Pharm Exam 2

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication?

"I feel nauseated and have no appetite"

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? A. "I can walk a mile a day." B. "I've had a backache for several days." C. "I am urinating more frequently." D. "I feel nauseated and have no appetite."

"I feel nauseated and have no appetite."

A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication? A. Bradycardia B. Tremor C. Cough D. Constipation

A. Bradycardia

Contraindication of Propranolol

Asthma

A nurse at a provider's office receives a phone call from a client who reports nausea and unrelieved chest pain after taking a nitroglycerin tablet 5 min ago. Which of the following is an appropriate response by the nurse? A. Tell the client to take an antacid. B. Instruct the client to call 911. C. Tell the client to take another nitroglycerin tablet in 15 min. D. Advise the client to come to office.

B. Instruct the client to call 911.

A nurse is teaching a client who has angina pectoris about starting therapy with SL nitroglycerin tablets. The nurse should include which of the following instructions regarding how to take the medication? A. "Take this medication after each meal and at bedtime." B. "Take one tablet every 15 min during an acute attack." C. "Take one tablet at the first indication of chest pain." D. "Take this medication with 8 ounces of water."

C. "Take one tablet at the first indication of chest pain."

What sign is most indicative of dehydration in a client taking diuretics?

Decreased body weight

The physician tells you that a patient is hypokalemic. He has been taking a thiazide medication for treatment of his high blood pressure. You will instruct him to increase his dietary intake of which of the following? Select all that apply.

Green leafy vegetables Bananas and citrus fruit Low-fat products

Digoxin toxicity: first sign

Anorexia

A nurse is assessing an older adult client who is receiving digoxin. The nurse should recognize that which of the following findings is a manifestation of digoxin toxicity? A. Anorexia B. Ataxia C. Photosensitivity D. Jaundice

Anorexia

Side effect of Hydrochlorothiazide

Hypokalemia

Digoxin toxicity will occur at what serum blood level?

2.0 ng/mg and above

A client who is taking digoxin would withhold the drug is his pulse rate were which of the following?

56 beats /minute

A nurse is providing instructions to a client who has a new prescription for sublingual nitroglycerin (Nitrostat) to treat angina pectoris. Which of the following instructions should the nurse include? A. "Place the tablet under your tongue, and then take a small sip of water." B. "The medication can take up to 15 minutes to take effect." C. "Avoid taking the medication prior to exercising." D. "Stop taking the medication and notify your provider if you develop a headache."

A. "Place the tablet under your tongue, and then take a small sip of water."

A nurse on a telemetry unit is caring for a client who has unstable angina and is reporting chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers 1 sublingual nitroglycerin tablet. After 5 min, the client states that his chest pain is now a severity of 2. Which of the following actions should the nurse take? A. Administer another nitroglycerin tablet. B. Initiate a peripheral IV. C. Call the Rapid Response Team. D. Obtain an ECG.

A. Administer another nitroglycerin tablet.

A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make? A. "A headache is an indication of an allergy to the medication." B. "A headache is an expected adverse effect of the medication." C. "A headache indicates tolerance to the medication." D. "A headache is likely due to the anxiety about the chest pain."

B. "A headache is an expected adverse effect of the medication."

A nurse is providing teaching to a client who has a new prescription for transdermal nitroglycerin paste. Which of the following statements by the client indicates the need for further teaching? A. "I should measure the dosage on the supplied paper." B. "I should leave the patch in place until it is time for the next dose." C. "I should get up slowly when I stand." D. "I might have a headache when I first start taking this medication."

B. "I should leave the patch in place until it is time for the next dose."

A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take? A. Offer the client a light snack. B. Measure the client's blood pressure. C. Measure the client's apical pulse. D. Weigh the client.

C. Measure the client's apical pulse.

A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take? A. Offer the client a light snack. B. Measure the client's blood pressure. C. Measure the client's apical pulse. D. Weigh the client.

C. Measure the client's apical pulse.

A nurse is caring for a client who has a new prescription for propranolol. The nurse should monitor the client for which of the following adverse reactions to this medication? A. Ototoxicity B. Tachycardia C. Postural hypotension D. Hypokalemia

C. Postural hypotension

A nurse is providing teaching to a client who has angina pectoris and a new prescription for nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching? A. "I'll dial 911 if I still have pain after taking 3 nitroglycerin tablets 5 minutes apart." B. "I'll dial 911 if I still have pain after taking 4 nitroglycerin tablets over a 20-minute period." C. "I'll dial 911 when I have pain and then take the nitroglycerin tablets." D. "I'll dial 911 if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 minutes apart while waiting."

D. "I'll dial 911 if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 minutes apart while waiting."

A nurse is teaching a client who has angina about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching? A. "Place one tablet under your tongue every 5 minutes for 30 minutes to relieve chest pain." B. "Nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries." C. "You can store the bottle of tablets in your bathroom medicine cabinet." D. "Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."

D. "Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."

A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following actions is appropriate? A. Withholding the medication if the heart rate is above 100/min B. Instructing the client to eat foods that are low in potassium C. Measuring apical pulse rate for 30 seconds before administration D. Evaluating the client for nausea, vomiting, and anorexia

D. Evaluating the client for nausea, vomiting, and anorexia

A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication? A. Hyperthermia B. Hypotension C. Ototoxicity D. Muscle pain

Hypotension

Verapamil by IV bolus to a client who is having cardiac dysrhythmias ...important side effect to monitor

Hypotension

You are visiting an 80-year-old patient in her home. She is receiving 0.125 of oral digoxin (Lanoxin) daily. She also takes hydrochlorothiazide 50 mg B.I.D. She complains of blurred vision and nausea. You observe she is confused and disoriented at times. Which of the following might be the problem?

The patient may have digitalis toxicity

A nurse is providing teaching to a client who has stable angina and a new prescription for transdermal nitroglycerin. Which of the following instructions should the nurse include? (Select all that apply.) A. Apply the patch to a hairless area and rotate sites. B. Apply a new patch each morning. C. Remove the patch for 10 to 12 hr daily. D. Apply the patch to dry skin and cover the area with plastic wrap. E. Apply a new patch at the onset of anginal pain.

A. Apply the patch to a hairless area and rotate sites. B. Apply a new patch each morning. C. Remove the patch for 10 to 12 hr daily.

A nurse is assessing a client prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication? A. Heart rate 46/min B. Oxygen saturation 95% C. Respiratory rate 18/min D. Blood pressure 160/94 mm Hg

A. Heart rate 46/min

A nurse is providing teaching for a client who has hypertension and a prescription change from metoprolol to metoprolol/hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching? A. "Now I will not have to diet to lose weight." B. "With the new medication, I should experience fewer side effects." C. "I will not have to do anything different because it is the same medication." on of the diuretic in the combination drug. D. "The extra letters after the name of medication means it is a stronger dose."

B. "With the new medication, I should experience fewer side effects."

A nurse is teaching a client who has a new prescription for transdermal nitroglycerin to treat angina pectoris. Which of the following instructions should the nurse include in the teaching? A. Apply a new transdermal patch once a week. B. Apply the transdermal patch in the morning. C. Apply the transdermal patch in the same location as the previous patch. D. Apply a new transdermal patch when chest pain is experienced.

B. Apply the transdermal patch in the morning.

A nurse is teaching with a group of nurses about the administration of nitroglycerin. Which of the following routes of administration provides the most rapid onset for the client? A. Transdermal patch B. Sublingual C. Suspended-release D. Topical ointment

B. Sublingual

Assessment prior to administration of Metoprolol

BP and HR

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? A. Check the client's vitals B. Request a dietitian consult C. Suggest that the client rests before eating the meal D. Request an order for an antiemetic

Check the client's vital signs

A nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. Which of the following findings should the nurse investigate further? A. Diet-controlled Type 2 diabetes mellitus B. A history of left-sided heart failure client to watch for signs of increasing left-sided heart failure, such as shortness of breath and weight gain indicating fluid retention, and report these findings to the provider. C. A concurrent prescription for tadalafil D. Recently treated bilateral pneumonia

B. A history of left-sided heart failure

A nurse in a provider's clinic is assessing a client who takes sublingual nitroglycerin for stable angina. The client reports getting a headache each time he takes the medication. Which of the following statements should the nurse make? A. "Take only one dose of nitroglycerin to reduce the risk of getting a headache." B. "There's nothing that can be done to relieve the headaches that nitroglycerin causes." C. "Try taking a mild analgesic to relieve the headache." D. "We will ask the provider to prescribe a different medication for you."

C. "Try taking a mild analgesic to relieve the headache."

5.A nurse is providing teaching to a client who has stable angina and a new prescription for nitroglycerin oral, sustained-release capsules. Which of the following instructions should the nurse include? A. Take 1 capsule at the onset of anginal pain. B. Stop taking the medication if side effects are troublesome. C. Take the medication with meals. D. Swallow the capsules whole.

D. Swallow the capsules whole.