358 test 2
The nurse is caring for a pediatric patient with a prescription for 0.2 mg/kg bolus of verapamil. What is the correct dose for a pediatric patient with a weight of 34 lb?
3.1 mg
The nurse has a prescription to administer 250 mL of half-normal saline (0.45%NS) over 4 hours. What is the correct pump setting for this prescription?
63ml/hr
To prevent the development of tolerance to nitroglycerin transdermal patch, the nurse instructs the patient to perform which action? A Apply the nitroglycerin patch in the morning and remove it at night for 8 hours. B: Use the nitroglycerin patch for acute episodes of angina only. C: Apply a new nitroglycerin patch every other day. D: Switch to sublingual nitroglycerin when the systolic blood pressure is greater than 140 mm Hg.
A Apply the nitroglycerin patch in the morning and remove it at night for 8 hours.
For a patient receiving IV nitroglycerin, what are the priority nursing interventions? (Select all that apply.) Select all that apply. A: Monitor blood pressure. B: Assess for worsening chest pain. C: Measure intake and output. D: Auscultate lung sounds. E: Check the heart rate.
A: Monitor blood pressure. B: Assess for worsening chest pain. E: Check the heart rate.
For a patient receiving a positive inotropic drug, which nursing assessments should be performed? (Select all that apply.) Select all that apply. A: Monitor serum electrolytes. B: Obtain daily weights. C:Auscultate lung sounds. D: Review red blood cell count. E: Check apical pulse.
A: Monitor serum electrolytes. B: Obtain daily weights. C:Auscultate lung sounds. E: Check apical pulse
When teaching a patient about symptoms of hypokalemia, the nurse will instruct the patient to notify the health care provider if which symptom occurs? A: Muscle weakness B: Blurred vision C: Constipation D: Diaphoresis
A: Muscle weakness
For a patient receiving an IV infusion of alteplase which nursing actions should be taken? (Select all that apply.) Select all that apply. A: Monitor for an increase in liver enzymes. B: Record vital signs and report changes. C: Administer injections intramuscularly. D: Assess for cardiac dysrhythmias. E: Observe for signs and symptoms of bleeding.
B: Record vital signs and report changes. D: Assess for cardiac dysrhythmias. E: Observe for signs and symptoms of bleeding.
A nurse is caring for a client who has a new prescription for alirocumab to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of alirocumab (select all) A: Muscle aches B: Vasculitis C: Hearing loss D: Urticaria E: Jaundice
B: Vasculitis D: Urticaria E: Jaundice
A nurse is caring for a client who has a new prescription for digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for digoxin toxicity? A: Phenytoin B: Verapamil C: Warfarin D: Aluminum hydroxide
B: Verapamil
A patient is taking gentamicin [Garamycin] and furosemide [Lasix]. The nurse should counsel this patient to report which symptom? A.Frequent nocturia B.Headaches C.Ringing in the ears D.Urinary retention
C.Ringing in the ears
A patient receiving IV nitroglycerin at 20 mcg/min and now complains of dizziness. Nursing assessment reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. What is the priority nursing action? A: Notify the health care provider. B: Assess the patient's lung sounds. C: Decrease the IV nitroglycerin by 10 mcg/min. D: Recheck the patient's vital signs in 1 hour.
C: Decrease the IV nitroglycerin by 10 mcg/min.
Which are adverse effects of alpha blockade? (Select all that apply.) Select one or more: a. Hypertension b. Reflex tachycardia c. Nasal congestion d. Ejaculation e. Hypernatremia
b. Reflex tachycardia c. Nasal congestion e. Hypernatremia
Lovastatin [Mevacor] is prescribed for a patient for the first time. The nurse should provide the patient with which instruction? Select one: a. "Take lovastatin with your evening meal." b. Take this medicine before breakfast c. "You may take lovastatin without regard to meals." d. "Take this medicine on an empty stomach."
a. "Take lovastatin with your evening meal."
A patient with asthma uses albuterol [Ventolin] for wheezing. The nurse assesses the patient and notes vital signs of HR, 96 beats/min; RR, 18 breaths per minute; and BP, 116/78 mm Hg. The patient has clear breath sounds and hand tremors. What will the nurse do? Select one: a. Ask the patient how often the inhaler is used. b. Check the patient's blood glucose level. c. Request an order for isoproterenol [Isuprel] to reduce side effects. d. Stop the medication and report the tremors to the provider.
a. Ask the patient how often the inhaler is used.
Which of the following foods are a good source of potassium when a patient is prescribed a potassium-wasting diuretic? (select all that apply) Select one or more: a. Baked potato b. Cantalope c. Pork d. Spinach e. Cucumber
a. Baked potato b. Cantalope d. Spinach e. Cucumber
The potassium-sparing diuretic spironolactone [Aldactone] prolongs survival and improves heart failure symptoms by which mechanism? Select one: a. Blocking aldosterone receptors b. Increasing diuresis c. Reducing venous pressure d. Reducing afterload
a. Blocking aldosterone receptors
Which laboratory result would be a priority to report to a prescribed when a patient is receiving intravenous fluids containing potassium? Select one: a. Creatinine 4.2 mg/dL b. Potassium 3.5 mEq/L c. Serum glucose 220 mg/dL d. Blood urea nitrogen (BUN) 19 mg/dL
a. Creatinine 4.2 mg/dL
A patient is taking a calcium channel blocker (CCB) for stable angina. The patient's spouse asks how calcium channel blockers relieve pain. The nurse will explain that CCBs: Select one: a. help relax peripheral arterioles to reduce afterload. b. improve coronary artery perfusion. c. increase the heart rate to improve myocardial contractility. d. increase the QT interval.
a. help relax peripheral arterioles to reduce afterload.
A patient who was in a motor vehicle accident sustained a severe head injury and is brought into the emergency department. The provider orders intravenous mannitol [Osmitrol]. The nurse knows that this is given to: Select one: a. reduce intracranial pressure. b. reduce renal perfusion. c. reduce peripheral edema. d. restore extracellular fluid.
a. reduce intracranial pressure.
A patient is taking a calcium channel blocker (CCB) for stable angina. The patient's spouse asks how calcium channel blockers relieve pain. The nurse will explain that CCBs: a.Help relax peripheral arterioles to reduce afterload. b.Improve coronary artery perfusion. c.Increase the heart rate to improve myocardial contractility. d.Increase the QT interval.
a.Help relax peripheral arterioles to reduce afterload.
A patient brought to the emergency department requires sutures. The prescriber orders a local anesthetic with epinephrine. The nurse understands that epinephrine is ordered to: Select one: a. prevent hypertension induced by the anesthetic. b. allow a reduced dose of the anesthetic. C: reduce anesthetic-induced nausea D: reduce the pain of an injection
b. allow a reduced dose of the anesthetic.
A nurse is discussing the difference between stable and variant angina with a group of nursing students. Which statement by a student indicates the need for further teaching? a."Beta blockers are effective in stable angina but not in variant angina." b."Variant angina is the result of increased oxygen demand by the heart." c."In both types of angina, prophylactic treatment is possible." d."Variant angina is primarily treated with vasodilators to increase oxygen supply."
b."Variant angina is the result of increased oxygen demand by the heart."
A patient who takes nitroglycerine to treat stable angina reports having erectile dysfunction and states that he plans to ask his primary provider for a prescription for tadalafil [Cialis]. What will the nurse tell this patient? a."You should avoid sexual activity since this increases oxygen demands on the heart." b."You should discuss another antiangina medication with your provider." c."You should not take tadalafil and nitroglycerine within 30 to 60 minutes of each other." d."You may take these two drugs together safely as long as you take them as directed."
b."You should discuss another antiangina medication with your provider."
The nurse is discussing home management with a patient who will begin taking an alpha-adrenergic antagonist for hypertension. Which statement by the patient indicates understanding of the teaching? Select one: a. "I need to stop the medication if my heart rate increases." b. "I should not drive while taking this medication." c. "I should change position slowly while on this medication" d. "I will stop taking the medication if I feel dizzy."
c. "I should change position slowly while on this medication"
A nurse is discussing the difference between stable and variant angina with a group of nursing students. Which statement by a student indicates the need for further teaching? Select one: a. "Beta blockers are effective in stable angina but not in variant angina." b. "In both types of angina, prophylactic treatment is possible." c. "Variant angina is primarily treated with vasodilators to increase oxygen supply." d. "Variant angina is the result of increased oxygen demand by the heart."
d. "Variant angina is the result of increased oxygen demand by the heart."
A nurse is instructing a patient receiving a cholesterol-lowering agent. Which information should the nurse include in the patient education? Select one: a. "This medication will replace other interventions you have been trying." b. "It is important for you to double your dose if you miss one to maintain therapeutic blood levels." c. "Stop taking the medication if you experience constipation." d. "You should continue your exercise program to increase your HDL serum levels."
d. "You should continue your exercise program to increase your HDL serum levels."
To treat a patient with pulmonary edema, the nurse prepares to administer which diuretic to this patient? A: Amiloride B: Spironolactone C: Triamterene D: Furosemide
D: Furosemide
A patient with elevated triglyceride levels unresponsive to HMG-CoA reductase inhibitors will most likely be prescribed which drug? A: Cholestyramine B: Colestipol C: Simvastatin D: Gemfibrozil
D: Gemfibrozil
A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in teaching? A: Contact provider if heart rate is less than 60/min. B: Check pulse rate for 30 seconds and multiply result by 2 C: Increase intake of sodium D: Take with food if nausea occurs
A: Contact provider if heart rate is less than 60/min.
A pediatric patient weighing 66 lb is prescribed digoxin 12 mcg/kg in 3 evenly divided doses a day. How much will the nurse administer per dose?
120 mcg
The nurse has a prescription to administer 500 mL of lactated Ringer's solution over 4 hours. What is the correct pump setting for this prescription?
125ml/hr
Albuterol's primary action is which one of the following Select one: a. Bronchodilation b. Bradycardia c. Vasoconstriction d. Vasodilation
A: Bronchodilation
Sodium channel blockers are considered which class of antidysrhythmic drugs? A: Class I B: Class III C: Class IV D: Class II
A: Class I
Which statement by the patient demonstrates a need for further education regarding nitroglycerin sublingual tablets? A: "I can take up to four tablets at 5-minute intervals for chest pain." B: "If I get a headache, I should keep taking my nitroglycerin and use Tylenol to relieve my headache." C: "I should change positions slowly to avoid getting dizzy from the drug's effect on my blood pressure." D: "I should keep my nitroglycerin in a cool, dry place."
A: "I can take up to four tablets at 5-minute intervals for chest pain."
The nurse is giving discharge instructions to a patient prescribed warfarin for atrial fibrillation. Which statement by the patient indicates a need for further instruction from the nurse? A: "I will increase the dark green leafy vegetables in my diet." B: "I will avoid activities that have a risk for injury such as contact sports." C: "I will contact my health care provider if I develop excessive bruising." D: "I will take my medication in the early evening each day."
A: "I will increase the dark green leafy vegetables in my diet."
The patient states to the nurse, "My friend said nitroglycerin relieves angina pain by reducing preload. What is preload?" Which statement by the nurse explains preload to this patient? A: "It is the blood return to the heart." B: "It is dilation of arteries and veins throughout the body." C: "It is the oxygen demand of the heart." D: "It is the pressure against which the heart must pump."
A: "It is the blood return to the heart."
The patient asks the nurse, "What is the best way to store sublingual nitroglycerin when I travel?" What is the appropriate response by the nurse? A: "It's best to keep it in its original container away from heat and light." B: "You can protect it from heat by placing the bottle in an ice chest." C: "Keep it in the glove compartment of your car to prevent exposure to heat." D: "You can put a few tablets in a resealable bag and carry it in your pocket."
A: "It's best to keep it in its original container away from heat and light."
The nurse would question the use of milrinone in a patient with which condition? A: Aortic regurgitation B: Systolic heart failure C: Acute renal failure D: Mitral valve prolapse
A: Aortic regurgitation
A patient prescribed digoxin 0.25 mg and furosemide 40 mg for the treatment of systolic heart failure states, "I am starting to see yellow halos around lights." What is the appropriate nursing intervention? A: Assess for other symptoms of digoxin toxicity. B: Document the finding and reassess in 1 hour. C: Perform a visual acuity test on each eye. D: Prepare to administer digoxin immune fab.
A: Assess for other symptoms of digoxin toxicity.
A nurse is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? (select all) A: Assess for tinnitus B: Report urine output 50ml/hr C: Monitor blood potassium levels D: Elevate the head of bed slowly before ambulation E: Recommend eating a banana daily
A: Assess for tinnitus C: Monitor blood potassium levels D: Elevate the head of bed slowly before ambulation E: Recommend eating a banana daily
When caring for a patient with angina pectoris, the nurse would question a prescription for a noncardioselective beta blocker in a patient with which pre-existing condition? A: Bronchial asthma B: Atrial fibrillation C: Myocardial infarction D: Hypertension
A: Bronchial asthma
A nurse is taking a medication history from a client who has angina and is to begin take ranolazine. The nurse should report which of the following medications in the client's history that can interact with ranolazine (select all) A: Digoxin B: Simvastatin C: Verapamil D: Amlodipine E: Nitroglycerin transdermal patch
A: Digoxin B: Simvastatin C: Verapamil
The nurse recognizes that the patient understands the teaching about warfarin when the patient verbalizes an increased risk of bleeding with concurrent use of which herbal product/products? (Select all that apply.) Select all that apply. A: Dong quai B: Glucosamine C: Ginkgo D: Garlic E: St. John's wort
A: Dong quai C: Ginkgo D: Garlic E: St. John's wort
Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are generally administered at which time of day? A: Evening B: 12:00 noon C: Morning D: Afternoon
A: Evening
A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation of digoxin toxicity? (Select all) A: Fatigue B: Constipation C: Anorexia D: Rash E: Blurred vision
A: Fatigue C: Anorexia E: Blurred vision
Why does the health care provider prescribe furosemide 40 mg twice a day by mouth for a patient with a history of renal insufficiency? A: Furosemide is effective in treating patients with impaired kidney function. B: Furosemide helps the kidney with reabsorption of sodium and water. C: Furosemide has an antagonist effect to prevent respiratory alkalosis. D: Furosemide is effective in treating patients with hypoaldosteronism.
A: Furosemide is effective in treating patients with impaired kidney function.
For a patient prescribed hydrochlorothiazide, the nurse should closely monitor which laboratory test value? A: Glucose B: Calcium C: Chloride D: Sodium
A: Glucose
Potassium-sparing diuretics may cause which common adverse reactions? (Select all that apply.) Select all that apply. A: Headache B: Muscle weakness C: Dizziness D: Hyperkalemia E: Mental confusion
A: Headache C: Dizziness D: Hyperkalemia
Acetazolamide is used to treat which conditions? (Select all that apply.) Select all that apply. A: High-altitude sickness B: Dry eye syndrome C: Edema associated with heart failure D: Cardiac dysrhythmias E: Open-angle glaucoma
A: High-altitude sickness C: Edema associated with heart failure E: Open-angle glaucoma
For patients prescribed amiodarone, the nurse should monitor for which potential adverse effects of this drug? (Select all that apply.) Select all that apply. A: Hypothyroidism B: Diarrhea C: Visual halos D: Photosensitivity E: Blue gray skin discoloration F: Overgrowth of gum tissue
A: Hypothyroidism C: Visual halos D: Photosensitivity E: Blue gray skin discoloration
When caring for a patient with a serum potassium of 2.8 mEq/L, what is the appropriate nursing intervention when giving IV replacement therapy? A: Maintain infusion rate at no greater than 20 mEq/hr. B: Administer potassium as a bolus over 10 minutes. C: Apply ice packs to site of IV administration. D: Teach the patient signs and symptoms of hypokalemia.
A: Maintain infusion rate at no greater than 20 mEq/hr.
Before administering isosorbide mononitrate sustained-release tablet to a patient, what is the priority nursing intervention? A: Obtain a blood pressure reading. B: Advise the patient that Tylenol is used to treat headache. C: Emphasize that the patient should swallow the tablet whole. D: Remind the patient to take the tablet before meals.
A: Obtain a blood pressure reading.
The nurse understands adenosine is used to treat which condition? A: Paroxysmal supraventricular tachycardia (PSVT) B: Atrial flutter C: Second-degree atrioventricular block D: Atrial fibrillation
A: Paroxysmal supraventricular tachycardia (PSVT)
Which are therapeutic effects of digoxin? A: Positive inotropic, negative chronotropic, and negative dromotropic B: Positive inotropic, negative chronotropic, and positive dromotropic C: Negative inotropic, negative chronotropic, and negative dromotropic D: Positive inotropic, positive chronotropic, and negative dromotropic
A: Positive inotropic, negative chronotropic, and negative dromotropic
A nurse is teaching a client who has a new prescription for nitroglycerin transdermal patch for angina pectoris. Which of the following instructions should the nurse include? A: Remove the patch each evening B: Cut eat patch in half if angina attacks are under control C: Take off the nitroglycerin patch for 30 minutes if a headache occurs D: Apply a new patch every 48 hours
A: Remove the patch each evening
A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions? A: Remove the prior dose before applying a new dose B: Rub the ointment directly into your skin until it is no longer visible C: Cover the applied ointment with a clean gauze pad D: Apply the ointment to the same skin area each time
A: Remove the prior dose before applying a new dose
A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include? A: Take the medication with food B: Plan to take the medication at bed time C: Expect increased swelling of the ankles D: Fluid intake should be limited in the morning
A: Take the medication with food
A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in teaching? A: Take this medication in the evening B: Change position slowly when rising from a chair C: Maintain a stead intake of green leafy vegetables D: Consume no more than 1L fluid/day
A: Take this medication in the evening
Which laboratory test result is a common adverse effect of furosemide? A: Hypernatremia B: Hypokalemia C: Hypophosphatemia D: Hyperchloremia
B: Hypokalemia
A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide [Lasix]. The nurse notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern? A.Blood glucose level of 120 mg/dL B.Potassium level of 3.4 mEq/L C.Oxygen saturation of 90% D.Sodium level of 140 mEq/L
B.Potassium level of 3.4 mEq/L
Which instruction would be included in the discharge teaching for a patient with a transdermal nitroglycerin patch? A: "Make sure to rub a lotion or cream on the skin before putting on a new patch." B: "Apply the patch to a hairless, nonirritated area of the chest, upper arm, back or shoulder." C: "If you get chest pain, apply a second patch next to the first patch." D: "If you get a headache, remove the patch for 4 hours and then reapply."
B: "Apply the patch to a hairless, nonirritated area of the chest, upper arm, back or shoulder."
The nurse is providing discharge teaching for a patient with a new prescription for nitroglycerin sublingual tablets. Which statement by the patient indicates an understanding of the nurse's discharge instructions about this medication? A: "I will need to refill my prescription when I feel burning under my tongue." B: "I will keep my nitroglycerin tablets in their original glass container." C: "My nitroglycerin tablets are not affected by cold or heat." D: "I can take some aspirin if I get a headache related to nitroglycerin."
B: "I will keep my nitroglycerin tablets in their original glass container."
A patient is prescribed oral anticoagulant therapy while still receiving IV heparin infusion. The patient is concerned about risk for bleeding. What is the nurse's best response? A: "Because of your mechanical valve replacement, it is especially important for you to be fully anticoagulated, and the heparin and warfarin together are more effective than one alone." B: "It usually takes 4 to 5 days to achieve a full therapeutic effect for warfarin, so the heparin infusion is continued to help prevent blood clots until the warfarin reaches its therapeutic effect." C: "Because you are now getting out of bed and walking around, you have a higher risk of blood clot formation and therefore need to be on both medications." D: "Bleeding is a common adverse effect of taking warfarin. If bleeding occurs, your health care provider will prescribe an injection of medication to stop the bleeding."
B: "It usually takes 4 to 5 days to achieve a full therapeutic effect for warfarin, so the heparin infusion is continued to help prevent blood clots until the warfarin reaches its therapeutic effect."
A patient asks the nurse about using potassium supplements while taking spironolactone. What is the nurse's best response? A: "I would recommend that you take two multivitamins every day." B: "This diuretic is potassium sparing, so there is no need for extra potassium." C: "You will need to take potassium supplements for the medication to be effective." D: "I will call your health care provider and discuss your concern."
B: "This diuretic is potassium sparing, so there is no need for extra potassium."
A nurse is reviewing the protocol for administration of IV adenosine. What is the most important nursing intervention to remember when giving this medication? A: Flush the IV catheter with normal saline B: Administer it as a fast IV push C: Monitor the infusion site for hematoma D: Assess for burning sensation at the IV site
B: Administer it as a fast IV push
The patient's serum digoxin level is 0.4 ng/mL. How does the nurse interpret this laboratory value result for digoxin? A: Normal therapeutic level B: Below the therapeutic level C: Above the therapeutic level D: A toxic serum blood level
B: Below the therapeutic level
Which statement by the nurse explains to the patient the action of cholestyramine to decrease blood lipid levels? A: Inhibits absorption of dietary cholesterol in the small and large intestine. B: Binds to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces. C: Inhibits lipolysis in adipose tissue and decreases the hepatic synthesis of triglycerides in the liver. D: Stimulates the biliary system to increase excretion of dietary cholesterol.
B: Binds to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces.
The nurse will assess a patient receiving gemfibrozil and warfarin for the increased risk of which adverse effect? A: Deep vein thrombosis B: Bleeding C: Clotting D: Vitamin K toxicity
B: Bleeding
Which drug class is used to treat both hypertension and dysrhythmias? A: Alpha-adrenergic-blocking B: Calcium channel blockers C: Direct-acting vasodilators D: Sodium channel blockers
B: Calcium channel blockers
A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks. The client asks, "What is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?" Which of the following responses should the nurse make? A: take two more sublingual tablets at the same time B: Call the emergency response team C: Take a sustained release nitroglycerine capsule D: Wait another minutes then take a second sublingual tablet.
B: Call the emergency response team
Which medication is an antiplatelet drug? A: Enoxaparin B: Clopidogrel C: Alteplase D: Heparin
B: Clopidogrel
A nurse is monitoring a client who takes aspirin daily. The nurse should identify which of the following manifestations as adverse effects of aspirin? (select all) A: Hypertension B: Coffee-ground emesis C: Tinnitus D: Paresthesia of the extremities E: Nausea
B: Coffee-ground emesis C: Tinnitus E: Nausea
The nurse understands that a patient receiving nitroglycerin would be monitored for which common adverse effects associated with this medication? (Select all that apply.) Select all that apply. A: Blurred vision B: Flushing C: Dizziness D: Headache E: Hypotension
B: Flushing C: Dizziness D: Headache E: Hypotension
The nurse is caring for a patient with renal insufficiency and thrombocytopenia. Along with platelet transfusions, the nurse would expect to administer which blood product to increase deficient clotting factors in this patient? A: Whole blood B: Fresh-frozen plasma C: Plasma protein factors D: Albumin
B: Fresh-frozen plasma
The nurse is caring for a patient who has peripheral edema and is hypotensive after receiving 5000 mL of normal saline intravenous (IV). The nurse anticipates administering which IV solution to correct the fluid imbalance? A: 3% saline solution B: Hetastarch C: Lactated Ringer's solution D: D5W
B: Hetastarch
A nurse is planning care for a client who has a new prescription for torsemide. The nurse should plan to monitor for which of the following conditions as potential adverse reactions of this medication? (select all) A: Respiratory acidosis B: Hypokalemia C: Hypotension D: Ototoxicity E: Ventricular dysrhythmias
B: Hypokalemia C: Hypotension D: Ototoxicity E: Ventricular dysrhythmias
A nurse is administering a dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication? A: Lowered heart rate B: Increased urine output C: Decreased conduction through AV node D: Vasoconstriction of renal blood vessels
B: Increased urine output
What is the mechanism of action of ezetimibe? A: Decreases the adhesion of cholesterol in the arteries. B: Inhibits absorption of dietary and biliary cholesterol in the small intestine. C: Binds to bile acids in the intestine, inhibiting its reabsorption into the blood. D: Inhibits the biosynthesis of cholesterol in the liver.
B: Inhibits absorption of dietary and biliary cholesterol in the small intestine.
A nurse is planning to administer SQ enoxaparin 40mg using a prefilled syringe 40mg/0.4mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take? A: Expel the air bubble from the prefilled syringe before injecting B: Insert the needle completely into the client's tissue C: Administer the injection into the client's thigh D: Aspirate carefully after inserting the needle into the client's skin
B: Insert the needle completely into the client's tissue
A patient prescribed spironolactone asks the nurse to assist with food choices that are low in potassium. The nurse would recommend which food choices? (Select all that apply.) Select all that apply. A: Winter squash B: Lean meat C: Bananas D: Apples E: Pineapple
B: Lean meat D: Apples E: Pineapple
Enoxaparin sodium is an anticoagulant used to prevent and treat deep vein thrombosis and pulmonary embolism. This medication is in which drug class? A: Thrombolytic drug B: Low-molecular-weight heparin C: Oral anticoagulant D: Glycoprotein IIb/IIIa inhibitor
B: Low-molecular-weight heparin
A nurse is planning to administer IV alteplase to a client. Which of the following interventions should the nurse plan to take? A: Administer IM enoxaparin along with the alteplase dose. B: Obtain the client's weight C: Administer aminocaproic acid IV prior to alteplase infusion D: Prepare to administer alteplase within 8 hours of manifestation onset
B: Obtain the client's weight
The patient asks the nurse, "What is the difference between dalteparin and heparin?" What is the nurse's best response? A: "There is really no difference, but dalteparin is preferred because it is less expensive." B: "The only difference is that the heparin dosage calculation is based on the patient's weight." C: "Dalteparin is a low-molecular-weight heparin that has a more predictable anticoagulant effect." D: "I'm not really sure why some health care providers choose dalteparin and some heparin."
C: "Dalteparin is a low-molecular-weight heparin that has a more predictable anticoagulant effect.
The nurse determines the patient has a good understanding of the discharge instructions regarding warfarin with which patient statement? A: "I should keep taking ibuprofen for my arthritis." B: "I should decrease the dose if I start bruising easily." C: "I should use a soft toothbrush for dental hygiene." D: "I will double my dose if I forget to take it the day before."
C: "I should use a soft toothbrush for dental hygiene."
The nurse provides discharge instructions to a patient prescribed cholestyramine. Which statement by the patient indicates teaching was effective for this drug? A: "I will take Questran 1 hour before my other medications." B: "This drug can cause flushing, itching and gastrointestinal upset." C: "I will increase fiber in my diet and drink more fluids." D: "I will notify my health care provider if I have muscle pain."
C: "I will increase fiber in my diet and drink more fluids."
A patient weighing 44 lb is prescribed a digoxin loading dose of 0.03 mg/kg to be administered in three divided doses. How much will the nurse administer in each dose? A: 0.4 mg B: 0.6 mg C: 0.2 mg D: 0.3 mg
C: 0.2 mg
When preparing to administer intravenous furosemide to a patient with renal dysfunction, the nurse will administer the medication no faster than which rate? A: 6 mg/min B: 2 mg/min C: 4 mg/min D: 8 mg/min
C: 4 mg/min
While assessing the patient, the nurse notes edema of the hands and feet at +3 from third spacing. The patient is having signs and symptoms of intravascular dehydration, and the total protein laboratory result is 4.6 g/dL. The nurse anticipates the health care provider will prescribe which IV solution for this patient? A: Whole blood B: Lactated Ringer's solution C: 5% albumin D: Normal saline
C: 5% albumin
When teaching a patient regarding the administration of digoxin, the nurse instructs the patient not to take this medication with which food? A: French toast B: Scrambled eggs C: Wheat bran D: Bananas
C: Wheat bran
A nurse is completing a nursing hx for a client who is taking simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client's medications? A: Hx of severe constipation B: History of hypertension C: Active hepatitis C D: Type 2 diabetes mellitus
C: Active hepatitis C
The nurse would question the use of mannitol for which patient condition? A: Cerebral edema from head trauma B: Increased intraocular pressure C: Anuria related to end-stage kidney disease D: Oliguria from acute renal failure
C: Anuria related to end-stage kidney disease
A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider? A: Blood sodium 144 B: Urine output 120ml/4hr C: Blood potassium 5.2 mEq/L D: Blood pressure 140/90 mmHg
C: Blood potassium 5.2 mEq/L
Joe comes in to the ER with a severe allergic reaction to peanuts. Epinephrine is administered. You assess Joe for which of the following adverse effects of epinephrine? Select one: a. Hypotension b. Bradycardia c. Chest Pain d. Hypoglycemia
C: Chest pain
The patient is prescribed ibutilide, a class III antiarrhythmic drug. The nurse understands this drug has been prescribed for which reason? A: Conversion of life-threatening ventricular dysrhythmias B: Treatment of PSVT C: Conversion of recent-onset atrial fibrillation and flutter D: Treatment of dysrhythmias in patients with acute renal failure
C: Conversion of recent-onset atrial fibrillation and flutter
To evaluate the therapeutic effects of mannitol, the nurse should monitor the patient for which clinical finding? A: Increase in urine osmolality B: Decrease in serum osmolality C: Decrease in intracranial pressure D: Increase in cerebral blood volume
C: Decrease in intracranial pressure
A nurse is caring for a client who has increased intracranial pressure and is receiving mannitol. Which of the following findings should the nurse report to the provider? A: Blood glucose 150 B: Urine output 40 mL/hr C: Dyspnea D: Bilateral equal pupil size
C: Dyspnea
During the IV administration of a hypertonic saline solution to treat a patient with severe hyponatremia, the nurse monitors for which signs and symptoms of hypernatremia? A: Mental confusion and seizures B: Vomiting and diarrhea C: Flushed skin and increased thirst D: Lethargy and hypotension
C: Flushed skin and increased thirst
When assessing a patient taking triamterene, the nurse would monitor for which possible adverse effect? A: Hypokalemia B: Hypoglycemia C: Hyperkalemia D: Hypernatremia
C: Hyperkalemia
By which action does atorvastatin decrease lipid levels? A: Binding to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces B: Decreasing the amount of triglycerides produced by the liver and increasing the removal of triglycerides by the liver C: Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver D: Stimulating the gallbladder and biliary system to increase excretion of dietary cholesterol
C: Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver
Calcium channel blockers reduce myocardial oxygen demand by decreasing afterload. How would the nurse explain afterload to the patient? A: It is the total volume of blood in the heart. B: It is the contractility of the heart muscle. C: It is the force against which the heart must pump. D: It is the pressure within the four chambers of the heart.
C: It is the force against which the heart must pump.
A nurse is collecting data from a client who is taking gemfibrozil. Which of the following assessment findings should the nurse identify as an adverse effect of this medication? A: Mental status change B: Tremor C: Jaundice D: Pneumonia
C: Jaundice
A nurse is caring for a client who has atrial fibrillation and a new prescription for dabigatran. Which of the following medications is prescribed concurrently to treat adverse effect of dabigatran? A: Vitamin K B: Protamine C: Omeprazole D: Probenecid
C: Omeprazole
Calcium channel blockers have which pharmacodynamic effect? A: Shortened refractory period B: Coronary vasodilation C: Positive inotropic D: Positive chronotropic
C: Positive inotropic
A nurse in a provider's office is monitoring blood electrolytes for four clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity? A: Calcium 9.2 B: Calcium 10.3 C: Potassium 3.4 D: Potassium 4.8
C: Potassium 3.4
A nurse is caring for a client who is receiving heparin by continuous IV infusion. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer? A: Vitamin K B: Atropine C: Protamine D: Calcium gluconate
C: Protamine
The nurse is caring for a patient prescribed amiodarone. The nurse knows the MOST serious adverse effect of this medication can occur in which body system? A: Gastrointestinal B: Immune C: Respiratory D: Nervous
C: Respiratory
The nurse is teaching treatment of acute chest pain for a patient prescribed nitroglycerin sublingual tablets. Which instructions would the nurse include? A: Chew or swallow the tablet for the quickest effect. B: Keep the tablets locked in a safe place until you need them. C: Sit or lie down before taking medication. D: Take five tablets every 3 minutes for chest pain.
C: Sit or lie down before taking medication.
The nurse notes a patient's international normalized ratio (INR) value of 2.5. What is the meaning of this reported value? A: The patient needs the subcutaneous heparin dose increased. B: The patient is not receiving enough warfarin for a therapeutic effect. C: The patient's warfarin dose is within the therapeutic range. D: The patient is receiving too much heparin and is at risk for bleeding.
C: The patient's warfarin dose is within the therapeutic range.
The nurse is preparing a patient with acute chest pain for an emergency angioplasty. The nurse would anticipate administering which medication to prevent platelet aggregation? A: Aminocaproic acid B: Warfarin C: Tirofiban D: Protamine
C: Tirofiban
The nurse administers a moderate dose of dopamine (Inotropin) to a client. What data collected by the nurse demonstrates that the drug is effective? Select one: a. Decrease in blood sugar b. Increased urine retention c. Bronchoconstriction d. Increased heart rate & blood pressure
D: Increased heart rate and BP
Which statement by the patient indicates a need for further instruction about colestipol from the nurse? A: "I might need to take fat-soluble vitamins to supplement my diet." B: "I should take this medication 1 hour after or 4 hours before my other medications." C: "The potential adverse effects of this drug are rash and itching." D: "I will mix and stir the powder thoroughly with at least 1 to 2 oz of fluid."
D: "I will mix and stir the powder thoroughly with at least 1 to 2 oz of fluid."
A patient who is taking nitroglycerin sublingual tablets is complaining of flushing and headaches. What is the nurse's best response? A: "Stop taking the nitroglycerin because you are experiencing an allergic reaction to the medication." B: "Put a cold wet washcloth or use an icepack on your forehead and lie down in a quiet place." C: "Immediately notify your health care provider because these symptoms are not related to the sublingual nitroglycerin." D: "These are the most common adverse effects of nitroglycerin. They should subside with continued use of nitroglycerin."
D: "These are the most common adverse effects of nitroglycerin. They should subside with continued use of nitroglycerin."
The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin? A: Complete blood count B: Prothrombin time (PT) C: Blood urea nitrogen D: Activated partial thromboplastin time (aPTT)
D: Activated partial thromboplastin time (aPTT)
To decrease the skin flushing adverse effect reaction of niacin (nicotinic acid), which action should the nurse take? A: Administer niacin with a liquid antacid. B: Give niacin with all other morning medications. C: Apply cold compresses to the head and neck. D: Administer aspirin 30 minutes before each dose.
D: Administer aspirin 30 minutes before each dose.
When applying nitroglycerin ointment, the nurse would perform which action? A: Use the fingers to spread the ointment evenly over a 3-inch area. B: Massage and then gently rub the ointment into the skin. C: Apply a thick layer of ointment on the nitroglycerin paper. D: Apply the ointment to a nonhairy part of the upper torso.
D: Apply the ointment to a nonhairy part of the upper torso.
To prevent the occurrence of cinchonism in a patient prescribed quinidine, which instruction is most important for the nurse to provide for this patient? A: Increase dietary intake of potassium. B: Remind the patient to change positions slowly. C: Advise the patient to wear sunscreen every day. D: Avoid drinking grapefruit juice.
D: Avoid drinking grapefruit juice.
The nurse would question a prescription for colesevelam in a patient with which condition? A: Glaucoma B: Renal disease C: Hepatic disease D: Bowel obstruction
D: Bowel obstruction
Before administering a dose of an antidysrhythmic drug to a patient, what nursing assessment must be completed? A: Obtain temperature and pulse oximetry on room air. B: Evaluate peripheral pulses and level of consciousness. C: Measure urine output and specific gravity. D: Check apical pulse and blood pressure.
D: Check apical pulse and blood pressure.
Which discharge instruction should the nurse include for a patient prescribed an antilipemic medication? A: "Lifestyle changes are no longer necessary when taking this medication." B: "It is important to take a double dose to make up for a missed dose." C: "Stop taking the medication if it causes nausea and vomiting." D: Continue your exercise program and maintain a low-fat diet
D: Continue your exercise program and maintain a low-fat diet
The nurse is preparing to administer digoxin 0.25 mg intravenous push to a patient. Which is an expected patient outcome related to the administration of digoxin? A: Reduction in urine output B: Increase in blood pressure C: Low serum potassium D: Decrease in the heart rate
D: Decrease in the heart rate
The nurse reviews an adult patient's laboratory values and notes a digoxin level of 11 ng/mL and a serum potassium level of 6.2 mEq/L. The nurse would notify the health care provider and anticipate which medication will be prescribed to administer? A: Atropine B: Epinephrine C: Sodium polystyrene sulfonate D: Digoxin immune Fab
D: Digoxin immune Fab
It is most important for the nurse to instruct a patient prescribed nitroglycerin to avoid which substance? A: Grapefruit juice B: Antacids C: Potassium-sparing diuretics D: Erectile dysfunction drugs
D: Erectile dysfunction drugs
A patient who is prescribed an anticoagulant requests an aspirin (acetylsalicylic acid) for headache relief. What is the nurse's best action? A: Explain that acetylsalicylic acid is contraindicated and administer ibuprofen. B: Explain that a common initial adverse effect is a headache for this drug. C: Administer 650 mg of acetylsalicylic acid and reassess pain in 30 minutes. D: Inform the patient of potential drug interactions with anticoagulants.
D: Inform the patient of potential drug interactions with anticoagulants.
The nurse would question a prescription for simvastatin in a patient with which condition? A: Hepatic disease B: Diabetes C: Heart failure D: Leukemia
D: Leukemia
To assess for a potentially serious adverse effect to HMG-CoA reductase inhibitors, the nurse should monitor which laboratory results? A: Urine specific gravity B: Serum electrolytes C: Complete blood count D: Liver function studies
D: Liver function studies
While observing a patient self-administer enoxaparin, the nurse identifies the need for further teaching when the patient performs which self-injection action? A: Administers the medication into subcutaneous (fatty) tissue B: Does not aspirate before injecting the medication C: Injects the medication greater than 2 inches away from the umbilicus D: Massages the site after administration of the medication
D: Massages the site after administration of the medication
A nurse is caring for a client who is prescribed isosorbide mononitrate for chronic stable angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer? A: Furosemide B: Captopril C: Ranolazine D: Metoprolol
D: Metoprolol
The nurse is providing discharge teaching for a patient about potential serious adverse effects to simvastatin. Which symptom may indicate the patient is experiencing a serious adverse effect to this medication? A: Headache B: Itching C: Weight loss D: Muscle pain
D: Muscle pain
Before emergency surgery, the nurse would anticipate administering which medication to a patient receiving heparin? A: Phenytoin B: Vitamin E C: Vitamin K D: Protamine
D: Protamine
While the nurse is providing care to a patient, the health care provider prescribes an IV potassium chloride infusion. For which condition would this prescription be given? A: Multiple sclerosis B: Cirrhosis of the liver C: Hypertension D: Renal failure
D: Renal failure
A nursing student asks the nurse about receptor specificity of adrenergic agonist medications. What will the nurse say? Select one: a. "As the dosage of these medications increases, drugs in this class are more selective." b. "Dopamine is selective for dopamine receptors and has no effects on alpha or beta receptors." c. "Epinephrine is the most selective alpha-adrenergic agonist medication." d. "Specificity is relative and is dose dependent."
D: Specificity is relative and is dose dependent
To treat a patient diagnosed with primary hyperaldosteronism, the nurse would expect to administer which diuretic? A: Hydrochlorothiazide B: Furosemide C: Acetazolamide D: Spironolactone
D: Spironolactone
A patient receiving an IV infusion of one unit of packed red blood cells suddenly develops shortness of breath, chills, and is feeling hot. What is the nurse's priority action? A: Maintain a patent IV line with normal saline. B: Check the vital signs. C: Notify the health care provider. D: Stop the blood transfusion.
D: Stop the blood transfusion.
A nurse is teaching a client who is taking digoxin and has a new prescription for colesevelam. Which of the following instructions should the nurse include in the teaching? A: Take digoxin with your morning dose of colsevelam B: Your sodium and potassium levels will be monitored periodically while taking colsevelam C: Watch for bleeding or bruising while taking this D: Take this with food and at least one glass of water
D: Take this with food and at least one glass of water
The nurse is providing education to a patient prescribed spironolactone and furosemide. What information does the nurse explain to the patient regarding both medications together? A: This combination maintains water balance to protect against dehydration and electrolyte imbalance. B: Using two drugs increases blood osmolality and the glomerular filtration rate. C: The lowest dose of two different types of diuretics is more effective than a large dose of one type. D: This combination promotes diuresis but decreases the risk of low levels of potassium.
D: This combination promotes diuresis but decreases the risk of low levels of potassium.
Which method of administration of nitroglycerin has the longest duration of action? A: Intravenous (IV) infusion B: Immediate-release tablet C:Sublingual tablet D: Transdermal patch
D: Transdermal patc
Phosphodiesterase inhibitors (PDIs) have an added advantage in treating heart failure. These drugs cause a positive inotropic effect and what other effect? A: Platelet inhibition B: Vasoconstriction C: Bronchodilation D: Vasodilation
D: Vasodilation
A patient is receiving lidocaine by continuous intravenous (IV) infusion. The nurse understands this medication is prescribed for what condition? A: Sinus bradycardia B: Atrial fibrillation C: First-degree heart block D: Ventricular dysrhythmias
D: Ventricular dysrhythmias
The nurse is caring for a patient admitted with gastrointestinal bleeding who is anticoagulated with warfarin. Which medication should the nurse anticipate administering? A: Protamine B: Vitamin E C: Calcium gluconate D: Vitamin K
D: Vitamin K
The primary action of alpha-1 adrenergic receptor agonists is which one of the following: Select one: a. Increased renal perfusion b. Increased speed of conduction in the heart c. Bronchodilation d. Vasoconstriction
D: vasoconstriction
A patient is being started on nicotinic acid [Niaspan] to reduce triglyceride levels. The nurse is providing patient education and should include teaching about which adverse effects? (Select all that apply.) Select one or more: a. Facial flushing b. Constipation c. Hypoglycemia d. Gastric upset e. Itching
a. Facial flushing d. Gastric upset e. Itching
A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug? Select one: a. Furosemide [Lasix] b. Hydrochlorothiazide [HydroDIURIL] c. Mannitol [Osmitrol] d. Spironolactone [Aldactone]
a. Furosemide [Lasix]
A patient with volume overload begins taking a thiazide diuretic. The nurse will tell the patient to expect which outcome when taking this drug? Select one: a. Improved exercise tolerance b. Increased cardiac output c. Prevention of cardiac remodeling d. Prolonged survival
a. Improved exercise tolerance
Which action is of greatest priority when a patient is diagnosed with hyperkalemia? Select one: a. Initiate cardiac monitoring b. Administer polystyrene sulfonate c. Teach food that should be avoided because of high potassium content d. Question the patient about past medical history
a. Initiate cardiac monitoring
A patient with Stage C heart failure (HF) who has been taking an ACE inhibitor, a beta blocker, and a diuretic begins to have increased dyspnea, weight gain, and decreased urine output. The provider orders spironolactone [Aldactone]. The nurse will instruct the patient to: Select one: a. avoid potassium supplements. b. monitor for a decreased heart rate. c. take extra fluids. d. use a salt substitute instead of salt.
a. avoid potassium supplements.
A nursing student asks the nurse why epinephrine, and not other adrenergic agonists, is used to treat anaphylactic shock. What will the nurse tell the student? Select one: a. "Epinephrine is the only adrenergic agonist that may be given parenterally." b. "Epinephrine has the ability to activate multiple types of adrenergic receptors. c. "Other adrenergic agonists have more severe adverse effects and are not safe in the doses needed to treat anaphylaxis." d. "Other adrenergic agonists have little or no effects on beta2-adrenergic receptors."
b. "Epinephrine has the ability to activate multiple types of adrenergic receptors.
Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in blood pressure, which indicator would the nurse use to evaluate a successful response? Select one: a. Decrease in pulse b. Increase in urine output c. Weight gain d. Improved gastric motility
b. Increase in urine output
A patient with a history of elevated triglycerides and LDL cholesterol begins taking nicotinic acid [Niacin]. The patient reports uncomfortable flushing of the face, neck, and ears when taking the drug. What will the nurse advise the patient? a."Ask your provider about taking an immediate-release form of the medication." b."You should take 325 mg of aspirin a half hour before each dose of Niacin to prevent this effect." c."You should stop taking the Niacin immediately since this is a serious adverse effect." d."Ask your provider about assessing your serum uric acid levels which may be elevated."
b."You should take 325 mg of aspirin a half hour before each dose of Niacin to prevent this effect."
(HMG-CoA) reductase inhibitors (statins) are generally administered at which time of day? a.Morning b.Evening c.Afternoon d.12:00 noon
b.Evening
A patient is started on nifedipine (Procardia) concurrently with a beta blocker for hypertension. The rationale for concurrent use of a beta blocker is to produce which of the following effects? a.Decreased flushing b.Prevention of reflex tachycardia c.Prevention of constipation d.Increased cardiac effects
b.Prevention of reflex tachycardia
A patient asks a nurse how nitroglycerin works to relieve stable anginal pain. The nurse correctly states, "Nitroglycerin: a.Increases the oxygen supply to the cardiac muscle." b.Promotes vasodilation, which reduces preload and oxygen demand." c.Increases ventricular filling to improve cardiac output." d.Dilates coronary arteries to increase blood flow to the heart."
b.Promotes vasodilation, which reduces preload and oxygen demand."
A patient taking gemfibrozil [Lopid] and rosuvastatin [Crestor] concurrently begins to complain of muscle aches, fatigue, and weakness. What should the nurse monitor? a.For tendon tenderness b.The patient's creatinine kinase levels c.The patient's liver function tests d.For a lupus like syndrome
b.The patient's creatinine kinase levels
A nurse is providing discharge teaching instructions for a patient taking cholestyramine [Questran]. Which statement made by the patient demonstrates a need for further teaching? Select one: a. "I will take warfarin [Coumadin] 1 hour before my medicine." b. "I will increase the fluids and fiber in my diet." c. "I can take cholestyramine with my hydrochlorothiazide." d. "I will take digoxin 4 hours after taking the cholestyramine."
c. "I can take cholestyramine with my hydrochlorothiazide."
A patient with type 1 diabetes is taking NPH insulin, 30 units every day. A nurse notes that the patient is also taking metoprolol [Lopressor]. What education should the nurse provide to the patient? Select one: a. "Metoprolol has no effect on diabetes mellitus or on your insulin requirements." b. "Metoprolol interferes with the effects of insulin, so you may need to increase your insulin dose." c. "Metoprolol may mask signs of hypoglycemia, so you need to monitor your blood glucose closely." d. "Metoprolol may potentiate the effects of the insulin, so the dose should be reduced."
c. "Metoprolol may mask signs of hypoglycemia, so you need to monitor your blood glucose closely."
A nurse is discussing heart failure with a group of nursing students. Which statement by a student reflects an understanding of how compensatory mechanisms can compound existing problems in patients with heart failure? Select one: a. "An increase in arteriolar tone to improve tissue perfusion can decrease resistance." b. "An increase in contractility to increase cardiac output can cause pulmonary edema." c. "When the heart rate increases to increase cardiac output, it can prevent adequate filling of the ventricles." d. "When venous tone increases to increase ventricular filling, an increase in arterial pressure occurs."
c. "When the heart rate increases to increase cardiac output, it can prevent adequate filling of the ventricles."
A patient who takes nitroglycerine to treat stable angina reports having erectile dysfunction and states that he plans to ask his primary provider for a prescription for tadalafil [Cialis]. What will the nurse tell this patient? Select one: a. "You may take these two drugs together safely as long as you take them as directed." b. "You should not take tadalafil and nitroglycerine within 30 to 60 minutes of each other." c. "You should discuss another antiangina medication with your provider." d. "You should avoid sexual activity since this increases oxygen demands on the heart."
c. "You should discuss another antiangina medication with your provider."
Which plasma lipoprotein level is most concerning when considering the risk of coronary atherosclerosis? Select one: a. Elevated cholesterol b. Elevated high-density lipoprotein c. Elevated low-density lipoprotein d. Elevated very-low-density lipoprotein
c. Elevated low-density lipoprotein
A patient with chronic hypertension is admitted to the hospital. During the admission assessment, the nurse notes a heart rate of 96 beats/min, a blood pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting edema of the ankles, and distension of the jugular veins. The nurse will contact the provider to request an order for which medication? Select one: a. ACE inhibitor b. Digoxin [Lanoxin] c. Furosemide [Lasix] d. Spironolactone [Aldactone]
c. Furosemide [Lasix]
A hospitalized patient complains of acute chest pain. The nurse administers a 0.3-mg sublingual nitroglycerin tablet, but the patient continues to complain of pain. Vital signs remain stable. What is the nurse's next step? Select one: a. Apply a nitroglycerin transdermal patch. b. Continue dosing at 10-minute intervals. c. Give a second dose of nitroglycerin in 5 minutes. d. Request an order for intravenous nitroglycerin.
c. Give a second dose of nitroglycerin in 5 minutes.
A nurse is reviewing a patient's medications and realizes that gemfibrozil [Lopid] and warfarin [Coumadin] are to be administered concomitantly. Which effect will the nurse anticipate in this patient? Select one: a. Increased levels of gemfibrozil b. Decreased levels of gemfibrozil c. Increased anticoagulant effects d. Reduced anticoagulant effects
c. Increased anticoagulant effects
A patient is taking gentamicin [Garamycin] and furosemide [Lasix]. The nurse should counsel this patient to report which symptom? Select one: a. Frequent nocturia b. Headaches c. Ringing in the ears d. Urinary retention
c. Ringing in the ears
A patient is taking enalapril [Vasotec]. The nurse understands that patients taking this type of drug for heart failure need to be monitored carefully for: Select one: a. hypernatremia. b. hypertension. c. hyperkalemia. d. hypokalemia.
c. hyperkalemia.
A patient who is taking simvastatin [Zocor] develops an infection and the provider orders azithromycin [Zithromax] to treat the infection. The nurse should be concerned if the patient complains of: Select one: a. nausea. b. tiredness. c. muscle pain. d. headache.
c. muscle pain
A nurse is reviewing a patient's medications and realizes that gemfibrozil [Lopid] and warfarin [Coumadin] are to be administered concomitantly. Which effect will the nurse anticipate in this patient? a.Increased levels of gemfibrozil b.Decrease anticoagulant effects c.Increased anticoagulant effects d.Decreased levels of gemfibrozil
c.Increased anticoagulant effects
The generic names of alpha-1 receptor antagonists share what common suffix? Select one: a. -pril b. -sartan c. -lol d. -osin
d. -osin
A nurse prepares to administer a scheduled dose of digoxin. The nurse finds a new laboratory report showing a plasma digoxin level of 0.7 ng/mL. What action should the nurse take? Select one: a. Withhold the drug for an hour and reassess the level. b. Withhold the drug and notify the prescriber immediately. c. Administer Digibind to counteract the toxicity. d. Check the patient's apical pulse, and if it is within a safe range, administer the digoxin.
d. Check the patient's apical pulse, and if it is within a safe range, administer the digoxin.
The client is receiving terazosin (Hytrin) for treatment of hypertension. Considering the client's history of prostatic hypertrophy, the nurse may see which of the following effects? Select one: a. Signs of a urinary tract infection b. Dilute, pale, yellow urine c. Urinary retention d. Improved urinary flow
d. Improved urinary flow
A patient asks a nurse how nitroglycerin works to relieve stable anginal pain. The nurse correctly states, "Nitroglycerin: Select one: a. dilates coronary arteries to increase blood flow to the heart." b. increases the oxygen supply to the cardiac muscle." c. increases ventricular filling to improve cardiac output." d. promotes vasodilation, which reduces preload and oxygen demand."
d. promotes vasodilation, which reduces preload and oxygen demand."
A patient with heart failure who has been taking an ACE inhibitor, a thiazide diuretic, and a beta blocker for several months comes to the clinic for evaluation. As part of the ongoing assessment of this patient, the nurse will expect the provider to evaluate: Select one: a. complete blood count. b. ejection fraction. c. maximal exercise capacity. d. serum electrolyte levels.
d. serum electrolyte levels.
A nurse counsels an elderly patient who is just beginning verapamil (Calan) therapy. The nurse should include which pertinent and important side effect in the patient's education? a.Diarrhea is common and can be treated with antacids. b.Photophobia occurs in many patients and can be minimized by wearing sunglasses and sunblock. c.Migraine headache is common and is relieved by reducing the dose. d.Dizziness may occur; therefore, caution must be used when walking or rising from a sitting position.
d.Dizziness may occur; therefore, caution must be used when walking or rising from a sitting position.
A patient about to receive a morning dose of digoxin has an apical pulse of 50 beats/min. What will the nurse do next? a.Administer the dose. b.Administer the dose and notify the prescriber. c.Check the radial pulse for 1 full minute. d.Withhold the dose and notify the prescriber.
d.Withhold the dose and notify the prescriber.
A nurse is explaining activation of adrenergic receptors to some student nurses during a clinical rotation at the hospital. Which statement by a student demonstrates a need for further teaching? •a. "Beta1 activation results in increased cardiac output." •b. "Beta2 activation results in bronchodilation." •c. "Beta2 activation results in hypoglycemia" •d. "Alpha1 activation results in vasoconstriction of blood vessels"
•c. "Beta2 activation results in hypoglycemia"