pharm 43,44,45,46,47,48

A male client who has been receiving verapamil for several months comes to the clinic reporting significant dizziness, light-headedness, and fatigue. He also reports frequent episodes of nausea and swelling of his ankles. Drug toxicity is suspected. Which question would be critical to ask the client?

"Have you been drinking any grapefruit juice lately?

The nurse is assessing a client taking a beta blocker as treatment for angina. Which statement by the client indicates to the nurse that the client is experiencing an adverse effect of the medication?

"I feel so down about my life."

The nurse is caring for a male client with a history of hypertension and Prinzmetal angina who is currently taking amlodipine 10 mg orally every day, and minoxidil 25 mg orally twice a day. The client stated that he is concerned about a recent enlargement of his breasts. What is the best therapeutic response to the client's concern?

"The increase in breast size is an adverse effect of minoxidil, and I will notify your primary care provider so other options may be explored."

Which question would be most important for a nurse to ask a female client who is starting on an angiotensin II receptor blocker for hypertension?

"When was your last menstrual period?"

A client receives subcutaneous heparin at 8 am and is scheduled for the next dose at 8 pm. The nurse would expect to obtain a specimen for an aPTT test at which time?

1400

The primary health care provider prescribes sotalol (Betapace) 80 mg BID orally. The drug is available in 40 mg tablets. The nurse will administer how many tablets in 24 hours?

4

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

After reviewing antiarrhythmic drugs, a group of nursing students demonstrate understanding of the drugs when they identify which as a class II antiarrhythmic? Select all that apply.

Acebutolol Propranolol

The physician is considering prescribing a beta blocker for a patient who is experiencing angina. For which condition should the patient be assessed before the physician orders the medication?

All the above

A nurse is explaining to a client the physiology of the heart with reference to the cardiac valves. Which statement by the client about the function of the cardiac valves demonstrates the correct understanding of the nurse's explanation?

Allow blood to flow in one direction only

The nurse is caring for a client that reports chest pain that is relieved by nitroglycerin. The client has a history of angina and asks why this keeps occurring. What is the best response by the nurse?

Angina occurs when the hearts demand for oxygen exceeds the supply

A 25-year-old female client has been told that a statin (HMG-CoA reductase inhibitor) drug would help in the management of their elevated cholesterol levels. Which question should the nurse prioritize when conducting the client's history?

Are you now or do you plan to become pregnant in the near future?"

After teaching a group of students about myocardial infarction (MI), the instructor determines that the teaching was successful when they identify what as the major cause of death associated with MI?

Arrhythmias

A staff nurse on a renal unit knows that most patients require treatment for hypertensive disease. What would the nurse expect to assess prior to the beginning of antihypertensive treatment?

Baseline renal function

The client receiving propranolol (Inderal) at home for management of a ventricular arrhythmia should monitor which parameter?

Blood pressure daily

A breast-feeding woman is prescribed a Class 3 antiarrhythmic. What information should the nurse provide to the client regarding the safety of the breast-feeding while taking this medication?

Breast-feeding must be discontinued and other forms of feeding should be introduced.

A client with asthma has been prescribed a beta-blocker for management of angina. For what adverse reaction should the nurse observe?

Bronchospasm

A nurse is educating a patient with hypertension who is prescribed losartan on the mechanism of action of the drug. Which mode of action helps losartan to bring about its antihypertensive effect?

By blocking the angiotensin II receptors

The 47-year-old client is experiencing chest pain and has taken three sublingual nitroglycerin tablets, but the pain remains. What should the client do next?

Call 911

What would contraindicate the use of nitrates?

Cerebral hemorrhage

After teaching a group of students about angina, the instructor determines that the teaching was successful when the students describe stable angina as:

Chest pain that is relieved by rest

Which property is related to the ability of the heart cells to transmit an action potential of electrical impulse?

Conductivity

An adult client with no known history of cardiovascular disease presents with atrial flutter. The client is prescribed propafenone PO 150 mg every 8 hours for 24 hours. What is the cardiac care nurse's priority assessment during this period?

Continuous ECG monitoring

A client with angina is prescribed atenolol. Following absorption of the drug, the nurse should monitor the client for what anticipated effect?

Decreased heart rate

A 35-year-old female client controls the symptoms of her cardiovascular disease with ACE inhibitors. She discovers that she is pregnant and contacts her primary care provider regarding her medication regimen. What would the nurse expect the provider to do?

Discontinue the drug

A client prescribed ramipril earlier in the week states, "Now I have a nagging, dry cough." How should the nurse best follow-up the client's statement?

Drugs like ramipril often cause a cough in clients; we should speak to the health care provider."

A patient is receiving an ACE inhibitor. The nurse ensures that the patient's hydration status is maintained to prevent:

Excessive hypotension

There are two pathways that can be activated by the coagulation process. One pathway begins when factor XII is activated. The other pathway begins when there is trauma to a blood vessel. What are these pathways?

Extrinsic and intrinsic pathways

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 patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment?

Frequently monitor blood cholesterol.

The health care provider has prescribed ezetimibe for a client diagnosed with hyperlipidemia. The nurse is prepared to prioritize which assessment to evaluate the drug's effectiveness?

Frequently monitoring blood cholesterol

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

What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism?

His dietary intake of saturated fat

Fluid moves into the arterial end of a capillary due to:

Hydrostatic pressure

A client with diabetes is prescribed propranolol. For what should the client be assessed?

Hypoglycemia

A 48-year-old client with a blood pressure of 198/112 mm Hg reports severe headache and drowsiness. The nurse notes that the client is disoriented and has begun to vomit. What is the primary nursing goal for this client experiencing a hypertensive emergency?

Implement interventions to lower blood pressure.

An electrocardiogram (ECG) is prescribed for a client experiencing signs and symptoms associated with a cardiac dysfunction. Which function of the heart will this diagnostic tool help evaluate?

Ineffective pumping

A client receiving amlodipine for angina is now reporting dizziness. Which intervention should the nurse prioritize to help alleviate the condition?

Instruct the client to lie down.

Lidocaine (Xylocaine) is available in a variety of dosage forms. How should a nurse administer lidocaine to a client with a ventricular arrhythmia?

Intravenously

Which lipid level would the nurse interpret as being high?

LDL cholesterol of 190 mg/dL

An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy?

Liver panel

A client with primary hypertension asks the nurse why the prescriber added another medication to assist with lowering the blood pressure. What is the nurse's best response?

Many clients require two or more drugs for high blood pressure."

Proper function of the cardiovascular system relies on blood following the correct pathway through the heart. Valves within the heart separate the organ's chambers and prevent blood from flowing in the wrong direction. What valve separates the left atrium and left ventricle?

Mitral

A backflow of blood is noted in the left ventricle from the left atrium. The patient is suffering from a defect in which valve?

Mitral valve

How can the home care nurse assist the client or the client's family members who have hypertension? (Select all that apply.)

Monitoring for drug effects Promoting compliance with the prescribed pharmacologic modifications Promoting compliance with the prescribed lifestyle modifications

A client is receiving warfarin. The nurse would expect to administer this drug by which route?

Oral

A client is to receive clopidogrel. The nurse would expect to administer this agent by which route?

Oral

A client is taking warfarin to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin monitored?

PT and INR

The effects of warfarin (Coumadin) are monitored by what laboratory test(s)?

PT and INR

The nurse is teaching a client with arrhythmia about the prescribed verapamil. Which potential adverse reaction should the nurse point out to the client?

Peripheral edema

A client, newly diagnosed with hypertension is started on captopril, an ACE inhibitor. The client should be informed of the possibility of what adverse effect?

Persistent cough

A nurse is conducting a community presentation on heart disease, cholesterol, and risk factors. The nurse determines that the class has been successful when the class correctly chooses which point as true?

Physical activity raises HDL cholesterol levels.

The nursing instructor has completed a teaching session explaining the various antihypertensive drugs. The instructor determines additional training is needed when the students choose which drugs as an angiotensin-converting enzyme inhibitor?

Pindolol

The health care provider has prescribed fenofibrate for a client discovered to have very high serum triglyceride levels. The nurse should question this order if the client has a history of which additional disorder?

Primary biliary cirrhosis

The pharmacology instructor is discussing heparin with the students. How would the instructor explain the action of heparin?

Promotes the inactivation of clotting factors

The nurse is leading an educational discussion on childhood hypertension at a local school board meeting. A particular focus of the discussion is the promotion of nonpharmacologic treatment measures. Which of the following is appropriate for managing hypertension in children? Select all that apply.

Promoting exercise Preventing obesity Reducing dietary sodium

A client has begun taking cholestyramine. Which action by the nurse best addresses likely adverse effects?

Promoting fiber and fluid intake

A client exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering:

Protamine sulfate

What is the mechanism of action for medications prescribed to treat a rapid arrhythmia?

Reducing automaticity

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.

Regular aerobic exercise Diet with more fruits and vegetables Decreased alcohol consumption Smoking cessation

A nursing instructor overhears a group of nursing students comparing various drugs used for cardiac disorders. The instructor determines the previous class was successful when the students correctly determine antianginals provide which action(s)? Select all that apply.

Relief of pain of acute anginal attacks Prevention of anginal attacks Treatment of chronic stable angina pectoris

The client receives a prescription for niacin. The nurse is providing education about the medication and possible adverse effects. Which adverse affect would the nurse include?

Some people get very flushed skin when they take this medication

A client diagnosed with a dysrhythmia has not responded appreciably to treatment with oral propranolol. When the medication is discontinued, what instruction should the nurse provide the client to maximize safety?

Taper down the propranolol dose over a period of 2 weeks

A male patient who uses sublingual nitroglycerin tells the nurse that when he puts it under his tongue, he feels a fizzing sensation. Which response by the nurse would be most appropriate?

That means that the drug is still potent and working."

What sequence describes the flow of electrical impulses in the heart?

The Sinoatrial node, the atrioventricular node, bundle of His, right and left bundle branches, and the Purkinje fibers.

A client has severe aortic valve disease. When educating the client about anatomy, what would the nurse include?

The aortic valve separates the left ventricle and aorta.

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."

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

Which client statement demonstrates an accurate understanding of the action of a prescribed anticoagulant?

This medication will keep unnecessary clots from forming in my blood."

The nurse is teaching a young female about the prescribed anticoagulant. The nurse determines the session is successful when the client correctly indicates they will apply which recommendation?

Use a reliable contraceptive

A nurse is caring for a 50-year-old client who has undergone cardiac surgery and received heparin as part of the intraoperative anticoagulation regimen. The health care provider has now ordered the administration of protamine sulfate. What should be the nurse's priority action before administering protamine?

Verify the client's heparin levels before giving protamine.

A client who has been treated with warfarin after cardiac surgery is found to have an INR of 9.0. Which medication will be administered to assist in the development of clotting factors?

Vitamin K

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.

How does captopril contribute to a reduction of a client's blood pressure?

blocking the conversion of angiotensin I to angiotensin II

When describing the drugs classified as class IV antiarrhythmics, the nurse would identify these as:

calcium channel blockers.

The chest pain and pressure a client experiences during an anginal attack is caused by which of the following?

decreased oxygen supply to the heart

In addition to being synthesized in the liver and intestine, from where are blood lipids derived?

diet

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

The nurse is caring for a client recovering from cardiac bypass surgery. For which prescribed medication would the nurse question giving the client aminocaproic acid as prescribed?

heparin

Propranolol is ordered for a client who has a cardiac arrhythmia. It will be important for the nurse to determine if the person has a history of:

hypersensitivity to beta blockers.

A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by:

inhibiting the movement of calcium ions across the cardiac muscle cell membrane.

A client has been prescribed lovastatin for high cholesterol. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels in which manner?

inhibits cholesterol syntheses.

A 59-year-old client is on warfarin therapy. On follow-up visits to the clinic, the nurse will assess the client's:

intake of vitamin K.

What is the primary goal of antidysrhythmic drug therapy for a client who has been successfully cardioverted?

maintenance of normal sinus rhythm (NSR)

The client with a 10-year history of hypertension would like to know what effect the condition has on the heart. What is the nurse's best response?

myocardium hypertrophy

A client has been admitted to the emergency department with signs and symptoms of shock and the client's hypotension has not responded adequately to fluid volume replacement. The nurse will prepare to administer:

norepinephrine.

A group of nursing students is preparing a poster presentation describing the anatomy and function of the heart. In their diagram of the organ, they label the structure that separates the left and right sides of the heart as the:

septum.

The results of the CAST study have limited the use of antiarrhythmics to:

short-term use to treat life-threatening ventricular arrhythmias

While teaching a patient about sublingual nitroglycerin, the nurse explains proper use and storage. When the patient asks whether the medication ever expires, the nurse should respond that it:

should be replaced every six months

A client has been diagnosed with a problem associated with the heart's right atrium. Which statement indicates that the client understands the diagnosis?

the top chamber, responsible for receiving blood from my body's veins, is the problem.

Contraction of the right atrium sends blood through the:

tricuspid valve.

A client diagnosed with heart disease is prescribed an antiarrhythmic drug. Further teaching is needed when the client makes which statement?

"I know I must take my medication every day for my heartbeat to be fixed."

A nurse is giving discharge instructions to a client receiving nitroglycerin for angina. The nurse recognizes the client needs additional information when the client makes what statement?

"I will take a pill every 15 minutes until the pain subsides."

A client experiencing a ventricular arrhythmia has received a bolus of lidocaine. What is the recommended rate for continuous infusion of lidocaine IV now prescribed for this client?

1 to 4 mg/min

What formula will the nurse expect to use when calculating the IV loading dose for a 76-year-old client prescribed procainamide?

10 mg/kg

The community health nurse is performing a home visit to an older adult client whose medication regimen includes simvastatin 70 mg orally each evening. The client's pharmacy has provided a supply of simvastatin 20 mg tablets and simvastatin 10 mg tablets. When checking the client's pill organizer, the nurse should ensure that there are what number of simvastatin tablets in each day's evening administration? Record your answer as a whole number.

4

An appropriate goal for a client taking niacin would be to reduce total serum cholesterol to which level?

<200 mg/dL

Which statement would be true about the mechanism of action of class II antiarrhythmic agents?

Block the stimulation of the adrenergic receptors

Ms. Quinn is admitted to the surgical intensive care unit after open heart surgery. The health care provider prescribes IV nitroglycerin, according to a hospital protocol for titration of the drug. Which factor would be most important when determining increases or decreases in the dose?

Current blood pressure

A client is diagnosed with an atrial septal defect (ASD) that has caused a hole between the two upper chambers of the heart. What is the direct result of such a defect?

Deoxygenated and oxygenated blood will mix

The client is prescribed warfarin. His INR is 5.2. At what level is this dose?

Elevated

A 54-year-old client has a cholesterol level of 240 mg/dL (6.2064 mmol/L). What serum concentration of cholesterol would this client have?

High

The patient has been placed on a nitroprusside drip for the treatment of a hypertensive crisis. Which mechanism of action does the nurse know is true for nitroprusside?

It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins.

A client is receiving low-molecular-weight heparin (LMWH) to prevent thromboembolic complications. The nursing student asks the instructor the reason why this treatment is given instead of heparin. What is the instructor's best explanation of the rationale for LMWH over heparin?

LMWH is associated with less thrombocytopenia than standard heparin."

A nurse working on the acute-care medical surgical floor is caring for an older adullt client originally admitted for severe hypertension and stroke. The client has been inpatient for eight days and has now developed a deep vein thrombosis to the left lower extremity. The health care provider has placed orders to start anticoagulation therapy. While preparing the heparin drip, the nurse receives new lab results showing an international normalized ratio (INR) of 3.9. What should be the nurse's priority action in this scenario?

Notify the health care provider about the lab results.

Which factor would necessitate a reduction in the dosage of disopyramide?

Renal impairment

Which enzyme is produced in the kidney?

Renin

Which is released initially when blood flow to the kidneys is decreased?

Renin

A client has a complex cardiac history that includes recurrent ventricular fibrillation. After the failure of more conservative treatments, the care team has introduced oral amiodarone. What assessments should be prioritized by the nurse who is providing care for this client?

Respiratory assessment

Which area of the heart is supplied by the right coronary artery?

Right side of the heart

Arteries and veins transport blood throughout the body. How can an artery be described?

Rigid resistance tubes

Which are components of the heart's conduction system? (Select all that apply.)

SA node Purkinje fibers Bundle branches AV node

During a routine check up of a 45-year-old patient with renal disease, the nurse observes an increase in the patient's blood pressure. Which is the most likely consequence of renal impairment?

Secondary hypertension

The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which?

The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which?

A client is on warfarin therapy for atrial fibrillation and the INR is 4.2 with no protocols for adjustment. What is the priority action by the nurse?

The nurse should hold the medication and notify the health care provider.

After teaching a group of students about circulation, the instructor determines that the teaching was successful when the students identify it as:

a high to low pressure system.

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.

The nurse is caring for a 76-year-old client who is receiving IV heparin 5000 units q4h. At the initiation of therapy, the client's control activated thromboplastin time (aPTT) was found to be 35 seconds. One hour prior to the next scheduled dose, aPTT is determined to be 92 seconds. Based on this result, the nurse will:

hold the dose and contact the provider.

A client accidentally ingested extra doses of warfarin at home and now presents with an elevated INR and bleeding. Which medication will the nurse prepare as prescribed to administer along with vitamin K?

prothrombin complex concentrate

A patient with metabolic syndrome usually has increased plasminogen activator levels.

true