Exam 2 Drugs & Disease
A 37-year-old client presents with a blood pressure of 118/86 mm Hg. What advice should the nurse provide to this client?
"Be aware of your salt intake and limit hidden salt."
What is the focus of the renal system's renin-angiotensin-aldosterone system?
The regulation of blood pressure
The nurse is teaching a 45-year-old client about ways to lower elevated cholesterol levels. One method to lower cholesterol levels is to exercise, which:
increases HDL and decreases triglycerides
A client's serum cholesterol is 286 mg/dL. Lovastatin (Mevacor) is prescribed. The nurse plans care based on the fact that the action of lovastatin
inhibits the production of cholesterol
The nurse is taking care of a client with high cholesterol and triglyceride values. In teaching the client about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired goal for cholesterol levels is:
low LDL values and high HDL values
A 58-year-old man has recently been prescribed atorvastatin (Lipitor) in an effort to reduce his cholesterol levels. The man has acknowledged the potentially harmful effects of hyperlipidemia and is motivated to make changes to resolve this health problem. What advice should the nurse give to this client?
"It's a good idea to keep your intake of saturated fat to a bare minimum."
A client was given a new prescription for a transdermal nitroglycerin patch. What client education should the nurse provide regarding this medication
"Put your patch on a part of your skin that doesn't have too much hair on it."
The nurse teaches the client how to use topical nitroglycerin and includes what teaching points in the teaching plan? Select all that apply
"Rotate application sites." "Assess the skin for signs of breakdown."
A client is diagnosed with angina pectoris. What would the nurse include when explaining this condition to the client
"The heart muscle isn't getting enough oxygen."
A patient is switched from furosemide (Lasix) to spironolactone (Aldactone). The patient asks the nurse why she has been switched to a new medicine. What is the best answer that will provide patient education regarding the change
"You will lose less potassium with spironolactone than with furosemide."
A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which action should the nurse do first when he reports chest pain?
Administer a tablet under the tongue and repeat the action in 5 and 10 minutes if the pain has not subsided
In which situation would blood be most likely to be rapidly relocated from central circulation to the lower extremities?
A client is helped out of bed and stands up
A nurse is caring for a client with acute renal failure. The health care provider has prescribed a diuretic therapy for the client to promote dieresis. What intervention should the nurse perform to prevent the inconvenience caused by increased urination
Administer the drug early in the day
A nurse is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics. Treatment of high cholesterol using statins would be contraindicated in which client?
An obese male client who is a heavy alcohol user and who has cirrhosis of the liver
The client has a daily antihypertensive medication prescribed. Taking the blood pressure prior to administration of the medication is which step of the nursing process?
Assessing
When considering vital signs, which assessment is focused on the functioning of the body's resistance system
Blood pressure
Beta-adrenergic blockers help to control angina but can cause
Decreased contraction of the heart
A client is diagnosed with atherosclerosis. What would the nurse say is the most likely cause of his angina
Decreased oxygenation to the myocardium
A client is diagnosed with atherosclerosis. What would the nurse say is the most likely cause of his angina?
Decreased oxygenation to the myocardium
A nurse is caring for a client who has been diagnosed with primary hypertension. What nursing interventions should be included in the teaching plan? Select all that apply.
Diet with more fruits and vegetables Regular aerobic exercise Decreased alcohol consumption Smoking cessation
What type of diet should a patient taking diuretics have?
Eat potassium-rich or low-potassium diet as appropriate
What intervention may help the client increase HDL levels?
Exercise
The nurse assists and educates clients about blood pressure regulation. Which information is important to include in the review with clients about blood pressure?
Force exerted by the blood against the walls of the blood vessels
A 50-year-old man is having routine blood work done as part of his yearly physical. The doctor informs him that his good cholesterol is low. To which form of cholesterol is the doctor referring
HDL
The health care provider is discussing major risk factors for coronary artery disease (CAD) with a client. The most important information for the provider to include would be
History of cigarette smoking and elevated blood pressure
Atherosclerosis begins in an insidious manner with symptoms becoming apparent as long as 20 to 40 years after the onset of the disease. Although an exact etiology of the disease has not been identified, epidemiologic studies have shown that there are predisposing risk factors to this disease. What is the major risk factor for developing atherosclerosis
Hypercholesterolemia
The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be
Hypertension
A client who has been taking hydrochlorothiazide arrives at the clinic for his 1-month follow-up appointment. The client tells the nurse that he feels weaker since he began taking the drug. What should the nurse consider as a possible cause of these symptoms
Hypokalemia
The nurse is caring for a client with hypertension and recognizes this will have what impact on afterload
Increased afterload
The student attends a health fair and has his serum cholestrol checked. He has a high lipoprotein level (LDL). He understands which of the following about LDL cholesterol
It is believed to play an active role in the pathogenesis of the atherosclerotic lesion
A nurse has been assigned to patient who receives hydrochlorothiazide each morning for the treatment of primary hypertension. Which of the following components of the patient's morning blood work should prompt the nurse to temporarily hold the drug this morning and consult with the physician
K+ 3.0 mEq/L
How is the blood pressure affected by kidney function
Kidney function alters sodium retention
A client diagnosed with hyperlipidemia is prescribed a statin. The nurse is reviewing the client's history and would notify the client's health care provider if which condition was noted in the client's history?
Liver disease
While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which physiologic process
Peripheral Vascular Resistance
A nurse is caring for a client who is taking digoxin and a loop diuretic. Which would be most important for the nurse to monitor
Potassium levels
The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide?
Potassium losses are greater with hydrochlorothiazide than with spironolactone
A nurse is measuring the BP of a client. The client asks what the BP measures. What is the best response by the nurse about the measurement of BP?
Pressure of blood within the arteries
The nurse cautions a client receiving nitrate therapy about avoiding the use of alcohol to prevent which reaction?
Severe hypotension
A 37-year-old woman with moderately elevated lipid levels requests immediate pharmacotherapy for her dyslipidemia. The nurse explains that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered. The nurse explains the rationale for this regimen as:
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
A nurse is providing patient teaching to a patient who has been experiencing unstable angina. What will the nurse's explanation of this condition include
There is a pronounced narrowing of the coronary arteries, and the heart is experiencing episodes of ischemia or lack of oxygen even when you are resting
When a combination of drugs needs to be incorporated into the drug regimen for a hypertensive client, what type of diuretic is typically used to treat hypertension initially
Thiazide
The nurse is reviewing with the client the three major layers of the heart wall and how they relate to the pericardium. What is the best description by the nurse to the client about the myocardium layer of the heart?
Thick, strong muscles making up the middle layer
A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for treatment of hypertension. What expected outcome does the nurse expect this medication will have
Will prevent the conversion of angiotensin I to angiotensin II
A 26-year-old white male client has been prescribed captopril for hypertension. A nurse has been assigned to the client to provide education regarding the use of this drug. The nurse will advise the client that:
a persistent, dry cough may occur; however, it is not serious.
A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication
at bedtime
When providing medication teaching about to a client prescribed spironolactone, what foods should the client be instructed to avoid?
bananas
A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regularly assessing the patient's heart rate, the nurse should prioritize assessment of the patient's
blood pressure
A client with angina is prescribed propranolol. Following absorption of the drug, the nurse should monitor the client for what desired effect
decreased heart rate
An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for
falls
A patient who was diagnosed with hypertension and started on losartan calls the clinic 2 weeks after beginning the therapy. She reports to the nurse that she still feels "funny in the head" and that according to her daughter-in-law, who is a nurse and who is monitoring her blood pressure, her blood pressure is still high. The nurse will question the patient concerning
taking her medication with grapefruit juice