Pharm

A patient who has been taking an antihypertensive medication for several years is recovering from a myocardial infarction. The prescriber changes the patient's medication to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is the nurse's response? A) "ACE inhibitors can prevent or reverse pathologic changes in the heart's structure." B) "ACE inhibitors help lower LDL cholesterol and raise HDL cholesterol." C) "ACE inhibitors increase venous return to the heart, improving cardiac output." D) "ACE inhibitors regulate electrolytes that affect the cardiac rhythm."

A) "ACE inhibitors can prevent or reverse pathologic changes in the heart's structure."

A nurse is giving aspirin to a patient during acute management of STEMI. The patient asks why a chewable tablet is given. Which response by the nurse is correct? A) "Aspirin is absorbed more quickly when it is chewed." B) "Chewing aspirin prevents it from being metabolized by the liver." C) "Chewing aspirin prevents stomach irritation." D) "More of the drug is absorbed when aspirin is chewed."

A) "Aspirin is absorbed more quickly when it is chewed."

A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. Which statement by the student indicates a need for further teaching? A) "Beta blockers block the actions of angiotensin II." B) "Beta blockers decrease heart rate and contractility." C) "Beta blockers decrease peripheral vascular resistance." D) "Beta blockers decrease the release of renin."

A) "Beta blockers block the actions of angiotensin II."

A female patient with essential hypertension is being treated with hydralazine (Apresoline) 25 mg twice daily. The nurse assesses the patient and notes a heart rate of 96 beats per minute and a blood pressure of 110/72 mm Hg. The nurse will request an order to: A) administer a beta blocker. B) administer a drug that dilates veins. C) reduce the dose of hydralazine. D) give the patient a diuretic.

A) administer a beta blocker.

A nurse is teaching a patient who will begin taking verapamil (Calan) for hypertension about the drug's side effects. Which statement by the patient indicates understanding of the teaching? A) "I may become constipated, so Ishould increase fluids and fiber." B) "I may experience a rapid heart rate as a result of taking this drug." C) "I may have swelling of my hands and feet, but this will subside." D) "I may need to increase my digoxin dose while taking this drug."

A) "I may become constipated, so Ishould increase fluids and fiber."

A patient with a history of angina and hypertension is being started on nicotinic acid (Niacin). The nurse is providing patient education. What statement made by the patient demonstrates a need for further teaching? A) "I will take Tylenol with my medication to reduce the inflammatory effects." B) "I will be cautious taking this medication, because I have mild liver damage." C) "I will take an aspirin 30 minutes before my niacin to reduce flushing." D) "This medication will lower my triglyceride levels."

A) "I will take Tylenol with my medication to reduce the inflammatory effects."

A nursing student is helping to care for a patient who takes verapamil for stable angina. The nurse asks the student to explain the purpose of verapamil in the treatment of this patient. Which statement by the student indicates a need for further teaching? A) "It relaxes coronary artery spasms." B) "It reduces peripheral resistance to reduce oxygen demands." C) "It reduces the heart rate, AV conduction, and contractility." D) "It relaxes the peripheral arterioles to reduce afterload."

A) "It relaxes coronary artery spasms."

Lovastatin (Mevacor) is prescribed for a patient for the first time. The nurse should provide the patient with which instruction? A) "Take lovastatin with your evening meal." B) "Take this medicine before breakfast." C) "You may take lovastatin without regard to meals." D) "Take this medicine on an empty stomach."

A) "Take lovastatin with your evening meal."

A patient with diabetes develops hypertension. The nurse will anticipate administering which type of medication to treat hypertension in this patient? A) ACE inhibitors B) Beta blockers C) Direct-acting vasodilators D) Thiazide diuretics

A) ACE inhibitors

A diabetic patient is recovering from a myocardial infarction but does not have symptoms of heart failure. The nurse will expect to teach this patient about: A) ACE inhibitors and beta blockers. B) biventricular pacemakers. C) dietary supplements and exercise. D) diuretics and digoxin.

A) ACE inhibitors and beta blockers.

A nurse is caring for a patient who is receiving verapamil (Calan) for hypertension and digoxin (Lanoxin) for heart failure. The nurse will observe this patient for: A) AV blockade. B) gingival hyperplasia. C) migraine headaches. D) reflex tachycardia.

A) AV blockade.

A patient with stable exertlonal angina has been receiving a beta blocker. Before giving the drug, the nurse notes a resting heart rate of 55 beats per minute. Which is an appropriate nursing action? A) Administer the drug as ordered, because this is a desired effect. B) Withhold the dose and notify the provider of the heart rate. C) Request an order for a lower dose of the medication. D) Request an order to change to another antianginal medication.

A) Administer the drug as ordered, because this is a desired effect.

A patient with renal failure is undergoing chronic hemodialysis. The patient's hemoglobin is 10.6 gm/dL. The provider orders sodium-ferric gluconate complex (SFGC [Ferrlecit]). What will the nurse expect to do? A) Administer the drug intravenously with erythropoietin. B) Give a test dose before each administration of the drug. C) Have epinephrine on hand to treat anaphylaxis if needed. D) Infuse the drug rapidly to achieve maximum effects quickly.

A) Administer the drug intravenously with erythropoietin.

The patient with which of the following is most at risk for folic acid deficiency? A) Alcoholism B) Sprue C) Gastrectomy D) Peptic ulcer disease

A) Alcoholism

A patient has heart failure and is taking an ACE inhibitor. The patient has developed fibrotic changes in the heart and vessels. The nurse expects the provider to order which medication to counter this development? A) Aldosterone antagonist B) Angiotensin IIreceptor blocker (ARB) C) Beta blocker D) Direct renin inhibitor (DRI)

A) Aldosterone antagonist

A patient arrives in the emergency department complaining of chest pain that has lasted longer than 1 hour and is unrelieved by nitroglycerin. The patient's electrocardiogram reveals elevation of the ST segment. Initial cardiac troponin levels are negative. The patient is receiving oxygen via nasal cannula. Which drug should be given immediately? A) Aspirin 325 mg chewable B) Beta blocker given IV C) Ibuprofen 400 mg orally D) Morphine intravenously

A) Aspirin 325 mg chewable

The potassium-sparing diuretic spironolactone (Aidactone) prolongs survival and improves heart failure symptoms by which mechanism? A) Blocking aldosterone receptors B) Increasing diuresis C) Reducing venous pressure D) Reducing afterload

A) Blocking aldosterone receptors

A patient has been taking digoxin (Lanoxin) 0.25 mg, and furosemide (Lasix) 40 mg, daily. Upon routine assessment by the nurse, the patient states, "I see yellow halos around the lights." The nurse should perform which action based on this assessment? A) Check the patient for other symptoms of digitalis toxicity. B) Withhold the next dose of furosemide. C) Continue to monitor the patient for heart failure. D) Document the findings and reassess in 1hour.

A) Check the patient for other symptoms of digitalis toxicity.

A patient with hypertension who has been taking captopril (Capoten) for several months is admitted to the hospital. The patient reports that food "tastes funny." What will the nurse do? A) Compare the patient's admission weight to a previous weight. B) Notify the provider to request a different antihypertensive medication. C) Reassure the patient that this is a temporary side effect of the drug. D) Request an order for a white blood cell count (WBC) with differential.

A) Compare the patient's admission weight to a previous weight.

A patient with a recent onset of nephrosclerosis has been taking an ACE inhibitor and a thiazide diuretic. The patient's initial blood pressure was 148/100 mm Hg. After 1 month of drug therapy, the patient's blood pressure is 130/90 mm Hg. The nurse will contact the provider to discuss: A) adding a calcium channel blocker to this patient's drug regimen. B) lowering doses of the antihypertensive medications. C) ordering a high potassium diet. D) adding spironolactone to the drug regimen.

A) adding a calcium channel blocker to this patient's drug regimen.

A patient with angina who uses sublingual nitroglycerin tells the nurse that the episodes are increasing in frequency and usually occur when the patient walks the dog. The patient reports needing almost daily doses of the nitroglycerin and states that one tablet usually provides complete relief. What will the nurse do? A) Contact the provider to suggest ordering a transdermal patch for this patient. B) Question the patient about consumption of grapefruit juice. C) Suggest that the patient limit walking the dog to shorter distances less frequently. D) Suggest that the patient take two tablets of nitroglycerin each time, because the symptoms are increasing in frequency.

A) Contact the provider to suggest ordering a transdermal patch for this patient.

The nurse is caring for a patient who is taking a vasodilator that dilates capacitance vessels. The nurse will expect which effect in this patient? A) Decrease in cardiac work B) Increase in cardiac output C) Increase in tissue perfusion D) Increase in venous return

A) Decrease in cardiac work

An older adult patient with congestive heart failure develops crackles in both lungs and pitting edema of all extremities. The physician orders hydrochlorothiazide (HydroDIURIL). Before administering this medication, the nurse reviews the patient's chart. Which laboratory value causes the nurse the most concern? A) Elevated creatinine clearance B) Elevated serum potassium level C) Normal blood glucose level D) Low levels of low-density lipoprotein (LDL) cholesterol

A) Elevated creatinine clearance

A nurse is obtaining a medication history on a newly admitted patient, who reports taking minoxidil for hypertension. Admission vital signs reveal a heart rate of 78 beats per minute and a blood pressure of 120/80 mm Hg. What is an important part of the initial assessment for this patient? A) Evaluating ankle edema B) Monitoring for nausea and vomiting C) Noting the presence of hypertrichosis D) Obtaining a blood glucose

A) Evaluating ankle edema

A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug? A) Furosemide (Lasix) B) Hydrochlorothiazide (HydroDIURIL) C) Mannitol (Osmitrol) D) Spironolactone (Aidactone)

A) Furosemide (Lasix)

Which two-drug regimen woulq pe appropriate for a patient with hypertension who does not have other compelling conditions? A) Hydrochlorothiazide and nadolol B) Hydralazine and minoxidil C) Spironolactone and amiloride D) Trichlormethiazide and hydrochlorothiazide

A) Hydrochlorothiazide and nadolol

A patient has three separate blood pressure (BP) readings of 120/100 mm Hg, 138/92 mm Hg, and 126/96 mm Hg. Which category describes this patient's BP? A) Hypertension B) Isolated systolic hypertension C) Normal D) Prehypertension

A) Hypertension

A patient with vitamin B12 deficiency is admitted with symptoms of hypoxia, anemia, numbness of hands and feet, and oral stomatitis. The nurse expects the prescriber to order which of the following therapies? A) IM cyanocobalamin and folic acid B) IM cyanocobalamin and antibiotics C) PO cyanocobalamin and folic acid D) PO cyanocobalamin and blood transfusions

A) IM cyanocobalamin and folic acid

A patient with moderate heart failure begins taking a thiazide dil.lretic. The nurse will tell the patient to expect which outcome when taking this drug? A) Improved exercise tolerance B) Increased cardiac output C) Prevention of cardiac remodeling D) Prolonged survival

A) Improved exercise tolerance

A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do? A) Instruct the patient not to get up without assistance. B) Make sure the patient takes a potassium supplement. C) Report the presence of a dry cough to the prescriber. D) Request an order for a diuretic to counter the side effects of the ACE inhibitor.

A) Instruct the patient not to get up without assistance.

A patient with hypertension with a blood pressure of 168/110 mm Hg begins taking hydrochlorothiazide and verapamil. The patient returns to the clinic after 2 weeks of drug therapy,, and the nurse notes a blood pressure of 140/85 mm Hg and a heart rate of 98 beats per minute. What will the nurse do? A) Notify the provider and ask about adding a beta blocker medication. B) Reassure the patient that the medications are working. C) Remind the patient to move slowly from sitting to standing. D) Request an order for an electrocardiogram.

A) Notify the provider and ask about adding a beta blocker medication.

A hospitalized patient has a blood pressure of 145/96 mm Hg. The nurse caring for this patient notes that the blood pressure the day before was 132/98 mm Hg. The patient reports ambulatory blood pressure readings of 136/98 and 138/92 mm Hg. The patient has a history of a previous myocardial infarction and has adopted a lifestyle that includes use of the DASH diet and regular exercise. What will the nurse do? A) Notify the provider and discuss ordering a beta blocker for this patient. B) Notify the provider and suggest a thiazide diuretic as initial therapy. C) Order a diet low in sodium and high in potassium for this patient. D) Recheck the patient's blood pressure in 4 hours to verify the result.

A) Notify the provider and discuss ordering a beta blocker for this patient.

A patient is receiving oral iron for iron deficiency anemia. Which antibiotic drug, taken concurrently with iron, would most concern the nurse? A) Tetracycline B) Cephalosporin C) Metronidazole (Flagyl) D) Penicillin

A) Tetracycline

A nurse is reviewing the medications of a patient with diabetes before discharge. The nurse realizes that the patient will be going home on cole yelam, a bile acid sequestrant, and insulin. What patient education should the nurse provide in the discharge teaching for this patient? A) The patient needs to monitor t'h'e;.' lood sugar carefully, because colesevelam can cause hypoglycemia. B) The patient needs to monitor the blood sugar carefully, because colesevelam can cause hyperglycemia. C) The patient needs to take the insulin at least 3 hours before the colesevelam. D) The patient needs to use an oral antidiabetic agent or agents, not insulin, with colesevelam.

A) The patient needs to monitor t'h'e;.' lood sugar carefully, because colesevelam can cause hypoglycemia.

A patient who has recently immigrated to the United States from an impoverished country appears malnourished. The patient's folic acid levels are low, and the vitamin B12 levels are normal. The nurse expects this patient's treatment to Include: A) a diet high in folic acid. B) intramuscular folic acid. C) oral folic acid and vitamin B12. D) oral folic acid supplements.

A) a diet high in folic acid.

A patient with atrial fibrillation is receiving warfarin (Coumadin). The nurse notes that the patient's INR is 2.7. Before to giving the next dose of warfarin, the nurse will notify the provider and: A) administer the dose as ordered. B) request an order to decrease the dose. C) request an order to give vitamin K (phytonadione). D) request an order to increase the dose.

A) administer the dose as ordered.

A patient who took an overdose of verapamil has been treated with gastric lavage and a cathartic. The emergency department nurse assesses the patient and notes a heart rate of 50 beats per minute and a blood pressure of 90/50 mm Hg. The nurse will anticipate: A) administering intravenous norepinephrine (NE) and isoproterenol. B) assisting with direct-current (DC) cardioversion. C) placing the patient in an upright position. D) preparing to administer a beta blocker.

A) administering intravenous norepinephrine (NE) and isoproterenol.

A patient with heart failure who has been given digoxin (Lanoxin) daily for a week complains of nausea. Before giving the next dose, the nurse will: A) assess the heart rate (HR) and give the dose if the HR Is greater than 60 beats per minute. B) contact the provider to report digoxin toxicity. C) request an order for a decreased dose of digoxin. D) review the serum electrolyte values and withhold the dose if the potassium level is greater than 3.5 mEq/L.

A) assess the heart rate (HR) and give the dose if the HR Is greater than 60 beats per minute.

The nurse has just received an order for tenecteplase (TNKase) for a patient experiencing an acute myocardial infarction. The nurse should administer this drug: A) by bolus injection. B) by infusion pump over 24 hours. C) slowly over 90 minutes. D) via monitored, prolonged infusion.

A) by bolus injection.

A patient is taking a vasodilator that relaxes smooth muscles in veins. To help minimize drug side effects, the nurse caring for this patient will: A) caution the patient not to get up without assistance. B) encourage the patient to increase fluid intake. C) tell the patient to report shortness of breath. D) warn the patient about the possibility of bradycardia.

A) caution the patient not to get up without assistance.

A patient newly diagnosed with heart failure is admitted to the hospital. The nurse notes a pulse of 90 beats per minute. The nurse will observe this patient dosely for: A) decreased urine output. B) increased blood pressure. C) jugular vein distension. D) shortness of breath.

A) decreased urine output.

A nurse is reviewing a patient's most recent blood count and notes that the patient has a hemoglobin of 9.6 gm/dL and a hematocrit of 33%. The nurse will notify the provider and will expect initial treatment to include: A) determining the cause of the anemia. B) giving intravenous iron dextran. C) giving oral carbonyl iron (Feosol). D) teaching about dietary iron.

A) determining the cause of the anemia.

A patient with Stage C heart failure (HF) who has been taking an ACE inhibitor, a beta blocker, and a diuretic begins to have increased dyspnea, weight gain, and decreased urine output. The provider orders spironolactone (Aidactone). The nurse will make sure that the patient: A) does not take potassium supplements. B) monitors for a decreased heart rate. C) takes extra fluids. D) uses a salt substitute instead of salt.

A) does not take potassium supplements.

A patient is taking a calcium channel blocker (CCB) for stable angina. The patient's spouse asks how calcium channel blockers relieve pain. The nurse will explain that CCBs: A) help relax peripheral arterioles to reduce afterload. B) Improve coronary artery perfusion. C) increase the heart rate to improve myocardial contractility. D) increase the QT interval.

A) help relax peripheral arterioles to reduce afterload.

A 5-year-old patient seen in an outpatient clinic is noted to have hypertension on three separate visits. Ambulatory blood pressure monitoring confirms that the child has hypertension. As an initial intervention with the child's parents, the nurse will expect to: A) perform a detailed health history on the child. B) provide teaching about antihypertensive medications. C) reassure the parents that their child may outgrow this condition. D) teach the parents about lifestyle changes and a special diet.

A) perform a detailed health history on the child.

A patient who is taking warfarin (Coumadin) has just vomited blood. The nurse notifies the provider, who orders lab work revealing a PT of 42 seconds and an INR of 3.5. The nurse will expect to administer: A) phytonadione (vitamin Kt) 1mg IV over 1hour. B) phytonadione (vitamin K1) 2.5 mg PO. C) protamine sulfate 20 mg PO. D) protamine sulfate 20 mg slow IV push.

A) phytonadione (vitamin Kt) 1mg IV over 1hour.

A patient who was in a motor vehicle accident sustained a severe head injury and is brought into the emergency department. The provider orders intravenous mannitol (Osmitrol). The nurse knows that this is given to: A) reduce intracranial pressure. B) reduce renal perfusion. C) reduce peripheral edema. D) restore extracellular fluid.

A) reduce intracranial pressure.

A patient who recently started therapy with an HMG-COA reductase inhibitor asks the nurse, "How long will it take until I see an effect on my LDL cholesterol?" The nurse gives which correct answer? A) "At least 6 months is required to see a change." B) "A reduction usually is seen within 2 weeks." C) "Blood levels normalize immediately after the drug is started." D) "Cholesterol will not be affected, but triglycerides will fall within the first week."

B) "A reduction usually is seen within 2 weeks."

A nurse provides teaching to a patient with angina who also has type 2 diabetes mellitus, asthma, and hypertension. Which statement by the patient indicates a need for further teaching? A) "An ACE inhibitor, in addition to nitroglycerin, will lower my risk of cardiovascular death." B) "Beta blockers can help control hypertension." C) "I should begin regular aerobic exercise." D) "Long-acting, slow-release calcium channel blockers can help with anginal pain."

B) "Beta blockers can help control hypertension."

A patient with variant angina wants to know why a beta blocker cannot be used to treat the angina. Which response by the nurse is correct? A) "A beta1-selective beta blocker could be used for variant angina." B) "Beta blockers do not helprelax coronary artery spasm." C) "Beta blockers do not help to improve the cardiac oxygen supply." D) "Beta blockers promote constriction of arterial smooth muscle."

B) "Beta blockers do not helprelax coronary artery spasm."

A 12-year-old female patient is admitted to the hospital before sinus surgery. The nurse preparing to care for this patient notes that the admission hemoglobin is 10.2 gm/dL, and .the hematocrit is 32%. The nurse will ask the child's parents which question about their daughter? A) "Does she eat green, leafy vegetables?" B) "Has she begun menstruating?" C) "Is she a vegetarian?" D) "Is there a chance she might be pregnant?"

B) "Has she begun menstruating?"

A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide (HydroDIURIL) and digoxin. The prescriber has ordered spironolactone (Aidactone) to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching? A) "I can expect improvement within a few hours after taking this drug." B) "I need to stop taking potassium supplements." C) "I should use salt substitutes to prevent toxic side effects." D) "I should watch closely for dehydration."

B) "I need to stop taking potassium supplements."

A nurse is reviewing the phenomenon of reflex tachycardia with a group of nursing students. Which statement by a student indicates understanding of this phenomenon? A) "Baroreceptors in the aortic arch stimulate the heart to beat faster." B) "Reflex tachycardia can negate the desired effects of vasodilators." C) "Reflex tachycardia is more likely to occur when beta blockers are given." D) "Venous dilation must occur for reflex tachycardia to occur."

B) "Reflex tachycardia can negate the desired effects of vasodilators."

A patient has begun taking an HMG-COA reductase inhibitor. Which statement about this class of drugs made by the nurse during patient education would be inappropriate? A) "Statins reduce the risk of stroke." B) "You should come into the clinic for liver enzymes in 1month." C) "Statins reduce the risk of coronary events in people with normal LDL levels." D) ''You should maintain a healthy lifestyle and avoid high-fat foods."

B) "You should come into the clinic for liver enzymes in 1month."

A patient tells a nurse that she is thinking about getting pregnant and asks about nutritional supplements. What will the nurse recommend? A) A balanced diet high in green vegetables and grains B) 400 to 800 mg of folic acid per day C) A multivitamin with iron D) Vitamin B12 supplements

B) 400 to 800 mg of folic acid per day

A patient is admitted to the hospital with unstable angina and will undergo a percutaneous coronary intervention. Which drug regimen will the nurse expect to administer to prevent thrombosis in this patient? A) Aspirin, clopidogrel, omeprazole B) Aspirin, heparin, abciximab (ReoPro) C) Enoxaparin (Lovenox), prasugrel (Effient), warfarin (Coumadin) D) Heparin, alteplase, abciximab (ReoPro)

B) Aspirin, heparin, abciximab (ReoPro)

A patient is admitted to the coronary care unit from the emergency department after initial management of STEMI. A primary percutaneous coronary intervention has been performed. The nurse notes an initial heart rate of 56 beats per minute and a blood pressure of 120/80 mm/Hg. The patient has a history of stroke and a previous myocardial infarction. Which order will the nurse question? A) Aspirin B) Beta blocker C) Clopidogrel D) Heparin

B) Beta blocker

An 88-year-old patient with heart failure has progressed to Stage D and is hospitalized for the third time in a month. The nurse will expect to discuss which topic with the patient's family? A) Antidysrhythmic medications B) End-of-life care C) Heart transplantation D) Implantable mechanical assist devices

B) End-of-life care

A female patient who begins taking spironolactone (Aidactone) as an adjunct to furosemide (Lasix) complains that her voice is deepening. What will the nurse do? A) Contact the provider to obtain an order for a complete blood count (CBC) and liver function tests. B) Explain that this drug binds with receptors for steroid hormones, causing this effect. C) Report this side effect to the provider and request another medication for this patient. D) Teach the patient to report any associated cough, which may indicate a more severe side effect.

B) Explain that this drug binds with receptors for steroid hormones, causing this effect.

A nurse is preparing to administer digoxin (Lanoxin) to a patient. The patient's heart rate is 62 beats per minute, and the blood pressure is 120/60 mm Hg. The last serum electrolyte value showed a potassium level of 5.2 mEq/L. What will the nurse do? A) Contact the provider to request an increased dose of digoxin. B) Give the dose of digoxin and notify the provider of the potassium level. C) Request an order for a diuretic. D) Withhold the dose and notify the provider of the heart rate.

B) Give the dose of digoxin and notify the provider of the potassium level.

The nurse is caring for a pregnant patient who is in labor. The woman reports having had mild preeclampsia with a previous pregnancy. The nurse notes that the woman has a blood pressure of 168/102 mm Hg. The nurse will contact the provider to request an order for which drug? A) Angiotensin-converting enzyme (ACE) inhibitor B) Hydralazine (Apresoline) C) Magnesium sulfate D) Sodium nitroprusside

B) Hydralazine (Apresoline)

A man asks a nurse why he cannot use digoxin (Lanoxin) for his heart failure, because both of his parents used it for HF. The nurse will explain that digoxin is not first-line therapy for which reason? A) It causes tachycardia and increases the cardiac workload. B) It does not correct the underlying pathology of heart failure. C) It has a wide therapeutic range that makes dosing difficult. D) It may actually shorten the patient's life expectancy.

B) It does not correct the underlying pathology of heart failure.

A patient will begin taking dabigatran etexilate (Pradaxa) to prevent stroke. The nurse will include which statement when teaching this patient? A) Dabigatran should be taken on an empty stomach to improve absorption. B) It is important not to crush, chew, or open capsules of dabigatran. C) The risk of bleeding with dabigatran is less than that with warfarin (Coumadin). D) To remember to take dabigatran twice dally, a pill organizer can be useful.

B) It is important not to crush, chew, or open capsules of dabigatran.

A patient with angina who is taking ranolazine (Ranexa) has developed a respiratory infection and a dysrhythmia. The provider has ordered azithromycin (Zithromax) for the infection and amlodlpine for the dysrhythmia. A nursing student caring for this patient tells the nurse that the patient's heart rate is 70 beats per minute, and the blood pressure is 128/80 mm Hg. The nurse asks the student to discuss the plan for this patient's care. Which action is correct? A) Observe the patient closely for signs of respiratory toxicity. B) Question the order for azithromycin (Zithromax). C) Report the patient's increase in blood pressure to the provider. D) Request an order for a different calcium channel blocker.

B) Question the order for azithromycin (Zithromax).

A nurse caring for a patient receiving heparin therapy notes that the patient has a heart rate of 98 beats per minute and a blood pressure of 110/72 mm Hg. The patient's fingertips are purplish in color. A stat CBC shows a platelet count of less than 100,000 mm3• The nurse will: A) administer oxygen and notify the provider. B) discontinue the heparin and notify the provider. C) request an order for protamine sulfate. D) request an order for vitamin K (phytonadione).

B) discontinue the heparin and notify the provider.

A patient Is admitted to the emergency department with chest pain. An electrocardiogram shows changes consistent with an evolving myocardial infarction. The patient's cardiac enzymes are pending. The nurse caring for this patient will expect to: A) administer aspirin when cardiac enzymes are completed. B) give alteplase (Activase) within 2 hours. C) give tenecteplase (TNKase) immediately. D) obtain an order for an INR.

B) give alteplase (Activase) within 2 hours.

A patient who has taken warfarin (Coumadin) for a year begins taking carbamazepine. The nurse will anticipate an order to: A) decrease the dose of carbamazepine. B) increase the dose of warfarin. C) perform more frequent aPTT monitoring. D) provide extra dietary vitamin K.

B) increase the dose of warfarin.

A patient with new-onset exertional angina takes a nitroglycerin sublingual tablet, but the pain intensifies. The nurse notes that the patient has a heart rate of 76 beats per minute and a blood pressure of 120/82 mm Hg. The electrocardiogram is normal. The patient's lips and nail beds are pink, and there is no respiratory distress. The nurse will anticipate providing: A) an angiotensin-converting enzyme (ACE) inhibitor. B) intravenous nitroglycerin and a beta blocker. C) ranolazine (Ranexa) and quinidine. D) supplemental oxygen and intravenous morphine.

B) intravenous nitroglycerin and a beta blocker.

The nurse is taking a medication history on a newly admitted patient. The patient reports taking folic acid and vitamin B12. The nurse notifies the provider because of the concern that folic acid can: A) cause fetal malformation. B) mask the signs of vitamin Bn deficiency. C) negatively affect potassium levels. D) worsen megaloblastic anemia.

B) mask the signs of vitamin Bn deficiency.

A postoperative. patient will begin anticoagulant therapy with rivaroxaban (Xarelta) after knee replacement surgery. The nurse performs a history and learns that the patient is taking erythromycin. The patient's creatinine clearance is 50 ml/min. The nurse will: A) administer the first dose of rivaroxaban as ordered. B) notify the provider to discuss changing the patient's antibiotic. C) request an order for a different anticoagulant medication. D) request an order to increase the dose of rivaroxaban.

B) notify the provider to discuss changing the patient's antibiotic.

A nurse is caring for a patient after hip replacement surgery. The patient has been receiving iron replacement therapy for 2 days. The nurse notes that the patient's stools appear black. The patient is pale and complains of feeling tired. The patient's heart rate is 98 beats per minute, respirations are 20 breaths per minute, and the blood pressure is 100/50 mm Hg. The nurse will contact the provider to: A) report possible gastrointestinal hemorrhage. B) request a hemoglobin and hematocrit (H&H). C) request an order for a stool guaiac. D) suggest giving a hypertonic fluid bolus.

B) request a hemoglobin and hematocrit (H&H).

A patient who does not consume alcohol or nicotine products reports a strong family history of hypertension and cardiovascular disease. The patient has a blood pressure of 126/82 and a normal weight and body mass index for height and age. The nurse wiJJ expect to teach this patient about: A) ACE inhibitors and calcium channel blocker medications. B) the DASH diet, sodium restriction, and exercise. C) Increased calcium and potassium supplements. D) thiazide diuretics and lifestyle changes.

B) the DASH diet, sodium restriction, and exercise.

A patient has been receiving heparin while in the hospital to treat deep vein thromboses and will be discharged home with a prescription for enoxaparin (Lovenox). The nurse provides teaching for the nursing student who asks about the advantages of enoxaparin over heparin. Which statement by the student indicates a need for further teaching? A) "Enoxaparin does not require coagulation monitoring." B) "Enoxaparin has greater bioavailability than heparin." C) "Enoxaparin is more cost-effective than heparin." D) "Enoxaparin may be given using a fixed dosage."

C) "Enoxaparin is more cost-effective than heparin."

A nurse is discussing fibrinolytic therapy for the acute phase of STEMI management with a group of nursing students. Which statement by a student indicates understanding of this therapy? A) "Fibrinolytics are effective when the first dose is given up to 24 hours after symptom onset." B) "Fibrinolytics should be given once cardiac troponins reveal the presence of STEMI." C) "Fibrinolytics should be used with caution in patients with a history of cerebrovascular accident." D) "Patients should receive either an anticoagulant or an antiplatelet agent with a fibrinolytic drug."

C) "Fibrinolytics should be used with caution in patients with a history of cerebrovascular accident."

A nurse is providing discharge teaching instructions for a patient taking cholestyramine (Questran). Which statement made by the patient demonstrates a need for further teaching? A) "I will take warfarin (Coumadin) 1hour before my medicine." B) "I will increase the fluids and fiber in my diet." C) "I can take cholestyramine with my hydrochlorothiazide." D) "I will take digoxin 4 hours after taking the cholestyramine."

C) "I can take cholestyramine with my hydrochlorothiazide."

A patient who is taking furosemide (Lasix) and digoxin will begin taking captopril (Capoten). The nurse is providing information about the drug. Which statement by the patient indicates a need for further teaching? A) "I can use acetaminophen for analgesia if needed." B) "I should stop taking the Lasix about a week before starting the Capoten." C) "I should take this medication on a full stomach." D) "I will need to have blood tests done every 2 weeks for a few months."

C) "I should take this medication on a full stomach."

A nurse is preparing to assist a nursing student in administering intravenous verapamil to a patient who also receives a beta blocker. The nurse asks the nursing student to discuss the plan of care for this patient. Which statement by the student indicates a need for further teaching? A) "I will check to see when the last dose of the beta blocker was given." B) "I will monitor vital signs closely to assess for hypotension." C) "I will monitor the heart rate frequently to assess for reflex tachycardia." D) "I will prepare to administer intravenous norepinephrine if necessary."

C) "I will monitor the heart rate frequently to assess for reflex tachycardia."

A patient who has been taking verapamil (Calan) for hypertension complains of constipation. The patient will begin taking amlodipine (Norvasc) to prevent this side effect. The nurse provides teaching about the difference between the two drugs. Which statement by the patient indicates that further teaching is needed? A) "I can expect dizziness and facial flushing with nifedipine." B) "I should notify the provider if Ihave swelling of my hands and feet." C) "I will need to take a beta blocker to prevent reflex tachycardia." D) "I will need to take this drug once a day."

C) "I will need to take a beta blocker to prevent reflex tachycardia."

A patient has been taking chlorthalidone to treat hypertension. The patient's prescriber has just ordered the addition of spironolactone to the patient's drug regimen. Which statement by the patient indicates a need for further teaching? A) "I should continue following the DASH diet when adding this drug." B) "I should not take an ACE inhibitor when adding this drug." C) "I will need to take potassium supplements when adding this drug." D) "I will not experience a significant increase in diuresis when adding this drug."

C) "I will need to take potassium supplements when adding this drug."

During discharge instruction, a nurse wants to assess a patient's understanding of treatment with cholestyramine (Questran). Which statement made by the patient best demonstrates a need for additional teaching? A) "I will take cholestyramine (Questran) 1hour before my other medications." B) "I will increase fluids and fiber in my diet." C) "I will weigh myself weekly." D) "I will have my blood pressure checked weekly."

C) "I will weigh myself weekly."

A nurse is providing teaching for a patient with stable angina who will begin taking nitroglycerin. Which statement by the patient indicates understanding of the teaching? · A) "I should not participate in aerobic exercise while taking this drug." B) "I should take aspirin daily to reduce my need for nitroglycerin." C) "If Itake nitroglycerin before exertion, Ican reduce the chance of an anginal attack." D) "I take nitroglycerin to increase the amount of oxygen to my heart."

C) "If Itake nitroglycerin before exertion, Ican reduce the chance of an anginal attack."

A prescriber orders ramipril (Altace) for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home. Which statement by the patient indicates understanding of the teaching? A) "I am less likely to develop diabetic nephropathy when taking this medication." B) "I should check my blood sugar more often, because hyperglycemia is a side effect of this drug." C) "Taking this medication helps reduce my risk of stroke and heart attack." D) "This medication will probably prevent the development of diabetic retinopathy."

C) "Taking this medication helps reduce my risk of stroke and heart attack."

A nursing student who Is preparing to care for a postoperative patient with deep vein thrombosis asks the nurse why the patient must take heparin rather than warfarin. Which response by the nurse is correct? A) "Heparin has a longer half-life." B) "Heparin has fewer adverse effects." . C) "The onset of warfarin is delayed." D) "Warfarin prevents platelet aggregation."

C) "The onset of warfarin is delayed."

A nurse is discussing heart failure with a group of nursing students. Which statement by a student reflects an understanding of how compensatory mechanisms can compound existing problems in patients with heart failure? A) "An increase in arteriolar tone to improve tissue perfusion can decrease resistance." B) "An increase in contractility to increase cardiac output can cause pulmonary edema." C) "When the heart rate increases to increase cardiac output, it can prevent adequate filling of the ventricles." D) "When venous tone increases to increase ventricular filling, an increase in arterial pressure occurs."

C) "When the heart rate increases to increase cardiac output, it can prevent adequate filling of the ventricles."

A nurse preparing to administer morning medications notes that a patient with a history of hypertension has been prescribed the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten) concurrently with spironolactone (Aidactone). Morning laboratory results reveal a serum sodium level of 144 mg/dL, a serum potassium level of 5.1 mEq/L, and a blood glucose level of 128 mgjdL. Which intervention is appropriate? A) Administer the medications as ordered. B) Ask the patient about the use of salt substitutes. C) Contact the provider to report the laboratory values. D) Request an order for furosemide (Lasix).

C) Contact the provider to report the laboratory values.

A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication? A) Angioedema B) Cancer C) Cough D) Renal failure

C) Cough

A patient is taking clonidine for hypertension and reports having dry mouth and drowsiness. What will the nurse tell the patient? A) Beta blockers can reverse these side effects. B) Discontinue the medication immediately and notify the provider. C) Drink extra fluids and avoid driving when drowsy. D) Notify the provider if symptoms persist after several weeks.

C) Drink extra fluids and avoid driving when drowsy.

A postoperative patient reports pain in the left lower extremity. The nurse notes swelling in the lower leg, which feels warm to touch. The nurse will anticipate giving which medication? A) Aspirin B) Clopidogrel (Piavix) C) Enoxaparin (Lovenox) D) Warfarin (Coumadin)

C) Enoxaparin (Lovenox)

A nurse is reviewing a patient's medications before administration. Which drug-to-drug interactions should most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L? A) Furosemide (Lasix) and enalapril (Vasotec) B) Amlodipine (Norvasc) and spironolactone (Aidactone) C) Eplerenone (Inspra) and spironolactone (Aidactone) D) Metoprolol (Lopressor) and furosemide (Lasix)

C) Eplerenone (Inspra) and spironolactone (Aidactone)

A patient with chronic hypertension is admitted to the hospital. During the admission assessment, the nurse notes a heart rate of 96 beats per minute, a blood pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting edema of the ankles, and distension of the jugular veins. The nurse will contact the provider to request an order for which medication? A) ACE inhibitor B) Digoxin (Lanoxin) C) Furosemide (Lasix) D) Spironolactone (Aldactone)

C) Furosemide (Lasix)

A hospitalized patient complains of acute chest pain. The nurse administers a 0.3 mg sublingual nitroglycerin tablet, but the patient continues to complain of pain. Vital signs remain stable. What is the nurse's next step? A) Apply a nitroglycerin transdermal patch. B) Continue dosing at 10-minute intervals. C) Give a second dose of nitroglycerin in 5 minutes. D) Request an order for intravenous nitroglycerin.

C) Give a second dose of nitroglycerin in 5 minutes.

A nurse is administering a vasodilator that dilates resistance vessels. The nurse understands that this drug will have which effect on the patient? A) Decreased cardiac preload B) Decreased cardiac output C) Increased tissue perfusion D) Increased ventricular contraction

C) Increased tissue perfusion

A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom? A) It indicates that a serious side effect has occurred. B) It is a common side effect that occurs in almost all patients taking the drug. C) It may be uncomfortable enough that the drug will need to be discontinued. D) It occurs frequently in patients taking the drug but will subside over time.

C) It may be uncomfortable enough that the drug will need to be discontinued.

A patient has undergone a primary percutaneous coronary intervention with a sirolimus-eluting stent. The provider has ordered a daily dose of 243 mg of aspirin. What will the nurse tell this patient about the dose of aspirin? A) It will be necessary indefinitely. B) It will decrease to 81 mg per day in 6 months. C) It will decrease to 162 mg per day in 3 months. D) It will increase to 325 mg per day in 1month.

C) It will decrease to 162 mg per day in 3 months.

A patient with hypertension will begin taking an alpha1 blocker. What will the nurse teach this patient? A) A persistent cough is a known side effect of this drug. B) Eat foods rich in potassium while taking this drug. C) Move slowly from sitting to standing when taking this drug. D) Report shortness of breath while taking this drug.

C) Move slowly from sitting to standing when taking this drug.

A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide (Lasix). The nurse notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern? A) Blood glucose level of 120 mg/dL B) Oxygen saturation of 90% C) Potassium level of 3.5 mEq/L D) Sodium level of 140 mEq/L

C) Potassium level of 3.5 mEq/L

A nurse checks a patient's vital signs in the hospital and notes a blood pressure of 146/98 mm Hg. What will the nurse do? A) Instruct the patient to consume a Jaw-sodium diet. B) Prepare the patient for an electrocardiogram and blood tests. C) Recheck the patient's blood pressure in the other arm. D) Request an order for a thiazide diuretic.

C) Recheck the patient's blood pressure in the other arm.

A patient has undergone a PCI, and the provider orders clopidogrel to be given for 12 months, along with an ACE inhibitor and heparin. What will the nurse do? A) Question the need for heparin. B) Request an order for a beta blocker. C) Request an order for aspirin. D) Suggest ordering clopidogrel for 14 days.

C) Request an order for aspirin.

A prescriber has ordered rosuvastatin (Crestor) for a patient with non-alcoholic-related cirrhosis. Which intervention would be most appropriate for the nurse before administration of this drug? A) Question the order, because rosuvastatin is contraindicated in patients with liver disease. B) No intervention is necessary; just administer the drug as ordered. C) Review the baseline liver function test results. D) Assess the patient for liver disease.

C) Review the baseline liver function test results.

A patient is taking gentamicin (Garamycin) and furosemide (Lasix). The nurse should counsel this patient to report which symptom? A) Frequent nocturia B) Headaches C) Ringing in the ears D) Urinary retention

C) Ringing in the ears

A patient has 2+ pitting edema of the tower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEqjL. Which diuretic agent ordered by the prescriber should the nurse question? A) Bumetanide (Bumex) B) Furosemide (Lasix) C) Spironolactone (Aidactone) D) Hydrochlorothiazide (HydroDIURIL)

C) Spironolactone (Aidactone)

A nurse is evaluating a patient admitted to the emergency department with an evolving STEMI for possible administration of thrombolytic therapy. Which information, identified during history taking, would contraindicate this type of therapy? A) The patient just completed her last menstrual cycle. B) The patient states that the chest pain started 1hour ago. C) The patient has a history of a small cerebral aneurysm. D) The patient has hypertension that is well controlled by diuretic therapy.

C) The patient has a history of a small cerebral aneurysm.

A patient has had blood pressures of 150/95 mm Hg and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will expect this pptient's provider to order: A) a beta blocker. B) a loop diuretic and spironolactone. C) a thiazide diuretic. D) counseling on lifestyle changes.

C) a thiazide diuretic.

A nurse is reviewing a patient's medications and realizes that gemfibrozil (Lopid) and warfarin (Coumadin) are to be administered concomitantly. This finding concerns the nurse, who is aware that the ____ will be ____. A) level of gemfibrozil; increased B) level of gemfibrozil; reduced C) anticoagulant effects; increased D) anticoagulant effects; reduced

C) anticoagulant effects; increased

A patient who is taking clopidogrel (Piavix) calls the nurse to report black, tarry stools and coffee-ground emesis. The nurse will tell the patient to: A) ask the provider about using aspirin instead of clopidogrel. B) consume a diet high in vitamin K. C) continue taking the clopidogrel until talking to the provider. D) stop taking the clopidogrel immediately.

C) continue taking the clopidogrel until talking to the provider.

A patient is taking a thiazide diuretic for hypertension and quinidine to treat a dysrhythmia. The prescriber orders digoxin 0.125 mg to improve this patient's cardiac output. The nurse should contact the provider to request: A) adding spironolactone (Aidactone). B) reducing the dose of digoxin. C) discontinuing the quinidine. D) giving potassium supplements.

C) discontinuing the quinidine.

A patient is taking enalapril (Vasotec). The nurse understands that patients taking this type of drug for heart failure need to be monitored carefully for: A) hypernatremia. B) hypertension. C) hyperkalemia. D) hypokalemia.

C) hyperkalemia.

A patient with heart failure who takes a thiazide diuretic and digoxin (Lanoxin) is admitted for shortness of breath. The patient's heart rate Is 66 beats per minute, and the blood pressure is 130/88 mm Hg. The serum potassium level is 3.8 mEq/l, and the digoxin level is 0.8 ng/mL. The nurse admitting this patient understands that the patient: A) has digoxin toxicity. B) is showing signs of renal failure. C) is experiencing worsening of the disease. D) needs a potassium-sparing diuretic.

C) is experiencing worsening of the disease.

A patient with malaise has been taking daptomycin (Cubicin) for an infection and is concurrently taking simvastatin (Zocor). The nurse should be concerned if the patient complains of: A) nausea. B) tiredness. C) muscle pain. D) headache.

C) muscle pain.

A patient presents to the clinic with complaints of muscle aches, muscle pain, and weakness. Upon review of the individual's medications, the nurse notes that the patient is concurrently taking gemfibrozil (Lopid) and atorvastatin (Lipitor). The nurse should assess the patient for the development of: A) migraines. B) hypothyroidism. C) myopathy. D) heart failure.

C) myopathy.

A nursing student asks a nurse why a patient in hypertensive crisis is receiving both intravenous sodium nitroprusside (Nitropress) and oral hydralazine (Apresoline). The nurse will explain that this is done to prevent: A) cyanide poisoning. B) fluid retention. C) rebound hypertension. D) reflex tachycardia.

C) rebound hypertension.

A patient is diagnosed with moderate vitamin B12 deficiency. The nurse reviews the laboratory work and notes that the plasma B12 is low; also, a Schilling test reveals B12 malabsorption. The provider orders oral cyanocobalamin 500 meg per day. The nurse will contact the provider to: A) discuss IM dosing. B) request an order for folic acid. C) suggest an increased dose. D) suggest platelet transfusion therapy.

C) suggest an increased dose.

A nurse is providing patient education about colesevelam (Welchel), a bile acid sequestrant. Which statement made by the patient demonstrates a need for further teaching? A) "Colesevelam will reduce my levels of low-density lipoprotein." B) "Colesevelam will augment my statin drug therapy." C) "I will not have to worry about having as many drug interactions as Idid when Itook cholestyramine." D) "I cannot take digoxin while on this medication."

D) "I cannot take digoxin while on this medication."

A female patient who is not taking any other medications is prescribed aliskiren (Tekturna), a direct renin inhibitor (DRI). The nurse reviews medication information with the patient. Which statement by the patient indicates understanding of the teaching? A) "If Iget pregnant, Ishould stop taking this drug by the second trimester." B) "If Itake this drug with a high-fat meal, it will be more effective." C) "I should restrict my potassium intake while taking this drug." D) "I should take this medication 1hour before sitting down to a meal."

D) "I should take this medication 1hour before sitting down to a meal."

A patient has been taking warfarin (Coumadln) for atrial fibrillation. The provider has ordered dabigatran etexilate (Pradaxa) to replace the warfarin. The nurse teaches the patient about the change in drug regimen. Which statement by the patient indicates understanding of the teaching? A) "I may need to adjust the dose of dabigatran after weaning off the warfarin." B) "I should continue to take the warfarin after beginning the dabigatran until my INR is greater than 3." C) "I should stop taking the warfarin 3 days before starting the dabigatran." D) "I will stop taking the warfarin and will start taking the dabigatran when my INR is less than 2."

D) "I will stop taking the warfarin and will start taking the dabigatran when my INR is less than 2."

A patient in the emergency department has severe chest pain. The nurse administers morphine intravenously. The patient asks the nurse why morphine is given. Whichresponse by the nurse is correct? A) "Morphine helps by reducing anxiety and relieving pain." B) "Morphine helps by reducing pain and dissolving clots." C) "Morphine helps by relieving pain and lowering blood pressure." D) "Morphine helps by relieving pain and reducing the cardiac oxygen demand."

D) "Morphine helps by relieving pain and reducing the cardiac oxygen demand."

A nurse is caring for a patient with hypertension and diabetes. The patient's prescriber recently ordered an angiotensin-converting enzyme (ACE) inhibitor. Which statement by the patient indicates understanding of the nurse's teaching about this drug? A) "ACE inhibitors only dilate veins, so Imay have more edema in my ankles." B) "ACE inhibitors prevent the nervous system from causing increased blood pressure." C) "This drug can also cause shortness of breath because of bronchoconstriction." D) "This drug will help lower my blood pressure and will benefit my kidneys."

D) "This drug will help lower my blood pressure and will benefit my kidneys."

A nursing student asks the nurse why multi-drug therapy is often used to treat hypertension. Which statement by the student indicates a need for further teaching? A) "Multi-drug therapy often means that drugs may be given in lower doses." B) "Some agents are used to offset adverse effects of other agents." C) "Treatment of hypertension via different mechanisms increases success." D) "Two or more drugs will lower blood pressure more quickly."

D) "Two or more drugs will lower blood pressure more quickly."

A nurse is discussing the difference between stable and variant angina with a group of nursing students. Which statement by a student indicates the need for further teaching? A) "Beta blockers are effective in stable angina but not in variant angina." B) "In both types of angina, prophylactic treatment is possible." C) "Variant angina is primarily treated with vasodilators to increase oxygen supply." D) "Variant angina is the result of increased oxygen demand by the heart."

D) "Variant angina is the result of increased oxygen demand by the heart."

A nurse has provided education for a patient newly diagnosed with hypertension who is just beginning therapy with antihypertensive medications. Which statement by the patient indicates a need for further teaching? A) "I may experience serious long-term problems even if Iam not having symptoms." B) "I should report side effects to the provider since other drugs may be substituted." C) "I will need to take medications on a long-term basis." D) "When my symptoms subside, Imay discontinue the medications."

D) "When my symptoms subside, Imay discontinue the medications."

A nurse is instructing a patient receiving a cholesterol-lowering agent. Which information should the nurse include in the patient education? A) "This medication will replace other interventions you have been trying." B) "It is important for you to double your dose if you miss one to maintain therapeutic blood levels." C) "Stop taking the medication if you experience constipation." D) "You should continue your exercise program to increase your HDL serum levels."

D) "You should continue your exercise program to increase your HDL serum levels."

A nurse prepares to administer a scheduled dose of digoxin. The nurse finds a new laboratory report showing a plasma digoxin level of 0.7 ng/ml. What action should the nurse take? A) Withhold the drug for an hour and reassess the level. B) Withhold the drug and notify the prescriber immediately. C) Administer Digibind to counteract the toxicity. D) Check the patient's apical pulse, and if it is within a safe range, administer the digoxin.

D) Check the patient's apical pulse, and if it is within a safe range, administer the digoxin.

A patient takes an ACE inhibitor to treat hypertension and tells the nurse that she wants to become pregnant. She asks whether she should continue taking the medication while she is pregnant. What will the nurse tell her? A) Controlling her blood pressure will decrease her risk of preeclampsia. B) Ask the provider about changing to an ARB during pregnancy. C) Continue taking the ACE Inhibitor during her pregnancy. D) Discuss using methyldopa instead while she is pregnant.

D) Discuss using methyldopa instead while she is pregnant.

A patient diagnosed with STEMI is about to undergo a primary percutaneous coronary intervention (PCI). Which combination of pharmacotherapeutic agents will be given to augment this procedure? A) Beta blocker and nitroglycerin B) Abciximab and a fibrinolytic drug C) Angiotensin-converting enzyme (ACE) inhibitor and aspirin D) Heparin, aspirin, and clopidogrel

D) Heparin, aspirin, and clopidogrel

An Asian patient comes to the clinic. Upon assessment, the nurse notes a sllght yellow tint to the skin and sclera, edema, and hepatomegaly. The drug history reveals that the patient has been taking rosuvastatin (Crestor) for 6 months. The nurse is concerned, because rosuvastatin (Crestor) has been shown to do what? A) Cause renal and pancreatic toxicity specifically in Asian patients B) Cause renal failure C) Create myoglobin in the urine D) Reach levels twice as high in Asians as in Caucasians, resulting in a greater chance of hepatotoxicity

D) Reach levels twice as high in Asians as in Caucasians, resulting in a greater chance of hepatotoxicity

A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse reviewing this patient's chart before administering the medication will be most concerned about which other disease process? A) Bronchial asthma B) Coronary artery disease C) Diabetes mellitus D) Renal artery stenosis

D) Renal artery stenosis

A patient is admitted with severe hypertensive crisis. The nurse will anticipate administering which medication? A) Captopril PO B) Hydralazine (Apresoline) 25 mg PO C) Minoxidil 20 mg PO D) Sodium nitroprusside (Nitropress) IV

D) Sodium nitroprusside (Nitropress) IV

A patient with hypertension is taking furosemide {Lasix) for congestive heart failure. The prescriber orders digoxin to help increase cardiac output. What other medication will the nurse expect to be ordered for this patient? A) Bumetanide (Bumex) B) Chlorothiazide (Diuril) C) Hydrochlorothiazide (HydroDIURjL) D) Spironolactone (Aidactone)

D) Spironolactone (Aidactone)

A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient? A) The fetus most likely will have serious congenital defects. B) The fetus must be monitored closely while the patient is taking this drug. C) The patient's prescriber probably will change her medication to an ARB. D) The patient should stop taking the medication and contact her provider immediately.

D) The patient should stop taking the medication and contact her provider immediately.

A patient taking gemfibrozil (Lopid) and rosuvastatin (Crestor) concurrently begins to complain of muscle aches, fatigue, and weakness. What should the nurse monitor? A) For tendon tenderness B) For a lupuslike syndrome C) The patient's LFT results D) The patient's creatinine kinase levels

D) The patient's creatinine kinase levels

A 55-year-old patient asks a nurse about taking aspirin to prevent heart disease. The patient does not have a history of myocardial infarction. Her cholesterol and blood pressure are normal, and she does not smoke. What will the nurse tell the patient? A) Aspirin is useful only for preventing a second myocardial infarction. B) She should ask her provider about using a P2Y12 ADP receptor antagonist. C) She should take one 81 mg tablet per day to prevent myocardial infarction. D) There is most likely no protective benefit for patients her age.

D) There is most likely no protective benefit for patients her age.

A patient is admitted to the hospital. The patient's initial laboratory results reveal megaloblastic anemia. The patient complains of tingling of the hands and appears confused. The nurse suspects what in this patient? A) Celiac disease B) Folic acid deficiency C) Iron deficiency anemia D) Vitamin B12 deficiency

D) Vitamin B12 deficiency

A patient was given a 30-day supply of Feosol and has been taking the drug for 4 weeks for iron deficiency anemia. The patient's initial hemoglobin was 8.9 gm/dL. The nurse notes that the hemoglobin has risen to 9.7 gm/dL. What will the nurse ask the patient about? A) Dietary iron intake B) Gastrointestinal (GI) upset C) Whether stools have been tarry or black D) Whether the prescription needs to be refilled

D) Whether the prescription needs to be refilled

A patient who takes warfarin (Coumadin) is brought to the emergency department after accidentally taking too much warfarin. The patient's heart rate is 78 beats per minute and the blood pressure is 120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not complain of pain. The nurse will anticipate an order for: A) vitamin K (phytonadione). B) protamine sulfate. C) a PTT. D) a PT and an INR.

D) a PT and an INR.

A nursing student asks a nurse how beta blockers increase the oxygen supply to the heart in the treatment of anginal pain. The nurse tells the student that beta blockers: A) dilate arterioles to improve myocardial circulation. B) improve cardiac contractility, which makes the heart more efficient. C) increase arterial pressure to improve cardiac afterload. D) increase the time the heart is in diastole.

D) increase the time the heart is in diastole.

A patient begins taking nifedipine (Procardia), along with a beta blocker, to treat hypertension. The nurse understands that the beta blocker is used to: A) reduce flushing. B) minimize gingival hyperplasia. C) prevent constipation. D) prevent reflex tachycardia.

D) prevent reflex tachycardia.

A patient asks a nurse how nitroglycerin works to relieve anginal pain. The nurse correctly states, "Nitroglycerin: A) dilates coronary arteries to increase blood flow to the heart." B) increases the oxygen supply to the cardiac muscle." C) increases ventricular filling to improve cardiac output." D) promotes vasodilation, which reduces preload and oxygen demand."

D) promotes vasodilation, which reduces preload and oxygen demand."

A patient is receiving heparin postoperatively to prevent deep vein thrombosis. The nurse notes that the patient has a blood pressure of 90/50 mm Hg and a heart rate of 98 beats per minute. The patient's most recent aPTT is greater than 90 seconds. The patient reports lumbar pain. The nurse will request an order for: A) a repeat aPTT to be drawn immediately. B) analgesic medication. C) changing heparin to aspirin. D) protamine sulfate.

D) protamine sulfate.

A patient who takes warfarin for atrial fibrillation undergoes hip replacement surgery. On the second postoperative day, the nurse assesses the patient and notes an oxygen saturation of 83%, pleuritic chest pain, shortness of breath, and hemoptysis. The nurse will contact the provider to report possible _____ and request an order for _____. A) congestive heart failure; furosemide (Lasix) B) hemorrhage; vitamin K (phytonadione) C) myocardial infarction: tissue plasminogen activator (tPA) D) pulmonary embolism; heparin

D) pulmonary embolism; heparin

A patient with heart failure who has been taking an ACE inhibitor, a thiazide diuretic, and a beta blocker for several months comes to the clinic for evaluation. As part of the ongoing assessment of this patient, the nurse will expect the provider to evaluate: A) complete blood count. B) ejection fraction. C) maximal exercise capacity. D) serum electrolyte levels.

D) serum electrolyte levels.

A patient who has begun using transdermal nitroglycerin for angina reports occasional periods of tachycardia. The nurse will expect the prescriber to order: A) digoxin (Lanoxin) to slow the heart rate. B) immediate discontinuation of the nitroglycerin. C) periods of rest when the heart rate increases. D) verapamil as an adjunct to nitroglycerin therapy.

D) verapamil as an adjunct to nitroglycerin therapy.