client. Which statement by the client indicates the teaching has been effective?
D. I will rotate the site where I apply the patch.
A client recently diagnosed with heart failure is being discharged with a prescription for lisinopril. Which client teaching related to this new medication is important to review at discharge?
D. Teach the client to rise slowly and sit on side of bed for several minutes before rising.
The nurse is assigned to watch the cardiac monitors in the constant care unit and notes four different patients displaying arrhythmias. Which arrhythmia is the nurse's highest immediate priority?
D. Ventricular fibrillation
A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's INR is 6.2. Which of the following medications should the nurse prepare to administer?
D. Vitamin K
A client who had Gastric bypass surgery 6 months ago is profoundly anemic. The client has memory loss and periodic hallucinations. A diagnosis of folate deficiency has been proposed. Why would the nurse question this provisional diagnosis?
Folate deficiency anemia does not produce neurologic symptoms.
The nurse is preparing to hang the next bag of heparin to a client diagnosed with DVT. 'The client's current laboratory values are as follows PT 12.7 (control 12.9) INR 1 PTT 63 (control 36) T Which intervention should the nurse implement?
Hang the IV bag at the same rate
A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values should indicate to the nurse that the therapy is
Hgb
The nurse is providing group education about lipids to patients who have been diagnosed with hyperlipidemia What does the the instruction include?
High density lipoprotein (HIDI) is called good, cholesterol from the body and gets rid of it in the liver.
Bile acid binding drugs produce their therapeutic effects by:
Increasing excretion of cholesterol in the feces
The nurse is preparing to administer a calcium channel blocker to a client experiencing angina. Which mechanism of action makes this medication appropriate for this client?
It decreases afterload.
The nurse is caring for a client newly prescribed the combination of amlodipine and lisinopril.. Which client statement is MOST concerning to the nurse?
My tongue feels strange and thick for a while after I take these mediations
The nurse teaches the patient that intake of potassium-rich foods should NOT be increased during therapy with which of the following medications?
Spironolactone (Aldactone)
The nurse administers a Cardiac glycoside for what therapeutic effect?
To increase the force of the contraction of the heart
A nurse is providing discharge teaching for a client who has a new prescription for warfarin.Which of the following instructions should the nurse include in the teaching?
Use an electric razor while on this medication
A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?
Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
You are caring for a patient in the Emergency Department (ED) who is in Pulmonary edema. The patient is treated with furosemide (Lasix). What will you monitor?
potassium levels
