Unit 6 Exam

The nurse is teaching a patient regarding therapeutic lifestyle changes that can be implemented to control cholesterol levels in the blood. The nurse knows the patient has understood the teaching when the patient states: Select all that apply A) "I will maintain an optimal weight." B) "I will implement a medically supervised exercise plan. C) "I will increase saturated fat in my diet." D) "I will increase insoluble fiber in my diet." E) "I will eliminate tobacco use."

A) "I will maintain an optimal weight." B) "I will implement a medically supervised exercise plan. E) "I will eliminate tobacco use."

A nurse is teaching a client who has a new prescription for ferrous sulfate. Which of the following statements by the client indicates an understanding of the teaching? A) "I will not take this medication with milk or antacids" B) "I will expect the color of my urine to be amber." C) "I should expect increased bruising." D) "I will not get as many infections."

A) "I will not take this medication with milk or antacids"

The nurse is administering iron dextran to a client diagnosed with iron-deficiency anemia. Which intervention should the nurse implement? A) Administer the medication by the Z-track method B) Make sure the client is well hydrated C) Check for allergies to fish or other seafood D) Give the medication subcutaneously in the deltoid

A) Administer the medication by the Z-track method

The nurse is providing group education about lipids to patients who have been diagnosed with hyperlipidemia. What does the best instruction include? A) High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver. B) High density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and reduces the amount of plaque build-up. C) High density lipoprotein (HDL) decreases the bad cholesterol (low density lipoprotein [LDLJ), and promotes excretion of it through the kidneys. D) High density lipoprotein (HDL) decreases low density lipoprotein (LDL) and prevents it from converting to very low density lipoprotein (VDRL), which is the worst kind of cholesterol in the body

A) High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver.

Which of the following indicates that a patient understands how to use sublingual nitroglycerin? A) I should feel a fizzing or burning sensation B) I should put the pill between my tongue and cheek C) I need to avoid taking any sips of water before using the drug D) I can chew the tablet once it starts dissolving

A) I should feel a fizzing or burning sensation

The client diagnosed with angina who is prescribed nitroglycerin (NTG) tells the nurse, "I don't understand why I can't take my sildenafil. I need to take it so that I can make love to my wife." Which statement is the nurse's best response? A) If you take the medications together, they may cause you to have very low blood pressure B) You're worried your wife will be concerned if you cannot make love C) If you wait at least 8 hours after taking your NTG you can take you sildenafil D) You should get clarification with your healthcare provider about taking sildenafil

A) If you take the medications together, they may cause you to have very low blood pressure

Which of the following drugs should be avoided by a patient taking nitrates? A) Phosphodiesterase 5 inhibitors B) Beta blockers C) Nonsteroidal anti-inflammatory drugs D) Cardiac glycosides

A) Phosphodiesterase 5 inhibitors

A client with chronic stable angina is reporting chest pain. The nurse notices that the transdermal nitroglycerin patch that was applied 1 hour ago has peeled off. The client's vital signs are stable. Look at the medication orders below. What is the nurse's priority action? Medication administration record Medications Schedule Aspirin tablet: 81 mg PO, daily 0800 Metoprolol 25 mg PO, every 12 hours 0800 & 2000 Nitroglycerin patch: 0.4 mg transdermal. daily, remove after 12 hours 0800 Morphine sulfate: 2 mg IV push, every 6 hours PRN for pain PRN Nitroglycerin tablets: 0.4 mg sublingual, q5 minutes PRN up to 2 additional dose A) Administer PRN morphine B) Administer PRN sublingual nitroglycerin C) Apply a new transdermal nitroglycerin patch D) Obtain a 12-lead electrocardiogram

B) Administer PRN sublingual nitroglycerin

A client is being treated for a thromboembolic disorder. If the goal is to prevent clot formation, the nurse anticipates the client will be treated with which classifications of drug? Select all that apply. A) Clotting factor concentrates B) Anticoagulants C) Hemostatics D) Antiplatelet agents E) Thrombolytics

B) Anticoagulants D) Antiplatelet agents

The nurse is discharging the female client diagnosed with deep vein thrombosis who is prescribed warfarin. Which statement indicates the client needs more teaching concerning this medication? A) "I should wear a MedicAlert bracelet in case of an emergency." B) "If I get cut, I will apply pressure for at least 5 minutes." C) "I will increase the amount of green, leafy vegetables I eat." D) "I will have to see my HCP regularly while taking this medication."

C) "I will increase the amount of green, leafy vegetables I eat."

A nurse assessing a client on a heparin drip notes bloody drainage in the nasogastric tube and indwelling urinary catheter. A stat activated partial thromboplastin time (aPTT) is drawn according to heparin protocol. The result is 224 seconds. Which action by the nurse is the most appropriate? A) Notify the supervisor and obtain a unit of clotting factors. B) Call the healthcare provider and prepare to administer vitamin K C) Notify the healthcare provider and prepare to administer protamine sulfate. D) Stop the infusion, increase the IV rate, and prepare to administer aminocaproic acid (Amicar)

C) Notify the healthcare provider and prepare to administer protamine sulfate.

The nurse is preparing to administer clopidogrel (Plavix), an antiplatelet agent, to the client with coronary artery disease. The client asks the nurse, "Why am I getting this medication?" Which statement by the nurse is most appropriate? A) It will help decrease your chance of developing deep vein thrombosis B) Clopidogrel will help decrease your LDL cholesterol levels in about 1 month C) The medication will help decrease your blood pressure if you take it daily D) This medication will help prevent your blood from clotting in the arteries

D) This medication will help prevent your blood from clotting in the arteries

The nurse explains the action of a beta-hydroxy-beta-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor as inhibiting what? A) An enzyme that controls the final step in production of cellular cholesterol production B) An enzyme used immediately for energy C) An enzyme that combines with proteins to become chylomicrons D) An enzyme used to make bile acids

A) An enzyme that controls the final step in production of cellular cholesterol production

A client with deep vein thrombosis (DVT) is receiving a continuous infusion of heparin. The client asks the nurse what the heparin is for. How should the nurse respond? A) Heparin will keep the current clot from getting bigger and help prevent new clots from forming B) Heparin will break up an existing clot and restore blood flow C) Heparin is a blood thinner that will help to dissolve the clot in your leg D) I'm sorry. This is something that your heath care provider can answer better upon arriving

A) Heparin will keep the current clot from getting bigger and help prevent new clots from forming

The nurse is preparing to administer a nitroglycerin (NTG) transdermal patch to the client diagnosed with a myocardial infarction (MI). Which intervention should the nurse implement? (Select all that apply) A) Question applying the patch if the client's blood pressure is less than 100/60 B) Use nonsterile gloves when applying the transdermal patch C) Date and time the transdermal patch prior to applying to client's skin D) Place the transdermal patch on the site where the old patch was removed E) Assess client for rapid relieve of angina pain

A) Question applying the patch if the client's blood pressure is less than 100/60 B) Use nonsterile gloves when applying the transdermal patch C) Date and time the transdermal patch prior to applying to client's skin

An adult client is brought to the emergency department (ED) and diagnosed with a thrombotic stroke. The team plans to administer alteplase (Activase), a thrombolytic. The client makes the following comments to a nurse. Which information is critical for the nurse to relay to the healthcare provider? A) "I had a blood clot in my leg last year after my baby was born." B) "I wonder if this was happening when I fell and hit my head last week" C) "I thought this was just my asthma acting up" D) "I can't believe this is happening. My baby is only a year old"

B) "I wonder if this was happening when I fell and hit my head last week"

The patient is receiving niacin. Although this drug is effective in lowering lipid levels, the patient complains of uncomfortable flushing. What is the best education by the nurse? A) "Be sure to take your niacin on an empty stomach as soon as you arise." B) "Take one aspirin 30 minutes before you take your niacin." C) "Take your niacin tablet with food and at least one full glass of water." D) "It may be time to ask your doctor about switching to another drug."

B) "Take one aspirin 30 minutes before you take your niacin."

The nurse is planning a teaching session for a client newly diagnosed with hemophilia A. Which information should be included? A) An extra protein is present that breaks down clots too quickly. B) A substance that is part of the clotting process is missing. C) The blood is missing a substance that inhibits clotting. D) There are not enough platelets present.

B) A substance that is part of the clotting process is missing.

A client diagnosed with myocardial infarction is prescribed thrombolytic therapy. The nurse recognizes that which is the goal of this therapy? A) Prevent platelet aggregation. B) Dissolve clots C) Prevent clot formation. D) Provide immediate relief of chest pain.

B) Dissolve clots

A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values should indicate to the nurse that the therapy is effective? A) Platelets B) Hgb C) WBC D) PT

B) Hgb

A healthcare professional is caring for a patient who is about to begin taking simvastatin (Zocor) to treat hyperlipidemia. The healthcare professional should tell the patient to report which of the following indications of a serious adverse reaction which could warrant stopping drug therapy? A) Diarrhea B) Muscle pain C) Lip numbness D) Somnolence

B) Muscle pain

The nurse is preparing to administer warfarin. The client's current laboratory values are as follows PT 18 INR 59 PTT 39 Which intervention should the nurse implement? A) Administer the medication as ordered B) Prepare to administer aquamephyton (vitamin K) C) Notify the healthcare provider to increase the dose D) Discontinue the IV bag immediately

B) Prepare to administer aquamephyton (vitamin K)

A patient is being discharged on cholestyramine (Questran). Patient teaching should include what about this medication? A) Should be administered with other medications B) Take other drugs 2 hours before or 4 hours after cholestyramine C) Should be administered 1 hour after other medications D) Take on an empty stomach with a sip of water

B) Take other drugs 2 hours before or 4 hours after cholestyramine

A nurse suspects that a patient is experiencing salicylism from too much aspirin. Which of the following would the nurse assess? A) Excitement B) Tinnitus C) Tachypnea D) Convulsions

B) Tinnitus

Bile acid binding drugs produce their therapeutic effects by A) inhibiting HIMO-CoA reductase B) increasing excretion of cholesterol in the feces C) decreasing dietary absorption of dietary lipids D) decreasing production of HDI

B) increasing excretion of cholesterol in the feces

A hospitalized client is prescribed warfarin (Coumadin). The nurse teaches the client to avoid which food on the lunch selection menu? A) Roast beef B) Whole wheat bread with margarine C) Broccoli salad D) Salt substitute

C) Broccoli salad

The primary care provider prescribed 5 mL of a medication to be given deep IM for a 40-year-old female who is 5'7" tall and weighs 135 lb. Which of the following is the most appropriate method of administration? A) A 3 mL syringe, #25 gauge, 5/8 inch needle B) Two 3-mL syringes, #20 gauge, 1 1/2 inch needle C) two 2 mL syringes, #23 gauge, 5/8 inch needle D) Two 2 mL syringes, #20 gauge, 1-inch needle

B) Two 3-mL syringes, #20 gauge, 1 1/2 inch needle

A clinic nurse is developing a teaching handout for clients who are prescribed warfarin (Coumadin) therapy. Which statements should be included in this information? Select all (2) that apply A) Tell your dentist you are taking warfarin prior to any procedures. B) "Place ice at the injection site if stinging or burning occurs." C) "Report to the lab for testing of activated partial thromboplastin time (aPTT)" D) "Take nonsteroidal anti-inflammatories (NSAIDs) for minor pain relief" E) "Use a soft bristle toothbrush."

A) Tell your dentist you are taking warfarin prior to any procedures. E) "Use a soft bristle toothbrush."

The nurse is preparing a patient for discharge who will receive a prescription for an beta-hydroxy-beta methylglutaryl coenzyme A (HMG-CoA) inhibitor. What statement by the patient demonstrates that they have a clear understanding of the teaching provide by the nurse? A) "I will not need to follow that low-fat diet anymore because this drug will take car of my lipids. B) "I should plan to take this drug before bedtime, because my body makes lipids mostly at night." C) "After I start taking this drug. I will not have to worry about the exercise routine doctor prescribed." D) "I should take this drug first thing in the morning and make sure I drink a full glass of water."

B) "I should plan to take this drug before bedtime, because my body makes lipids mostly at night."

A nurse is providing discharge teaching for a client who has a new prescription for warfarin. Which of the following instructions should the nurse include in the teaching? A) lf a dose of the medication is missed, double the dose at the next scheduled time B) Use an electric razor while on this medication. C) Mild nosebleeds are common during initial treatment D) Increase fiber intake to reduce the adverse effect of constipation.

B) Use an electric razor while on this medication.

The client who has had a gastric bypass surgery asks the nurse, "Why do I need to take vitamin B12 injections" Which statement is the best response? A) You have pernicious anemia and the injections will cure the problem B) Your body cannot absorb the vitamin from the food you eat C) You will need to take the injections daily until your body begins to make B12 D) Since the surgery you cannot eat enough food to eat the amount you need

B) Your body cannot absorb the vitamin from the food you eat

Which drug is most effective in reducing serum triglyceride levels? A) Beta-hydroxy-beta-methylglutaryl coenzyme A reductase inhibitors B) Bile acid sequestrants C) Fibrates D) Niacin

C) Fibrates

The nurse is teaching the client diagnosed with angina about sublingual nitroglycerin (NTG). Which statement indicates the client needs more teaching? A) I will always carry my NTG in a dark-colored bottle B) If I have chest pain, I will put a tablet underneath my tongue C) If my pain is not relieved with one tablet, I will get medical help D) I can expect to get a headache after taking my NTG

C) If my pain is not relieved with one tablet, I will get medical help

A client is diagnosed with a myocardial infarction and is receiving tissue plasminogen activator alteplase. Which action is a priority nursing intervention? A) Monitor for renal failure. B) Monitor psychosocial status. C) Monitor for signs of bleeding. D) Have heparin sodium available.

C) Monitor for signs of bleeding.

A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? A) "The I heparin increases the effects of the warfarin and decreases the length of your hospital stay" B) "Both heparin and warfarin work together to dissolve the clots" C) "I will call the provider to get a prescription for discontinuing the IV heparin today" D) "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level"

D) "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level"

A nurse is teaching a client who has a new prescription for clopidogrel (Plavix), an antiplatelet agent. Which of the following instructions should the nurse include? A) "Take this medication with food" B) "Take this medication three times daily" C) "Expect to have black colored stools while taking this medication." D) "You might have to stop taking this medication 5 days before any planned surgeries"

D) "You might have to stop taking this medication 5 days before any planned surgeries"

The nurse is preparing to hang the next bag of heparin to a client diagnosed with DVT. The client's current laboratory values are as follows PT 12.9 (control 12.9) INR 1 PTT 63 (control 36) Which intervention should the nurse implement? A) Notify the healthcare provider B) Order a STAT PT/INR/PTT C) Assess the client for abnormal bleeding D) Hang the IV bag at the same rate

D) Hang the IV bag at the same rate

A nurse is caring for a client who is scheduled for an outpatient surgical procedure and reports taking aspirin 81 mg daily, including this morning. The nurse should identify that this places the client at risk for which of the following complications? A) Decreased renal perfusion B) Myocardial infarction C) Respiratory depression D) Uncontrolled bleeding

D) Uncontrolled bleeding