NUR 203 Quiz 2
For which clinical manifestation should the nurse assess in a client with heart failure? (Select all that apply.) A. Peripheral edema B. Hypotension C. Pulmonary congestion D. Fatigue E. Dyspnea on exertion
A,C,D,E
A client continues to have chest pain after the first dose of sublingual (SL) nitroglycerin. Which standard protocol should the nurse follow? A. Administer another sublingual tablet in 5 minutes B. Wait 15 minutes and administer two more sublingual tablets C. Wait 3 minutes and reevaluate pain using a pain scale D. Administer atropine at 10 minutes if pain has not subsided
A
A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor immediately following an acute myocardial infarction (MI). For which reason should the nurse realize that this dose was prescribed? A. Reduce risk of mortality. B. Increase arterial pressure. C. Lower cardiac output. D. Increase preload to the heart.
A
An older client with a dysrhythmia asks why the first dose of an antidysrhythmic medication is being given at bedtime. Which reason should the nurse provide? A. Risk of hypotension as a first-dose effect B. Metabolizes better when in the supine position C. Sedative properties D. Causes confusion
A
Which adverse effect of lisinopril (Prinivil) should be reported to the healthcare provider? A: cough B: increase urine output C: facial flushing D: fever
A
Which adverse effect should the nurse monitor a client for that is prescribed an antidysrhythmic? A. Palpitations, chest pain, weakness, and fatigue B. Anorexia, insomnia, confusion, and 2+ pitting peripheral edema C. Depression, irritability, fatigue, and nausea D. Low-grade fever, diaphoresis, weakness, and dry mucous membranes
A
Which client has the greatest risk for developing heart disease? A: A 68-year-old with stage 2 hypertension and recent myocardial infarction B: A 35-year-old with diabetes mellitus and prehypertension C: A 75-year-old with Parkinson's disease and normal blood pressure D: A 52-year-old with osteoporosis and stage 1 hypertension
A
Which route of administration should the nurse anticipate to use for a client's prescribed enoxaparin (Lovenox)? A.Administer the prescription into the abdomen, subcutaneously. B.Administer the prescription intramuscularly into the thigh. C.Administer the prescription orally. D.Administer the prescription via slow intravenous (IV) push
A
Which vital sign is of the greatest concern to the nurse prior to administering digoxin (Lanoxin)? A: apical pulse B: respiratory rate C: blood pressure D: temperature
A
Which statements should the nurse include in the teaching for a client prescribed warfarin (Coumadin) therapy? A. "Inform your dentist you are taking warfarin prior to any procedures." B. Report to the lab for testing of activated partial thromboplastin time (APTT)." C. Avoid strenuous activities." D. Place ice at the injection site if stinging or burning occurs." E. Take nonsteroidal anti-inflammatories (NSAIDs) for minor pain relief."
A and C- Warfarin increases the risk of bleeding from dental procedures. Strenuous or risky activities place the patient at risk for injury and bleeding
A client with Parkinson's disease is experiencing an increase in bradykinesia. Which assessment findings should the nurseanticipate?A: slow speech B: difficulty chewing C: shuffling feet when walking D: stooped posture E: lack of facial expression
A, B, C
Which conditions contribute to heart failure? A: uncontrolled hypertension B: coronary artery disease C: diabetes D: HIV E: mitral stenosis
A, B, C, E
Which findings should the nurse anticipate when assessing a client developing right-sided heart failure?A: ankle edema B: enlarged liver C: displaced apical heart rate D: shortness of breath E: coughing
A, B, C- Shortness of breath and coughing are symptoms associated with left-sided heart failure.
Which statements by the client are specifically associated with unstable angina? A: My chest has started hurting even if I am just watching television." B: "My chest starts hurting if I climb one set of stairs." C: "My attacks of chest pain are more frequent D: the pain occurs after I eat a meal E: the pain is worse than it use to be
A, C, E- pain that is predictable is usually stable angina
Which statements made by the client indicate an understanding of the compensatory mechanisms associated with heart failure? A:"My heart enlarged in order to compensate for the effects of heart failure." B: "My nervous system kicks in to compensate for the effects of heart failure." C: "My body will decrease blood flow to other organs in order to compensate for heart failure." D:"My body will increase urine output in order to compensate for the effects of heart failure." E: "My body will produce anti-inflammatory agents to compensate for heart failure
A,B,C
Which information should the nurse include the teaching for a client prescribed heparin? A. Self-administration of subcutaneous injections. B Symptoms of deep vein thrombosis. C. Required laboratory tests. D. Signs of abnormal bleeding. E Scheduled administration times with meals.
A,B,C,D
Which information should the nurse include when educating a client about coronary artery disease? A: Plaque causes narrowing of artery B: Plaque begins to accrue early in life C: Plaque causes narrowing of the veins D: Plaque affects the elasticity of the artery E: Plaque builds up in the myocardial tissue
A,B,D
Which prescriptions does the nurse anticipate to be included in the goal to reduce the post-MI mortality of a client? A: aspirin B: beta blockers C: narcotic analgesics D: ACE inhibitors E: antidysrhythmics
A,B,D
The nurse is explaining the action of an antianginal medication to a client. Which information should the nurse include? (Select all that apply.) A. Dilates veins so the heart receives more blood B. Blocks myocardial receptors to prevent increased afterload C. Lowers blood pressure D. Slows heart rate E. Causes the heart to contract with less force
A,C,D,E
Which lifestyle behaviors should the nurse discuss with a client to help reduce their risk of coronary arterydisease? A: abstinence from smoking B: decrease stress C: limit alcohol consumption D: maintain optimal weight E: limit sodium intake
A,C,E
A client is demonstrating signs of heart failure. Which disorders should the nurse suspect as a possible etiology? (Select all that apply.) A. Mitral stenosis B. Chronic hypotension C. Chronic renal failure D. Diabetes mellitus E. Coronary artery disease
A,D,E
Which adverse effect is shared among all antidysrhythmic drugs? A. Prodysrhythmic effects B. Impotence C. Photosensitivity D. Edema
A- All antidysrhythmic agents can worsen existing dysrhythmias or create new ones.
Depolarization occurs when which two electrolytes rush into the cell? A: calcium and sodium B: chloride and potassium C: calcium and magnesium D: sodium and potassium
A- An action potential begins when sodium and calcium flow into the cell, resulting in depolarization
A client with a dysrhythmia asks the nurse why they cannot take a prescription instead of have cardioversion for treatment? Which response should the nurse provide the client? A: Antidysrhythmic prescriptions have many side effects; cardioversion is considered safer." B: Special diets are necessary with antidysrhythmic prescriptions, and they are hard to follow. C: Antidysrhythmic prescriptions don't really work very well for most dysrhythmias D: There is a high risk of seizures when you take antidysrhythmic prescriptions
A- Antidysrhythmic medications can cause serious side effects and are normally reserved for patients with overt symptoms or for patients whose condition cannot be controlled by other means, such as cardioversion.
The nurse has completed the education for a client prescribed propranolol (Inderal). Which statement by the client indicates an understanding of the information? A. "I will take my pulse every day and call my healthcare provider if it is less than 60." B. I will call my healthcare provider if my anxiety increases and I start worrying again." C. I will take my pulse every day and call my healthcare provider if it is higher than 100." D. "I will call my healthcare provider if I lose more than 3 pounds a week."
A- Beta blockers decrease contractions of the myocardium and decrease the speed of conduction through the atrioventricular (AV) node. This can result in a significant decrease in heart rate, and the client should notify the healthcare provider if their heart rate falls below 60.
The nurse notes that a client receiving warfarin (Coumadin) has a high international normalized ratio (INR). Which question should the nurse include in the assessment? A: Do you eat a lot of garlic B: are u restricting ur fluids C: have u been eating a lot of salads and veggies D: do you drink a lot of milk
A- Garlic has been shown to decrease the aggregation of platelets, thus producing an anticoagulant effect.
Which food should the nurse instruct the client prescribed warfarin (Coumadin) to avoid? A: tomato salad w kale and basil B: fettuccine alfredo C: salt substitute D: whole wheat bread w margarine
A- Kale is high in vitamin K and must be avoided when a client receives warfarin.
Which is the most serious adverse effect associated with milrinone (Primacor)? A: ventricular dysrhythmia B: nausea C: headache D: atrial dysrhythmia
A- Milrinone is a phosphodiesterase inhibitor that can cause ventricular dysrhythmias
Which is the priority outcome for the client with type 1 diabetes mellitus prescribed propranolol (Inderal)? A. The client will maintain blood glucose within normal limits. B. The patient will perform activities of daily living. C. The client will decrease the required number of calories/day. D. The client will maintain adequate peripheral circulation.
A- Propranolol should be used cautiously in clients with type 1 diabetes mellitus due to the hypoglycemic effects
Which is a priority assessment for the client receiving reteplase (Retavase) intravenously? A: abnormal bleeding B: fluid balance C: respiratory rate D: blood glucose
A- Reteplase is used to dissolve blood clots. The most serious adverse effect of reteplase is abnormal bleeding
Which is the purpose of the AV node? A: delay impulse from SA node B: enhance impulse from SA node C: pace the heart at 40-60 bpm D: pace heart at 60-100
A- The AV node delays the impulse as it travels from the atria to the ventricle
Which information about the primary therapeutic action of an antianginal prescription should the nurse include in client teaching? A: "The prescription decreases how much oxygen your heart needs." B: "This prescription will thin your blood so your heart receives more oxygen." C: "This prescription increases the oxygen to your heart by increasing nitric oxide production." D: "This prescription increases the amount of oxygen your heart receives."
A- decrease the frequency of angina episodes by reducing the myocardial demand for oxygen.
The nurse has provided education about dysrhythmias for a group of clients. Which statement made by a client indicates an understanding of the information? A: "The sodium, potassium, and calcium levels must be okay for the heart to have an electrical impulse." B: "The sodium, potassium, and magnesium levels must be okay for the heart to have an electrical impulse." C: "Potassium is the most important electrolyte when it comes to the electrical impulse in the heart." D: "Enhancing potassium and sodium is how our prescriptions will work to prevent dysrhythmias."
A- "Enhancing potassium and sodium is how our prescriptions will work to prevent dysrhythmias."
Which laboratory study is used to evaluate the proper dosage for heparin therapy? A: aPtt B: serum heparin levels C: sedimentation rate D: complete blood count
A-: aPtt is used to help identify the correct dosage of heparin therapy for the client
The nurse has provided education for a client with diabetes mellitus prescribed metoprolol (Lopressor) for hypertension. Which statement made by the client indicates an understanding of the information? A: "I might need less insulin when I take metoprolol (Lopressor)." B: "I might be able to change from insulin to a pill with metoprolol (Lopressor)." C: "I might need more insulin when I take metoprolol (Lopressor)." D: "I might not need to check my blood sugars as often with metoprolol (Lopressor).
A: Metoprolol may enhance the hypoglycemic effects of insulin and oral hypoglycemic agents, so the client might require less insulin.
A client prescribed furosemide (Lasix) and digoxin (Lanoxin) reports using an over-the-counter antacid for recurrent heartburn. Based on this information, which effect should the nurse be concerned about? A: Decreased effectiveness of digoxin (Lanoxin) B: Increased effectiveness of furosemide (Lanoxin) C: Hypermagnesemia D: Hyponatremia
A: antacids may decrease digoxin
Which prescription should the nurse anticipate will most likely prescribed for a client with Alzheimer's disease? A.Donepezil hydrochloride (Aricept) B.Levodopa (Larodopa) C. Benztropine mesylate (Cogentin) D.Haloperidol (Haldol
ALevodopa/Benztropine is used for Parkinsons
A client who is taking sublingual nitroglycerin asks how the medication works so quickly. Which response should the nurse provide? A. "Vasodilation occurs, relaxing both arteries and veins." B. "Coronary arteries dilate, which relaxes spasms, allowing more blood to flow to the myocardium." C. "Receptors are blocked in the heart, slowing the heart rate." D. "Dysrhythmias are quickly suppressed, while oxygen saturation in the heart is increased."
B
The nurse is caring for a client with a DVT (deep vein thrombosis) receiving heparin intravenously (IV). Which is the priority outcome for the client? A.The client will comply with dietary restrictions. B.The client will not experience bleeding C.The client will not disturb the intravenous infusion. D.The client will keep the right leg elevated on two pillows.
B
The nurse is preparing to administer nitroglycerine via the intravenous route. Which should the nurse do prior to the administration of the prescription? A: Darken the room to decrease light exposure. B: Cover the intravenous (IV) bottle to decrease light exposure. C: Use gloves to prevent self-administration. D: Instruct the client to avoid moving the arm in which the prescription is infusing.
B
The nurse notes the blood pressure and red blood cell (RBC) count of a client receiving heparin is low. Which should the nurse suspect has occurred? A: clot formation B: internal bleeding C: dehydration D: decreased activated partial thromboplastin time (aPTT
B
Which additional prescribed treatment should the nurse anticipate for the client prescribed heparin therapy? A: Advil prn for headaches B: obtaining aPTT C: weekly weights D: low vitamin K diet
B
Which client prescribed metoprolol (Toprol-XL) is most risk for adverse effects? A: The client with an apical pulse rate of 100 B: The client with chronic bronchitis C: The client with compensated heart failure D: The client with a history of migraines
B
Which describes the primary action of anticoagulant therapy? A: decrease prothrombin time B: prevent formation of blood clots C: increase number of platelets D: dissolve blood clots
B
Which should the nurse anticipate to be included in the treatment plan for a client with stage A heart failure? A: beta blocker B: lifestyle modifications C: cardiac glycoside D: angiotensin converting enzyme inhibitor
B
The client tells the nurse, "My healthcare provider says I have atrial fibrillation. Is this serious and how is it treated?" Which responses should the nurse provide the client? A: "This condition is best treated with what we call antidysrhythmic drugs." B: "This is very common; your doctor will discuss the best treatment with you." C: "Depending on your symptoms, your healthcare provider may use an electrical shock." D: "This is quite serious; did your healthcare provider discuss a heart transplant?" E: "It is very serious, even more serious than a ventricular dysrhythmia."
B and C- atrial fibrillation is the most common dysrhythmia
Which classifications of prescriptions are used to increase cardiac output by increasing the force of myocardial contractions? A: Angiotensin receptor blockers B: Cardiac glycosides C: Adrenergic blockers D: Phosphodiesterase inhibitors E: ACE inhibitor
B and D- ARBs and ACEIs increase cardiac output by lowering BP and BV, adrenergic blockers decrease cardiac workload
Which are the goals of antianginal therapy? A: Increased blood flow to the peripheral blood vessels. B: Decreased myocardial oxygen demand C: Decreased oxygen consumption of brain D: Increased blood flow to the myocardium E: Increased myocardial contractility.
B and D- Angina is a mismatch between myocardial oxygen supply and oxygen demand. Basic antianginal strategies are to increase oxygen supply by increasing blood flow to the coronary arteries or to decrease myocardial oxygen demand.
Which conditions is the use of thrombolytic therapy contraindicated in? A: venous emboli B: history of intracranial hemorrhage C: hemophilia D: liver disease E: peptic ulcer disease
B, C, D, E
The patient tells the nurse, "This educational video you gave me shows normal electrical conduction through the heart, but I still don't understand it. Can you explain it to me?" What are the nurse's best responses? A: "Conduction through the bundle of His is the slowest in the heart." B: "Conduction begins in the sinoatrial (SA) node and travels to the atrioventricular (AV) node." C: "Conduction continues through the bundle branches to the Purkinje fibers." D: "Conduction travels from the atrioventricular (AV) node through the bundle of His." E: The sinoatrial (SA) node is located in the left atrium."
B, C, D- conduction through AV node is slowest and SA node is in the RA
Which information should the nurse include in the education for a client prescribed antianginal therapy? A: The prescriptions increase heart rate B: The prescriptions dilate the veins so the heart receives less blood C: The prescriptions cause heart to contract with less force D: The prescriptions increase BPE: The prescriptions increase ability of body to produce RBCs
B,C
A client is recovering from myocardial infarction (MI). Which laboratory value should the nurse monitor for changes? (Select all that apply.) A. Partial prothrombin time (PPT) B. Creatinine kinase-MB (CK-MB) C. Total creatinine kinase (CK) D. Troponin E. High-density lipoprotein (HDL)
B,C,D
Which should the client be instructed to avoid when prescribed an anticoagulant? A: citrus fruits B: alcohol C: contact sports D: prolonged sitting E: hard toothbrush
B,C,D,E
The nurse is preparing to administer a medication to a client with a dysrhythmia. Which should the nurse recall as the function of cardiac medications in the treatment of dysrhythmias? (Select all that apply.) A. Increase the amount of sodium B. Alter autonomic activity C. Reduce the amount of calcium D. Alter conduction E. Change the level of potassium
B,D
Which current prescription should the nurse be concerned with for the client newly prescribed amiodarone (Cordarone)? A: oxycodone B: warfarin C: omeprazole D: fluoxetine
B- Amiodarone can block the metabolism of warfarin.
Which is the most sensitive and effective biomarker of a myocardial infarction? A. Creatine kinase B. Troponin C: White blood cells D: Myoglobin
B- Troponin is a cardiac-specific and the most sensitive and effective biomarker after a myocardial infarction.
Which prescription should the nurse anticipate to increase the myocardial contractility for a client with heartfailure? A: lisinopril B: digoxin C: carvedilol D: furosemide
B- cardiac glycosides increase cardiac output by increasing contractionLisinopril (ACE inhibitor) lowers peripheral resistance and blood volume; carvedilol (beta blocker) lowers HR; furosemide (diuretic) lowers blood volume
Which information should the nurse include in the discharge plan for a client prescribed digoxin (Lanoxin)? A: "If you miss a dose, take two doses." B: "Report mental changes such as feelings of depression." C: "Report the development of a metallic taste in the mouth." D: "Stop the prescription if your pulse is irregular."
B- digoxin may result in depression
Which statement is accurate regarding the physiological changes associated with heart failure? A: Blood backs up into the lungs due to right ventricular hypertrophy. B: Cardiac remodeling occurs after prolonged ventricular hypertrophy. C: Blood pressure increases, resulting in lowered afterload. D: The walls of the heart shrink, leading to lower cardiac output.
B- heart walls thicken/enlarge w HF this is referred to as cardiac remodeling
The nurse is preparing to provide education for a client prescribed carbidopa (Sinemet). Which information should the nurse include? A: avoid caffeinated drinks B: take on empty stomach C: take w meals D: take w protein food
B: for better absorption
Which assessment finding in an older adult prescribed levodopa (Stalevo) should the nurse be most concerned with? A: Diarrhea B: Muscle twitching C: hypertension D: dark urine
B: may indicate toxicity
Which client should the nurse anticipate a prescription for reteplase (Retavase) therapy post myocardia linfarction? A: A 45-year-old female with a 2-week-old cranial artery repair B: A 70-year-old male with active GI bleed C: A 54-year-old female with type 2 diabetes D: A 62-year-old with a recent hemorrhagic stroke
C- Contraindications for reteplase therapy include a history of CVA (stroke), recent surgical procedure, and active bleeding.
A client experiences steady, intense, crushing chest pain. Which health problem should the nurse suspect? A. Coronary artery disease B. Myocardial infarction C. Angina pectoris D. Myocardial ischemia
C
A client is diagnosed with stage C heart failure (HF). Which medications should the nurse recognize as most effective in treating this stage of the disease? A. IV nitrogen B. Phosphodiesterase inhibitor C. IV diuretic D. Anticoagulant
C
A client receiving diltiazem (Cardizem) asks the nurse why they get a headache after taking the prescription. Which response should the nurse provide the client? A."Diltiazem (Cardizem) increases prostaglandin synthesis, giving you the headache." B."Diltiazem (Cardizem) causes the blood vessels in your brain to narrow, giving you the headache." C."Diltiazem (Cardizem) causes the blood vessels in your brain to widen, giving you the headache." D."Diltiazem (Cardizem) releases Substance P, activating pain receptors in your brain and giving you theheadache."
C
A client with coronary artery disease (CAD) asks what causes the health problem. Which explanation should the nurse provide? A. "Your peripheral arteries are blocked so your heart is receiving little blood supply." B."Your heart muscle is too weak to pump an adequate supply of blood." C."A build-up of plaque in your coronary arteries is preventing an adequate blood supply to your heart." D. "Your coronary arteries are overdilated, which is causing your symptoms."
C
The nurse has completed the education for a client with angina prescribed nitroglycerine (Nitrostat). Which statement made by the client indicates further teaching is required? A."I should take a tablet as soon as chest pain occurs. "B."If my pain is not reduced 5 minutes after taking one tablet I should call EMS." C."I can take up to 5 tablets to resolve the chest pain." D."I can take three tablets, one every 5 minutes."
C
The nurse is providing a client education about dysrhythmias. Which statement should the nurse include in theteaching? A: "Dysrhythmias cause serious electrolyte imbalances; this results in heart block." B: "Dysrhythmias are the result of long-standing, uncontrolled hypertension." C: "Dysrhythmias interrupt the normal electrical pathways in the heart so it can't beat properly." D: "Dysrhythmias alter the blood flow through the heart and cause it to stop beating."
C
Which client is at greatest risk for developing heart failure? A: 52-year-old Caucasian female with asthma B: 75-year-old Caucasian male who is overweight C: 69-year-old African American male with hypertension D: 50-year-old African American female who smokes
C
Which information should the nurse include in the education for a client prescribed an antidysrhythmic? A: Elevate your extremities if you notice any swelling." B: Weigh yourself every other day." C: Take the first dose of your prescription before bed." D: Take your medication while you are lying down."
C
Which should the nurse include in the plan of care for the patient with Parkinson's disease? A.Limit exercise to decrease the possibility of fractures. B.Check peripheral circulation for thrombophlebitis. C.Monitor the client for the ability to chew and swallow. D.Monitor the client for psychotic symptoms.
C
The nurse is reviewing the prescription history for a client receiving levodopa (Stalevo). Which routine prescription is mostconcerning? A: Synthroid B: Metformin C: Ca anatacid D: Aspirin
C: calcium antacid can decrease levodopa therapeutic effect
A client in heart failure asks the nurse how difficulty breathing is related to a heart problem. Which information should the nurse provide the client? A."The right side of your heart has weakened and blood has entered your lungs." B."The right side of your heart has enlarged and cannot effectively pump blood." C."What you have is called congestive heart failure." D."The left side of your heart is weak and pumps blood too quickly." E."The left side of your heart has weakened and blood has entered your lungs."
C and E- left HF aka congestive HF is associated w pulmonary congestion. Right HF results in peripheral edemaHF results from inability of left ventricle to pump blood
Which classification of prescription should the nurse anticipate to be prescribed to a client newly diagnosed with chronic heart failure? A: beta adrenergic blockers B: diuretics C: Angiotensin-converting enzyme (ACE) inhibitor D: cardiac glycosides
C- ACE inhibitor is first line treatment for chronic HF-Beta are standard for stage 3 HFCardiac glycosides (digoxin) reserved for advanced HFDiuretics treat HF symptoms like fluid V overload, edema, pulmonary congestion
Which describes the mechanism of action of anticoagulant prescriptions? A. Conversion of plasminogen to plasmin B. Prevention of fibrin from dissolving C. Inhibition of thrombi formation D. Alteration of plasma membrane and platelets
C- Anticoagulants are used to prolong bleeding time and thereby prevent thrombi from forming or enlarging.
Which statement is accurate regarding the use of beta-adrenergic blockers for use in clients with heart failure? A. Dosage changes are done on a daily basis for the first 2 weeks. B. Higher doses are used initially until optimal vital signs are achieved. C. They are generally used in combination with other heart-failure drugs. D. This drug class does not have an effect on the bronchioles of the lungs.
C- Beta-adrenergic blockers are rarely used to treat heart failure alone. They are commonly used in combination with ACE inhibitors.
Which occurs initially in the cardiac conduction pathway? A: The action potential moves over the bundle branches B: The action potential moves through the AV node C: The SA node generates an action potentiaL D: The action potential travels across the bundle of His
C- Once an AP is generated in the SA node, it moves to the AV node, across the bundle of His, across the bundle branches, and through the Purkinje fibers. It is at this point that the action potential reaches the ventricles, causing the muscle to contract.
Which should the nurse recognize are adverse effects associated with digoxin (Lanoxin)? A.Tachycardia and hypotension B.Blurred vision and tachycardia C.Anorexia and nausea D.Anorexia and constipation
C- hypotension could occur but not tachycardia (would be bradycardia), diarrhea is more likely
Which factor increases cardiac output? A: reduced cardiac B: peripheral vascular resistance C: increase in preload D: hypovolemia
C- increased preload results in more forceful contraction and increases cardiac output
A client asks the nurse how hypertension can lead to heart failure. Which response should the nurse provide the client? A: Hypertension limits the amount of blood entering the left ventricle increasing the workload of the heart to pump an adequate amount of blood into the circulatory system." B: Hypertension causes resistance in the venous system requiring the heart to work harder to pump the blood forward." C: Hypertension increases the resistance in the blood vessels causing the heart work harder to pump the blood out against the resistance of the arteries." D: Hypertension limits the ability of the heart to stretch before emptying resulting in the heart working harder to pump the blood out into the arterial system.
C- peripheral resistance that occurs in hypertension causes the heart to work harder to pump the blood out into the arterial system
A client post-acute myocardial infarction asks the nurse why they are prescribed reteplase (Retavase) intravenously (IV). Which response should the nurse provide the client? A: The prescription will increase the strength of the muscles in the heart during each beat." B: "The prescription thins your blood so more clots will not develop." C: "The prescription is dissolving the clot that has caused your heart attack." D: "The prescription dilates the arteries in the heart so it can get more oxygen."
C- thrombolytic therapy is administered to dissolve clots obstructing the coronary arteries, thus restoring circulation to the myocardium.
Which assessment finding warrants the nurse to hold the dosage of benztropine (Cogentin) and notify the healthcare provider? A: BP 142/80 B: respiratory rate of 14 C: pulse of 112 D: Temp of 100.2
C: Benztropine can cause tachycardia
The nurse is providing education for a client about the characteristics of Alzheimer's disease. Which information should the nurse include? A: More women than men are effected B: The disease is characterized by the degeneration of the neurons. C: Chronic inflammation of the brain may be a cause of the disease. D: The disease mainly affects people over 50 years of age.
C: Chronic inflammation and excess free radicals may cause neuron damage and contribute to Alzheimer'sParkinson's disease is characterized by the degeneration of the neurons.
Which adverse effect should the nurse instruct the client to monitor for while receiving warfarin sodium? A: headache B: rash C: pain D: bleeding
D
Which is the primary desired outcome for a client that has experienced several episodes of angina? A: The client will experience relief of chest pain with anticoagulant therapy. B: The client will experience relief of chest pain with aspirin therapy. C: The client will experience relief of chest pain with therapeutic lifestyle changes. D: The client will experience relief of chest pain with nitrate therapy.
D
A client asks the nurse if angina is the same thing as having a heart attack. Which response should the nurseprovide? A: "They are basically the same." B: "Actually, it depends on what type of angina you mean; there are several types." C: "They have some things in common, for example, severe emotional distress and panic can accompany both angina and myocardial infarction." D: "Angina means heart muscle is not getting enough oxygen, while heart attack, or myocardialinfarction, means part of your heart has died."
D
A client is prescribed an intravenous infusion of milrinone (Primacor) for acute heart failure. Which is a priority nursing assessment during the infusion? A: Vital signs every 15 minutes B: Monitor for hypertension C: Monitor for symptoms of atrial fibrillation D: Continuous ECG monitoring
D
A client with a history of gastrointestinal (GI) bleeding caused by aspirin requires an antiplatelet medication. Which medication should the nurse anticipate as an alternative to aspirin? A. Abciximab (ReoPro), a glycoprotein IIb/IIIa inhibitor B. Atenolol (Tenormin), a beta-adrenergic agonist C. Amiodarone (Cordarone), a vasopressor D. Clopidogrel (Plavix), an adenosine diphosphate receptor blocker
D
A client with heart failure asks what caused the health problem. Which response should the nurse make to the client? A. The heart has a limited ability to increase contractility, and in a diseased heart, the increased preload leads to volume overload and pulmonary congestion." B. "Cardiac output is normal, but the increased pressure in the ventricle creates higher pressure in the pulmonary capillaries, resulting in pulmonary edema." C. "The left ventricle is forced to work harder due to the increased preload or afterload, which results in thickening of the heart walls." D. "The left side of the heart has weakened, causing fluid to build up in the capillaries in the lung, which ultimately decreases oxygen in the heart."
D
The nurse is assessing the adherence of a male client prescribed propranolol (Inderal) for adherence to the treatment plan. Which is an important question for the nurse to ask the client? A: "Have you noticed any difficulty in your ability to concentrate?" B: "Have you noticed any changes in your bowel function?" C: "Has your appetite increased or decreased?" D: Have you noticed any changes in your sexual functioning?
D
Which is the primary pharmacologic goal in the treatment of a client experiencing stable angina? A. Establish a regular exercise program and diet plan. B. Eliminate blockages by using thrombolytics. C. Increase venous blood flow to the right atrium. D. Increase cardiac oxygen supply and reduce cardiac oxygen demand.
D
Which laboratory test is used to measure the effectiveness of warfarin sodium therapy? A: complete blood count B: platelet count C: aPTT D: international normalized ratio (INR)
D
Which statement describes the purpose for the use of acetylcholinesterase inhibitors prescribed to treat Alzheimer's disease? A:Reverse the structural damage within the brain. B: Increase synthesis of acetylcholine. C:Increase enzymatic breakdown leading to increased neuronal production. D:Intensify the effect of acetylcholine at the receptor.
D
Which statement made by the client indicates an understanding of self-care while taking prescriptions to treat their heart failure? A: "I will cut back on my smoking." B: I will check my pulse every few days." C: "I will schedule my lab work if I am not feeling well." D: "I will weigh myself every day in the morning after I wake up."
D
Which prescription is indicated for the prevention of blood clots? A: captopril B: reteplase C: morphine D: abciximab
D -Abciximab is a glycoprotein IIb/IIIa inhibitor (antiplatelet agent) used to prevent blood clots. Captopril is an ACE inhibitor, morphine is used for analgesia, and reteplase is used to break up blood clots.
Which statements made by a client indicates an understanding of the education provided by the nurse regarding digoxin (Lanoxin) toxicity? A: "I should limit my fluids while taking this medication." B: "It is okay to keep taking my ginseng." C: "If I have nausea, it means I must stop the medication." D: "I can drink orange juice every morning." E: "I must check my pulse and not take the medication if it is less than 60."
D and E- OJ is a source of K which will minimize toxicity
Which statement by the client receiving nitroglycerine (Nitrostat) should the nurse be concerned about? A: I really don't like taking those little pills, I would like to use a patch." B: My angina has been a little more frequent I would like something to take for the pain." C: I'm going water skiing tomorrow; I hope my angina isn't a problem." D: I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem.
D- A patient with erectile dysfunction is likely to use sildenafil (Viagra). Concurrent use of sildenafil(Viagra) and nitroglycerine (Nitrostat) may cause life-threatening hypotension and cardiovascular collapse.
Which action of Lisinopril (Prinivil) results in a decrease in the blood volume? A: Antagonistic effect on angiotensin-converting enzyme. B: Causes a diuretic effect by lowering the amount of sodium lost in the urine. C: Causes hypernatremia and increased renal tubule permeability resulting in a diuretic effect. D: decrease aldosterone secretion
D- ACE inhibitors decrease aldosterone secretion from the adrenal cortex resulting in a lowering of the blood volume
A client states to the nurse, "I read that my antidysrhythmic drug can actually cause me to have irregular heartbeats. How can this be?" Which response should the nurse provide the client? A: "The literature is not always accurate, but if you have concerns I recommend discussing them with your healthcare provider." B: "Your prescription is not the problem; it is when you mix it with over-the-counter (OTC) drugs that you develop irregular beats." C: "The aspirin that you take every day will help you avoid experiencing the irregular heartbeats." D: "Your medication blocks the flow of the electrolytes in your heart, and this can cause irregularbeats."
D- Most antidysrhythmic drugs act by interfering with myocardial action potentials, blocking the action of sodium, potassium, and calcium channels and causing some irregular beats.
Which prescriptions reduce the heart's demand for oxygen by lowering heart rate? A.Anticoagulants and beta-adrenergic blockers B.Organic nitrates and calcium channel blockers C.Calcium channel blockers and anticoagulants D.Beta-adrenergic blockers and calcium channel blockers
D-Organic nitrates dilate vessels, and anticoagulants prevent blood clots from forming.
