Exam 2
A patient with variant angina wants to know why a beta blocker cannot be used to treat the angina. Which response by the nurse is correct?
"Beta blockers do not help relax coronary artery spasm."
A nursing student is helping to care for a patient who takes verapamil for stable angina. The nurse asks the student to explain the purpose of verapamil in the treatment of this patient. Which statement by the student indicates a need for further teaching?
"It relaxes coronary artery spasms."
A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis asks the nurse why the patient must take heparin rather than warfarin. Which response by the nurse is correct?
"The onset of warfarin is delayed."
A nurse is discussing the use of cocaine as a local anesthetic with a nursing student. Which statement by the student indicates understanding of this agent?
"Vasoconstrictors should not be used as adjunct agents with this drug."
A patient with diabetes develops hypertension. The nurse will anticipate administering which type of medication to treat hypertension in this patient?
ACE inhibitors
A patient with asthma and depression develops stable angina. In addition to organic nitrites, which other medications will be used to treat this condition?
ACE inhibitors, Antiplatelet drugs, Calcium channel blockers, Cholesterol-lowering drugs
Which medications are included in first-line therapy for heart failure?
Agents that inhibit the renin-angiotensin-aldosterone system (RAAS), Beta blockers, Diuretics
Which side effects are more common in second-generation antipsychotic medications than in first-generation antipsychotic medications?
Agranulocytosis, Anticholinergic effects, Metabolism by CYP3A4
A patient has heart failure and is taking an ACE inhibitor. The patient has developed fibrotic changes in the heart and vessels. The nurse expects the provider to order which medication to counter this development?
Aldosterone antagonist
Which are expected effects of cardiac glycosides?
Decreased heart rate, Modulation of neurohormonal systems, Positive inotropic effects
A patient with bipolar disorder has been taking lithium [Lithobid] for several years. The patient has developed a goiter, and serum tests reveal hypothyroidism. What will the nurse expect the provider to order for this patient?
Administration of levothyroxine
The nurse is caring for a pregnant patient who is in labor. The woman reports having had mild preeclampsia with a previous pregnancy. The nurse notes that the woman has a blood pressure of 168/102 mm Hg. The nurse will contact the provider to request an order for which drug?
Angiotensin-converting enzyme (ACE) inhibitor
A patient is admitted to the hospital with unstable angina and will undergo a percutaneous coronary intervention. Which drug regimen will the nurse expect to administer to prevent thrombosis in this patient?
Aspirin, heparin, abciximab [ReoPro]
A prescriber has ordered propranolol [Inderal] for a patient with recurrent ventricular tachycardia. The nurse preparing to administer this drug will be concerned about what in the patient's history?
Asthma
Which two classes of antidysrhythmic drugs have nearly identical cardiac effects?
Beta blockers and calcium channel blockers
The potassium-sparing diuretic spironolactone [Aldactone] prolongs survival and improves heart failure symptoms by which mechanism?
Blocking aldosterone receptors
A patient who has been taking an SSRI tells the nurse that the drug has caused reduced sexual performance, weight gain, and sedation. The nurse will suggest that the patient ask the provider about using which drug?
Bupropion [Wellbutrin]
A nurse is screening a patient being admitted to the hospital. The patient reports being fired for drinking at work. On further questioning, the patient reveals a history of daily alcohol consumption of more than six packs of beer each day, regular morning drinking, and several unsuccessful attempts to stop drinking. The nurse detects alcohol on the patient's breath. The nurse will inform the provider of these findings and request an order for which medication?
Chlordiazepoxide [Librium]
A patient who has recurrent migraine headaches is prescribed sumatriptan [Imitrex]. Which aspect of this patient's history is of concern when taking this drug?
Coronary artery disease
Which side effects of opioid analgesics can have therapeutic benefits?
Cough suppression
A patient will begin taking dabigatran etexilate [Pradaxa] to prevent stroke. The nurse will include which statement when teaching this patient?
Dabigatran should be taken on an empty stomach to improve absorption.
A nurse in a mental health hospital finds a patient with schizophrenia who takes haloperidol [Haldol] lying rigid in bed with a temperature of 41.3°C. A cardiac monitor shows cardiac dysrhythmias. What will be included in the treatment of this patient? (Select all that apply.)
Dantrolene, Intravenous fluids, Withdrawal of haloperidol
Which drugs are used to prevent migraine headaches? (
Divalproex [Depakote], Amitriptyline [Elavil], Timolol
A surgical patient is receiving succinylcholine [Anectine] with an inhalation anesthetic. The patient is intubated, has an indwelling urinary catheter, and has ongoing monitoring of vital signs. Which symptom during the perioperative period is cause for concern?
Elevated temperature
A postoperative patient reports pain in the left lower extremity. The nurse notes swelling in the lower leg, which feels warm to the touch. The nurse will anticipate giving which medication?
Enoxaparin [Lovenox]
Partially correct 0.67 points out of 2.00 Not flaggedFlag question Question text Which sedative-hypnotics are useful for both difficulty falling asleep and difficulty maintaining sleep?
Eszopiclone [Lunesta], Flurazepam [Dalmane], Extended-release zolpidem [Ambien CR]
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?
Facial flushing, Gastric upset, Itching
A patient asks the nurse what can be given to alleviate severe, chronic pain of several months' duration. The patient has been taking oxycodone [OxyContin] and states that it is no longer effective. The nurse will suggest discussing which medication with the provider?
Fentanyl [Duragesic] transdermal patch
A patient arrives in the emergency department acutely intoxicated and difficult to arouse. The patient's friends tell the nurse that the patient took a handful of diazepam [Valium] pills while at a party several hours ago. The nurse will expect to administer which drug?
Flumazenil [Romazicon]
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?
Furosemide [Lasix]
Which two-drug regimen would be appropriate for a patient with hypertension who does not have other compelling conditions?
Hydrochlorothiazide and nadolol
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?
Increased anticoagulant effects
A patient asks a nurse why he cannot use digoxin [Lanoxin] for his heart failure, because both of his parents used it for HF. The nurse will explain that digoxin is not the first-line therapy for which reason?
It does not correct the underlying pathology of heart failure.
A patient is admitted to a hospital for treatment for first-time symptoms of mania and is exhibiting euphoric mania. Which medication will the provider order?
Lithium [Lithobid]
A postoperative patient is reporting pain as a 7 on a scale from 1 to 10, with 10 being the worst pain. The nurse caring for the patient assesses vital signs of HR, 76; RR, 16; and BP, 110/70. The patient has vomited twice. Which postoperative medications will the nurse expect to administer?
Morphine and ondansetron [Zofran]
A patient with hypertension will begin taking an alpha1 blocker. What will the nurse teach this patient?
Move slowly from sitting to standing when taking this drug.
A patient who has undergone treatment for alcoholism several times, with relapse occurring shortly after each treatment, has just completed detoxification. The patient requests a medication to help maintain abstinence. Which drug will the nurse expect the provider to prescribe?
Naltrexone [ReVia]
A patient is taking digoxin [Lanoxin] and develops a dysrhythmia. The nurse reports this finding to the prescriber, who will most likely order what?
Phenytoin [Dilantin]
A patient in the emergency department is given intravenous diazepam [Valium] for seizures. When the seizures stop, the nurse notes that the patient is lethargic and confused and has a respiratory rate of 10 breaths per minute. The nurse will expect to administer which of the following?
Respiratory support
A patient taking gemfibrozil [Lopid] and rosuvastatin [Crestor] concurrently begins to complain of muscle aches, fatigue, and weakness. What should the nurse monitor?
The patient's creatinine kinase levels Correct
A patient who has a history of asthma experiences three or four migraine headaches each month. The patient uses sumatriptan [Imitrex] as an abortive medication and has developed medication overuse headaches. The patient asks the nurse what can be done to prevent migraines. The nurse will suggest that the patient discuss which preventive medication with the provider?
Topiramate [Topamax]
A patient who travels frequently for business reports occasional instances of being unable to fall asleep. The patient tells the nurse that job demands require staying up late and then getting up early for meetings. The nurse expects that the provider will prescribe which medication for this patient?
Zaleplon [Sonata]
A nurse is assisting a physician who is preparing to suture a superficial laceration on a patient's leg. The physician asks the nurse to draw up lidocaine with epinephrine. The nurse understands that epinephrine is used with the lidocaine to:
prolong anesthetic effects and reduce the risk of systemic toxicity from lidocaine.
A nursing student asks a nurse how beta blockers increase the oxygen supply to the heart in the treatment of anginal pain. The nurse tells the student that beta blockers:
dilate arterioles to improve myocardial circulation.
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:
help relax peripheral arterioles to reduce afterload.
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:
hyperkalemia.
A neonate is born to a patient who reports taking venlafaxine [Effexor XR]. The nurse caring for the infant will observe the infant for:
irritability, tremor, and respiratory distress.
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:
muscle pain.
A patient who is taking warfarin [Coumadin] has just vomited blood. The nurse notifies the provider, who orders laboratory work revealing a PT of 42 seconds and an INR of 3.5. The nurse will expect to administer:
phytonadione (vitamin K1) 1 mg IV over 1 hour.
A patient is receiving heparin postoperatively to prevent deep vein thrombosis. The nurse notes that the patient has a blood pressure of 90/50 mm Hg and a heart rate of 98 beats/min. The patient's most recent aPTT is greater than 90 seconds. The patient reports lumbar pain. The nurse will request an order for:
protamine sulfate.
