ATI - The Cardiovascular System Test

A nurse is teaching a client who has a new prescription for quinidine. Which of the following statements should the nurse include?

("Monitor your pulse rate and report changes.")For quinidine, a heart rhythm medication, monitor pulse rate and notify doctors. Quinidine increases digoxin toxicity. It is not a side effect of quinidine, but gastrointestinal issues, dizziness, headaches, and taste changes are.

A nurse is caring for a client who is about to begin captopril therapy. Which of the following adverse effects should the nurse instruct the client to report because it can indicate a need to discontinue drug therapy? (Select all that apply)

ACE inhibitor captopril can cause persistent rash, taste distortion, tongue swelling, angioedema, photosensitivity, and dry cough. These side effects may indicate drug discontinuation. Clients should use sunscreen, protective clothing, and limit sun exposure. Dry cough may indicate drug discontinuation.

A nurse is caring for a client who has a glomerular filtration rate of 10 mL/min and a reduced urine output. The nurse should clarify a prescription for hydrochlorothiazide for this client because of which of the following characteristics of the drug?

Adequate kidney function is essential for clients who take hydrochlorothiazide, a thiazide diuretic, to promote urine production and effective excretion.

A nurse is teaching a client who has a new prescription for nitroglycerin. The nurse should instruct the client that which of the following manifestations is a potential adverse effect of this drug?

Adverse effects of nitrates, such as nitroglycerin, include headaches, which can be severe at the beginning of nitrate therapy but decrease in severity with continued exposure to nitrates.

A nurse is caring for a client who is taking digoxin and develops changes on their ECG tracing and other manifestations that indicate the client has severe digoxin toxicity. Which of the following drugs should the nurse expect to administer to treat this complication?

Antigen-binding fragments, also called digoxin immune Fab, binds to digoxin and blocks its action. The nurse should prepare to administer this antidote IV to clients who have severe digoxin toxicity.

A nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. When speaking to the client about the drug, which of the following instructions should the nurse include? (Select all that apply).

Apply a new patch at anginal pain onset, not at the onset. Apply to dry skin, rotate sites, start daily, remove for 10-12 hours, and avoid sleeping hours to prevent tolerance development.

A nurse should identify that which of the following drugs is used only for the short-term treatment of a cardiac dysrhythmia because of the serious adverse effects associated with long-term use?

B. Procainamide:

A nurse is caring for a client who has a new prescription for aliskiren to treat hypertension. The nurse should monitor the client for which of the following findings as an adverse effect of the drug? (Select all that apply).

Direct renin inhibitor aliskiren can cause hyperkalemia, throat swelling, angioedema, constipation, cough, and joint pain. Nurses must monitor potassium levels and seek medical attention for adverse effects. Cough may occur, but constipation is not.

A nurse is caring for a client who is taking a diuretic. The nurse should instruct the client to include which of the following foods in their diet to increase potassium intake?

Diuretics can deplete the body of potassium, so the nurse should instruct the client to include potassium-rich foods in their diet, such as raisins and other dried fruits.

A nurse is caring for a client who has a new prescription for dobutamine. The nurse should clarify the prescription with the provider if the client is receiving which of the following types of drugs? (Select all that apply).

Dobutamine, a sympathomimetic drug, can cause lithium toxicity in lithium-takers. MAOIs and dobutamine can cause toxicity and tachydysrhythmia. General anesthetics cause dysrhythmias. Dobutamine can poison tricyclic antidepressants. Beta-blockers reduce dobutamine's effects.

A nurse is teaching a client who has a new prescription for gemfibrozil. Which of the following instructions should the nurse include? (Select all that apply).

Gemfibrozil must be taken 30 minutes before a meal. Monitor new fried food intolerance, bloating, and abdominal pain. Expect periodic liver function testing and muscle tenderness. Gemfibrozil increases liver toxicity, so take it twice daily.

A nurse is caring for a client who is taking amiodarone to treat atrial fibrillation. Which of the following should the nurse instruct the client to avoid while taking this drug?

Grapefruit juice, particularly in large amounts, can cause toxicity of potassium channel blockers, such as amiodarone.

A nurse is administering hydrochlorothiazide to a client who has gouty arthritis. The nurse should monitor the client for which of the following findings that indicates an adverse effect of this drug?

Hyperuricemia, or increased uric acid levels, along with gouty arthritis, can occur in clients who have a history of these conditions and are taking hydrochlorothiazide.

A nurse is caring for a client who has a new prescription for verapamil to treat atrial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions?

Large amounts of grapefruit juice can increase blood levels of verapamil by inhibiting its metabolism. An excess amount of the drug in the body can intensify otherwise therapeutic effects like hypotension, causing serious risk for syncope and dizziness.

A nurse is providing teaching to a client who has a new prescription for losartan to treat hypertension. The nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug and needs to be reported?

Losartan, an angiotensin II receptor blocker, can cause angioedema, which often manifests as swelling around the eyes and lips. Clients who develop this adverse effect should stop taking the drug and seek medical attention.

A nurse is assessing a client who is taking a loop diuretic and is experiencing a thready, irregular pulse, orthostatic hypotension, and confusion. The nurse should identify that these manifestations indicate which of the following adverse effects?

Manifestations of hypokalemia include a thready, irregular pulse, orthostatic hypotension, anxiety, confusion, skeletal muscle weakness, hypoactive bowel sounds, polyuria, nausea, and vomiting.

A nurse should recognize that milrinone is contraindicated for a client who has which of the following conditions?

Milrinone, a phosphodiesterase inhibitor, is contraindicated for clients who have had an allergic reaction to phosphodiesterase inhibitors and for clients who have an acute myocardial infarction and aortic or pulmonary valve disorders.

A nurse is caring for a client who has a new prescription for propranolol to treat a tachydysrhythmia. The nurse should instruct the client to avoid taking which of the following types of over-the-counter drugs while taking propranolol?

NSAIDs can interact with propranolol and decrease the anti-hypertensive action because vasoconstriction can occur in some COX-2 inhibitors. The nurse should instruct the client to avoid taking NSAIDs and propranolol at the same time.

A nurse is caring for a client who has a depressive disorder and requires a prescription drug to treat hypertension. The nurse should recognize that which of the following antihypertensive drugs is contraindicated for this client?

Severe depression and an increased risk for suicide are adverse effects of adrenergic neuron blockers, such as reserpine. These adverse effects develop because of the depletion of serotonin and norepinephrine and can persist after clients discontinue taking the drug.

A nurse is reviewing new prescriptions with a client who has heart disease. The nurse should instruct the client that which of the following drugs is prescribed to treat hypercholesterolemia?

Simvastatin is a type of medication known as a statin that helps lower cholesterol levels in the blood. It is commonly prescribed to patients with hypercholesterolemia to reduce their risk of cardiovascular events, such as heart attacks and strokes.

A nurse is providing teaching to a client who is taking simvastatin. The nurse should instruct the client to report which of the following manifestations as an indication of a serious adverse reaction that could require discontinuing drug therapy?

Simvastatin, an HMG-CoA reductase inhibitor (statin), can cause myopathy or pain in muscles and joints that can progress to rhabdomyolysis. With this rare but serious adverse effect, muscle protein breaks down and is excreted, resulting in kidney damage.

A nurse is caring for a client who is taking spironolactone to treat hypertension. The nurse should recognize that which of the following client laboratory values requires immediate intervention?

Spironolactone is a diuretic and an aldosterone antagonist that can cause hyperkalemia and places the client at risk for cardiac dysrhythmias. This potassium level is outside the expected reference range of 3.5 to 5.0 mEq/L and requires immediate intervention.

A nurse is caring for a client who is taking carvedilol and has a prescription for an oral antidiabetic drug to manage their new diagnosis of type 2 diabetes mellitus. By taking both drugs concurrently, the nurse should identify that the client is at an increased risk for which of the following conditions?

There are two factors that increase the client's risk for hypoglycemia. Alpha/beta blockers, such as carvedilol, potentiate the hypoglycemic effects of insulin and oral hypoglycemic drugs. Also, carvedilol can mask tachycardia in clients who have hypoglycemia. Carvedilol should be used with caution by clients who have diabetes mellitus.

A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify the prescription with the provider if the client has a history of which of the following conditions?

Verapamil, a calcium channel blocker, can affect AV conduction and is contraindicated for clients who have sick sinus syndrome or second- or third-degree AV block. Verapamil is indicated for hypertension, angina pectoris, and the management of atrial flutter and fibrillation. It is also prescribed for the management of migraine headaches.

A nurse is caring for a client who is taking atorvastatin and has a new prescription for gemfibrozil. The nurse should recognize that this drug combination places the client at an increased risk for which of the following adverse effects?

When taking a statin drug, it is important to know that concurrent use of fibric acid derivatives, such as gemfibrozil, or other drugs to lower cholesterol, can increase the risk for myopathy.