EXAM 2
C
A 25-year-old woman comes to the clinic because of a chronic, nonproductive cough. Assessment reveals that she has a history of asthma, and dextromethorphan (Robitussin) is prescribed for her. The nurse will question this order because a) respiratory secretions may be thickened. b) serotonin syndrome may result. c) secretions may be retained. d) persistent coughing may develop.
A, C, D
A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.) a) Exercise b) Warm weather c) Pollutants d) Allergens
B
A 45-year-old female client is being seen in the physician's office for a dry, hacking cough that is keeping her up at night. The physician prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? a) Dextromethorphan works by inhibiting allergen response. b) Dextromethorphan works in the medulla to suppress the cough reflex. c) Dextromethorphan works on the receptors in the throat to prevent a cough. d) Dextromethorphan works by relaxing the smooth muscles in the bronchioles.
c
A 59-year-old patient is on warfarin therapy. On follow-up visits to the clinic, the nurse will assess the patient's: a) blood glucose level. b) presence of skin-related disorders. c) intake of vitamin K. d) presence of breathing disorders.
D
A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect? a) By promoting the rapid excretion of vitamin K by the gastrointestinal mucosa b) By inhibiting the action of vitamin K at its sites of action c) By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis d) By inactivating clotting factors and thus stopping the coagulation cascade
C
A 65-year-old man who just had a heart attack is placed on aspirin, 81 mg daily. The nurse is explaining the purpose of this medication to the client. What would be the best explanation? a) The aspirin is being prescribed because it reduces the prostaglandins in your body. b) The aspirin is being prescribed because it will protect your heart. c) The aspirin is being prescribed because it reduces your risk of a second heart attack. d) The aspirin is being prescribed to relieve the pain from the heart attack.
B
A 70-year-old resident of a long-term care facility has experienced increasing pain, swelling, and redness to her lower leg over the past 12 hours, prompting the care providers at the facility to have the woman brought to the local emergency department. Diagnostic testing has confirmed deep vein thrombosis (DVT) and an IV infusion of alteplase (Activase) has been initiated? Unlike anticoagulants, a thrombolytic such as alteplase can a) potentiate the action of vitamin K. b) break down existing clots. c) prevent the formation of new clots. d) inhibit platelet aggregation.
A
A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by: a) inhibiting the movement of calcium ions across the cardiac muscle cell membrane. b) decreasing sodium and potassium conduction. c) blocking adrenergic receptors and producing antisympathetic effects. d) weakening diastolic depolarization and the action potential duration.
D
A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is: a) Antihistamines are not recommended for this issue; only antibiotics are useful. b) Antihistamines are recommended for extended use, as long as you monitor for adverse effects. c) Antihistamines are not used for this issue. d) Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.
D
A client's digoxin level is reported to be 2.2 ng/mL. This result indicates: a) a therapeutic drug level. b) a subtherapeutic drug level. c) a loading dose has been given. d) digitalis toxicity.
A
A critical care nurse is caring for a patient after open-heart surgery. What nursing intervention would the nurse initiate to help detect life-threatening dysrhythmias and manage and minimize any that occur? a) Monitor cardiac rhythm continuously. b) Palpate the client's pulse and observe the client's response. c) Provide supplemental oxygen. d) Monitor blood pressure continuously.
B
A female patient diagnosed with chronic atrial flutter has been prescribed verapamil in conjunction with digoxin to control ventricular rate. To enhance the therapeutic effect of the drug, the nurse will instruct the patient to: a) avoid fresh fruit. b) avoid grapefruit and grapefruit juice. c) take the medication with meals. d) take an aspirin every day. Submit your answer
D
A female patient has a history of clot formation in the past. She is scheduled for bowel resection due to an obstruction. What anticoagulant agent will be administered prophylactically? a) Warfarin (Coumadin) b) Streptokinase (Streptase) c) Acetylsalicylic acid (Aspirin) d) Heparin
C
A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report what should it occur? a) A skin rash b) Sudden occurrence of sleepiness and drowsiness c) Presence of blood in urine or stools d) Dizziness
A
A nurse assessing a patient on digoxin observes features of toxicity. Which visual disturbance should the nurse assess for in such patients? a) Yellow or green vision b) Difficulty of near vision c) Double vision d) Complete loss of vision Submit your answer
B
A nurse is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which drug may be ordered? a) Ticlopidine b) Protamine sulfate c) Coumadin d) Alteplase
B
A nurse is caring for a patient receiving the anticoagulant drug warfarin. What pre-administration assessments should the nurse perform before administering the drug to the patient? a) Monitor for hypersensitivity reaction. b) Assess prothrombin time (PT) and INR. c) Assess for signs of bleeding. d) Observe for signs of thrombus formation.
B
A nurse is caring for a patient who is taking digoxin and a loop diuretic. Which would be most important for the nurse to monitor? a) Sodium levels b) Potassium levels c) Liver enzymes d) Electrocardiogram results Submit your answer
A
A nurse is preparing to discharge a female patient newly prescribed warfarin (Coumadin). While assessing the patient's knowledge of their drug, what would indicate that the patient needs further instruction concerning her drug therapy? a) "I take aspirin for my arthritis." b) "I walk two miles a day." c) "I drink a glass of wine about once a week." d) "I love to eat homegrown tomatoes in the summer." Submit your answer
B
A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following? a) Vitamin C b) Coffee c) Salt d) Alcohol
C
A patient is to receive abciximab. The nurse would expect to administer the drug by which route? a) Oral b) Intramuscular c) Intravenous d) Subcutaneous
B
A patient with cardiac arrhythmia is prescribed verapamil. Which of the following possible adverse effects should the nurse inform the patient about? a) Diarrhea b) Peripheral edema c) Hyperactivity d) Hypertension Submit your answer
B
A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regularly assessing the patient's heart rate, the nurse should prioritize assessment of the patient's a) intake and output. b) blood pressure. c) cognition. d) exercise tolerance.
A
Aspirin is the prototype anticoagulant. a) False b) True
B
Expectorants elicit their effect by which mechanism? a) Anesthetizing stretch receptors in the respiratory passages b) Thinning respiratory secretions c) Breaking down thick mucus in the lower lungs d) Depressing the cough center in the brain
B
Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication? a) Albuterol decreases vital capacity. b) Albuterol causes relaxation of the bronchial smooth muscles. c) Albuterol blocks the stimulation of the beta-2 receptors. d) Albuterol causes stimulation of the bronchial tissue.
B
Ms. Jones, 32 years old, has been admitted to the hospital for cardiac dysrhythmias. The nurse understands that the heart has a specialized electrical system, with the pacemaker of the heart in what location? a) Right atrium b) Sinoatrial node c) Bundle of His d) Atrioventricular node
A
Ms. Main is sent home with subcutaneous heparin after a total hip replacement. What symptom would indicate a serious drug reaction? a) Tarry stools b) Hypotension c) Stomach pain d) Headache
C
Ms. Smith is started on antiarrhythmic therapy to treat atrial fibrillation. The nurse caring for Ms. Smith knows which occurrence is a potential side effect of this medication? a) Malignant hyperthermia b) Shortness of breath c) Other arrhythmias d) Angina
A
Nesiritide is a human B-type natriuretic peptide. a) True b) FalsE
C
Propranolol is ordered for a patient who has a cardiac arrhythmia. It will be important for the nurse to determine if the patient has a history of a) hypersensitivity to sulfonylureas. b) idiosyncratic reaction to cinchona derivatives. c) hypersensitivity to beta blockers. d) chronic heart failure secondary to a tachyarrhythmia.
B
Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines. a) True b) False
B
The client asks, "What is the difference between antitussive medications and expectorants?" The best response is: a) There is no difference in functions. b) Antitussives suppress coughing, and expectorants loosen bronchial secretions. c) Both drug types loosen bronchial secretions. d) Antitussives liquefy bronchial secretions, and expectorants assist in the expectoration of those secretions.
A
The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler? a) Nervousness b) Hypotension c) Bradycardia d) Fatigue
B
The most common adverse effects associated with antiplatelet agents are headache and dizziness. a) True b) False
B
The nurse caring for a 38-year-old patient started on albuterol (Proventil) should advise the patient that they may experience what adverse effects? a) Polydipsia b) Tachycardia c) Diarrhea d) Hypotension
A
The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time? a) 15 minutes prior to exercising b) One hour before exercise c) In the morning of the day when exercise is planned d) Immediately on beginning to exercise Submit your answer
D
The nurse is teaching a group of patients with allergic rhinitis about the use of their medications. What would be the most essential information to give these patients about preventing possible drug interactions? a) Use only one pharmacy so the pharmacist can check drug interactions for you. b) OTC medications are safe to use. c) Ask the pharmacy tech to assist you in selecting an OTC medication. d) Read drug labels before taking OTC medications. Submit your answer
C
The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations? a) Acetylcysteine b) Theophylline c) Albuterol d) Beclomethasone
D
The pharmacology instructor is discussing effects on the heart of different medication. What is the term the instructor would use to describe the effect of a medication that increases the force of the contractions of the heart? a) Positive chronotropic b) Negative inotropic c) Negative dromotropic d) Positive inotropic
D
What action by the patient would indicate that the patient is obtaining maximum benefit from their inhaler? a) The patient administers 3 doses of medication within a 1-minute time frame. b) The patient exhales as soon as he compresses the inhaler. c) The patient inhales as soon as the inhaler enters his mouth. d) The patient holds his breath for several seconds after releasing the medication.
A, B, C
What effects are exerted by aspirin? (Select all that apply.) a) Antipyretic b) Analgesic c) Anti-inflammatory d) Anti-infective e) Antiviral
B
What statement by a 61-year-old client who is to take an antitussive with codeine indicates that the teaching has been effective? a) "This medication may make me anxious and nervous." b) "This medication can cause drowsiness, so I will avoid driving while I use it." c) "I should call the physician if I develop nausea, diarrhea, or stomach cramps while taking this medication." d) "I will take this medication anytime I start to cough."
C
When heart failure occurs, one of the results is increased preload. What is this? a) The amount of blood pooled in the extremities b) The resistance the heart must overcome c) The amount of blood returning to the heart d) The pulse rate caused by venous distention
D
Which drug is classified as an expectorant? a) Acetylcysteine (Mucomyst) b) Benzonatate (Tessalon Perles) c) Dextromethorphan (Delsym) d) Guaifenesin (Robitussin) Submit your answer
C
Which drug is in the class of drugs called human B-type natriuretic peptides? a) Milrinone (Primacor) b) Bosentan (Tracleer) c) Nesiritide (Natrecor) d) Digoxin (Lanoxin)
C
Which electrolyte imbalance can precipitate digoxin toxicity? a) Hyponatremia b) Hypernatremia c) Hypokalemia d) Hyperkalemia
B
Which is classified as an antiplatelet agent? a) Alteplase (Activase) b) Clopidogrel (Plavix) c) Warfarin (Coumadin) d) Enoxaparin (Lovenox) e) Phytonadione (Mephyton)
C
Which is the result of positive inotropic activity? a) Decreased heart rate b) Increased conduction velocity c) Increased cardiac output d) Increased pre-load
D
You are caring for a patient who is taking an adrenergic bronchodilator. In what disease process should adrenergic bronchodilators be used cautiously? a) Liver failure b) Respiratory failure c) Renal failure d) Heart failure