Pharm 2 Final
When teaching the client to safely administer nitroglycerin ointment, the nurse should convey which instruction?
"Make sure you squeeze the ointment on to a paper measuring scale before applying it." Ch 35 Q 3
A client, diagnosed with erectile dysfunction, is taking nitroglycerin for chest pain. What is the best explanation for why a nitrate-like sildenafil would be contraindicated?
"Nitroglycerin and sildenafil cause a severe decrease in blood pressure." Ch 35 Q 2
The nurse teaches the client how to use topical nitroglycerin patches. Which points will the nurse include in the teaching plan? Select all that apply.
"Rotate application sites.""Assess the skin for signs of breakdown.""Make sure no one touches the side with the medication." Ch 35 Q 3
A client prescribed nitroglycerin reports to the nurse that he is having headaches. How should the nurse best respond?
"You may experience headaches as an adverse reaction to nitroglycerin." Ch 35 Q 1
A client with leukemia is scheduled to begin treatment with a cytokine. What anticipatory guidance should the nurse provide?
"You'll likely feel flu-like after starting this medication." Ch 50 Q 1
The nurse is caring for diverse group of clients. Which client is most likely to benefit from the administration of cyclosporine?A client with chronic renal failure who is recovering from a kidney transplantA client who has multiple sclerosis and who has not responded to conservative treatmentA client who has undergone treatment for malignant melanoma but who is now palliativeA client being treated for active pulmonary tuberculosis
A client with chronic renal failure who is recovering from a kidney transplant Ch 49 Q 1
A female client is admitted to the hospital for treatment of a pulmonary embolism. Forty-eight hours after therapy has started, the client reports bleeding from her gums when she brushes her teeth. What orders can the nurse anticipate receiving from the health care provider to reverse the effects of the heparin?
Administer protamine sulfate, at a dosage of 1 mg per 100 units of heparin, for a maximum dose of 100 mg. Ch 36 Q 9
A client is receiving corticosteroids and digoxin. The nurse will carefully monitor the client for which potential adverse reaction?A) Increased risk for toxicityB) Decreased muscle functionC) Increased risk of hyperkalemiaD) Decreased serum corticosteroid levels
Answer: A Rationale: The nurse should observe for an increased risk for digitalis toxicity when corticosteroids are given with digoxin. Musculoskeletal disturbances are a potential adverse reaction to glucocorticoids. Hypokalemia, not hyperkalemia, is a recognized adverse reaction to the use of fludrocortisone. It can also occur when corticosteroids and digoxin and potassium-depleting diuretics are used together. The effects of corticosteroids may be decreased when administered with hydantoins, rifampin, and theophyllines. Ch 41 Q 2
A client has been prescribed glucocorticoids for the treatment of congenital adrenal hyperplasia. Which should the nurse prioritize on the ongoing assessment for the client?A) Take and record vital signs every 4 to 8 hours.B) Test the serum electrolyte levels.C) Auscultate the abdomen and record the findings.D) Observe for signs of blanching of the skin.
Answer: A Rationale: When glucocorticoids are administered to the client, the nurse should take and record vital signs every 4 to 8 hours if the client is not continuously monitored. The nurse need not perform assessments related to serum electrolyte levels, abdominal auscultation, or skin blanching. These are appropriate for a client receiving vasopressin therapy. Ch 41 Q 1
After teaching a group of nursing students about the various drugs used to treat musculoskeletal conditions, the instructor determines that the teaching was successful when the students correctly choose which drug as being used to treat osteoporosis?A) DMARDsB) Bone resorption inhibitorsC) Skeletal muscle relaxantsD) Uric acid inhibitors
Answer: B Rationale: Bone resorption inhibitors are used to treat osteoporosis. Disease-modifying antirheumatic drugs (DMARDs) are used to treat rheumatoid arthritis. Uric acid inhibitors are used to treat gout. Skeletal muscle relaxants are used to alleviate muscle spasms and cramping. Ch 29 Q 1
A client prescribed treatment for atrial fibrillation is now prescribed levothyroxine for hypothyroidism. The nurse prepares to monitor the client for increased cardiac dysfunction if the client is prescribed which current medication(s)? Select all that apply.A) LisinoprilB) DigoxinC) DiltiazemD) MetoprololE) Warfarin
Answer: B, D Rationale: A client with a heart condition controlled on digoxin and metoprolol must be monitored closely by the nurse for worsening atrial fibrillation if levothyroxine is initiated due to decrease effectiveness of digoxin and β-blockers (metoprolol). There are no recognized reactions when lisinopril (ACE inhibitor) or diltiazem (calcium channel blocker) are used with thyroid replacements. The use of warfarin (anticoagulant) with levothyroxine may result in prolonged bleeding. Ch 42 Q 4
The nurse is administering a bisphosphonate to a client with Paget disease. Which finding on assessment should the nurse prioritize?A) Altered renal functionB) Increased skin rashesC) Serum calcium levelsD) Hematology function
Answer: C Rationale: The nurse should monitor the serum levels of calcium before, during, and after bisphosphonate therapy because bisphosphonates act primarily on the bone by inhibiting normal and abnormal bone resorption. These drugs are used cautiously in clients with renal function impairment but do not alter renal function. The nurse should monitor the client's renal function when allopurinol is administered and hematology function when methotrexate is administered Ch 29 Q 3
The administration of immunizations to a client is a form of what type of immunity?Artificial active immunityNaturally active immunityPassive active immunityAttenuated active immunity
Artificial active immunity Ch 47 Q 2
A client diagnosed with angina has been prescribed nifedipine 15 mg PO three times a day. The client has received the first two doses of the medication and reports dizziness. What is the nurse's best action?
Assess the client's blood pressure. Ch 35 Q 2
In some cases, low-dose amiodarone may be used to prevent recurrence of what cardiac disorder?
Atrial fibrillation Ch 37 Q 9
A 4-year-old girl is brought to the emergency department by her mother. The mother reports the child has been vomiting, The nurse notes the child's face is flushed and is diaphoretic. The mother thinks the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which drug would be administered?AcetylcholineAtropineCevimelineNicotine
Atropine Ch 26 Q 2
The nurse is administering an adrenergic agonist to a client. The nurse realizes that this medication will cause stimulation of the sympathetic nervous system. Which effects will it produce? Select all that apply. Pupil constriction Bronchodilation Decreased heart rate Decreased bladder tone
Bronchodilation Decreased bladder tone Ch 24 Q 1, 5
A 60-year-old client experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The client has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?
By inactivating clotting factors and thus stopping the coagulation cascade Heparin, along with antithrombin, rapidly promotes the inactivation of factor X, which, in turn, prevents the conversion of prothrombin to thrombin. Ch 36 Q 4
The nurse is working on the pediatric oncology unit. Which immunotherapy will the nurse clarify if ordered for a pediatric client?
Checkpoint inhibitors Ch 51 Q 1
A nurse is providing discharge instructions to a client who is taking atenolol (Tenormin) to treat hypertension. What aspect of this client's drug therapy may indicate a potential drug-drug interaction?TetracyclineOral contraceptivesIbuprofenLevothyroxine
Ibuprofen Ch 24 Q 2
The nurse regularly administers monoclonal antibodies (mAbs) and monitors clients for adverse effects. Which immune system reaction(s) may occur with this therapy? Select all that apply.Infection, skin eruptionsUpper respiratory infection (URI) with coughAntibody developmentHeadache and dizzinessNausea and abdominal pain
Infection, skin eruptionsUpper respiratory infection (URI) with coughAntibody development Ch 51 Q 1
The nurse is providing education to a client with asthma on the therapeutic action of inhaled corticosteroid agents. How will the nurse describe the action?
Inhaled corticosteroid agents reduce airway inflammation. Ch 31 Q3
A client is ordered to receive cyclosporine intravenously, and the nurse has explained the need for frequent blood work. This blood work is required because of what characteristic of cyclosporine?It decreases erythropoiesis.It has been linked to spontaneous hemolysis.It has a narrow therapeutic range.It can precipitate a thyroid storm.
It has a narrow therapeutic range. Ch49 Q 1
A male client is having angina. As the nurse prepares to administer sublingual nitroglycerin, it is noted that the client's blood pressure is 82/54. What is the best action of the nurse?
Notify the health care provider.he client is having angina and it must be addressed. If the blood pressure is less than 90 systolic, the nurse should not administer the medication and call the provider immediately. Ch 35 Q 1
Which of the following is an anticholinergic drug that may be used in the treatment of overactive bladder?Belladonna tinctureBenztropineTrihexyphenidylOxybutynin
Oxybutynin Ch 26 Q 1
A nursing instructor determines that a class on adrenergic blockers was successful when the students identify which medication is an alpha-adrenergic blocker? Phentolamine Metoprolol Atenolol Clonidine
Phentolamine Ch 24 Q 1
The pharmacology instructor is describing medications that increase the contractile force of the heart. Which term describes this effect?
Positive inotropic Ch 37 Q 6
A nurse is caring for a 64-year-old female client who is receiving IV heparin and reports bleeding from her gums. The nurse checks the client's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which drug may be ordered?
Protamine sulfate Ch 36 Q 9
A client with breast cancer being treated with tamoxifen is also taking the oral anticoagulant coumadin (Warfarin) for chronic atrial fibrillation. What is important to monitor in this client?
Prothrombin time Ch 50 Q 2
A client has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the client has been prescribed cholestyramine. What change in this client's lipid profile will the nurse identify as the most likely goal of therapy? Reduction in triglycerides Reduction in total serum cholesterol levels Increase in HDL levels Reduction in LDL cholesterol levels
Reduction in LDL cholesterol levels Ch 33 Q 1
The nurse is teaching a 63-year-old client about sustained-release oral nitrates which has been prescribed for treatment of angina. Which instructions would the nurse offer to the client when teaching how to properly self-administer the medication?
Take the medication on an empty stomach Ch 35 Q 1
Why are inhaled steroids used to treat asthma and COPD?
They act locally to decrease release of inflammatory mediators Ch 31 Q 1
A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response? They block nicotinic receptors. They compete with serotonin for muscarinic acetylcholine receptor sites. They act to block the effects of the parasympathetic nervous system. They increase norepinephrine at the neuromuscular junction.
They act to block the effects of the parasympathetic nervous system. Ch 26 Q 2
A nurse is teaching a group of clients about immunizations . What benefit of immunization should the nurse describe?They are generally considered to be risk freeThey are best reserved for clients under age 65They provide the person with active immunity.Promote the development of antigens for the disease.
They provide the person with active immunity. Ch 47 Q 2
Which laboratory assessments are necessary for the nurse to review for a client receiving a filgrastim? Select all that apply.WBCANCplateletssodiumpotassium
WBC ANC absolute neutrophil count Ch 48 Q 1
A hospital client demonstrating peripheral edema has been prescribed furosemide. How should the nurse best determine the extent of the client's desired fluid loss? Assess the client's skin turgor on a daily basis. Test the osmolarity of the client's urine regularly. Weigh the client daily. Auscultate the client's chest each morning.
Weigh the client daily. Ch 32 Q 1
Which client is most likely to benefit from the administration of a nasal steroid?
a client who has chronic allergic rhinitis (hay fever) Ch 30 Q 3
A client has recently been prescribed a drug that treats hypertension by blocking the sympathetic receptors in the sympathetic nervous system. This action is characteristic of which? an adrenergic antagonist. an adrenergic agonist. a cardiotonic. a neurotransmitter.
an adrenergic antagonist. Ch 24 Q 6
A client is receiving digoxin and experiences severe bradycardia. Which medication would the nurse anticipate administering if prescribed?
atropine Ch 37 Q 2
Epinephrine causes relaxation of: bronchioles. smooth muscles in the intestinal wall. superficial blood vessels. sphincter muscles.
bronchioles. Ch 24 Q 5
The nurse provides client teaching related to medication and lifestyle changes the client can make to reduce serum lipid levels. One month later, the nurse evaluates the client teaching as having been effective based on what data? Select all that apply. decreased total cholesterol levelterm-46 decreased high-density lipoprotein (HDL) decreased low-density lipoprotein (LDL) blood pressure 118/28 mmHg weight loss of 8 lb (3.6 kg)
decreased total cholesterol level decreased low-density lipoprotein (LDL) blood pressure 118/28 mmHg weight loss of 8 lb (3.6 kg) Ch 33 Q 1, 3
Recommended treatments for clients with dyslipidemia are made according to their blood levels of total and low-density lipoproteins (LDL) cholesterol and risk factors for cardiovascular disease. What does the impact of existing cardiovascular disease have on recommendations? decreases target serum LDL level increases target serum high-density lipoproteins (HDL) level has no effect on either LDL or HDL levels decreases target serum triglyceride level Existing cardiovascular disease entails a lower target LDL serum level in these clients.
decreases target serum LDL level ch 33 Q 1
The nurse prepares to administer a preoperative anticholinergic to a client. What is a desired effect based upon the characteristics of the prescribed medication?dry mucous membraneswheezingheart rate 50bilateral constricted
dry mucous membranes Ch 26 Q 1
By what means does warfarin achieve the desired anticoagulant effects?
preventing synthesis of clotting factors in the liver Ch 36 Q 7
A client is given a beta blocker for a heart arrhythmia. The client asks the nurse how a beta blocker can treat/prevent a heart arrhythmia. Which response by the nurse is correct? "Beta blockers provide membrane-stabilizing effects that contribute to the anti-arrhythmic activity." "Beta blockers increase oxygen consumption in the heart, which decreases the chance of arrhythmias." "Beta blockers cause vasoconstriction, which prevents electrical impulses from going as quickly through the heart." "Beta blockers increase the heart's excitability, which increases the chance of arrhythmias."
"Beta blockers provide membrane-stabilizing effects that contribute to the anti-arrhythmic activity." Ch 24 Q 5
A nurse has been caring for a 49-year-old man who was hospitalized with recurrent ventricular fibrillation and received IV amiodarone. The man is now scheduled to be discharged on oral amiodarone, and the nurse has just completed discharge instructions. Which statements made by the client indicates that further instruction is necessary?
"I am going on a cruise next week and plan to just lie in the sun all day and relax." The nurse will be concerned if the client is planning to go on a cruise and lie in the sun all day. Photosensitivity is a problem for some clients who take amiodarone. With long-term treatment, a blue-gray discoloration of the exposed skin may be seen. Ch 37 Q9
After teaching a client about prescribed statin therapy, the nurse determines that additional teaching is needed when the client makes which statement? "I can take the drug with grapefruit juice." "I should take the dose around bedtime." "I need to be careful when I'm out in the sun." "I should report any problems with muscle pain or weakness."
"I can take the drug with grapefruit juice." the client should choose juices other than grapefruit juice because of the risk for an enzyme reaction
The nurse is teaching a client diagnosed with angina how to properly store and use nitroglycerin sublingual tablets. Which statement made by the client establishes a need for additional teaching by the nurse?
"I will keep the bottle of nitroglycerin in my pants pocket." Ch 35 Q 1
A female client has been diagnosed with hyperthyroidism. She asks the nurse why she is taking a medication that decreases her blood pressure like her grandmother takes. What is the nurse's best response when teaching her about the action and use of propranolol (Inderal) in the treatment of hyperthyroidism? "The administration of propranolol will decrease your heart rate." "The administration of propranolol will promote bronchodilation." "The administration of propranolol will prevent respiratory depression." "The administration of propranolol will decrease the systolic blood pressure."
"The administration of propranolol will decrease your heart rate." Ch 42 Q 1
The nurse is providing education to an older adult client who has been prescribed atorvastatin. How should the nurse describe the common adverse effects of the drug? "Some clients experience mild chest pain initially." "Most people who experience side effects from atorvastatin report stiffness in their joints." "The more serious side effects of atorvastatin involve a risk of bleeding."
"The most common side effects of atorvastatin include some mild gastrointestinal upset." Ch 33 Q 2
A client is receiving anticoagulant therapy and has an INR done. Which result would the nurse interpret as being therapeutic?
2.4 Explanation: When anticoagulant therapy is used, the INR is maintained between 2 and 3. The other values are not therapeutic. Ch36 Q 10
A nurse is monitoring the drug level of a client receiving quinidine. Which serum drug level would the nurse immediately report to the primary health care provider?
6.2 mcg/mL Therapeutic serum levels of quinidine is 2-5 mcg/mL
The nurse is caring for several clients being treated with adrenergic antagonists. Which client is most likely to benefit from the administration of tamsulosin?A 76-year-old male client with urinary hesitation and nocturiaAn 81-year-old male client admitted with pulmonary edema and exacerbation of heart failureA 66-year-old male client with a history of ischemic heart disease and worsening anginal painA 58-year-old male client with narrow-angle glaucoma and recent loss of
A 76-year-old male client with urinary hesitation and nocturiaTamsulosin is used to treat benign prostatic hyperplasia, not heart failure, glaucoma or angina.
A nurse is reviewing a client's history and medications prior to discharge. The client has been prescribed a new antiadrenergic medication. Which condition or medication would require the nurse to talk with the provider prior to discharge? Select all that apply. Active hepatitis B Treatment for depression with an MAOI Pregnancy Renal impairment Polycythemia
Active hepatitis B Treatment for depression with an MAOI Pregnancy Renal impairment Ch 24 Q 3
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. Ch 35 Q 3
A client, scheduled to receive one unit of packed red blood cells, has a history of an allergic reaction to a transfusion in the past. What class of medication will assist in preventing a reaction to the packed red blood cell transfusion?
Antihistamines Ch 30 Q 5
The health care provider is preparing to administer edrophonium to confirm myasthenia gravis in a 47-year-old male client. What other drug must be available when edrophonium is administered?AtropineNeostigminePyridostigmineRivastigmine
Atropine Ch 26 Q 2
When describing the action of atorvastatin, which would the nurse include? Blocking the enzyme that is involved in cholesterol synthesis Binding with bile acids to form an insoluble complex that is excreted Stimulating the breakdown of lipoproteins from the tissues Decreasing dietary cholesterol absorption from the small intestine
Blocking the enzyme that is involved in cholesterol synthesis
A client is admitted to the emergency department with severe chest pain. The emergency department health care provider orders intravenous nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which assessment?
Blood pressure Ch 35 Q 1
What sign is most indicative of dehydration in a patient taking diuretics?Bradycardia Dry cough Body weight Decreased hematocrit
Body weight Ch 32 Q 1
A client receives a beta-specific agonist. What would lead the nurse to determine that the drug is effective? Bronchodilation Decreased heart rate Tremor Slowed cardiac conductivity
Bronchodilation Ch 24 Q 5
An older adult client with a history of heart failure has presented to the emergency department in respiratory distress. Assessment reveals the presence of pulmonary edema, and an infusion of IV furosemide has been prescribed. For the duration of treatment, the nurse should prioritize assessments related to which expected age-related dysfunctions? Select all that apply. Cardiac function Cognitive function Respiratory function Renal function Hepatic function
Cardiac function Renal function Hepatic function Ch 32 Q 5
A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?
Decongestants Ch 30 Q 6
As part of a routine physical examination, a 60-year-old client's primary care provider has ordered blood work that includes cholesterol levels. What result would strongly suggest the need for an antihyperlipidemic drug? Elevated LDL levels Elevated HDL levels A high ratio of HDL to LDL Low VLDL levels
Elevated LDL levels Ch 33 Q 1
A client is admitted to the hospital with deep vein thrombosis (DVT). An infusion of heparin is established. What action best protects the client's safety?
Ensure that protamine sulfate is readily available. Ch 36 Q 9
A nurse is teaching a client diagnosed with asthma about the disease. Which should the nurse instruct the client to avoid because it may cause bronchoconstriction?
Extremely cold temperatures ch 31 Q4
The nurse is aware that cholinergic blocking agents will be used preoperatively for what type of anesthesia?TopicalGeneralRegionalLocal
General26 Ch 26 Q 1
The nurse should instruct the client to take what action if nitroglycerin tablets taken sublingually are not effective in eliminating chest pain?
Go to the emergency department. Ch 35 Q 1
The nurse is evaluating the effectiveness of drug therapy in a client with hyperlipidemia. Effective therapy is best demonstrated by which laboratory values? HDL 58 LDL 96 Cholesterol 178 HDL 58 LDL 115 Cholesterol 210 HDL 78 LDL 115 Cholesterol 189 HDL 82 LDL 96 Cholesterol 240
HDL 58 LDL 96 Cholesterol 178 Normal HDL should be greater than 40 mg/dl, LDL should be less than 100 mg/dl, and total cholesterol should be less than 200 mg/dl. Ch 33 Q 1
The nurse is teaching a course to students about immunologic agents. In order for the students to understand active immunity, the nurse explains that there are agents that provide active immunity. Which is an active immunity agent?Haemophilus influenzae type B conjugateAntithymocyte globulin€Botulism immune globulin (BIG-IV)Crotalidae polyvalent immune Fab
Haemophilus influenzae type B conjugate Ch 47 Q 2
After administering a nitrate, the nurse would be alert for which reactions? Select all that apply.
Headache Hypotension Flushing Ch 35 Q 1
The nursing instructor is discussing common adverse effects of dyslipidemia drugs. Which of the following would the instructor identify as adverse effects of statins? Bloating and hypertension Neuropathy and flatulence Headache and nausea Constipation and hypertension
Headache and nausea Ch 33 Q 2
A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition? Heart disease Diabetes Glaucoma Hypertension
Heart disease Ch 33 Q 4
The nurse is caring for a client who is receiving amiodarone. Which assessment would be considered a priority?
Heart rate checks Ch 37 Q 9
The nurse recognizes that treatment for digitalis toxicity includes which of the following?
Holding the medication Ch 37 Q 2
An older adult client has a complex medical history that includes heart failure, type 1 diabetes, and diabetic nephropathy. The nurse has questioned a health care provider's prescription for oral spironolactone because the client's health problems would contribute to a high risk of which adverse reaction? Metabolic acidosis Hypocalcemia Hemolytic anemia Hyperkalemia
Hyperkalemia Ch 32 Q 4
Adrenergics are a category of bronchodilators used in the treatment of asthma and COPD. A specific adverse effect contraindicates these medications for clients with cardiac tachyarrhythmias. In what conditions is cautious use recommended? (Select all that apply.)
Hypertension Seizure disorders Diabetes mellitus Ch24 Q 3
The nurse understands that older clients taking anticholinergic drugs are more likely to have all of the following symptoms EXCEPT:Blurred vision.Hypertension.Constipation.Confusion.
Hypertension. Ch 26 Q 1
A client is administered diltiazem IV, followed by propranolol IV. The nurse should assess for what potential side effect of this medication combination?
Impaired myocardial contractility Ch 34 Q 1
A client with multiple sclerosis is prescribed treatment with a monoclonal antibody. Which action(s) would the nurse add to the client's plan of care? Select all that apply.Monitor for pulmonary edema.Evaluate white blood cell count.Explain the development of alopecia.Assess for cytokine release syndrome.Prepare to treat gastrointestinal symptoms.
Monitor for pulmonary edema. Assess for cytokine release syndrome. Ch 51 Q 1
The adrenergic branch of the nervous system controls many functions in the body. The nurse knows that which body functions are controlled by the adrenergic branch? (Select all that apply.) Heart rate Respiratory rate Gross muscle movement Muscle blood flow fine muscle movements
Muscle blood flow Heart rate Respiratory rate Ch 24 Q 5
A client is taking lovastatin. The nurse will teach the client about what potential adverse effects? Nausea and constipation Muscle pain on exertion and muscle stiffness Fatigue and mental disorientation Pruritis and bruising
Nausea and constipation Ch 33 Q 2
Clients who are taking nifedipine should be monitored for which of the following adverse effects?
Peripheral edema Ch 35 Q 2
The nurse knows that part of the education plan for a client with the diagnosis of hyperlipidemia needs to include which lifestyle changes? (Select all that apply.) Reduction in the intake of carbohydrates Reduction of the intake of saturated fats Weight loss Increased physical activity
Reduction of the intake of saturated fats Weight loss Increased physical activity Ch 33 Q 3, 4
The nurse provides client education on how to use translingual nitroglycerin. The client has an angina attack. The client uses the drug. At which step during the client usage would the nurse intervene?
Shakes the canister gently before using Ch 35 Q 3
After teaching a group of students about beta-1 selective blockers, the instructor determines that the teaching was successful when the students identify what as a contraindication to using this group of drugs?Sinus bradycardiaThyroid diseaseDiabetesCOPD
Sinus bradycardia
A nurse is preparing to administer a prescribed nitrate to a client with angina. The nurse understands that nitrates are available in which dosage forms? Select all that apply.
Sublingual Transdermal Parenteral Ch 35 Q 3
A 42-year-old female with breast cancer has had a radical mastectomy. She will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What will the nurse include in the teaching plan concerning the drug therapy?
Take special care when shaving or brushing her teeth. Ch 50 Q 2
Expectorants elicit their effect by which mechanism?
Thinning respiratory secretions Ch 30 Q 7
The nurse is preparing a client for pacemaker surgery. The health care provider orders atropine to be given 30 minutes before the client is taken to the operating room. The nurse knows this medication is ordered for what reason?To increase the heart rate to prevent complication prior to the pacemaker being insertedTo cause bladder relaxation during surgery so that the client will not have the urge to void during surgeryTo relax the bowel to prevent the client from having a bowel movement during surgeryTo dry up respiratory secretions to prevent aspiration during surgery
To dry up respiratory secretions to prevent aspiration during surgery26 Ch 26 Q 1
When administering an alpha-adrenergic blocker, the nurse would expect which response to occur?VasodilationVasoconstrictionTachypneaBradycardia
Vasodilation Ch 24 Q 1
A group of nursing students are reviewing cardiotonic *digoxin drugs. The students demonstrate understanding of the information when they identify which adverse reaction associated with cardiotonic medications?
Visual disturbances Ch 37 Q 1
The nurse is caring for a 73-year-old client receiving warfarin. When the nurse performs the initial shift assessment, the nurse observes blood in the client's urinary drainage bag. After reporting the observation to the physician, which substance will the nurse likely administer?
Vitamin K Ch 36 Q 9
A 91-year-old client is being discharged on the diuretic spironolactone. What assessment finding would the nurse attribute to adverse effects of this medication? polyuria and polyphagia confusion and irregular heart rate diarrhea and positive stool for occult blood (FOB) test blood pressure of 160/109 mm Hg
confusion and irregular heart rate Ch 32 Q 4
The nurse administers warfarin to a client. Which expected effect should the drug have on the body?
decrease in production of vitamin K-dependent clotting factors Ch 36 Q 5
The nurse is caring for an older adult client who receives furosemide on a regular basis. The nurse should prioritize assessments related to what health problem? dehydration urinary retention hypernatremia dysrhythmias
dehydration ch 32 Q 5
In addition to being synthesized in the liver and intestine, from where are blood lipids derived? diet exercise kidneys medications
diet Ch 33 Q 4
The nurse is preparing to administer eye drops containing an anticholinergic preparation to a client prior to an eye examination. Before administration, the nurse explains that the eye drops will cause what pupil reaction?constrictionbrisk responsedilatationtemporary fixation
dilation Ch 26 Q 1
What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction?
diphenhydramine (antihistamine---Bendadryl) Ch 30 Q 5
A nurse has an order to apply nitroglycerin topically, twice a day. The nurse's initial action will be to do which?
don a pair of gloves. Ch 35 Q 3
The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin? headache and flatulence. increased appetite and blood pressure. fatigue and mental disorientation. hiccups, sinus congestion, and dizziness.
headache and flatulence. Ch 33 Q 2
What information identified by the client's history should the nurse consider to be a contraindication for the administration of a nonselective beta-adrenergic blocker?i mplanted pacemaker history of exercise-induced asthma history of gallbladder disease a current urinary tract infection
history of exercise-induced asthma Ch 24 Q 3
A client presents to the ED with wheezing and blood-tinged sputum. The nurse suspects the client is experiencing pulmonary edema. The nurse should suspect the cause of the pulmonary edema is most likely:
left ventricular failure. Ch 37 Q 5
When educating clients on the immune system, the nurse identifies which white blood cells to be involved in cell-mediated immunity (CMI) along with T lymphocytes?neutrophilseosinophilsbasophilsmacrophages
macrophages Ch 47 Q 2
A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of: muscle pain. dry mouth. pruritus (itching) increased thirst.
muscle pain. Ch 33 Q 2
A client has been diagnosed with angina and prescribed nitroglycerin. What aspect of the client's health history should prompt the nurse to monitor the client particularly closely after administration of the drug?
orthostatic hypotension Ch 35 Q 1
A client taking diltiazem for hypertension has come to the clinic for a follow-up appointment. The nurse will assess the client for which adverse effects?
peripheral edema and bradycardia Ch 34 Q 1
The nurse is caring for a client who is experiencing pulmonary edema. The client is treated with furosemide. What will the nurse monitor most closely?sodium levels bone narrow function calcium levels potassium levels
potassium levels Ch 32 Q 1
A 23-year-old client presents at the clinic with a migraine headache. What beta-adrenergic blocking agent will best prevent future migraine headaches? propranolol nadolol timolol sotalol
propranolol Ch 42 Q 1
A client presents to the emergency department with rales, wheezing, and blood-tinged sputum. The nurse should select interventions to address what health problem?
pulmonary edema Ch 36 Q 1
The nurse is preparing to administer sublingual nitroglycerin to a client for the first time. What effect might the client experience right after administration?
throbbing headache or dizziness Ch 35 Q 1
A client is diagnosed with acute sinusitis. To promote sinus drainage, what medication will the nurse anticipate being prescribed for this client?
topical decongestants Ch 30 Q 6
After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states: "I need to make sure I don't eat too many high potassium foods." "I should take the medicine around dinnertime for the best effect." "I need to take the drug on an empty stomach." "I can still use my salt substitute if I want to."
"I need to make sure I don't eat too many high potassium foods." Ch 32 Q 4
The nurse provides client teaching for a client diagnosed with angina about the prescribed nitroglycerin transdermal patch. Which client statement establishes the need for further teaching?
"I will apply the patch for 24 hours and then remove it, and place another transdermal patch." The nitroglycerin transdermal patch needs to be applied in the morning, and then removed after 10-12 hours, and left off until the next morning. Ch 35 Q 3
A 52-year-old client who experienced a myocardial infarction has an order for discharge. Part of the discharge teaching includes prior administration of nitroglycerin for chest pain. Which statement by the client indicates understanding of the teaching provided?
"I will take three nitroglycerin tablets 5 minutes apart, and if I do not have any relief I will seek emergency care immediately." Ch 35 Q 3, 1
The nurse is caring for a client who has been diagnosed with angina and has been prescribed nitroglycerin. What teaching about the client's lifestyle should the nurse provide?
"It is best for your health to eliminate or reduce your intake of alcoholic beverages." Ch 35 Q 1
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." "I'll give you the names of some salt substitutes that you can start using to season your food." "A low-fat diet is a good idea, and the animal sources of fat are always preferable to plant sources." "Try to get most of your food energy from protein sources rather than carbohydrates."
"It's a good idea to keep your intake of saturated fat to a bare minimum." Ch 33 Q 4
A client's angina pectoris is being successfully treated on an outclient basis with sublingual nitroglycerin. What teaching point should the nurse convey to the client when reporting concern about the headache that follows the use of the medication?
"This is a common adverse effect of nitroglycerin; try taking acetaminophen to treat your headache." Ch 35 Q 1
A nurse is educating a group of nursing students on the adverse effects of antihypertensive drugs. The nurse explains that orthostatic hypotension occurs initially in the therapy. Which of the following pressure changes in an upright position would indicate orthostatic hypotension?
A fall in the systolic pressure by 10 mm Hg
The nurse is providing education to a client who has been prescribed nitroglycerin transdermal spray. What instruction should the nurse provide the client concerning how to administer the spray?
Administer the spray as soon as chest pain develops. Ch 35 Q 3
Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?
Albuterol causes relaxation of the bronchial smooth muscles. Ch 31 Q 2
The nurse is teaching a client about non-pharmacologic methods of controlling serum cholesterol levels. What lifestyle change may help increase high-density lipoprotein (HDL) levels? Quitting smoking Increasing aerobic exercise Losing weigh All the above changes may help increase HDL levels.
All the above changes may help increase HDL levels. Ch 33 Q 3, 4
A nurse is preparing discharge teaching for a client who is prescribed glucocorticoid therapy. Which instructions should the nurse point out in the teaching plan for the client and caregivers? A) Report any symptoms of sore throat or fever immediately. B) Notify the primary health care provider if glucose appears in the urine. C) Measure the amount of fluids taken each day. D) Take the oral drug with meals or snacks.
Answer: D Rationale: The nurse should instruct the client to take the oral drug with meals or snacks to decrease the gastrointestinal effects and upsets in the teaching plan for the client and caregivers. Reporting any symptoms of sore throat or fever immediately and notifying the primary health care provider if glucose appears in the urine should be included in the teaching plan for a client undergoing adrenocorticotropic hormone (ACTH) therapy. The nurse should instruct the client to measure the amount of fluids taken each day in the teaching plan for the client receiving vasopressin. Ch 41 Q 1
The nursing instructor explains to students that positive inotropic action affects the heart in which way?
Increased myocardial contraction Ch 37 Q 6
A client is administered atropine to increase the heart rate. What is the action of atropine?It provides long-acting antihistamine blockage.It exacerbates the parasympathetic vagal stimulation.It blocks cell wall synthesis of gram-negative bacilli.It blocks the parasympathetic vagal stimulation.
It blocks the parasympathetic vagal stimulation. Ch 26 Q 2
A client is prescribed filgrastim. Which is the nurse's best explanation of how this drug works? It inhibits the growth of bacteria in the body. It functions like insulin, lowering the blood sugar. It aids in the development of platelets by the bone marrow. It stimulates growth and production of WBCs to fight off infection.
It stimulates growth and production of WBCs to fight off infection. Ch 48 Q 1
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? Platelets 400,000/mLHgb 12.1 g/dL Na+ 135 mEq/LK+ 3.0 mEq/L
K+ 3.0 mEq/L Ch 32 Q 2
What is the basis for a nurse's recommendation of a period of intensive diet therapy and lifestyle modification before initiation of drug therapy for a client newly diagnosed with dyslipidemia? Therapeutic lifestyle changes are the preferred method for lowering blood lipids. Continued therapeutic lifestyle changes during drug therapy will guarantee success. Therapeutic lifestyle changes are easier to comply with than medication therapies. Nonpharmacologic interventions are cheaper than using medications.
Therapeutic lifestyle changes are the preferred method for lowering blood lipids. Ch 33 Q 3
When reviewing beta1-selective adrenergic blocking agents, which medication is found to be most often prescribed for clients diagnosed with hypertension?acebutololatenololbetaxololbisoprolol
atenolol
A 78-year-old man is admitted to the emergency department (ED) with bradycardia resulting from overdose of donepezil. The nurse knows that the ED is likely to order which medication?bethanecholpseudoephedrinepropranololatropine
atropine Ch 26 Q 2
A nurse is caring for a client in the critical care unit. Phentolamine (Regitine, OraVerse) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Before administering this drug, the nurse will check the client's chart for indications of: peptic ulcer disease. history of acute myocardial infarction. diabetes mellitus. obesity.
history of acute myocardial infarction. The nurse will check the chart for any indication of a history of acute myocardial infarction. Phentolamine is contraindicated in clients with this history or any evidence of coronary artery disease because of its cardiac-stimulating effects and resultant increases in myocardial oxygen demand. Ch 24 Q 4
A 49-year-old client is admitted with uncontrolled chest pain. The client is currently taking nitroglycerin. The primary health care provider adds nifedipine to the client's regimen. The nurse should observe the client for what adverse effect?
hypotension Ch 35 Q 2
The nurse is caring for a 64-year-old client who has been diagnosed with diabetes and is being treated with a beta1-selective adrenergic blocking agent. What health education should the nurse prioritize with this client?the correct technique for taking their own radial pulsethe need to weigh themselves once a week at the same time of daythe benefit of eating several small meals daily, rather than three larger mealsidentifying the signs and symptoms related to shortness of breath
identifying the signs and symptoms related to shortness of breath
A nurse in the intensive care unit is caring for a client in shock and has started IV administration of dopamine (Intropin). For a client in shock, dopamine helps to: decrease heart rate. decrease blood pressure. increase blood pressure. increase body temperature.
increase blood pressure. Ch 23 Q 1
What assessment finding indicates to the nurse that a client's left-sided heart failure is worsening?
increased crackles in lung fields Ch 37 Q 5
The nurse provides a client with a dose of the beta-selective adrenergic agonist isoproterenol. Which assessment finding indicates the medication is effective? constricted pupils warm, dry skin increased heart rate decreased urine output
increased heart rate Ch 24 Q 5
The nurse is teaching a 45-year-old client about ways to lower cholesterol level. What effects of exercise does the nurse describe on high-density lipoproteins (HDLs) and low-density lipoproteins (LDLs)?increases HDL and decreases LDL increases LDL and decreases triglycerides decreases HDL and increases LDL decreases both HDL and LDL
increases HDL and decreases LDL Ch 33 Q 3
The nurse is providing education to the parents of a child who has been newly diagnosed with asthma. During teaching, the nurse should explain that asthma attacks occur when mast cells release substances that cause what reaction?
inflammation. Ch 31 Q 3
The nurse is reviewing information collected from the parent of a pediatric client who uses the adrenergic drug albuterol inhaler as prescribed for asthma. Which information would the nurse suspect caused the client to have the extreme reaction to the adrenergic drug?received acetaminophen participated in physical education class used the albuterol inhaler in the morning received an over-the-counter (OTC) cold remedy
received an over-the-counter (OTC) cold remedy Children are at risk for complications associated with the use of adrenergic agonists, including tachycardia, hypertension, tachypnea, and gastrointestinal (GI) complications. Because phenylephrine is often found in over-the-counter (OTC) allergy and cold preparations, parents need to be instructed to be careful with the use of these drugs. Parents should check the labels for ingredients, monitor the recommended dose, and avoid combining drugs that contain similar ingredients. The client's symptoms are not caused by the acetaminophen, participating in physical education class, or using the albuterol inhaler in the morning. Vomiting, a fast heartbeat, deep respirations, and muscle cramps are all adverse effects of an adrenergic drug. Ch 24 Q 2