exam 4 saunder

Atenolol has been prescribed for a client with hypertension, and the client asks the nurse about the side effects of the medication. What should the nurse tell the client is an occasional side effect of this medication?

Decreased libido

A client admitted to the hospital is taking atenolol. The nurse monitors the client for which sign or symptom of an adverse effect of the medication?

Hypotension

What should the nurse anticipate when evaluating for the effects of raloxifene in an older client?

Increased bone density

A client with cardiac disease has begun taking propranolol, and the nurse provides information to the client about the medication. The nurse should tell the client to contact the primary health care provider (PHCP) if which symptoms develop?

Night cough and dyspnea Propranolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, antidysrhythmic, and antimigraine medication. It may precipitate heart failure or myocardial infarction in clients with cardiac disease. Signs of heart failure include dyspnea (particularly on exertion or lying down), night cough, peripheral edema, and distended neck veins. If signs of heart failure occur, the PHCP should be notified.

The nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris. The client is receiving sotalol orally daily. Which assessment finding indicates to the nurse that the client is experiencing a side or adverse effect related to the medication?

Palpitations

The nurse is reviewing the use of diltiazem for clients with Prinzmetal's variant angina. The nurse should provide information based on which action of the medication?

The medication works by inhibiting calcium movement across cell membranes of cardiac and smooth muscle.

The nurse is administering a dose of a prescribed diuretic to an assigned client. The nurse should monitor the client for hypokalemia as a side effect of therapy if the client has been receiving which medication?

Bumetanide Bumetanide is a loop diuretic that places the client at risk for hypokalemia.

A client with hypertension has begun taking spironolactone. The nurse teaches the client to limit intake of which food?

Citrus fruits

The primary health care provider has prescribed clonidine for a client with hypertension. The nurse should inform the client that which is a side effect of this medication?

Constipation Side effects of clonidine include dry mouth, drowsiness, constipation, and hypotension.

A home health nurse instructs a client about the use of a nitrate patch. The nurse should make which statement to the client to prevent client tolerance to nitrates?

"Have a 12-hour 'no-nitrate' time."

The nurse has completed giving medication instructions to a client receiving benazepril. Which client statement indicates to the nurse that the client needs further instruction?

"I can use salt substitutes freely and eat foods high in potassium."he client taking an angiotensin-converting enzyme (ACE) inhibitor is instructed to take the medication exactly as prescribed, to monitor blood pressure weekly, and to continue with other lifestyle changes to control hypertension. The client should change positions slowly to avoid orthostatic hypotension and report fever, mouth sores, or sore throat (neutropenia) to the health care provider. In addition, salt substitutes and high-potassium foods should be avoided because they contain potassium and increase the risk for hyperkalemia.

A client with angina pectoris has been given a new prescription for nitroglycerin transdermal patches. The client indicates an understanding of how to use this medication administration system by making which statement?

"I need to apply the patch in the morning and leave it in place for 12 to 14 hours as directed."

The nurse has given a client information about the use of nitroglycerin sublingual tablets. The client has a prescription for PRN (as needed) use if chest pain occurs. Which client statement indicates an understanding of this medication?

"I need to discard unused tablets 6 months after the bottle is opened."

The clinic nurse is providing instructions to a client with hypertension who will be taking captopril. Which statement by the client indicates a need for further instruction?

"I need to drink at least 4 quarts (4 liters) of water daily."

A home health care nurse is visiting an older client at home. Furosemide is prescribed for the client, and the nurse teaches the client about the medication. Which statement, if made by the client, indicates the need for further teaching?

"I need to drink lots of coffee and tea to keep myself healthy."

Atenolol has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching?

"If I feel that my heart rate is too low, I should stop the medication."

The home care nurse has given instructions to a client who is beginning therapy with digoxin for atrial fibrillation. The nurse determines a need for further teaching if the client makes which statement?

"If I miss a dose, I should just take 2 the next day."

A client is experiencing impotence after taking guanfacine. The client states, "I would sooner have a stroke than keep living with the effects of this medication." What is the most appropriate response by the nurse?

"You are concerned about the effects of your medication."

A client with nausea and bradycardia is admitted to a medical unit. The family hands the nurse a small white envelope labeled "heart pill." The envelope is sent to the pharmacy and it is found to be digoxin. A family member states, "That primary health care provider doesn't know how to take care of my family." Which statement would convey a therapeutic response by the nurse?

"You are concerned your loved one receives the best care."

A hospitalized client with coronary artery disease complains of substernal chest pain. After assessing the client's heart rate and blood pressure, the nurse administers nitroglycerin, 0.4 mg sublingually. After 5 minutes the client states, "My chest still hurts." Which actions should the nurse take? Select all that apply.

-Assess the client's pain level. -Check the client's blood pressure. -Administer a second nitroglycerin, 0.4 mg sublingually.

Potassium chloride intravenously is prescribed for a client with heart failure experiencing hypokalemia. Which actions should the nurse take to plan for preparation and administration of the potassium? Select all that apply.

-Obtain an intravenous (IV) infusion pump. -Monitor urine output during administration. -Monitor the IV site for signs of infiltration or phlebitis. -Ensure that the medication is diluted in the appropriate volume of fluid. -Ensure that the bag is labeled so that it reads the volume of potassium in the solution.

The nurse is preparing to administer furosemide 40 mg by intravenous (IV) injection (IV push) to a client. The nurse should administer the medication over which time period?

2 minutes

A client who is receiving digoxin daily has a serum potassium level of 3 mEq/L (3 mmol/L) and reports anorexia. The health care provider prescribes a serum digoxin level to be done. The nurse checks the results and should recognize which level that is outside of the therapeutic range?

2.2 ng/mL (2.8 nmol/L) The optimal therapeutic range for digoxin is 0.5 to 2.0 ng/mL (0.63 to 2.56 nmol/L). If the client is experiencing symptoms such as anorexia and is experiencing hypokalemia as evidenced by a low potassium level, digoxin toxicity is a concern.

The nurse is caring for a client with hypertension who is receiving torsemide orally daily. Which laboratory test result would indicate to the nurse that the client may be experiencing a side or adverse effect related to the medication?

A potassium level of 3.1 mEq/L (3.1 mmol/L)

A hospitalized client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin, gr 1/4 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure remains stable, the nurse should take which action next?

Administer another nitroglycerin tablet.

The nurse has completed medication administration that included a nitroglycerin. Within minutes, the client is complaining of a headache. Which is the priority nursing action at this time?

Administer the prescribed analgesic.

Hydrochlorothiazide has been prescribed for a client with hypertension. The nurse contacts the primary health care provider (PHCP) to verify the prescription if which condition is noted in the assessment data?

Allergy to sulfonamides Hydrochlorothiazide is a diuretic and antihypertensive medication that is used to treat mild to moderate hypertension, edema associated with heart failure, and nephrotic syndrome. The medication is a sulfonamide derivative. A contraindication to the use of this medication is a history of hypersensitivity to sulfonamides.

The nurse notes a persistent, dry cough in an adult client being seen in the ambulatory clinic. When questioned, the client states that the cough began approximately 2 months ago. On further assessment, the nurse learns that the client began taking quinapril shortly before the time that the cough began. How should the nurse interpret the development of the cough?

An expected although bothersome side effect of therapy

A client in the hospital emergency department who received nitroglycerin for chest pain has obtained relief but now complains of a headache. The nurse should interpret that this client is most likely experiencing which condition?

An expected medication side effect

The primary health care provider (PHCP) writes a prescription for atenolol for a client who was admitted to the hospital. The nurse contacts the PHCP to verify the prescription if which finding is noted in the assessment data?

Apical heart rate is 48 beats/min.

A client has recently begun medication therapy with propranolol. The long-term care nurse should plan to notify the primary health care provider (PHCP) if which assessment finding is noted?

Audible expiratory wheezes

A client is scheduled for a dose of ramipril. The nurse should check which measurement before administering the medication?

Blood pressure

The nurse has given a client the prescribed dose of intravenous hydralazine. The nurse evaluates the effectiveness of the medication by monitoring which client parameter?

Blood pressure

The nurse is administering a dose of clonidine to a client. The nurse should ensure that which item is in place before injecting the medication?

Blood pressure cuff

In reviewing the medication records of a group of clients, the nurse determines that which client would be at greatest risk for developing hyperkalemia?

Client receiving spironolactone

A client taking verapamil has been given information about side effects of this medication. The nurse determines that the client understands the information if the client states to watch for which most common side effect of this medication?

Constipation

A client who began medication therapy with prazosin hydrochloride 1 week earlier arrives at the health care clinic for follow-up evaluation and care. The nurse interprets that the client is experiencing the expected benefit of therapy if which is noted?

Decreased blood pressure

The nurse is monitoring a client with hypertension who is taking propranolol. Which assessment finding indicates a potential adverse complication associated with this medication?

Development of expiratory wheezes

The nurse is monitoring a client with heart failure who is taking digoxin. Which findings are characteristic of digoxin toxicity? Select all that apply.

Diarrhea Blurred vision Nausea and vomiting

The nurse has a prescription to give a client a scheduled dose of digoxin. Prior to administering the medication, the nurse should assess for which manifestations that could indicate digoxin toxicity?

Double vision, loss of appetite, and nausea

The nurse is administering a dose of triamterene to an assigned client. What is the most significant adverse effect of this medication for which the client should be monitored?

Hyperkalemia

The nurse is reviewing the record of a client who arrives at the health care clinic. The nurse notes that irbesartan has been prescribed for the client. The nurse should suspect that the client has which condition?

Hypertension

A client who is taking chlorothiazide comes to the clinic for periodic evaluation. In monitoring the client's laboratory test results for medication side effects, what is the clinic nurse most likely to note if a side or adverse effect is present?

Hypokalemia

The nurse is planning to administer hydrochlorothiazide to a client diagnosed with hypertension. The nurse should monitor for which adverse effects related to the administration of this medication?

Hypokalemia, hyperglycemia, sulfa allergy

A client has been prescribed pindolol for hypertension. The nurse provides anticipatory guidance, knowing that which common side effect of this medication may decrease client compliance?

Impotence A common side effect of beta-adrenergic blocking agents such as pindolol is impotence. Other common side effects include fatigue and weakness. Central nervous system side effects are rarer and include mental status changes, nervousness, depression, and insomnia. Mood swings, increased appetite, and difficulty swallowing are not side effects of this medication.

The nurse is planning discharge teaching for a client started on acetazolamide for a supratentorial lesion. Which information about the primary action of the medication should be included in the client's education?

It decreases cerebrospinal fluid production. Acetazolamide is a carbonic anhydrase inhibitor and a diuretic. It is used in the client with or at risk for increased intracranial pressure to decrease cerebrospinal fluid production. The remaining options are not actions of this medication.

The nurse is caring for a client who was prescribed furosemide. The nurse should monitor the client for damage of which kidney structure?

Nephron

The nurse has been given a medication prescription to administer intravenous (IV) hydralazine. The nurse obtains which priority piece of equipment needed for use during administration of this medication?

Noninvasive blood pressure cuff

The nurse is providing medication information to a client who is beginning medication therapy with enalapril. The nurse should tell the client that which is an anticipated, although unpleasant, side effect of this medication?

Persistent dry cough

A client is seen in the clinic complaining of anorexia and nausea. The primary health care provider (PHCP) suspects that the client may be experiencing digoxin toxicity. While waiting for test results to become available, the nurse should assess the client for which sign or symptom that would support a diagnosis of digoxin toxicity?

Photophobia

The nurse is planning to administer furosemide 40 mg by intravenous push (IVP) through an existing intravenous (IV) line. To deliver this medication safely, the nurse should perform which action?

Pinch the IV tubing above the injection port, and inject slowly over 1 to 2 minutes.

A client receiving total parenteral nutrition (TPN) has a history of heart failure. The primary health care provider (PHCP) has prescribed furosemide 40 mg by mouth daily to prevent fluid overload. Which laboratory value should the nurse monitor to identify the presence of an adverse effect of this medication?

Potassium

A client is due for a dose of bumetanide. The nurse should temporarily withhold the dose and notify the primary health care provider (PHCP) if which laboratory test result is noted?

Potassium level of 2.9 mEq/L (2.9 mmol/L)

A client is scheduled to receive a daily morning dose of furosemide. Which client laboratory result warrants a call to the primary health care provider (PHCP) prior to the medication administration?

Serum potassium of 2.8 mEq/L (2.8 mmol/L)

The nurse is educating a client about medroxyprogesterone. The nurse should provide the client with which information about the medication?

Should be administered intramuscularly every 3 months

Atenolol has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond regarding the action of this medication?

Slows the heart rate

The nurse is monitoring a client for adverse effects of medications. Which findings are characteristic of adverse effects of hydrochlorothiazide? Select all that apply.

Sulfa allergy Hypokalemia Hyperglycemia Hypercalcemia

A client is on enalapril for the treatment of hypertension. The nurse teaches the client to seek emergent care if which is experienced?

Swelling of the tongue

A client is taking amiloride 10 mg orally daily for hypertension. What medication instruction should the nurse provide to the client?

Take the dose in the morning.

The nurse is teaching a client who will be discharged on alendronate about the medication. Which should be included in the teaching plan? Select all that apply.

Take the medication at the same time daily. -Take the medication on an empty stomach. -Remain upright for 30 minutes following ingestion.

Alendronate is prescribed for a client with osteoporosis, and the nurse is providing instructions on administration of the medication. Which instruction should the nurse provide?

Take the medication with a full glass of water after rising in the morning. Precautions need to be taken with the administration of alendronate to prevent gastrointestinal adverse effects (especially esophageal irritation) and to increase absorption of the medication. The medication needs to be taken with a full glass of water after rising in the morning. The client should not eat or drink anything for 30 minutes following administration and should not lie down after taking the medication.

The nurse provides instructions to a client about newly prescribed furosemide. Which information should the nurse use to provide instructions in this teaching session?

The medication acts on the loop of Henle in the nephron.

Tamsulosin hydrochloride is prescribed for a client. The nurse should suspect that this medication is prescribed to relieve which condition?

Urinary obstruction

A client being treated for heart failure is administered intravenous bumetanide. Which outcome indicates that the medication has achieved the expected effect?

Urine output increases from 10 mL/hour to greater than 50 mL hourly.

A client with heart failure is scheduled to be discharged to home with digoxin and furosemide as daily prescribed medications. The nurse tells the client to report which finding as an indication that the medications are not having the intended effect?

Weight gain of 2 to 3 lb in a few days

The nurse is auscultating a 56-year-old adult client's apical heart rate before giving digoxin and notes that the heart rate is 48 beats/minute. Which action should the nurse take?

Withhold the digoxin, and assess for signs of decreased cardiac output and digoxin toxicity.

A primary health care provider (PHCP) writes a prescription for digoxin, 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is most important to be sure to implement which measure?

Withhold the medication and call the PHCP if the pulse is slower than 60 beats/min.