Review Questions-Exam 4

A patient is being discharged from the hospital on warfarin for deep vein thrombosis prevention. Which instructions should the nurse include in the patient's discharge teaching plan?

Wear a medical alert bracelet, Check all urine and stool for discoloration, Do not start any mediation without first talking to your healthcare provider

Which instruction should the nurse include when developing a teaching plan for a patient prescribed diltiazem for atrial fibrillation?

Weigh yourself daily at the same time each day, Notify the healthcare provider if a skin rash develops, Rise slowly from a lying to a sitting position

The nurse is caring for a patient receiving propranolol. Which clinical finding is most indicative of an adverse effect of this drug?

Wheezing

The nurse is teaching a patient about the side effects associated with doxazosin. Which statement by the patient indicates an understanding of the nurse's instructions?

When getting out of bed in the morning, I will sit on the side of the bed for several minutes before standing

The nurse is reviewing assessment data of four clients. Select the client who is at greatest risk for developing pernicious anemia.

A client who has undergone partial gastrectomy

About which patient should the nurse notify the healthcare provider immediately?

A patient who takes oral spironolactone 25 mg daily and enalapril 5 mg daily with a serum potassium level of 5.5

A nurse is assessing a client and becomes concerned that the client may be experiencing heart failure. Which of the following would be the best indicator to determine pressure being exerted on the right side of the heart?

Central venous pressure

Select the statement that best describes Buerger disease.

Disease of young, heavy cigarette smokers occurring before the age of 35

A patient is prescribed hydrazine for the treatment of essential hypertension. Which expected adverse effects should the nurse discuss with the patient?

Fatigue, dizziness, headache

Which patient symptoms should cause the nurse to be concerned about digoxin toxicity?

Fatigue, vomiting, blurred vision

Select the option that best describes the mediation of the systemic inflammatory responses that occurs in DIC.

Inflammatory mediators and cytokines

Which approach should a nurse take to administer intravenous acyclovir to an immunocompromised patient?

Infuse IV fluids during administration of the dose and for 2 hours afterward

A 62 year old female client presents to the emergency department and is diagnosed with acute heart failure syndrome. Assessment data would include:

Productive cough with frothy sputum

A client is at high risk for the development of rheumatic heart disease. The most important information for the nurse to provide would be:

Prompt diagnosis and treatment of streptococcal infections

Why does the nurse anticipate administering metoprolol rather than propranolol for diabetic patients who need a beta blocking agent?

Propranolol causes both beta 1 and beta 2 blockade

A client has been diagnosed with DVT. The nurse is planning care and recognizes that the client is most at risk for:

Pulmonary embolism

The nurse is monitoring a patient receiving ranolazine for angina. Which assessment finding indicates an adverse effect of this drug?

QT prolongation on the electrocardiogram

The nurse is reviewing the client's laboratory report. Select the report that represents a normal value of leukocytes.

6500

The nurse reviews the lab results of a client who has a thrombocyte count of 60,000. The client is at risk for:

Bleeding

A patient received desmopressin preoperatively to maintain hemostasis during a surgical procedure. Which postoperative assessment finding indicates the patient has experience an adverse effect of the drug?

+2 edema of the extremities

The nurse is ready to begin a heparin infusion for a patient with evolving stroke. The baseline aPTT is 40 seconds. Which aPTT value indicates that a therapeutic dose has been achieved?

70

Mature red blood cells have a life span of approximately

120 days

The nurse is monitoring hourly urine output of a client diagnosed with hypovolemic shock. The nurse is most concerned if the client's output is:

20 mL/hour

A client has been placed on bed rest. Select the percentage of the blood volume that will be distributed to the client's pulmonary circulation.

25%

The physician's order states calculate the pulse pressure of the client's BP. The blood pressure reading is as follows: systolic pressure of 146 and a diastolic pressure of 82. The pulse pressure would be:

64 (Difference)

Which needle length and gauge should the nurse choose to administer subcutaneous heparin/

5/8 inch 25 gauge

The nurse is assessing the blood pressure of a client who is experiencing cardiogenic shock. Which of the following blood pressure readings is most likely?

90/75

The nurse is preparing to administer an IV nitroglycerin infusion. For which patient should the nurse question the healthcare provider's prescription to administer IV nitroglycerin infusion?

A patient with a right ventricular infarction, confirmed by right sided ECG changes

The nurse is caring for a patient prescribed gemfibrozil. For which patient should the nurse question the use of this drug?

A patient with history of gallstones and elevated triglycerides

The nurse is caring for a group of patients taking warfarin. Which patients are at moderate to high risk for harm as a result of warfarin therapy?

A patient with variant genes that code for VKORC1 and CYP2CP, A woman with a new onset of symptoms of a pulmonary embolus, A patient with a prosthetic heart valve, for whom an interacting drug is being deleted from the regimen

The nurse observes a client care technician obtain a blood pressure on an obese client using a BP cuff that is too small. The nurse is aware that this will result in:

A reading that is too high

A patient with an elevated triglyceride level is prescribed a sustained release form of nicotinic acid. Which laboratory value is most important for the nurse to monitor for in this patient?

ALT

Select the most accurate statements that describe ARDS.

ARDS is a serious complication of shock, Abnormalities in surfactant contribute to ARDS, ARDS is a profound hypoxemia that is refractory to supplemental oxygen

A client diagnosed with chronic myleogenous leukemia is reporting a feeling of abdominal fullness/discomfort, low grade fever, night sweats, and bone pain. Based on these data, the client is now most likely experiencing the:

Accelerated phase

A client has begun to display manifestations of hepatic encephalopathy. The family is concerned and asks the nurse what caused this condition to develop. Which is the best response by the nurse?

Accumulation of ammonia in the blood

The leukemia most commonly found in children and adolescents is recognized as:

Acute lymphocytic leukemia

The health care provider suspects a client may have developed a leukemia that originates from the B cells. The provider would assess the client for:

Acute lymphocytic leukemia and chronic lymphocytic leukemia

The nurse identifies which medication as the drug of choice for most infection caused by herpes simplex viruses and varicella zoster virus?

Acyclovir

The patient is admitted for the management of a hypertensive emergency. The healthcare provider prescribed sodium nitroprusside drug therapy. What is the priority nursing action during this treatment?

Adjust the intravenous infusion rate to the blood pressure response

Which nursing action should prevent ad adverse effect of a liquid iron preparation?

Administer the iron preparation through a dropper

Select the priority of care for the medical management of a client with a dissecting aortic aneurysm.

Administration of sodium nitroprusside and beta adrenergic blocking medications

The nurse is caring for a client with sickle cell disease. The most important treatment for the nurse to provide would be:

Aggressive intravenous hydration and morphine

The radiologic studies of a client identify partial obstruction of the sphincter of the pancreas. The nurse recognizes that this is a result of:

Alcoholic beverages

Which medication promotes hemostasis in hemophilia A and B by inhibition of fibrinolysis?

Aminocaproic acid

The nurse understands that ventricular fibrillation is a common cause of death after MI. Which drug should be readily available to treat ventricular fibrillation?

Amiodarone

A patient is receiving isosorbide denigrate 20 mg 3 times per day for management of newly diagnosed stable angina. Which assessment finding would require an immediate nursing intervention?

An increase in the resting heart rate to 110 beats per minute from baseline rates of 68 to 72 beats per minute

Which is the priority nursing intervention for a patient receiving parenteral iron dextran?

An intravenous test dose of 25 mg over 5 minutes must be adminstered

The nurse is preparing to administer a daily dose of digoxin. What is the priority nursing intervention?

Analyze heart rate and rhythm.

A client is rushed to the emergency department with symptoms of urticaria, wheezing, chest tightness, and difficulty in breathing. The client is most likely experiencing which type of shock?

Anaphylactic

A 20 year old male client is experiencing a severe immunologically mediated reaction in which histamines have been released into the blood. Select the type of reaction most likely occurring with this client.

Anaphylactic shock

The nurse determines that teaching has been effective when a client diagnosed with chronic stable angina states:

Angina may result from exertion activity or emotional stress and be relieves within minutes by rest or by nitroglycerin.

The renin angiotensin aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising the blood pressure?

Angiotensin II

What are the primary regulatory systems of arterial pressure?

Autonomic nervous system, Renin angiotensin aldosterone system, Renal system

The home health nurse observes the patient for poorer use of topical nitroglycerin ointment. Which action by the patient indicates the need for further teaching?

Applies the prescribed ribbon of ointment to the applicator paper and places it on the chest

The nurse is developing a plan of care for a post surgical client. A major goal is to prevent the formation of prevention DVT. The most important intervention for the nurse to implement would be:

Apply sequential pneumatic compression devices to lower extremities

The nurse is assessing a client for early signs of constrictive pericarditis. The most likely manifestation would be:

Ascites

For all patients undergoing PCI, which drug is recommended to be combined with clopidogrel?

Aspirin

A client with a history of acute coronary syndrome asks why she needs to take aspirin 81 mg every day. The most appropriate response by the nurse would be:

Aspirin will help prevent blood clotting

The nurse is preparing to administer diltiazem and atenolol. What is the priority nursing intervention before administering these two medications to the patient?

Assess the heart rate

Which drug is the most effective for lowering LDL cholesterol?

Atorvastatin

The nurse is caring for several patients. For which patient diagnosis would a prescription for nifedipine be least appropriate?

Atrial fibrillation

The father of a 2 year old boy recently diagnosed with hemophilia A asks the nurse how to prevent complications for his son. The best response would be:

Avoid administering aspirin and non steroidal anti-inflammatory drugs

The nurse is teaching a patient prescribed captopril for the treatment of hypertension. Which instruction should the nurse include?

Avoid potassium salt substitutes, A persistent dry cough may occur, Report difficulty in breathing immediately

A high school soccer player has just been diagnosed with mononucleosis. He tells the nurse he feels ok and really needs to play in the championship game this weekend. The most important information for the nurse to provide would be:

Avoidance of contact sports for a minimum of 3 weeks after diagnosis is recommended.

A client is experiencing hepatorenal syndrome. The client may manifest:

Azotemia, increased serum creatinine, oliguria, ascites

Select the response that best describes the pressure sensitive receptors that respond to changes in the stretch of the vessel wall.

Baroreceptors

The nurse is developing a plan of care for a client diagnosed with infectious mononucleosis. The most appropriate intervention would be:

Bed rest and analgesics to relieve fever, headache, and sore throat

The health care provider is reviewing the results of a client's MRI. The results indicate a small spherical dilation at the circle of Willis. The provider would interpret this as:

Berry aneurysm

Calcium channel blockers work by reducing calcium influx into the cells of the heart and blood vessels. Calcium channels are coupled to which type of autonomic nervous system receptors?

Beta 1

A client who was diagnosed with hypertension is now taking a medication that decreases heart rate and cardiac output. The nurse determines that the medication is a:

Beta adrenergic blocker

Which classes of medications are prescribed as initial therapy for hypertension after a MI?

Beta blocker and ACE inhibitor

Which are the main types of drugs used to prevent or relieve anginal pain?

Beta blockers, nitrates, calcium channel blockers

A client's echocardiogram identified a narrowed valve that has resulted in a decreased blood flow between the left atria and left ventricle. The nurse would interpret this as the:

Bicuspid valve

What is the primary benefit of spironolactone in patients with heart failure?

Blockage of aldosterone receptors

A client was involved in an auto accident and suffered massive internal injuries that resulted in a large blood loss. Select the type of anemia the client is at greatest risk to develop.

Blood loss

Which assessment finding is most important for the nurse to obtain before administering hydralazine?

Blood pressure

A pregnant female client is at risk for the development of preeclampsia eclampsia. Select the most important data to assess.

Blood pressure 160/100 and proteinuria during the 30th week of pregnancy.

The nurse is monitoring a patient prescribed reserpine for the treatment of hypertension. Which assessment parameter indicates that this medication is effective?

Blood pressure of 118/72

The client's primary care physician is reviewing assessment data of a client and suspects a diagnosis of acute leukemia. To confirm the diagnosis, which of the following tests would be performed?

Bone marrow analysis

Select the option that describes the production of T lymphocytes.

Bone marrow, thymus, lymph nodes

A client is experiencing the early stage of multiple myeloma. The nurse would assess the client for:

Bone pain

The nurse is caring for a client who has just experienced an acute myocardial infarction and is diagnosed with pump failure. The nurse is aware that the client is experiencing which type of shock?

Cardiogenic

The health care provider is reviewing diagnostic tests that were ordered for a client diagnosed with heart failure. Select the test that would provide information about the client's ejection fraction and ventricular preload.

CCT

A client has a lymphoma that carries a risk of CNS involvement. The nurse anticipates the health care provider will prescribe:

CNS prophylaxis

The nurse is caring for a patient who is receiving enteral feedings because of dysphagia. The healthcare provider prescribes isosorbide mononitrate 60 mg SR daily via the enteral tube. What is the most appropriate action by the nurse?

Call the healthcare provider about an alternate form of nitrate for administration

The nurse is caring for a patient who takes warfarin for prevention of deep vein thrombosis. The patient has an INR of 1.2. Which action by the nurse is most appropriate?

Call the healthcare provider to increase the dose

Select the statements that most accurately describe secondary hypertension.

Can be corrected or cured by surgery or specific medical treatment, Accounts for 5% to 10% of hypertension cases, May be caused by oral contraceptives, Obstructive sleep apnea is an independent risk factor for secondary hypertension, Kidney disease is one of the most common causes

A patient is admitted to the hospital with a diagnosis of hypertension. The nurse understands that which medication works by preventing angiotensin II from binding with its receptor site?

Candesartan

Select the correct sequence of blood return to the heart.

Capillaries, venules, veins, right atrium

Which instruction about clopidogrel should the nurse include in the discharge teaching for a patient who has received a drug eluting coronary stent?

Check with your healthcare provider before taking any over the counter medications for gastric acidity

The nurse is the emergency department is receiving a report on a patient diagnosed with STEMI. What are the common biochemical markers and symptoms of STEMI?

Chest pain and ECG changes, Elevated troponin T levels, Elevated creatinine kinase level, Weakness and diaphoresis

The nurse is caring for a patient with anemia. What is a common cause of iron deficiency in the United States?

Chronic blood loss through the GI tract

An elderly client asks the nurse why so many older people develop anemia. The best response would be:

Chronic disease

A client's laboratory report shows the presence of the Philadelphia chromosome. The health care provider would recognize this as:

Chronic myelogenous leukemia

A client with a history of chronic pancreatitis is concerned about developing long term complications. The best response by the nurse would be:

Clients can develop signs of diabetes and malabsorption.

The nurse is monitoring therapy for a patient with hemophilia B. Which evaluation criterion is most important to determine whether the nidation dosage is effective?

Clinical response

A patient who abuses cocaine, opioids, and other drugs frequently abuses which drug?

Clonidine

A chid is scheduled for surgical correction of tetralogy of Fallot. Select the anticipated outcome of the surgical intervention.

Closure of the ventricular septal defect and relief of the right ventricular outflow obstruction

The nurse is caring for a patient prescribed a cholesterol lowering drug. Which drug is least likely to cause systemic side effects?

Colesevelam

A nurse is assessing a client in shock for complications of acute renal failure. The most important assessment for the nurse to obtain would be:

Continuous measurement of urine output

A patient is prescribed lisinopril as part of the treatment plan for heart failure. Which finding indicates the patient is experiencing the therapeutic effect of this drug?

Crackles in the lungs are no longer heard

For which medication order should the nurse notify the healthcare provider?

Cyanocobalamin 100 mag IV every month-should never be given IV

A patent presents to the emergency department with symptoms of acute myocardial infarction. After a diagnostic workup, the healthcare provider prescribes a 15 mg IV bolus of alteplase followed by 50 mg infused over 30 minutes. In monitoring this patient, which finding by the nurse most likely indicates an adverse reaction to this drug?

Decreasing level of consciousness

A patient is prescribed lisinopril 40 mg by mouth once a day for hypertension. For which therapeutic effect will the nurse monitor?

Decrease in blood pressure

The health care provider has determined that a client diagnosed with cariogenic shock will now require treatment with the intra aortic balloon pump. The expected effect of the treatment is:

Decreased after load

The nurse is developing a plan of care for a client with heart failure. The most important information for the nurse to consider would be:

Decreased cardiac output

A client has just experienced stimulation of the vagus nerve. Which of the following would the nurse anticipate to manifest in this client?

Decreased heart rate

Warfarin has been prescribed for a client. the nurse expects that the client will have:

Decreased prothrombin and other pro coagulation factors

A client is admitted to the emergency department after experiencing a motor vehicle accident and sustaining multiple injuries with significant blood loss. The nurse predicts that the client will display which of the following?

Decreased urinary output

The nurse is caring for several patients prescribed propranolol. IN which patient condition is propranolol contraindicated?

Diabetes

A client has developed constrictive pericarditis and myocardial hypertrophy. Select the most likely cause.

Diastolic dysfunction

Which drug would not be included in the treatment plan for a patient who will undergo a PCI?

Diltiazem

Which medication is most likely to cause the side effect of constipation?

Diltiazem

Which medication combination is useful in the treatment of variant angina?

Diltiazem and isosorbide mononitrate

A client who has been taking acetaminophen 1000 mg every 4 hours presents to the urgent care center with increased abdominal pain, elevated ALT, AST, and bilirubin levels. The nurse suspects the client is experiencing:

Direct hepatotoxic reaction

The nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding most likely relates to an adverse effect of heparin?

Discolored urine

The healthcare provider prescribes lovastatin for a patient discharged from the hospital most myocardial infarction. Which instructions are most important for the nurse to include in the patient's teaching plan?

Do not start any new medications without first talking to your healthcare provider, Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes, Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains

The nurse is assessing a patient in a clinic who has been taking clonidine for hypertension. Which clinical findings are most indicative of an adverse effect of this drug?

Drowsiness and dry mouth

A client is admitted to the hospital with a diagnosis of deep vein thrombosis and started on intravenous heparin therapy. Seven days later, the client's lab values identify a rapid decrease in platelets. The health care provider recognizes this as:

Drug induced thrombocytopenia

The nurse is providing dietary instruction for a client diagnosed with folic acid deficiency. The nurse should provide the client with what information to help assure the client ingests sufficient amounts of folic acid?

Eat green leafy vegetables daily, Include a variety of cereals in the daily diet, Alcohol consumption is a risk factor for folic acid deficiency

The nurse is caring for a patient who has diabetes and hypertension. Which medication is most likely to be prescribed to treat this patient's hypertension?

Enalapril

The nurse is administering iron dextran by IV infusion to a patient with iron deficiency. Which is the priority nursing action during the administration of this drug?

Ensure that epinephrine is available as needed

A client presents to the emergency department with suspected pancreatitis. Select the manifestations the nurse would assess the client for:

Epigastric pain, tenderness, fever, tachycardia

A 16 year old male client who has been diagnosed with infectious mononucleosis asks the health care provider what caused the condition. The best response would be:

Eptein Barr virus

The physician has just completed an assessment on a client diagnosed with cirrhosis. The client asks if she is at risk for any serious complications. Which would be the best response?

Esophageal varices

A client has been diagnosed with inherited hyper coagulability. Select the most likely cause.

Factor V gene mutation

When teaching a patient about therapy with famciclovir, which statements does the nurse include?

Famciclovir is generally well tolerated, Famciclovir is used in the treatment of acute herpes zoster

A patient is receiving weekly subcutaneous injections of peg interferon alfa 2a for chronic hepatitis C. A nurse teaches the patient that which adverse effect will diminish with continued therapy?

Flulike symptoms

A nurse is providing teaching to a group of patients regarding flu season in the United States. Which statement should the nurse include in the teaching?

For people who missed the best time, vaccinating as late as April may be of help

Which medication should be used with caution in a hypertensive diabetic patient?

Furosemide, metoprolol, hydrochlorothiazide

A client who has just been diagnosed with dilated cardiomyopathy asks the nurse what caused the condition. The most appropriate response would be:

Genetic abnormalities

The nurse is preparing to administer an oral dose of digoxin. The apical pulse rate is 64. What nursing action is most appropriate?

Give the medication

A patient is admitted to the emergency department complaining of chest pain, and the ECG shows and evolving STEMI. What intervention should the nurse anticipate?

Have the patient chew a 325 mg aspirin

A patient is admitted to the emergency department with a diagnosis of STEMI. Which is the priority nursing action?

Having the patient chew a 325 mg aspirin

The nurse understands patients receiving nitroglycerin are at risk for which adverse effects?

Headache, Dizziness, Tachycardia

A patient with angina pectoris has been prescribed nifedipine. Which possible adverse effects should the nurse expect with this medication?

Headache, Edema of ankle and feet, Overgrowth of gum tissue

Prior to discharge, the nurse provides teaching related to adverse effects of terazosin to the patient and caregivers. Which adverse effects should the nurse include in the teaching of this drug?

Headache, nasal congestion, erectile dysfunction, orthostatic hypotension

Complete the equation: Cardiac output= volume of blood ejected at each heartbeat x ___

Heart rate

The nurse is providing education to a client diagnosed with varicose veins. The nurse determines that teaching has been effective when the client states the the most likely cause of the varicosities is:

Heavy lifting

Select the option that best describes the pathogenesis of the anemia in a client with beta thalassemia

Heinz bodies repair DNA synthesis and damage the red cell membrane

The nurse is caring for a patient prescribed methyldopa. Which laboratory test is most important to obtain before treatment?

Hematocrit

Anemia refers to a deficiency of

Hemoglobin

A patient with a deep vein thrombosis receiving an IV heparin infusion asks the nurse how this medication works. What is the nurse's best response?

Heparin suppresses coagulation by helping antithrombin perform its natural functions

A client diagnosed with liver cancer asks the doctor what the best treatment option is. The most appropriate response would be:

Hepatic resection

A client tells the nurse that he is concerned about developing hepatitis after being exposed to contaminated feces, saliva, and food. The nurse is aware that the client is at risk for:

Hepatitis A

The physician suspects a client may have developed pancreatitis, and the physician has ordered laboratory blood work. Diagnosis confirming results would identify:

High serum amylase and lipase

Humoral control of blood flow involves the effect of vasodilator and vasoconstrictor substances in the blood. Select the factor that has a powerful vasodilator effect on arterioles and increases capillary permeability.

Histamine

The health care provider is discussing major risk factors for CAD with a client. The most important information for the provider to include would be:

History of cigarette smoking and elevated blood pressure

The nurse is assessing a patient with hemophilia for complication of clotting factor administration. Which assessment findings would indicated an adverse effect of this treatment?

Hives and urticaria, Bethesda titer of 40 units

A client is seen by the health care provider. The client states he has been experiencing fevers, chills, and night sweats. Upon further assessment, the health care provider palpates an enlarged supraclavicular lymph node. The health care provider recognizes the manifestations as:

Hodgkin lymphoma

The nurse is aware that a client diagnosed with multiple myeloma is most at risk for:

Hypercalcemia

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 with acute leukemia has developed gout. The nurse is aware that this results from:

Hyperuricemia

The nurse provide discharge instructions to a patient prescribed verapamil SR 120 mg PO daily for essential hypertension. Which statement by the patient indicates understanding of the medication?

I must make sure I swallow the pill whole

The nurse is caring for a 6 month old infant diagnosed with iron deficiency anemia. The nurse determines further teaching is necessary when the mother states

I must stop breast feeding my baby because of the anemia

The nurse is evaluating the teaching done with a patient who has a new prescription for transdermal clonidine. Which statement by the patient indicates understanding of the nurse's teaching?

I will apply the patch to a hairless intact skin area on my upper arm

The nurse is teaching a patient with essential hypertension who has a new prescription for verapamil. Which statements by the patient indicate that the teaching was effective?

I will increase my intake of fluid and foods high in fiber, I will call my healthcare provider if I notice swelling in my ankles

The nurse is providing discharge teaching for a patient with a new prescription for a nitroglycerin transdermal patch. Which statement by the patient indicates a need for further teaching?

I will limit my alcohol to one drink per day

The nurse is teaching the patient about atenolol. Which statement by the patient indicates a correct understanding of the nurse's instruction?

I will not stop taking this drug without the approval of my healthcare provider

Which statement made by the patient indicates understanding of teaching related to a new prescription for atenolol?

I will not stop taking this medication abruptly

The nurse is teaching a patient who has just been prescribed a vasodilator. Which statement by the patient indicates that the teaching was effective?

I will rise slowly when changing from a sitting to a standing position

The nurse is evaluating the teaching done with a patient who has a new prescription for fosinopril. Which statement by the patient indicates a need for further teaching?

I will use a salt substitute to lower my sodium intake

A client is diagnosed with hyperthyroidism and prescribed propylthiouracil. One month later, the client has blood drawn for routine lab test that includes a complete blood count with differential. The results show that the client has now developed neutropenia. The health care provider recognizes this as:

Idiosyncratic depression

What is the priority instruction a nurse gives to a male patient who is scheduled to receive ribavirin combined with peg interferon alfa 2a for treatment of hepatitis C?

If you are sexually active, use two reliable forms of birth control to prevent pregnancy

Which statement is most appropriate for the nurse to include in the discharge teaching plan for a 30 year old woman beginning a new prescription of clonidine?

If you stop taking this drug abruptly, your blood pressure might go up very high

The nurse knows that which statement is most accurate regarding hemophilia?

Immune tolerance therapy is more successful in eliminating inhibitor production in hemophilia A than in hemophilia B

The health care provider has completed the assessment of a client who presented to the emergency department with jaundice. The provider determines that the jaundice is a result of:

Impaired uptake of bilirubin by the liver

A client had developed jaundice. The nurse recognizes that the jaundice may have resulted from:

Impaired uptake of bilirubin by the liver cells, Decreased conjugation of bilirubin

The health care team is developing a plan of care for a client diagnosed with CHF. The primary treatment goal would be:

Improving quality of life by relieving symptoms

A client has experienced sympathetic nervous stimulation of the heart. The nurse is aware that the client may manifest which of the following?

Increased heart rate and increased contractility

A patient with SCA is receiving hydroxyurea. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect?

Increased production of fetal hemoglobin

The nurse is assessing lab values of a client with DIC. The nurse would anticipate the results to include:

Increased prothrombin time

The nurse is reviewing lab results of a client who has liver failure. The nurse determines that the client is at an increased risk for bleeding when the result include:

Increased prothrombin time

The nurse is reviewing the lab results of a client diagnosed with cholestasis. The nurse would anticipate:

Increased serum alkaline phosphatase

The mother of a newborn infant questions why her baby needs a vitamin K injection immediately after birth. The best response by the nurse would be:

Infants are not born with the normal intestinal bacteria that synthesize vitamin K for clotting

The nurse is implementing a plan of care for a client who has developed acute pancreatitis. It is most important for the nurse to:

Initiate gastric suctioning to prevent the synthesis of pancreatic enzymes

The nurse is assessing a client diagnosed with anemia and notes that the client's skin and mucous membranes are pale. The nurse interprets this as:

Insufficient hemoglobin

A client is concerned about acquiring hepatitis A and asks the nurse who should receive the HAV vaccine. The best response would be:

International travels visiting to regions where sanitation is poor, Homosexually active men, Users of illicit drugs, Workers employed in food handling

Which organ regulates the body's iron stores?

Intestines

Which adverse effect is the greatest concern with thrombolytic therapy?

Intracranial hemorrhage

A patient with heart failure has developed a cough while taking an ACE inhibitor. The health care provider discontinued the ACE inhibitor and prescribed an ARB as an alternative to the ACE inhibitor. The patient continues to have symptoms of heart failure despite using an ARB. Which medication should the nurse anticipate will be prescribed?

Isosorbide denigrate and hydralazine

A nursing instructor is explaining arterial circulation to a group of nursing students. Which of the following is the most appropriate information for the nurse to provid?

It contains one sixth of the total blood volume

The nurse is caring for a patient prescribed aliskiren. How does this medication lower blood pressure?

It inhibits the conversion of angiotensinogen into angiotensin I

The nurse is evaluating a client who is in her last month of pregnancy and at risk for permpartum cardiomyopathy. Select the most appropriate information for the nurse to consider.

It is a dilated cardiomyopathy, It is a disorder that can occur in the last month of pregnancy, The incidence is greater in women with twin fetuses

The nurse knows that which statement is accurate for enoxaparin?

It reduces the activity of factor Xa more than the activity of thrombin

The nurse is preparing to administer a dose of clonidine. Which is the best description of the action of this drug?

It selectively activates alpha 2 receptors in the CNS

The nurse is educating a pregnant client about the importance of folic acid. Select the food that has the highest levels of folic acid.

Kale

The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis?

LDL

The nurse is reviewing the lipid results of four clients. Select the client at greatest risk for cardiovascular disease.

LDL 205, HDL 40, Triglyceride 150

Which of the following blood flow patterns reduces friction, allowing the blood layers to slide smoothly over one another?

Laminar

The nurse has just completed teaching a client about acyanotic congenital heart disease. The nurse determines that teaching was effective when the client states that blood is shunted from the:

Left side of the heart to the right side of the heart

A patient admitted with DVT and subsequent PE required immediate anticoagulation. What mediation would be appropriate for this patient who has a history of HIT?

Lepirudin

Fondaparinux is not approved for use in which circumstance?

Prevention of ischemic complications in patients with unstable angina

A nurse develops a plan of care for a patient who has an outbreak of recurrent genital herpes and is taking oral acyclovir. Which outcome should be included?

Less frequent eruption of lesions

An adult male patient is taking medication for blood pressure management. The patient states to the nurse I'm not going to take the drugs anymore because they are interfering with my sex life. What is the most appropriate response by the nurse?

Let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect

The nurses caring for a patient with bipolar disorder treated with lithium. The patient has a new prescription of captopril for hypertension. The combination of these two drug makes which assessment particularly important?

Lithium level

The nurse determines that the capillary pore exchange of a client's gases, nutrients, and/or waste products would be best facilitated by which of the following?

Liver

What condition increases the patient's risk for the development of MI and DIC when receiving AICC?

Liver disease

A nurse is reviewing laboratory results of a client that were ordered to assess liver function. The results indicating injury to liver cells would include:

Liver enzymes

The physician states that a client has adequate collateral circulation. The nurse interprets this as:

Long term compensatory regulation of blood flow

A client is very much concerned about his family history of atherosclerosis and asks the nurse is there is anything he can do to decrease his risk. The client has type 2 diabetes. The best response would be:

Maintain normal weight, Control hypertension, Control blood glucose levels

Hemophilia is a genetically based bleeding disorder seen almost exclusively in which patients?

Male

A 40 year old client is admitted to the hospital after experiencing 3 days of extreme vomiting. The doctor reviews the lab results and notes that the hemoglobin and hematocrit are elevated. This is interpreted as:

Manifestation of dehydration

The nurse is caring for a patient receiving a nitroprusside intravenous infusion. The patient's wife asks why furosemide is being prescribed along with this drug. The nurse's response is based on which concept?

Many vasodilators cause retention of sodium and water

A patient has vitamin B12 deficiency following a subtotal gastrectomy. The nurse understands the patient has which type of anemia?

Megaloblastic

The nurse is reviewing the client's laboratory data showing an increased MCV and a normal MCHC. The client most likely has which of the following types of anemia?

Megaloblastic anemia

The nurse is caring for a pregnant patient experiencing a new episode of hypertension. Which medication does the nurse anticipate will be prescribed for this patient?

Methyldopa

The nurse is teaching a patient who has had an STEMI about home mediations. Which agent represents a drug category that should be taken by all post MI patients?

Metoprolol

Which discharge instruction should the nurse include for a patient prescribed cholestyramine?

Mix the drug with water or juice

The nurse has just administered the initial dose of enalapril to a newly admitted patient with hypertension. Whats the priority nursing intervention over the next several hours?

Monitor blood pressure

The healthcare provider prescribed an intravenous dose of diltiazem for treatment of a patient with atrial fibrillation. What is the priority nursing intervention?

Monitor electrocardiogram

Which medication is the treatment of choice for STEMI associated pain?

Morphine

A nurse is assessing a child who has a congenital heart defect for cyanosis. Select the most important area for the nurse to assess.

Mucous membranes

A patient with cardiovascular disease is taking rosuvastatin. The nurse is monitoring for potential adverse effects. Which finding indicates a potential adverse effect of this drug?

Muscle pain and tenderness

The nurse is developing a plan of care for a client diagnosed with stable angina. Select the most important goal for this client.

Myocardial infarction prevention

Which physiologic mechanism helps to ensure venous return despite low pressure in the venules?

Negative pressure in the right atrium

A nurse is preparing to administer ganciclovir to a patient for treatment of cytomegalovirus pneumonitis. Which laboratory result should the nurse recognize as a contraindication to use of this drug?

Neutrophil count below 500

What is the most appropriate nursing consideration for a patient who is prescribed verapamil and digoxin?

Notify the healthcare provider of nausea, vomiting, and visual changes

The laboratory calls to report a drop in the platelet count to 90,000 for a patient receiving heparin for the treatment of postoperative deep vein thrombosis. Which action by the nurse is the most appropriate?

Notify the healthcare provider to discuss the reduction or withdrawal of heparin

A client has been diagnosed with cholelithiasis. The nurse is aware the client is at risk for:

Obstruction of bile flow, Biliary colic, Acute cholecystitis, Chronic cholecystitis

A patient in a hypertensive crisis is being started on a continuous sodium nitroprusside infusion. What interventions are essential before the nurse administers nitroprusside?

Obtain a baseline weight and weigh daily, Prepare for arterial line insertion, Cover the solution with an opaque bag

The nurse is caring for a patient receiving clopidogrel to prevent blockage of coronary artery stents. Which other drug on the patient's medication administration record may reduce the antiplatelet effects of clopidogrel?

Omeprazole

The nurse reviews the mediation treatment regimen for a patient with chronic hypertension. To promote optimal medication adherence, which frequency of drug dosing should the nurse advocate for this patient?

Once a day

A client with a long history of stable angina suddenly experiences substernal pain that radiates to the left arm, neck, and jaw. He describes the pain as severe and feels as if he is suffocating. He has taken nitroglycerin and not experiences any relief. The client is most likely experiencing:

Onset of STEMI

A nurse is assessing a client diagnosed with severe mitral valve stenosis. The nurse anticipates the assessment will include:

Orthopnea

A nurse is caring for a patient prescribed doxazosin for hypertension. Safety is a priority because of which associated adverse effect?

Orthostatic hypotension

A client is brought to the emergency department with symptoms of ACS. Select the most important interventions that should be implemented.

Oxygen, morphine, ECG monitoring, nitrates, beta adrenergic blocking agents

A client with heart failure tells the nurse that he is frustrated and is unable to get a good night's rest. The client related that he falls asleep and is suddenly awakened and feels as though he is having a hard time breathing and is suffocating. The nurse recognizes this assessment as:

Paroxysmal nocturnal dyspnea

On demand therapy is indicated for which type of patient?

Patient who is bleeding or about to undergo surgery

The nurse reviews the prescribed medication for a patient with hemophilia who complains of bleeding related pain. Which medication should the nurse question if ordered for this patient?

Percodan

The nurse is assessing a client with right sided heart failure. It would be most important to assess the client for:

Peripheral edema

The nurse is caring for a patient with hypertension who is receiving verapamil. The patient has a healthy heart. What pharmacodynamic effects does the nurse expect from this drug?

Peripheral vasodilation, Coronary vasodilation

Select the most important treatment for TTP

Plasmapheresis

A patient is receiving a continuous heparin infusion for venous thromboembolism treatment. Which laboratory results should the nurse monitor?

Platelets, aPTT

The nurse is performing an admission assessment on a client with the diagnosis of primary polycythemia. The nurse anticipated that the assessment will include:

Plethora, hypertension, itching, pain

A nurse is assessing a client who has just been admitted to the unit with a diagnosis of acute pericarditis. The client would most likely manifest:

Pleuritic pian, fever, pericardial friction rub

A client tells the nurse that the doctor told her she has too many red blood cells accompanied by elevated white cells and platelet counts. The nurse recognizes this as:

Polycythemia vera

A patient is receiving cyanocobalamin for the treatment of pernicious anemia. Which electrolyte should the nurse monitor as a result of this treatment?

Potassium

The nurse is caring for a patient who takes spironolactone and quinapril for treatment of heart failure. What finding indicates a potential interaction between these two drugs?

Potassium level of 5.7

The nurse is teaching a client diagnosed with heart failure about preload. Which of the following would be the most appropriate information to provide?

Preload represents the volume work of the heart

The nurse notices significant edema surrounding and proximal to the peripheral IV site where epinephrine is being infused. Which action would the nurse anticipate first?

Prepare to administer phentolamine

A client is admitted with a suspected diagnosis of Hodgkins lymphoma. Select the diagnostic manifestation that would confirm the diagnosis.

Presence of Reed Sternberg cells

A nurse is teaching a client the correct technique for taking an arterial pulse. The nurse explains that the pulsations are:

Pressure pulses

A female client tells the health care provider that she has recently been experiencing episodes of changes occurring in the color of her fingertips especially when she experiences cold temperatures. She further states that the tips become pale, turn a bluish color, and then become reddened. The client is most likely experiencing:

Raynaud phenomenon

The nurse is teaching a group of patients about dietary approaches to reduce cholesterol levels. Which statement is most important to include in the teaching?

Read food labels and reduce your intake of saturated fats

A female client has been diagnosed with antiphospholipid syndrome. The nurse would anticipate the client to have a health history that may include:

Recurrent fetal loss, Hypertension during pregnancy, Uteroplacental insufficiency

The health care provider is preparing to assess a client who has been diagnosed with hypertrophic cardiomyopathy. The provider anticipates the assessment data will include:

Reduced chamber size

The nurse is caring for a client diagnosed with sickle cell disease. Select the most important factor for the nurse to be aware of that may cause the cells to sickle.

Reduced oxygen tension while the client sleeps

Which are beneficial effects that can be derives form simvastatin and other drugs in this class?

Reduction of LDL, Elevation of HDL, Stabilization of the plaque in coronary arteries, Reduction of risk of cardiovascular events

A client has been diagnosed with aplastic anemia. The nurse is aware that the client's lab results will identify:

Reduction of white blood cells

A client who has been diagnosed with mitral valve prolapse asks the nurse if there are any dietary modifications that should be incorporated into her lifestyle. The best response would be:

Refraining from caffeine, alcohol, and cigarettes may be sufficient to control symptoms

The nurse is caring for a patient receiving vitamin B12 because of a deficiency. What are common causes of this deficiency?

Regional enteritis and malabsorption, Celiac disease, Advancing age, Use of drugs that lower stomach acid

A client is experiencing circulatory shock. The nurse is aware that compensation will occur with stimulation of the beta 2 receptors. The nurse anticipates the client will experiences:

Relaxation of the bronchioles

Coagulation activated by the extrinsic pathway is initiated when:

Release of thromboplastin from the injured vessel wall

Which is the most beneficial treatment for patients experiencing an STEMI?

Reperfusion therapy

The nurse is preparing to administer medication to the following patients. Which medication should the nurse question before administering?

Reserpine to a patient with a history of depression

The nurse is caring for a patient prescribed digoxin for heart failure. Which finding would require immediate attention by the nurse?

Vomiting and diarrhea

A patient has been diagnosed with respiratory syncytial virus. The nurse anticipates administration of which drugs?

Ribavirin inhaled, palivizumab

The nurse is assessing a client who has just been admitted to the unit with a diagnosis of cholelithiasis. The nurse is aware that the client may manifest:

Right upper quadrant pain

A nurse is explaining the conduction system of the heart to a client who is experiencing an arrhythmia. Which would be the most appropriate explanation?

SA node, internodal pathways, AV node, AV bundle, Purkinje fibers

The nurse is teaching a group of high school students about the modes of transmission of infectious mononucleosis. The nurse determines that teaching was effective when the students state:

Saliva

The nurse is caring for a client with chronic lung disease who has a history of smoking 2 packs of cigarettes per day for 25 years. The client is at high risk for the development of:

Secondary polycythemia

Following the administration of guanfacine, the nurse should assess for which effects?

Sedation and dry mouth

The nurse is caring for a patient with renal artery stenosis who has been prescribed benazepril. Which laboratory result indicates an adverse effect of this drug?

Serum creatinine level of 2.3

A patient being treated for pernicious anemia with cyanocobalamin reports new onset of muscle weakness and states my heart is skipping beats. Which laboratory value most likely is contributing to these new symptoms?

Serum potassium level of 2.3

Which laboratory result may be a consequence of therapy with a thiazide diuretic?

Serum uric acid level of 10.4

The nurse is preparing to administer minoxidil 5 mg orally. What is the only cardiovascular indication for this medication?

Severe hypertension

A 26 year old female client has a neutrophil count of less than 500. The nurse would interpret this as:

Severe neutropenia

A client who has been diagnosed with acute symptomatic viral hepatitis is now in the icteric period. The nurse would expect the client to manifest:

Severe pruritus and liver tenderness

A client laboratory report indicates neutropenia. The nurse is aware the client is at greatest risk for development of infection. The most important area for the nurse to assess would be:

Skin

A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. The best response would be:

Smoking cessation, dietary measures to reduce LDL levels, Weight reduction if overweight

A patient is admitted to the unit in a hypertensive emergency and examination reveals papilledema. The nurse should expect which IV medications to be administered to achieve rapid controlled reduction of the patient's blood pressure?

Sodium nitroprusside

A patient with hypertensive emergency is admitted to the hospital. Which medication should the nurse be prepared to administer to this patient?

Sodium nitroprusside

A client with a known history of intravenous drug abuse has been diagnosed with infective endocarditis. Select the most likely cause of infection.

Staphylococcus aureus

The nurse is teaching the parent of a young child about administering ferrous sulfate to the child at home. Which teaching point should receive the highest priority?

Store the ferrous sulfate in a childproof container and keep it out of the child's reach

A patient with angina is being discharged with a prescription for nitroglycerin sublingual tablets. Which instruction should the nurse include?

Store the tablets in the original container and tightly close it after use

The health care provider is concerned that a client has developed a decrease in cardiac output. Cardiac output may be calculated as:

Stroke volume x heart rate

The nurse is caring for a patient who has been receiving intravenous sodium nitroprusside for 3 days. Which assessment data indicate the patient may be experiencing thiocyanate toxicity?

Sudden confusion

The nurse is assessing the ECG of a client who is experiencing unstable angina. The nurse observes:

T wave changes

In the failing heart, arterial pressure falls, stimulating the baroreceptor reflex to increase sympathetic nervous system activity. The nurse understands increased sympathetic activity will produce which response?

Tachycardia

A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for:

Tearing or ripping type pain in the chest or back

A client reporting a headache is diagnosed with giant cell arteritis. The nurse is aware that the vessels most commonly affected are the:

Temporal

A client refuses to take the 81 mg of aspirin ordered by the physician, stating I do not have any pain. The best response by the nurse would be:

The 81 mg of aspirin daily will protect you from a stroke or a heart attack

Select the client who may be at risk for developing an increase in resistance to blood flow.

The client admitted to the intensive care unit for extreme dehydration

The health care provider is reviewing lab results of a client diagnosed with heart failure. The provider notes that the client's ANP and BNP levels have been increasing and remain significantly elevated. These results would be interpreted as:

The condition is getting progressively worse

The nurse is caring for a 2 day old newborn infant who appears lethargic and has a yellowish tint to the skin. Select the most likely cause of this newborn's signs and symptoms.

The inability of the immature liver to conjugate bilirubin

A patient with nonvalvular atrial fibrillation is to be discharged on dabigatran etexilate. Which statement should the nurse include in the discharge teaching?

The medication must be stored in the manufacturer supplied bottle

A 42 year old male client recently diagnosed with liver cancer is noted as at high risk for bleeding abnormalities. The nurse recognizes this risk as a result of:

The reduction of clotting factors synthesized in the liver

Which statements accurately reflect Starling's law as applied to a healthy heart?

The right and left ventricles pump the same amount of blood, Cardiac output is equal to the volume of blood delivered by the veins, When venous return increases, cardiac output increases

The nurse is teaching a group of clients about hypertension. The nurse determines that teaching was effective when the clients state:

The systolic pressure is greater than or equal to 140, It is the most common cardiovascular disorder, The incidence increases with age

A client has been diagnosed with aorta stenosis and asks the nurse what this means. The most appropriate response would be:

The valve opening is narrowed and produces increased resistance to blood flow out of the left ventricle and into the aorta

A client tells the nurse that he has recently begun to take over the counter calcium supplements to ensure that his blood will clot. The best response by the nurse would be:

This is not necessary unless it has been prescribed by your health care provider

A client has an impaired platelet function that may have developed from inheritance, drugs, disease, or extracorporeal circulation. The health care provider would document this as:

Thrombocytopathia

A nurse is assisting a client with self care and observes the following: areas of bruising on the client's arms and legs, pinpoint hemorrhages on the legs, pin point hemorrhages in the mouth, platelets level of 90,000. The nurse recognizes these data as a manifestation of:

Thrombocytopenia

The nurse is preparing to administer medication to a client. Select the medication that the nurse would administer to prevent platelet aggregation.

Ticlopidine

The nurse is caring for a patient receiving hydrazine. The healthcare provider prescribes propranolol. The nurse knows that a drug such as propranolol often is combined with hydralazine for what purpose?

To protect against reflex tachycardia

The nurse identifies the blood vessel layer that constricts to regulate and control diameter as which of the following?

Tunica media

A client diagnosed with autosomal dominant von Willebrand factor disease is experiencing mild to moderate bleeding. The health care provider would classify the diagnosis as:

Type 2

An elderly client asks the nurse why so many older people develop heart failure. The best response would be increased:

Vascular stiffness

A client who has progressed to late stage heart failure is experiencing sympathetic stimulation. The nurse would assess the client for:

Vasoconstriction, Increased oxygen demand, Arrhythmia

The nurse is caring for a patient receiving nitrates for relief of angina. What pharmacodynamic action is responsible for the relief of anginal pain with nitrates?

Vasodilation leads to decreased preload which decreases oxygen demand

Which hemodynamic system serves as a reservoir for circulating blood?

Veins

The heart undergoes cardiac remodeling during the initial phase of heart failure. Which cardiac geometric change occurs during heart failure?

Ventricular wall thickening

Select the first stage of hemostasis

Vessel spasm

The nurse is caring for a client who is a strict vegetarian; the client is at great risk for the development of:

Vitamin B12 deficiency anemia

Which condition do the natriuretic peptides serve to protect the cardiovascular system?

Volume overload

A nurse is caring for a client in the intensive care unit who has sustained severe trauma and now has developed DIC. The nurse is aware that the client is experiencing:

Widespread coagulation and bleeding in the vascular compartment

A nurse should recognize that for maximum therapeutic effects against the influenza virus, oseltamivir should be taken when?

Within 12 hours of symptom onset

A nurse administering flu vaccines at an annual clinic should recognize that which individuals should be vaccinated, as recommended by the ACIP?

Women who will be pregnant during flu season, All children 6 months and older and older adults, Those 6 months to 18 years old receiving aspirin therapy

A 38 year old female is considering the use of oral contraceptives as a method of birth control. She asks her health care provider if any risks would be involve. The best response would be:

Yes, risks increase with age

The nurse is teaching a piiteitn with vitamin B12 deficiency caused by a previous gastrectomy and lack of intrinsic factor. Which statement by the nurse is the most appropriate to include in the teaching plan?

You may be prescribed a high dose of oral vitamin B12

After 3 weeks of therapy with oral ferrous sulfate, a patient calls the clinic nurse, complaining of continuous nausea and vomiting with this drug. Which the most appropriate response to this patient?

You may need a lower dose, I will contact your primary healthcare provider and call you back

A patient is to be discharged home with a new prescription for prazosin. Which statement is most important for the nurse to include in the teaching plan?

You should move slowly from a sitting to a standing position

The nurse is teaching a patient with severe hemophilia A about the disease. Which statements by the nurse are appropriate to include in the teaching plan?

You will need to be vaccinated for hepatitis A and B, You will learn to reconstitute powdered medication with saline

A patient diagnosed with a pulmonary embolism is receiving a continuous heparin infusion at 100 units/hr. Of which findings should the nurse immediately notify the healthcare provider?

aPTT of 40 seconds, Nosebleeds, aPTT of 100 seconds