Ch. 43, 44, 47
The nurse is providing medication teaching to a patient who will begin taking niacin with a bile acid sequestrant. How does the nurse instruct the patient to take these two medications? a) "Both medications should be taken 4 to 6 hours apart." b) "Both medications should be taken in the morning." c) "One medication should be taken in the morning but the other is taken at bedtime." d) "Both medications can be taken at once just before going to bed."
a) "Both medications should be taken 4 to 6 hours apart."
A patient has been prescribed losartan (Cozaar) for hypertension. What patient teaching points will the nurse include about this drug include? a) "Report onset of a cough or fever to health care provider." b) "Limit fluid intake to decrease urinary output." c) "Monitor blood pressure once a week." d) "Take the drug late in the day to prevent sleepiness."
a) "Report onset of a cough or fever to health care provider."
The patient is diagnosed with secondary hypertension. What will be the focus of nursing care to treat this patient? a) Administering epinephrine b) Administering antihypertensives c) Promoting healthy lifestyle d) Treating the cause
a) Administering epinephrine
The nurse is taking a health history on a 38-year-old man who is taking atorvastatin (Lipitor) for high cholesterol. What will the nurse question specifically related to the safe use of this drug? a) Alcohol b) Nicotine c) Caffeine d) Herbal therapy
a) Alcohol
A patient tells the nurse he has had an exacerbation of hemorrhoidal irritation. What drug would the nurse suspect is most likely to contribute to this adverse effect? a) Bile acid sequestrants b) Beta-hydroxy-beta-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors c) Cholesterol absorption inhibitor d) Fibrates
a) Bile acid sequestrants
The emergency department nurse is asked to prepare a nitroprusside (Nitropress) infusion for a patient being brought to the hospital in an ambulance. The nurse knows this drug is only used in what circumstances? a) Hypertensive emergencies b) Hypertension in a patient having a myocardial infarction c) Hypertension complicated by symptoms of a stroke d) Hypertension associated with diabetic ketoacidosis
a) Hypertensive emergencies
The nurse conducts a review of research related to Beta-hydroxy-beta-methylglutaryl coenzyme A inhibitors and finds the only one associated with data to show a reduction in coronary artery disease and incidence of myocardial infarction is what drug? a) Pravastatin (Pravachol) b) Lovastatin (Mevacor) c) Atorvastatin (Lipitor) d) Fluvastatin (Lescol)
a) Pravastatin (Pravachol)
The nurse evaluates an improvement in the patient's heart failure (HF) status based on what assessment finding? a) Using fewer pillows to sleep b) Increased skin turgor c) Heart rate regular d) Improved mental status
a) Using fewer pillows to sleep
An older adult patient is taking a sustained-release antihypertensive drug. What is the nurse's priority teaching point about this medication? a) "Take your blood pressure only at night." b) "Swallow the drug whole and do not to cut, crush, or chew it." c) "Take the drug before bedtime." d) "Use over-the-counter (OTC) drugs to control headache or cold symptoms."
b) "Swallow the drug whole and do not to cut, crush, or chew it."
A patient asks the nurse what cardiac glycosides do to improve his condition. What is the nurse's best response? a) "They decrease the force of myocardial contractions." b) "They help renal blood flow and increase urine output." c) "They increase heart rate." d) "They increase conduction velocity."
b) "They help renal blood flow and increase urine output."
After administering an IV dose of digoxin, the nurse would expect to see effects within what period of time? a) 30 to 120 minutes b) 5 to 30 minutes c) 1 hour d) 2 hours
b) 5 to 30 minutes
The patient asks the nurse what atorvastatin (Lipitor), newly prescribed, will do. What expected outcome will the nurse describe? a) Decrease in serum cholesterol only b) Decrease in serum cholesterol and low density lipoprotein (LDL) levels c) Decrease in sitosterol and serum cholesterol d) Decrease in campesterol and LDL levels
b) Decrease in serum cholesterol and low density lipoprotein (LDL) levels
A triage nurse in the emergency department is assessing a 78-year-old man. It is determined that the patient is experiencing severe digoxin toxicity. What drug will the nurse administer immediately? a) Inamrinone (Inocor) b) Digoxin immune Fab (Digibind) c) Verapamil hydrochloride (Calan) d) Quinidine sulfate
b) Digoxin immune Fab (Digibind)
What drug is a safe and effective calcium channel blocker only if the nurse administers them as sustained-release or extended-release preparations to treat hypertension? a) Aliskiren (Tekturna) b) Diltiazem (Cardizem) c) Atenolol (Tenormin) d) Metoprolol (Lopressor)
b) Diltiazem (Cardizem)
A patient who works on road construction has been diagnosed with hypertension. After attempting to decrease his blood pressure with lifestyle changes and a mild diuretic, it is determined that he will need to be placed on an angiotensin-converting enzyme (ACE) inhibitor. Based on his occupation, what is the nurse's priority assessment? a) Chronic constipation b) Excessive sweating on the job c) Three large meals a day d) One beer every night
b) Excessive sweating on the job
The nurse is providing patient teaching to a patient who has been prescribed digoxin. The patient tells the nurse that she occasionally use herbals and other alternative therapies. What herb would the nurse warn the patient to avoid taking with digoxin? a) Black cohosh b) Ginseng c) Saw palmetto d) Valerian
b) Ginseng
A patient has been started on losartan (Cozaar), an angiotensin II-receptor blocker (ARB), for hypertension. After 6 weeks of therapy, it is decided that the losartan alone is not controlling the patient's hypertension. What does the nurse anticipate will be added to the losartan regimen for better control of this patient's hypertension? a) Candesartan (Atacand) b) Hydrochlorothiazide (Hyzaar) c) Captopril (Capoten) d) Antidiuretic hormone (ADH)
b) Hydrochlorothiazide (Hyzaar)
The nurse reviews the patient's lab results and recognizes the patient is at risk for digoxin toxicity due to what electrolyte imbalance? a) Hyperkalemia b) Hypokalemia c) Hypernatremia d) Hyponatremia
b) Hypokalemia
After administering digoxin, what assessment finding would indicate to the nurse that the drug was having the desired effect? a) Increased heart size b) Increased urinary output c) Decreased respiratory rate d) Increased heart rate
b) Increased urinary output
A patient newly diagnosed with hypertension has just been given a prescription for medication. Along with promoting safety, what is the other goal of the nurse's teaching plan? a) A blood pressure of 120/80 b) Medication compliance c) A discussion with his insurance company about the cost of the drug d) Verbalization of why drugs should be kept out of the reach of children
b) Medication compliance
The nurse is providing drug teaching for a patient who is prescribed enalapril (Vasotec). What drug specific adverse effect will the nurse include in the drug teaching? a) Sedation b) Persistent cough c) Tachycardia d) Rash
b) Persistent cough
A patient is being discharged on cholestyramine (Questran). Patient teaching should include what about this medication? a) Should be administered with other medications b) Should be administered 1 hour before or 4 to 6 hours after other medications c) Should be administered 1 hour after other medications d) Should be administered on an empty stomach
b) Should be administered 1 hour before or 4 to 6 hours after other medications
The nurse is preparing digoxin for an infant. What is the nurse's priority intervention? a) To perform hand hygiene b) To have another nurse check dosage calculations c) To check the child's apical pulse d) To identify the patient by checking the ID bracelet
b) To have another nurse check dosage calculations
What is the nurse's priority to assess before giving a female patient her prescription for an angiotensin II-receptor blocker (ARB)? a) "Do you eat something when you take your medications?" b) "How much physical exercise do you get?" c) "When was your last menstrual period (LMP)?" d) "Have you always weighed 130 pounds since you grew up?"
c) "When was your last menstrual period (LMP)?"
The nurse is engaged in patient teaching about a newly prescribed bile acid sequestrant that may be mixed with a carbonated beverage. What bile acid sequestrant is the nurse describing? a) Cholestyramine (Questran) b) Colesevelam (Welchol) c) Colestipol (Colestid) d) Ezetimibe (Zetia)
c) Colestipol (Colestid)
The nurse is caring for a patient with hypertension who is preparing to be discharged from the hospital after suffering a myocardial infarction. What drug might the nurse administer that will both treat his hypertension and reduce myocardial oxygen consumption? a) Captopril b) Losartan c) Diltiazem d) Nitroprusside
c) Diltiazem
The nurse cares for a 10-year-old child brought to the clinic for an annual checkup who is diagnosed with hypercholesterolemia. What is the most common cause of hypercholesterolemia in children? a) Gender b) Diet c) Familial connection d) Exercise
c) Familial connection
A patient taking atorvastatin (Lipitor) comes to the clinic with complaints of acute muscle pain not associated with exercise or injury. The nurse will ask questions to determine if this patient has been taking what contraindicated substance? a) Over-the-counter (OTC) medications b) Ginseng c) Grapefruit juice d) Saw palmetto
c) Grapefruit juice
When administering milrinone (Primacor), the nurse will assess the patient for what common adverse effect? a) Hypoglycemia b) Confusion c) Hypotension d) Seizures
c) Hypotension
The nurse is preparing to teach the patient about diet therapy when beginning bile sequestrant medication to lower lipid levels. What important teaching point will the nurse include in the teaching plan? a) Increasing carbohydrate intake b) Reducing protein intake c) Increasing fiber intake d) Reducing fluid intake
c) Increasing fiber intake
A patient taking diltiazem (Cardizem) for hypertension has come to the clinic for a follow-up appointment. What adverse effects would the nurse assess the patient for? a) Chest pain and pale skin b) Shortness of breath and wheezing c) Peripheral edema and bradycardia d) Tachycardia and increased energy level
c) Peripheral edema and bradycardia
A 9-year-old child has received an order for oral pravastatin (Pravachol) 40 mg/d for genetically linked hyperlipidemia. In preparation for patient teaching concerning this drug, what initial action will the nurse take? a) Ask the parents to be present for the teaching session. b) Determine the appropriate time to discuss the drug with the patient. c) Question the doctor concerning the ordered dosage. d) Review the child's normal daily dietary intake of fatty foods.
c) Question the doctor concerning the ordered dosage.
A patient taking a calcium channel blocker is seen in the clinic and diagnosed with drug toxicity. When collecting the nursing history, what finding would indicate the likely cause of this drug toxicity? a) Intake of alcohol b) The use of eggs in the diet c) The ingestion of grapefruit juice d) Intake of aged cheese
c) The ingestion of grapefruit juice
The nurse is caring for a patient who has digoxin toxicity. As the nurse assesses the changes in the patient's daily activities, what finding could indicate the cause of the toxic level? a) The patient has been sleeping more lately. b) The patient took nitroglycerin for chest pain twice yesterday. c) The patient's daughter brought her a bag of licorice that she has been enjoying. d) The patient's intake of sodium increased lately because she's been eating seafood.
c) The patient's daughter brought her a bag of licorice that she has been enjoying.
The nurse is caring for a 35-year-old woman taking a beta-hydroxy-beta-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor to lower serum lipid levels. When teaching this patient about her medications what priority teaching point will the nurse include in the teaching plan? a) Need for frequent ophthalmic examinations b) Information about a cholesterol-lowering diet c) Use of barrier contraceptives d) Calling her doctor with any respiratory symptoms
c) Use of barrier contraceptives
The nurse provides teaching about digoxin to the 62-year-old patient. The nurse evaluates patient understanding and determines further teaching is needed when the patient says she will do what? a) "Take the medication daily in the morning." b) "Take her pulse before taking her dose." c) "Weigh herself daily at the same time." d) "Take the medication with a meal."
d) "Take the medication with a meal."
No antihypertensive medication is safe during pregnancy but if the benefit for the mother outweighs the risk to the fetus, what classification of medication can the nurse administer to the hypertensive pregnant woman? a) Angiotensin-converting enzyme (ACE) inhibitor b) Angiotensin-receptor blocker (ARB) c) Renin inhibitor d) Calcium channel blocker
d) Calcium channel blocker
The nurse is assessing a patient who reports taking cholestyramine (Questran) mixed with diet cola twice per day. What is an appropriate nursing diagnosis for this patient? a) Acute pain related to central nervous system and GI effects b) Constipation related to GI effects c) Noncompliance related to how the drug is taken d) Deficient knowledge regarding drug therapy
d) Deficient knowledge regarding drug therapy
A patient presents to the emergency department with rales, wheezing, and blood-tinged sputum. What does the nurse recognize that these symptoms indicate? a) Cardiomyopathy b) Cardiomegaly c) Valvular heart disease d) Pulmonary edema
d) Pulmonary edema
The nurse administers a cardiac glycoside for what therapeutic effect? a) To decrease cardiac output b) To decrease afterload c) To increase ventricular rate d) To increase the force of the contraction of the heart
d) To increase the force of the contraction of the heart
