Pharm 2 exam #2 prep U
A client with significant burns develops shock and requires adrenergic drug therapy. The nurse interprets this as which type of shock?
Hypovolemic
After teaching a client about prescribed statin therapy, the nurse determines that additional teaching is needed when the client makes which statement?
I can take the drug with grapefruit juice
A client is prescribed ethacrynic acid to treat edema secondary to heart failure. After teaching the client about this drug, the nurse determines that additional teaching is needed when the client states which of the following?
I need to avoid eating foods that contain potassium
After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states:
I need to make sure that I dint eat to many foods that are high in potassium
The nurse calculates the infusion rate for administering dopamine to a premature infant in the neonatal intensive care unit who is in cardiogenic shock secondary to a cardiac anomaly. What is the nurse's next priority action?
ask another nurse to perform a independent calculation.
A priority nursing assessment for a client who is to receive an alpha- or beta-adrenergic agonist would be to which action?
assess hear rate
A 49-year-old client reports frequent muscle cramps while on hydrochlorothiazide therapy. The nurse would advise the client to do which?
eat potassium-rich foods.
A client has recently been prescribed a drug that treats hypertension by blocking the sympathetic receptors in the sympathetic nervous system. This action is characteristic of which?
an adrenergic antagonist
Propranolol (Inderal) is used extensively as treatment for what condition?
angina
When describing the action of beta blockers to a client, the nurse would emphasize that the majority of drug action involve stimulation of the receptors in which organ?
heart
What would be a contraindication to the use of a non-selective adrenergic blocker?
heart block
A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition?
heart disease
When administering an adrenergic drug, a nurse understands that which is the primary neurotransmitter of the sympathetic nervous system?
norepinephrine
A client has been referred after an optometric examination that indicated a possibility of increased intraocular pressure. The nurse should anticipate a prescription for what medication?
timolol
Which medication exerts its effects by depressing the reabsorption of sodium in the kidney tubules, thereby increasing sodium and water excretion?
triamterene
What information should the nurse discuss with the client considering pregnancy regarding the use of a diuretic during pregnancy?
typically women on diuretics prior to becoming pregnant can remain on the medication during their pregnancy.
The teaching priority for a diabetic male client being treated with a non-specific beta-blocker would be to:
understanding signs and symptoms of hypo- or hyperglycemic reactions.
The nurse is caring for a 35-year-old client taking a beta-hydroxy-beta-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor to lower serum lipid levels. When teaching this client about the medication, what priority teaching point will the nurse include in the teaching plan?
use of barrier contraceptives
Which might occur in a client receiving colestipol?
vitamin A deficiency
HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category?
x
A client is given a beta blocker for a heart arrhythmia. The client asks the nurse how a beta blocker can treat/prevent a heart arrhythmia. Which response by the nurse is correct?
"Beta blockers provide membrane-stabilizing effects that contribute to the anti-arrhythmic activity."
The nurse is teaching a 62-year-old client about hydrochlorothiazide, which the health care provider has prescribed for treatment of hypertension. What statement, made by the client, suggests that the client understands the teaching?
"I will need to stand slowly." Diuretics, including hydrochlorothiazide, can cause orthostatic hypotension. Rising slowly to a standing position can reduce the risk of falls. Patients taking diuretics should restrict sodium intake to avoid the need for higher doses, which increase the likelihood of adverse effects. Taking diuretics with food can help avoid the GI irritation frequently associated with these drugs.
A 39-year-old nulliparous woman has been taking atorvastatin for 2 years and has now decided that she would like to become pregnant. What health education should the nurse provide to this client?
"It's important that you stop taking atorvastatin before you stop using contraception."
A 10-year-old child has edema caused by a heart defect. The client is taking furosemide. The dosage is 3 mg/kg/d. The child weighs 76 lbs. How many milligrams does the child receive each day?
105 mg The nurse will administer 105 mg/dose of the drug (76 lbs divided by 2.2 = 34.5 kg, 35 kg times 3 mg = 105 mg).
A patient is receiving acetazolamide in a sustained release form. The nurse would anticipate the onset of drug action in approximately which time frame?
2 hours
The nurse should be aware that diuresis will peak how long after furosemide is administered?
30 minutes
A client with a long-standing diagnosis of heart failure has been taking hydrochlorothiazide (HCTZ) for several weeks. The client reports experiencing moderate diuresis, but the care provider and the client agree that increased diuresis would be of benefit. However, the care provider has explained that the client is likely near the ceiling threshold of this drug. What is the main implication when a client prescribed hydrochlorothiazide (HCTZ) is told they are, "nearing the drug's ceiling threshold"?
A higher dose of HCTZ will not result in increased diuresis.
What intervention may help the client increase HDL levels?
Exercise
A nurse demonstrates understanding of diuretics when identifying which medication as exerting its effect by inhibiting the enzyme carbonic anhydrase?
Acetazolamide
The client is admitted to the ICU in hypovolemic shock. The physician orders a dopamine drip to treat the hemodynamic imbalances. What condition should the nurse check for and correct as a prerequisite to beginning the therapy?
Acidosis
A client is receiving dopamine intravenously in the right arm. The IV becomes dislodged from the vein, and dopamine has been being given in the surrounding tissue instead of the vein. What should the nurse do immediately after stopping the IV?
Administer phentolamine to the site
Which agent would be indicated for the treatment of benign prostatic hypertrophy? (Select all that apply.)
Alfuzosin Terazosin
The nurse is teaching a client about non-pharmacologic methods of controlling serum cholesterol levels. What lifestyle change may help increase high-density lipoprotein (HDL) levels?
All the above changes may help increase HDL levels
The nurse knows that which of the following clients is likely to have hypovolemic shock? Select all that apply.
An infant with severe diarrhea and vomiting. A woman bleeding profusely after giving birth. A teenage girl who has been taking 80 mg/day of unprescribed Lasix for five days.
A nurse is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics. Treatment of high cholesterol using statins would be contraindicated in which client?
An obese male client who is a heavy alcohol user and who has cirrhosis of the liver
Which condition is treated with an adrenergic agonist?
Anaphylaxis
A client goes to his primary care provider for a cut finger. The provider is going to put sutures into the tip of the client's finger. Lidocaine with 2% epinephrine is ordered verbally by the provider. What should the nurse do?
Ask if he really wants epinephrine in the lidocaine since he is working on the tip of the finger. The nurse remembers from her reading that epinephrine is contraindicated in fingertips.
A priority nursing assessment for a client who is to receive an alpha- or beta-adrenergic agonist would be to which action?
Assess heart rate
Which of the following adrenergic receptors is responsible for increased heart rate and increased force of myocardial contraction?
B1 receptors
A pregnant woman has severe hypertension and the provider orders a beta blocker. The client wants to know if it is safe for the fetus. How should the nurse respond?
Beta blockers are recommended for pregnant women because the risk to the fetus is less severe with other drugs.
The nurse knows that which class of drugs prevents epinephrine and norepinephrine from occupying receptor sites on the cell membranes?
Beta-adrenergic blocking drugs
A client is admitted to the emergency department with signs and symptoms of cardiogenic shock. Isoproterenol is administered intravenously. What assessment should the nurse prioritize when monitoring for therapeutic effects?
Blood pressure
Epinephrine causes relaxation of:
Bronchioles
A client receives a beta-specific agonist. What would lead the nurse to determine that the drug is effective?
Bronchodilation
A client receives a beta-specific agonist. what would lead the nurse to determine that the drug is effective?
Bronchodilation
The nurse is administering an adrenergic agonist to a client. The nurse realizes that this medication will cause stimulation of the sympathetic nervous system. Which effects will it produce? Select all that apply.
Bronchodilation decreased bladder tone
An 80-year-old client has been brought to the emergency department in shock. The client is receiving dopamine. The nurse should prioritize the assessment for what potentially serious adverse effect?
Cardiac arrhythmia
Mrs. Kelly Johnson, aged 46, was admitted to the hospital due to prior myocardial infarction, or heart attack. The diagnostic test revealed that her heart was unable to pump enough blood to adequately perfuse the vital organs. What type of shock does she seem to have suffered from?
Cardiogenic Shock
a client suffering an acute myocardial infarction may develop with type of shock?
Cardiogenic- obstructive shock
A client calls the cardiology office and reports fatigue and drowsiness since starting a new medication. The nurse knows that which medications has these as common side effects?
Carvedilol
Alpha/beta blockers block both alpha-adrenergic and beta-adrenergic receptors. Which antiadrenergic drug is an alpha/beta blocker?
Carvedilol
A client has come to get lab results at the cardiology clinic. The nurse notes that the digoxin level is elevated. The nurse knows that what other medication may be responsible for the increase in digoxin level?
Carvedilol (carve and dig)
Beta-blockers have a variety of therapeutic uses. Which agent is a beta-blocker used for the treatment of heart failure?
Carvedilol (Coreg)
The nurse is caring for a client newly prescribed rosuvastatin. The nurse should perform which preadministration or ongoing assessments? Select all that apply.
Check the aspartate aminotransferase (AST), and if it is three times the normal, notify the primary care provider. Inspect the skin and eyelids for flat or elevated yellow deposits (xanthomas) and chart, if present. Evaluate for development of fever, muscle weakness or tenderness, or extreme fatigue and report to primary care provider. Determine if dizziness and unsteadiness of gait occurs after administering first dose of rosuvastatin.
A home care nurse caring for a 59-year-old client taking a non-selective beta blocker teaches the client to notify the prescriber for a change in medication if the:
Client has a sudden onset cough
A male client diagnosed with bone cancer has an order for clonidine on his chart. The nurse is concerned that this may be a mistake and asks another nurse why clonidine would be ordered for this client. What would be an appropriate response from the second nurse?
Clonidine is sometimes prescribed for patients in extreme pain like this client.
A nurse is caring for a female client who breastfeeds her 3-month-old infant. The client tells the nurse that she has been taking garlic to reduce serum cholesterol levels. The nurse informs the client that which adverse effects may occur?
Colic in her infant
A nurse is caring for a 25-year-old client who has been prescribed an adrenergic drug for shock. Which action should the nurse implement?
Continually assess the client for physiological changes and notify the primary care provider with changes.
The nurse is caring for a client with peripheral edema who has just begun taking a diuretic. What assessments should the nurse use to evaluate the effectiveness of this medication? Select all that apply.
Daily weights Inspection of lower legs and feet Urine output
What is the basis for a nurse's recommendation to avoid a stringent fat-restricted diet when planning interventions to treat a client's dyslipidemia?
Diets with mare stringent fat restrictions rise serum triglyceride levels
The nurse is to adminsiter to the client regular doses of epinephrine as prescribed. Which nursing diagnoses is most appropriate for this client?
Disturbed sleep pattern, insomnia related to CNS excitation.
the clinic nurse is teaching a client about terbutaline. what would the nurse be sure to include in the teaching.
Dosage Adverse effects What problems to report immediately
What type of diet should a patient taking diuretics have?
Eat potassium-rich of low- potassium diet as appropriate
Adrenergic medications such as epinephrine and dopamine are commonly used for in the treatment of clients in which treatment settings? Select all that apply.
Emergency department intensive care unit dentist's office
A resident of a long-term care facility has been prescribed furosemide 40 mg PO daily. When beginning this drug therapy, what are appropriate nursing actions? Select all that apply.
Ensure the resident has easy access to a toilet or commode. Instruct the client to report any loss of hearing. Monitor the resident's blood pressure frequently.
an instructor is preparing a teaching plan for a group of students about adrenergic agonist. Which would the nurse include as an alpha- and beta-adrenergic agonist.
Epinephrine
After teaching a group of nursing students about diuretics, the instructor determines that the teaching was successful when the group identifies which as a loop diuretic?
Furosemide
An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema?
Furosemide Furosemide can be given intravenously to provide rapid relief from pulmonary edema. Mannitol is not normally used to treat pulmonary edema and neither HCTZ nor triamterene is used in the acute treatment of pulmonary edema.
A client prescribed both an ACE inhibitor and a beta-blocker for the treatment of hypertension has been consistently obtaining blood pressure readings in the vicinity of 145/90 mm Hg. As a result, the client's primary care provider has prescribed furosemide. What order would be most consistent with this client's health needs?
Furosemide 40 mg PO BID
A client asks the nurse about herbal products that can help to lower serum cholesterol and triglycerides. Which herbal product would the nurse include in the response?
Garlic
After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)?
Gemfibrozil
The three major classes of drugs used to control blood lipids are statins, bile acid resins (or sequestrants), and fibrates. Which is a fibrate?
Gemfibrozil
The nurse is evaluating the effectiveness of drug therapy in a client with hyperlipidemia. Effective therapy is best demonstrated by which laboratory values?
HDL 58 LDL 96 Cholesterol 178
The nursing instructor is discussing common adverse effects of dyslipidemia drugs. Which of the following would the instructor identify as adverse effects of statins?
Headache and nausea
The adrenergic branch of the nervous system controls many functions in the body. The nurse knows that which body functions are controlled by the adrenergic branch? (Select all that apply.)
Heart rate Respiratory rate Muscle blood flow
A 54-year-old client has a cholesterol level of 240 mg/dL (6.2064 mmol/L). What serum concentration of cholesterol would this client have?
High
A 91-year-old client, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the client about the drug, what major adverse effect should the nurse be sure to mention?
Hyperkalemia
An older adult client has a complex medical history that includes heart failure, type 1 diabetes, and diabetic nephropathy. The nurse has questioned a care provider's prescription for oral spironolactone because the client's health problems would contribute to a high risk of which adverse reaction?
Hyperkalemia
The nurse is preparing a client for discharge who will receive a prescription for a hydroxymethylglutaryl-coenzyme A (HMG-CoA) inhibitor. What statement by the client demonstrates a clear understanding of the teaching provided by the nurse?
I should plan to take this drug before bedtime because my body makes lipids mostly at night
The nurse is teaching a 45-year-old client about ways to lower cholesterol level. What effects of exercise does the nurse describe?
Increases high-density lipoproteins (HDLs) and decreases low-density lipoproteins (LDL)
A nurse has been assigned to patient who receives hydrochlorothiazide each morning for the treatment of primary hypertension. Which of the following components of the patient's morning blood work should prompt the nurse to temporarily hold the drug this morning and consult with the physician?
K+ 3.0 mEq/L Low potassium levels are likely to be exacerbated by the administration of HCTZ. The patient's sodium levels are within reference ranges and HCTZ is unlikely to influence hemoglobin and platelet levels.
A client presents to the emergency department reporting rapid heart rate, severe headache, and pounding in the chest. While obtaining the clients history, the nurse learns the client stopped taking medications because the prescriptions ran out and had no funds to refill them. The nurse knows that which medications being abruptly stopped could be causing these symptoms?
Labetalol
After reviewing the routes of administration for beta-specific adrenergic agonists, a group of students demonstrate the need for additional study when they identify isoproterenol as being administered by which route?
Oral
A client has been prescribed labetalol IV for a pheochromocytoma. What is the expected effect of the medication?
Management of the resulting hypertension
When teaching a class about diuretics, a nursing instructor describes a class of drugs that increases the density of the filtrate in the glomerulus. Which medication would the instructor cite as an example?
Mannitol (there is a increasing amout of dense people at DR OS's show)
The nurse is caring for a client with a severe head injury. An osmotic diuretic is ordered. The nurse understands which drug is an osmotic diuretic?
Mannitol (dr oss is a man that is tall )
The nurse is writing a plan of care for a client receiving an alpha-specific adrenergic agonist. What is the priority component of the client's plan of care?
Monitor blood pressure and heart rate frequently.
Epinephrine is contraindicated in clients with which diseases of disorders?
Narrow-angle(or closed-angle) glaucom.
when administering an adrenergic drug, a nurse understands that which is the primary neurotransmitter of the sympathetic nervous system?
Norepinephrine
A client is suspected of having pheochromocytoma. Which agent would the nurse identify as being used to help diagnose this disorder?
Phenotoamine
A nursing instructor determines that a class on adrenergic blockers was successful when the students identify which medications as an alpha-adrenergic blocker?
Phentolamine
A client has received a dose of dopamine intravenously. The client's IV was infiltrated, and the dopamine was injected into the subcutaneous tissues. Which medication will prevent the vasoconstriction and tissue necrosis based on this action?
Phentolamine mesylate (Regitine)
The emergency department (ED) nurse is caring for a client who is experiencing pulmonary edema. The client is treated with furosemide. What will the nurse monitor most closely?
Potassium levels
A 23-year-old client presents at the clinic with a migraine headache. What beta-adrenergic blocking agent will best prevent future migraine headaches?
Propranolol
The nurse is caring for a client with high serum cholesterol and triglyceride levels. In teaching the client about therapeutic lifestyle changes and the use of medications, the nurse explains that the desired goal for cholesterol levels is what?
Reduced low-density lipoprotein (LDL) values and increased HDL values
When providing client teaching to a client beginning therapy with a hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor, the nurse will explain the need for regular monitoring of what laboratory studies? Select all that apply
Renal function tests Liver function tests Lipid panel
Which would a nurse expect as a possible adverse effect when administering a beta-specific adrenergic agonist? (Select all that apply.)
Restlessness Headache
The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which?
Rhabdomyolysis
The nurse is developing a plan of care for a male client who has been admitted to the hospital after a myocardial infarction. The client begins lovastatin to lower his LDL levels and increase his HDL levels. Based on the adverse reaction of this medication, what would be the most appropriate nursing diagnosis?
Risk for injury to skeletal muscles related to adverse effects of drug therapy
After teaching a group of students about beta-1 selective blockers, the instructor determines that the teaching was successful when the students identify what as a contraindication to using this group of drugs?
Sinus bradycardia
A nurse is preparing to administer a diuretic that antagonizes the action of aldosterone. Which drug would the nurse be most likely to administer?
Spironalactone
When describing the adrenergic branch of the autonomic nervous system to a group of nursing students, the instructor would also refer to it as which type of nervous system?
Sympathetic nervous system
drugs that produce activity to the neurotransmitter norepinephrine are known as which of the following?
Sympathomimetics
A nurse is caring for a patient who is receiving mannitol. The nurse should be aware that the ongoing mannitol administration should be withheld if
The urine output is less than30 ml/hour after th test dose
A 37-year-old woman with moderately elevated lipid levels requests immediate pharmacotherapy for her dyslipidemia. The nurse explains that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered. The nurse explains the rationale for this regimen as:
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
The client has been ordered a nonselective beta-blocking agent called propranolol, PO. Propranolol is used in the treatment of which disorders?
all the above angina hypertension
What is the basis for a nurse's recommendation of a period of intensive diet therapy and lifestyle modification before initiation of drug therapy for a client newly diagnosed with dyslipidemia?
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
A provider orders timolol (Timoptic) for glaucoma. The order reads Timoptic 1 gtt PO bid. The nurse knows that something is wrong with this order. What is it?
Timoptic is given in the eye, not PO
The nurse is providing discharge instructions to a 72-year-old client who has been discharged home on a diuretic. What should the nurse include when providing discharge instructions regarding the use of a diuretic at home?
To weigh themselves on the same scale, at the same time of day, in the same clothing
A hospital client demonstrating peripheral edema has been prescribed furosemide. How should the nurse best determine the extent of the client's desired fluid loss?
Weigh the client daily.
A nurse is conducting a presentation for a local community group about hyperlipidemia. When discussing the factors that individuals can work on to reduce their risk, which information would the nurse include? Select all that apply.
Weight Diet
What client would be most likely to benefit from the administration of a beta2-specific adrenergic agonist?
a client who is having an exacerbation of chronic bronchitis
Which client is most likely to benefit from the administration of an adrenergic agonist?
a man who is in cardiogenic shock following a myocardial infarction.
First-dose effect occurs when the client experiences marked hypotension and syncope with sudden loss of consciousness with the first few doses of the sympatholytic. Which intervention might be helpful for the nurse to do to decrease the risk for first-dose effect?
administer the dose at bedtime.
A nurse is reviewing the therapeutic use of adrenergic agonists. When reviewing their use in clients of differing ages, what principle should guide the nurse's actions?
adrenergic agonist can be used for varied indications across the lifespan
Which activity increases high-density lipoproteins?
all of these
An older adult has been prescribed midodrine. What is the most important nursing action to include in the plan of care for this client?
assess positional blood pressures
The nurse is caring for a client who is taking an adrenergic blocking agent. What assessment would be among the nurse's priorities?
assessing heart rate
A nurse is providing patient teaching for a 62-year-old woman who is taking triamterene. The nurse will teach the patient to avoid what in her diet?
avocados The nurse will advise the patient to avoid foods high in potassium, which include apricots, avocados, bananas, cantaloupe, fish, honeydew, kiwi, meat, milk, oranges, potatoes, poultry, prunes, spinach, sweet potatoes, tomatoes, winter squash, and yams.
A 45-year-old client who is a construction worker has been diagnosed with hyperlipidemia and has been prescribed lovastatin. The nurse will advise the client to do which?
avoid prolonged exposure to sunlight.
Which adrenergic receptor is responsible for vasodilation of peripheral vessels and bronchodilation?
b2 receptors
In providing care to a client with wheezing, the nurse knows that a medication targets which receptors?
beta 2
What is the first drug of choice for treatment of a client with a history of a myocardial infarction (MI) 2 years ago?
beta-blockers
The nurse is assessing the client for adverse CNS effects after administering a nonselective adrenergic blocker based on the understanding that these effects occur due to:
blockage of norepinephrine's effect
When describing the action of atorvastatin, which would the nurse include?
blocking the enzyme that is involved in cholesterol synthesis
A 72-year-old Asian male, status post-MI, with a 10-year history of cardiovascular disorder has been prescribed clonidine. Because the drug is an alpha2-adrenergic agonist, the expected clinical effect is decreased:
blood pressure
A client has been admitted to the cardiac unit for heart failure and has been ordered carvedilol (Coreg). The client's blood pressure is 80/50. What should the nurse do?
call the provider and advise them of the clients blood pressure prior to administration of the medication.
An 80-year-old client has been brought to the emergency department in shock. The client is receiving dopamine. The nurse should prioritize the assessment for what potentially serious adverse effect?
cardiac arrhythmia
An elderly client with a history of heart failure has presented to the emergency department in respiratory distress. Assessment reveals the presence of pulmonary edema, and an infusion of IV furosemide has been prescribed. For the duration of treatment, the nurse should prioritize assessments related to which expected age-related dysfunctions? Select all that apply.
cardiac function renal function hepatic function
Blood lipids are a category of fatty acids, which are substances used within the body to perform essential functions. Which category of blood lipids is involved in the formation of atherosclerotic plaques?
cholesterol
Which category of blood lipids is involved in the formation of atherosclerotic plaques?
cholesterol
A client who has been taking a statin has seen an improvement in his cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medical regime?
cholestyamine
A client who has been taking a statin has seen an improvement in his cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medical regime?
cholestyramine
A 91-year-old client is being discharged on the diuretic spironolactone. What assessment finding would the nurse attribute to adverse effects of this medication?
confusion and irregular heart rate
A client is taking cholestyramine. The nurse will assess for which common adverse effect of the drug?
constipation
A nurse is teaching a client about minor adverse reactions to an adrenergic-blocking medication. The nurse includes information about which symptoms that would fall into this category?
constipation
A client has been prescribed a beta blocker. The nurse knows that beta blockers can have which effect on the heart?
decrease the heart rate
A client asks the nurse what the atorvastatin (Lipitor) prescribed for the client will do. What is an expected outcome for this client?
decrease un serum cholesterol and ldl levels
A client has had cholestyramine added to his or her treatment plan for dyslipidemia. What effect will cholestyramine have on the pharmacokinetics of the thiazide diuretic that the client is currently prescribed?
decreased absorption
The nurse is caring for a client who is receiving an intravenous infusion of dobutamine. What nursing diagnosis has most likely prompted this intervention?
decreased cardiac output
The nurse is caring for a client who is receiving an intravenous infusion of dobutamine. What nursing diagnosis has most likely prompted this intervention?
decreases cardiac output
In addition to being synthesized in the liver and intestine, from where are blood lipids derived?
diet
Diuretics increase the production and output of urine. Which statement helps explain how diuretics achieve these effects?
diuretics reduce the reabsorption of water in the kidneys
The client with a complex health history has been taking medication affecting both alph- and beta-receptor sites in the past. what medications would the nurse include in the category?
dobutamine epinephrine dopamine
As part of a routine physical examination, a 60-year-old client's primary care provider has ordered blood work that includes cholesterol levels. What result would strongly suggest the need for an antihyperlipidemic drug?
elevated LDL levels
The nurse is evaluating an 82-year-old client's medical record. The client is receiving hydrochlorothiazide. What abnormal laboratory result is related to the medication?
elevated uric acid levels
Which herbs has been removed from most weight-loss medications due to potential legal liability?
ephedra
An instructor is preparing a teaching plan for a group of students about adrenergic agonists. Which would the nurse include as an alpha- and beta-adrenergic agonist?
epinephrine
Which medication will most likely be administered to a client experiencing anaphylaxis?
epinephrine
Alpha- and beta-specific adrenergic agonists are primarily used to treat obstructive pulmonary conditions.
false
A nurse is caring for a client prescribed nicotinic acid for hyperlipidemia. The nurse would assess the client for which findings as a possibility?
flushing of the skin
The nurse is admitting a client with injuries following a bicycle crash. When reviewing the client's pre-admission medication regimen, the nurse reads that the client takes formoterol twice daily. When planning this client's care, the nurse should include:
frequent respiratory assessments
A client has edema of the lower extremities with crackles in the lung bases. What diuretic is most likely to be prescribed for a client assessed with lower extremity edema and bilateral lung crackles?
furosemide
Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema?
furosemide Loop diuretics, like furosemide, are the diuretics of choice when rapid effects are required since they produce extensive diuresis for short periods, after which the kidney tubules regain their ability to reabsorb sodium.
The three major classes of drugs used to control blood lipids are statins, bile acid resins (or sequestrants), and fibrates. Which is a fibrate?
gemfibrozil
An older adult client is being treated in the hospital for a stroke and is undergoing an extended stay on a rehabilitation unit. The client's spouse has been participating actively in the client's care and performs much of the feeding and hygiene needs. This evening, the client's spouse has brought in a number of healthy snacks to keep at the client's bedside. Knowing that the client's medication regimen includes simvastatin, the nurse would remove which item?
grapefruit juice
The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin?
headache and flatulence
The nurse is caring for a client who has high levels of total cholesterol and triglycerides. When discussing management of dyslipidemia with the client, the nurse will describe the desired blood lipid profile as:
high HDL cholesterol, low LDL cholesterol, low total cholesterol, and low triglyceride.
A nurse is caring for a client in the critical care unit. Phentolamine (Regitine, OraVerse) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Before administering this drug, the nurse will check the client's chart for indications of:
history of acute myocardial infarction
The nurse is taking a health history on a 58-year-old client who is taking atorvastatin for high cholesterol. What assessment question should the nurse prioritize related to the safe use of this drug?
how many alcoholic drinks so you have in a typical day or week
As part of a class presentation, a nursing student is describing the actions of the different diuretics. Which medication would the student include as exerting its diuretic effect by inhibiting the reabsorption of sodium and chloride ions in the ascending portion of the loop of Henle and the early distal tubule of the nephron?
hydrochlorothiazide
A group of nursing students are reviewing information about the types of shock. The students demonstrate understanding of the information when they identify which as occurring from a significantly diminished blood volume?
hypovolemic shock
The nurse is caring for a 64-year-old client with diabetes who is being treated with a nonselective beta-blocker. What health education should the nurse prioritize with this client?
identifying the signs and symptoms of hypo- or hyperglycemic reactions
A nurse in the intensive care unit is caring for a client in shock and has started IV administration of dopamine (Intropin). For a client in shock, dopamine helps to:
increase blood pressure
The nurse is caring for a 68-year-old female client with type 1 diabetes mellitus whose health care provider has ordered hydrochlorothiazide. As a consequence of taking the diuretic, the client may need to:
increase her insulin dose
the client is given epinephrine for an exacerbation of asthma. what response to the medication would the nurse expect?
increased ease of breathing and increases heart rate.
The stimulation of beta1 adrenergic receptors in the heart by epinephrine would cause what result?
increased heart rate
Why would potassium-sparing diuretics be contraindicated for clients experiencing renal failure?
they may cause hyperkalemia
the stimulation of a beta 1 adrenergic receptors in the heart by epinephrine would cause what result?
increased heart rate
the stimulation of beta1 adrenergic receptors in the heart by epinephrine would cause what result?
increased heart rate
which is an effect of epinephrine?
increased heart rate
A health care provider has prescribed triamterene to a male client with renal disease. The client informs the nurse that he is taking potassium supplements to address some heart problems. The nurse would be alert for:
increased risk of hyperkalemia.
A client is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce?
increased vasoconstrictive effects
The client is given epinephrine for an exacerbation of asthma. What response to the medication would the nurse expect?
increases ease of breathing and increased heart rate
Hydrochlorothiazide works by what mechanism of action?
increasing the excretion of sodium and chloride in the distal tubule
A client has been prescribed lovastatin for high cholesterol. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels in which manner?
inhibits cholesterol syntheses
A client has been prescribed dopamine. Which action would be appropriate for the nurse to implement?
inspect the needle site and surrounding tissues for leakage
A 68-year-old client with type 1 diabetes is to receive hydrochlorothiazide. Before administration of this medication, what information is most important for the nurse to communicate to the client?
insulin dose may need to be increased
Which observation might indicate that timolol is achieving the desired effect in a client?
intraocular pressure decreases
Which observation might indicate that timolol is achieving the desired effect on a client?
intraocular pressure decreases (Tim- "lol I feel like my eyes are about to explode!")
The perioperative nurse is caring for a client who is undergoing surgery. What drug should the nurse expect the client to be given if beta-specific adrenergic effects are desired to prevent bronchospasm during anesthesia?
isoproterenol
The male client is prescribed prazosin (Minipress) for hypertension. He asks the nurse how the medication works. What is the nurse's best response?
it works by making your blood vessels dilate
A 58-year-old man has recently been prescribed atorvastatin (Lipitor) in an effort to reduce his cholesterol levels. The man has acknowledged the potentially harmful effects of hyperlipidemia and is motivated to make changes to resolve this health problem. What advice should the nurse give to this client?
its a good idea to keep your intake of saturated fat to a bare minimum
A client diagnosed with hyperlipidemia is prescribed a statin. The nurse is reviewing the client's history and would notify the client's health care provider if which condition was noted in the client's history?
liver disease
An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy?
liver panel
Following a referral from the client's optometrist, a client has been assessed and diagnosed with open-angle glaucoma. When administering the client's subsequent medications, the nurse should prioritize what action?
monitor the clients potassium levels. Acetazolamide is the diuretic most commonly used for treating glaucoma. It creates a risk for hypokalemia, which the nurse must monitor. Fluid restriction would be unsafe, and there is no obvious need for culture and sensitivity testing of urine. The signs and symptoms of glaucoma are not affected by wearing eye patches.
A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of:
muscle pain.
A 16-year-old client arrives at the emergency department (ED) stung by a bee and used zn EpiPen prior to arriving in the ED. The client is breathing well now. What would the nurse do next for this client?
obtain from the client as much information about the bee sting physical reaction to the bee sting.
A nurse is providing teaching to a client prescribed midodrine. Which nursing instruction is very important that the client understands?
only take midodrine when standing. taking it while lying down can cause very high blood pressure.
A client is unconscious and experiencing increasing intracranial pressure. What type of diuretic will the client most likely be prescribed?
osmotic diuretic (DR Os pees in eyes but man is he tall )
A client with hypertension has been prescribed spironolactone. The client's previous diuretic, furosemide, has been discontinued. The nurse should explain what benefit of this change?
potassium losses are lower with spironolactone than with furosemide
Which of the following is a peripherally acting antiadrenergic drug?
prazosin
An adult client with multiple chronic health problems has been prescribed furosemide in the management of hypertension. When reviewing this client's current medication administration record, what drug should signal the nurse to a potentially increased risk of hypokalemia?
prednisone
The nurse frequently sees mature male clients with BPH seeking treatment for symptoms. After ensuring they do not test positive for prostate cancer, pharmacological intervention is one of a few treatment modalities available. Pharmacokinetics indicate alpha1-blocking agents as a treatment choice due to their:
prevention of smooth muscle contraction in nonvascular tissues
A client was brought by ambulance into the emergency department. The client appears disoriented, pale, tachycardic, and hypotensive. There is excessive bleeding from the head and bruises across the check and abdomen. What is the priority step in managing this client?
provide basic life support while attempting to treat hypovolemic shock.
How does the nurse providing medication education describe how the drug atorvastatin achieves its desired therapeutic effect?
reducing the amount of cholesterol synthesized by the liver
A client has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the client has been prescribed cholestyramine. What change in this client's lipid profile will the nurse identify as the most likely goal of therapy?
reduction in LDL cholesterol levels
The adrenergic branch of the nervous system controls many functions in the body. The nurse knows that which body functions are controlled by the adrenergic branch? (Select all that apply.)
respiratory rate muscle blood flow heart rate
A client with hyperlipidemia has been taking atorvastatin for several months. How can the therapeutic effect of the medication be best determined?
reviewing the clients laboratory
A nurse obtains an allergy history from a client based on the understanding that which class is associated with a cross-sensitivity reaction with sulfonamides?
thiazide diuretics
The nurse is preparing to administer a sympathomimetic drug to a client. How does this drug achieve a therapeutic effect?
simulating alpha- and beta- receptors
What substance is reabsorbed in the ascending limb of the loop of Henle?
sodium
The client receives a prescription for niacin. The nurse is providing education about the medication and possible adverse effects. Which adverse affect would the nurse include?
some people get flushed skin when they take this medication
A male client has been diagnosed with moderately increased LDL, and his primary care provider wishes to begin him on a statin. What is a potential disadvantage of statins that the care provider should consider? Select all that apply.
statins are expensive statins require regularly scheduled blood work
the nurse is preparing to administer sympathomimetic drug to a client. how does this achieve a therapeutic effect?
stimulating alpha beta-receptors
The nurse is preparing to administer a sympathomimetic drug to a client. How does this drug achieve a therapeutic effect?
stimulating alpha- and beta- receptors
Adrenergic drugs mimic the effects of stimulating what part of the nervous system?
sympathetic
The nurse is providing medication education to a client prescribed an adrenergic blocker. Which nervous system is the specific focus of this classification of medications?
sympathetic
The adrenergic branch of the autonomic nervous system is also known by which name?
sympathetic nervous system
client began taking hydrochlorothiazide 1 week ago and is reporting occasional dizziness when she stands up quickly from sitting or lying. What is the nurse's best action?
teach the client about the blood pressure effect of the medication and the relevant safety measures
Which client meets the criteria for alpha1-selective adrenergic blocking medication therapy?
the 64 year old male experiencing symptoms associated with enlarged prostate gland
The nurse is transcribing new orders for sympathomimetic medications prescribed for a geriatric client. What should the nurse expect the dosage to be?
the lowest possible effective dosage
The nurse is administering epinephrine IV push. The nurse checks for patency of the IV prior to administration of the drug. The nurse realizes that if the IV is infiltrated, the medication will result in tissue extravasation. What is the reason for such an occurrence?
the medication causes vasoconstriction, limiting the blood flow to the area
What should the nurse teach an older adult client about the potential adverse effects of atorvastatin?
the most common side effect of atorvastatin involve gastrointestinal upset
A patient is switched from furosemide (Lasix) to spironolactone (Aldactone). The patient asks the nurse why she has been switched to a new medicine. What is the best answer that will provide patient education regarding the change?
you will lose less potassium with spironolactone than with furosemide
