Exam 3 Cardiac Meds practice questions

The nurse is reviewing the following lab work on their client: Which medication does the nurse suspect is causing these values? A. Metoprolol B. Spironolactone C. Furosemide D. Dopamine

C. Furosemide Furosemide, a loop diuretic, is a potassium wasting drug. Monitoring our electrolyte imbalance is very important. Another adverse effect is hyperglycemia

A nurse is teaching the family of a client who has Alzheimer's disease about Donepezil. Which of the following statements should the nurse include in the teaching? A. " Donepezil can improve cognitive functioning during the earlier states of the disease"" B. " Donepezil cures the disease process if started at the first recognition of dementia." C. "Donepezil provides long-term several of memory loss int he last phase of the disease." D. " Donepezil accelerates the breakdown of acetylcholine within the clients brain."

A. " Donepezil can improve cognitive functioning during the earlier states of the disease" The nurse should inform the family that donepezil is used to treat the manifestations of mild to severe Alzheimer's disease, it is intended to prolong the clients ability to function in the early states of the disease

The nurse is performing discharge teaching to a client prescribed diltiazem. Which response by the client indicates understanding of teaching? A. " I may notice an elevated heart rate with the medication so I should check my pulses." B. " This medication is used to increase my blood pressure." C. "This medication may cause my airway to feel tight so I should take deep breaths." D. "If I notice a dry, tacky cough I should let the doctor know."

A. " I may notice an elevated heart rate with the medication so I should check my pulses." Diltiazem is a calcium channel blocker, it should lower the BP and HR, but an adverse effect we must watch for is relax tachycardia

A nurse if providing teaching to a clinic with hypertension and type 1 diabetes mellitus who has a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching? A. "I might have difficulty recognizing when my blood sugar is low"" B. " I will have a lower risk of developing an infection while I take this medication." C. " I should be concerned about losing excessive weight while I take this medication ." D. " I could have more problems with high blood sugar while taking this medication."

A. "I might have difficulty recognizing when my blood sugar is low" Metoprolol, a beta-adrenergic blocker, is used to treat hypertension. Because it decreases the heart rate, this common manifestation of hypoglycemia can be masked, and hypoglycemia might become more difficult to recognize. The client should be taught to recognize hypoglycemia by other manifestations such as hunger, nausea, and sweating

A nurse is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse including in the plan of care? (Select all that apply) A. Assess for tinnitus B. report urine output of 50mL/hr is C. Monitor blood potassium levels D. elevate the head of bed slowly before ambulation E. reocoment eating a banana daily

A. Assess for tinnitus C. Monitor blood potassium levels D. elevate the head of bed slowly before ambulation E. reocoment eating a banana daily Incorrect: B. report urine output of 50mL/hr is a urine output of 50mL/hr is within the expected reference range. 30mL/hr or less is a manifestation of dehydration

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? A. facial edema B. Sleepiness C. Peripheral edema

A. Facial edema Losartan, an angiotensin 11 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

The nurse knows these adverse effects are most likely caused by which class of medications? A. Adrenergic B. Cholinergic

B. Cholinergic Cholingeric is the parasympathetic system "rest and digest" Remember SLUDGE

Prior to administering furosemide, it is most important for the nurse to assess for allergies to which medication class? A. aminoglycosides B. sulfonamides C. macrolides D. penicillins

B. sulfonamides Furosemide has very similar chemical makeup to sulfa

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? A. Hyperuricemia B. hypernatremia C. hyperkalemia D. hypoglycemia

A. Hyperuricemia 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

The nurse is administering a loop diuretic to a client with heart failure. It is the most important for the nurse to determine if the patient is also taking which medication? A. Lithium B. acetaminophen C. penicillin D. theophylline

A. Lithium Lithium is a salt, there is potential to cause lithium toxicity with a loop diuretic because they BLOCK salts

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? A. Raisins B. Cabbage C. Cheese D. Eggs

A. Raisins 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 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) A. Rash B. Distorted taste C. swelling of the tongue D. photosensitivity E. dry cough

A. Rash -Captopril, an ACE inhibitor, can cause a persistent rash. This often indicates the need to discontinue drug therapy B. Distorted taste - Captopril can cause distortions in taste sensations and loss of taste which can lead to anorexia and weight loss. his often indicates the need to discontinue drug therapy C. swelling of the tongue -Captopril can cause angioedema, often manifesting as edema of the tongue, pharynx, and glottis. Clients who develop this adverse effect should discontinue the drug and seek medical attention E. dry cough -Captopril can cause a dry cough because of an accumulation of bradykinin. This often indicates the need to discontinue drug therapy

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 bedtime C. Expect increased swelling of the ankles D. Fluid intake should be limited in the morning

A. Take the medication with food The client should take hydrochlorothiazide with or after meals to prevent gastrointestinal upset

A nurse is providing teaching to a client who has a new prescription for lisinopril. Which of the following should the nurse include in teaching as an advisor effect of lisinopril? A. Tongue swelling B. Low potassium level C. Running nose D. Bruising

A. Tongue swelling Angioedema is a fatal response that occurs in about 2% of clients who use ACE inhibitors such as lisinopril. Manifestations of angioedema include swelling of the tongue, lips, or pharynx.

A nurse should recognize that milirone is contraindicated for a client who has which of the following conditions? A. acute myocardial infraction B. peripheral vascular disease C. Ulcerative colitis D. ventricular tachycardia

A. acute myocardial infraction 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 infraction and aortic or pulmonary valve disorders

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? A. grapefruit juice B. Milk C. Foods high in vitamin K D. NSAIDS

A. grapefruit juice grapefruit juice, particularly in large amounts, can cause toxicity f potassium channel blockers, such as amiodarone

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 pf this drug? A. Headache B. Constipation C. Hypertension D. Hyperglycemia

A. headache 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 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? A. hypokalemia B. hypoglycemia C. hypouricemia D. hyponatremia

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

A client who had an MI is newly prescribed a beta-blocker. What is the main benefit of beta-blocker therapy for this situation A. slows the HR B. vasodilation of the coronary artries C. increased forced of cardiac contraction D. increased BP

A. slows the HR Beta-blockers, such as metoprolol, atenolol, carvedilol, and propranolol have negative tropic effects ( lower HR, BP)

A nurse is teaching a client who has a new diagnosis of angina and has a prescription for isosorbide mononitrate 10mg PO twice daily. Which of the following client statements indicates an understanding of the teaching? A. " I can take my second dose of medication no later than 9:00pm" B. " I should change positions slowing when getting out of bed." C. "If I miss a dose, I should double the next dose." D. " I should notify my provider if I experience a headache while taking this medication."

B. " I should change positions slowing when getting out of bed." The nurse should identify that isosorbide mononitrate is an antianginal medication that produces vasodilation. Therefore, this medication can cause orthostatic hypotension. Clients should change positions slowly upon rising to minimize the effects

A nurse is caring for a client who is receiving continuous cardiac monitoring. Which of the following medications should the nurse anticipate administering to treat atrial fibrillation? A. Atropine B. Diltiazem C. Epinephrine D. Phenytoin

B. Diltiazem Diltiazem, a calcium channel blocker, is used to slow the ventricular rate in atrial fibrillation or fuller. Diltiazem is also prescribed to treated hypertension, angina, and other supra ventricular tachyarrhythmias

A nurse is admitting a client who has atrial fibrillation with a heart rate of 155/min. The nurse should anticipate a prescription from the provider for which of the following medications? A. Atropine B. Diltiazem C. Epinephrine D. Vaspressin

B. Diltiazem The nurse should anticipate the provider to prescribe diltiazem for the client who is experiencing atrial fibrillation. Diltiazem is an anti arrhythmic agent that reduces the ventricular rate in atrial fibrillation

A nurse is admitting a client who has unstable angina. Which of the following medications should the nurse anticipate administering to the client? A. Epinephrine B. Nitroglycerin C. Lidocaine D. Atropine

B. Nitroglycerin The nurse should anticipate administering nitroglycerin to a client who has unstable angina. This medication acts by relaxing or preventing spasms in the coronary arteries along with dilating the arteries, which increases oxygenation and blood flow

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? A. Sodium 140 mEq/L B. Potassium 5.3 mEq/L C. Chloride 100 mEq/L D. Magnesium 1.9 mEq/L

B. Potassium 5.3 mEq/L 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 client is mowing his lawn on a hot Saturday afternoon and begins to have chest pain. What should his first action be? A. take his sublingual nitroglycerin B. stop moving and sit or lie down C. go inside the house to cool off D. Call 911

B. stop moving and sit or lie down After sitting, we would take our nitro if angina persist, it can be taken in 3 doses 5 minutes apart. After the first dose, it angina does not improve, then we should call 911

A nurse is providing teaching to a client with a new diagnosis of heart failure who has a prescription for furosemide. Which of the following statements should the nurse include in the teaching. A. "you can take ibuprofen for headaches while taking this medication." B. " you may experience increased swelling in your lower extremities while taking this medication." C. " You should eat foods that are high in potassium while taking this medication" D. " You should take this medication at bedtime."

C. " You should eat foods that are high in potassium while taking this medication" The nurse should instruct this client who has a prescription for furosemide to consume foods that are high in potassium. Furosemide is a high-celling loop diuretic that depletes potassium, sodium, chloride, magnesium, and water.

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) A. " Apply a new patch at the onset of anginal pain." B. "Apply the patch to dry skin and cover the area with plastic wrap." C. "Apply the patch to a hairless area and rotate sites." D. "Apply a new patch when your start your day." E. " Remove patches for 10 to 12 hours each day."

C. "Apply the patch to a hairless area and rotate sites." D. "Apply a new patch when your start your day." E. " Remove patches for 10 to 12 hours each day."

A nurse is providing teaching to a client about a new prescription for captopril to treat hypertension. Which of the following client statements indicates an understanding of the teaching? A. " I might have a sore throat that will go away after a few days" B. " I will take this medication with food to avoid getting an upset stomach." C. "I might feel dizzy at times while taking this medication." D. " I will take ibuprofen if I get a fever while taking this medication."

C. "I might feel dizzy at times while taking this medication." Hypotension and dizziness are potential adverse effects if this medication. The nurse should monitor the clients blood pressure and instruct the client to change positions slowly

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? A. Acetylcysteine B. Flumazenil C. Antigen-binding fragments D. Deferoxamine

C. Antigen-binding fragments 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 monitoring a client who is receiving spironolactone. Which of the following should the nurse report to the provider? A. blood sodium 144 mEq/L B. Urine output 120mL in 4 hr C. Blood potassium 5.2 mEq/L D. blood pressure 149/90 mm Hg

C. Blood potassium 5.2 mEq/L blood potassium of 5.2 mEq/L indicates hyperkalemia. Because spironolactone causes potassium, retention, withhold the medication and notify the provider

The client who was mowing his lawn in now sitting down and continues to experience chest pain. When should he call 911? A. Immediately B. if the pain becomes more severe C. If one SL table does not relieve the pain after 5 minutes

C. If one SL table does not relieve the pain after 5 minutes

A nurse is caring for a client who has a prescription for hydrochlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? A. Thrombophlebitis B. Hyperactive reflexes C. Muscle weakness D. Hypoglycemia

C. Muscle weakness Hydrochlorothiazide is a thiazide diuretic used to treat hypertension and CHF. It promotes the exertion of water, sodium, and potassium and can cause hypokalemia. Manifestations of hypokalemia include muscle weakness, muscle cramps, and dysrhythmias.

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

C. NSAIDs 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 assessing a client who has been taking amiodarone for 6 months. Which adverse will the nurse monitor for? A. Glycosuria B. Dysphagie C. SOB D. Urticaria

C. SOB A rare adverse effect of amiodarone, an antidysrhythmic drug, is pulmonary toxicity

A nurse is caring for a client who has heart failure and is taking oral furosemide 40mg daily. For which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs A. Nasal congestion B. Tremors C. Tinnitus D. Frontal headache

C. Tinnitus Loop diuretics such as furosemide can cause ototoxicity. The client should be taught to notify the provider if tints, a full feeling in the ears, or hearing loss occurs

A nurse is assessing a client who has heart failure and is receiving digoxin. Which of the following findings should indicate to the nurse the client is experiencing digoxin toxicity? A. Suppression of dysrhythmias B. Increased atrioventricular (AV) conduction C. Visual disturbances D. Weight gain

C. Visual distrubances The nurse should recognize that nausea, vomiting, abdominal discomfort, fatigue, and visual disturbances are common manifestations that can indicate that the client is experiencing digoxin toxicity

The nurse is providing discharge teaching to a client taking furosemide. Which instruction is critical for the nurse to include? A. avoid prolonged exposure to the sun B. avoid foods high in potassium content C. contact your primary healthcare provider if you feel dizzy or weak D. weigh yourself once a week and report a gain/loss of more than 5 pounds

C. contact your primary healthcare provider if you feel dizzy or weak furosemide may cause electrolyte imbalance, such as hyponatremia, hypochloremia, hypokalemia, and dehydration. A sign of low potassium is dizziness or lightheadedness

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? A. Migraine headaches B. pancreatitis C. second-degreee AV block D. Angina pectoris

C. second-degreee AV block Verapamil a calcium channel blocker, can affect AV conduction and is contraindicated for clients who have sic 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

Which client is the best candidate to receive milrinone therapy? A. a client with atrial fibrillation who has not responded to other medications B. a patient with heart failure who is initiating treatment for the first time C. a patient with coronary ischemia who has reduced cardiac output D. a patient with acute decompensated heart failure who has dyspnea at rest

D. a patient with acute decompensated heart failure who has dyspnea at rest Milrionone is an phosphodiesterase inhibitor. It is a short term HF drug that requires intense supervision. It has a positive intrepid effect and causes vasodilation

A nurse is providing teaching for a client who has a new prescription for nitroglycerin administered through transdermal patch. Which of the following client statements indicates an understanding of the teaching? A. " I need to wear the patch continuously for it to be effective." B. " I will stop using the patch immediately if it gives me a headache." C. " I should change the patch whenever I have chest pain." D. " I need to rotate the location of my patch every few days."

D. " I need to rotate the location of my patch every few days." The nitroglycerin patch should be coated to different hairless areas of the clients body every few days to avoid local skin irritation

A nurse is providing discharge teaching to a client who has heart failure and a prescription for digoxin 0.125mg PO daily. Which of the following statements by the client indicates an understanding of the teaching? A. " I know that blurred vision is expected to happen while I'm taking digoxin." B. " I will measure my urine output each day and document it in my diary." C. " I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute." D. " I will eat fruits and vegetables that have a high potassium content each day."

D. " I will eat fruits and vegetables that have a high potassium content each day." Hypokalemia is an adverse effect of diuretic therapy. Because the client is taking digoxin, it is important to maintain a potassium level between 3.5-5 mg/dL to avoid digoxin toxicity

A nurse is providing teaching to a client who has heart failure and is taking spironolactone. Which of the following statements by the client indicates an understanding of the teaching? A. " I will increase my intake of citrus fruits, bananas, and potatoes." B. " I will use salt substitutes on my food." C. " I will drink as much water as I can while taking this medication." D. " I will watch for increased breast tissue growth while taking this medication."

D. " I will water for increased breast tissue growth while taking this medication." Spironolactone, which is derived from steroids, can cause adverse endocrine effects, such as gynecomastia, impotence in med, and irregular menses and hirsutism in women

Before administering oral digoxin, the nurse notes that the CNA charted the patients radial pulse as 52 bpm. What is the nurses next action? A. give the dose B. delay the dose until later C. hold the dose and notify the physician D. Check the apical pulse for 1 minute

D. Check the apical pulse for 1 minute The CNA stated the patients RADIAL pulse was 52. We should ALWAYS check the apical pulse for 1 full minute before administering

A nurse is caring for a client who has CHF and is taking digoxin. The client reports nausea and refuses to eat breakfast. Which of the following actions should the nurse take first? A. Encourage the client to eat the toast on the breakfast tray B. Administer an antiemetic C. Inform the clients provider D. Check the clients apical pulse

D. Check the clients apical pulse Nausea, anorexia, fatigue, visual effects and cardiac dysrhythmias are possible findings in digoxin toxicity.

The nurse suspects toxicity of which medication? A. Lisinopril B. losartan C. Nitroglycerin D. Digoxin

D. Digoxin An adverse effect of digoxin toxicity includes halo vision, and dysrhythmias

A nurse is caring for a client with benign prostatic hyperplasia who has a new prescription for doxazosin. Which of the following manifestations should the nurse monitor for as an adverse effect of doxazosin? A. Seizures B. Tachycardia C. Bronchodilation D. Hypotension

D. Hypotension Nonselective alpha1-adrenergic antagonists like doxazosin block sympathetic receptors in the blood vessels as well as receptors in the bladder. These agents promote vasodilation, which can cause decreased blood pressure

A client is experiencing a hypertensive crisis is in the emergency department. Which form of nitroglycerin is most appropriate for this? A. Sublingual spray B. transdermal patch C. oral capsule D. IV infusion

D. IV infusion

The nurse administers epinephrine and obtains the following vital sings on their assigned client: What medication effect on the heart is this client likely experiencing? A. Negative inotropy B. Postive inotropy C. Negative chronotropy D. Postive chronotropy

D. Postive chronotropy From the image, there would not be a way for us to determine the contraction, therefore we have a positive chronotropy ( increased HR) effect

A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client? A. Dextromethorphan B. Montelukast C. Ciprofloxacin D. Propranolol

D. Propranolol The nurse should identify that a client who is experiencing an acute asthma exacerbation requires the use of a beta2-agonist to alleviate bronchospasm and relax the client's airway. Therefore, propranolol is contraindicated for this client. Propranolol is a beta-blocker that is used to treat cardiac conditions, including hypertension. Blocking the beta receptors prevents the action of beta2-agonists such as albuterol.

A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects? A. Hypotension B. Hyperthermia C. Hypoglycemia D. Tachycardia

D. Tachycardia Adverse effects of epinephrine, an adrenergic agonist, can include tachycardia and dysrhythmias due to cardiac stimulation

A nurse is caring for a client who has a glomerular filtration rate of 10mL/min and a reduced urine output. The nurse should clarify a prescription for hydrochlorothiazide because of which of the following characteristics of the drug? A. The drug can cause hypoglycemia in clients who have a low urine output B. the drug does not reduce blood pressure for clients who have a low urine output C. the drug can increase the risk of pulmonary edema for clients who have renal insufficiency D. The drug does not promote diuresis for clients who have renal insufficiency

D. The drug does not promote diuresis for clients who have renal insufficiency Adequate kidney function is essential for clients who take hydrochlorothiazide, a thiazide diuretic, to promote urine production and effective excretion

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? A. Hyperglycemia B. bradycardia C. hypotension D. hypoglycemia

D. hypoglycemia These are two factors that increase the clients 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 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? A. Tachycardia B. dehydration C. diarrhea D. hypotension

D. hypotension Large amounts of grapefruit juice can increase blood levels of verapamilby 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