Pharm Exam 2
12. Which would a nurse identify as a nitrate? a. Isosorbide b. Amlodipine c. Nicardipine d. Metoprolol
A
2. A 10-year-old is brought into the clinic for an annual check-up and is diagnosed with hypercholesterolemia. What type of hypercholesterolemia is most often seen in children? a. Familial b. Gender specific c. Diet resistant d. Exercise resistant
A
20. An instructor is describing positive inotropic activity. Which would the instructor include as a result of this activity? a. Increased cardiac output b. Decreased heart rate c. Increased preload d. Increased conduction velocity
A
21. A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment? a. Frequently monitor blood cholesterol. b. Take a dietary history of the patient. c. Inspect skin and eyelids for evidence of xanthomas. d. Obtain reports of fasting blood sugar levels
A
5. A student asks the pathophysiology instructor what the function of renin is in the body. What is the instructor's best response to the student's question? a. "Renin is directly involved in the control of arterial blood pressure and it is essential for proper functioning of the glomerulus." b. "Renin is directly involved in the control of arterial blood pressure and the flow of blood through the pyramids of the kidney." c. "Renin is involved in venous blood pressure and it is essential for proper functioning of the glomerulus." d. "Renin is involved in venous blood pressure and controls the flow of blood through the tubules."
A
7. When describing the action of atorvastatin, which would the nurse include? a. Blocking the enzyme that is involved in cholesterol synthesis b. Binding with bile acids to form an insoluble complex that is excreted c. Decreasing dietary cholesterol absorption from the small intestine d. Stimulating the breakdown of lipoproteins from the tissues
A
Which drugs would be the safest to prescribe a client with a high risk for bleeding? Select all that apply. A.acetaminophen B. COX-2 inhibitors C. acetylsalicylic acid D. toradol E. naproxen
A, B
11. What does the use of cardiotonics lead to? (Select all that apply.) a. Improved perfusion to all body tissues b. Increase in blood pressure c. Improved myocardial contractility d. Increase in peripheral edema e. Increased myocardial efficiency
A, C, E
28. A client, age 55 years, is started on calcium channel blockers for anginal attacks. The nurse would assess the client for which reaction? Select all that apply. a. Peripheral edema b. Increase in the pulse rate c. Loss of weight d. Jugular vein distention e. Breathing difficulty
A, D, E
13. A male client has cirrhosis of the liver that has caused ascites. The nurse knows that what condition may occur if diuretics are used to reduce the ascites? a. Ammonia absorption b. Hepatic encephalopathy c. Subtherapeutic drug levels d. Hepatomegaly
B
15. The amount of fluid excreted as urine each day averages approximately less than how many liters? a. 1 L b. 2 L c. 3 L d. 4 L
B
16. The health care provider prescribes calcium channel blockers for a client who is diagnosed with angina pectoris. What is the action of calcium channel blockers? a. Prevent anginal episodes b. Improve blood supply to the myocardium c. Increase blood pressure to increase oxygenation to the myocardium d. Induce coronary artery vasospasm
B
17. The nurse is aware that the use of ranolazine is contraindicated in clients who have what condition? a. Congestive heart failure b. QT-interval prolongation c. Sinus tachycardia d. Arterial claudication
B
18. A client is diagnosed with atherosclerosis. What would the nurse say is the most likely cause of his angina? a. A reduction in plaque secondary to atherosclerosis b. Decreased oxygenation to the myocardium c. Decreased musculature of the myocardium related to plaque d. Hypertension of the myocardium
B
28. The class of diuretics that act to block the chloride pump in the distal convoluted tubules and lead to a loss of sodium and potassium and a minor loss of water are the: a. potassium-sparing diuretics. b. thiazide diuretics. c. carbonic anhydrase inhibitors. d. osmotic diuretics.
B
28. The client wants to know the difference between triglycerides and cholesterol. Which response by the nurse would be correct? a. "Triglycerides transport cholesterol throughout the body." b. "Triglycerides and cholesterol are fatlike substances found in your blood." c. "Triglycerides are found in your blood. Cholesterol is how the fat is transported." d. "Triglycerides are found in your blood. Cholesterol is found in the gallbladder."
B
3. A nurse is preparing to administer a diuretic that antagonizes the action of aldosterone. Which drug would the nurse be most likely to administer? a. Hydrochlorothiazide b. Spironolactone c. Acetazolamide d. Furosemide
B
39. The nurse is evaluating the effectiveness of drug therapy in a client with hyperlipidemia. Effective therapy is best demonstrated by which laboratory values? a. HDL 78 LDL 115 Cholesterol 189 b. HDL 58 LDL 96 Cholesterol 178 c. HDL 82 LDL 96 Cholesterol 240 d. HDL 58 LDL 115 Cholesterol 210
B
5. A male client takes cholesterol absorption inhibitors as a monotherapy without statins. He develops mild hepatic insufficiency. What would the nurse expect the health care provider to do? a. Increase the dosage of his medication b. Decrease the dosage of his medication c. Discontinue his medication d. Maintain the current dosage of his medication
B
6. A 68-year-old patient, an insulin-dependent diabetic, is to receive hydrochlorothiazide (HydroDIURIL). Prior to administering the dose, the nurse should inform the patient that: a. she will need to have her urine checked for ketones 4 times a day. b. her insulin dose may need to be increased. c. her insulin dose may need to be decreased. d. she will need to have a creatinine clearance done once a month
B
6. The nurse prepares to administer a phosphodiesterase inhibitor by what route? a. Oral b. IV c. Subcutaneous d. Intramuscular
B
7. What type of diet should a patient taking diuretics have? a. Eat low-sodium, low-potassium diet b. Eat potassium-rich or low-potassium diet as appropriate c. Eat sodium-rich or low-sodium diet as appropriate d. No effect on diet
B
5. A nurse suspects that a client is experiencing left-sided heart failure. Which would the nurse assess? (Select all that apply.) a. Hepatomegaly b. Hemoptysis c. Tachypnea d. Polyuria e. Peripheral edema f. Orthopnea
B, C, D, F
20. A nurse should be aware that use of statin drugs is contraindicated in clients with which conditions? (Select all that apply.) a. Carcinoma of the breast b. Serious hepatic disease c. Pregnancy d. Kidney disease e. Lactation
B, C, E
1. 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. A. Family history B. Weight C. Gender D. Diet E. Age
B, D
18. 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? a. "I must take my medication on an empty stomach." b. "I will need to make sure that I am consuming enough sodium." c. "I will need to stand slowly." d. "I can jump right into action!"
C
18. The pharmacology instructor is discussing cardiac glycosides with a class of pre-nursing students. According to the instructor, what physiologic effect do cardiac glycosides trigger? a. Increased ventricular rate b. Decreased cardiac output c. Increased force of heart contraction d. Decreased afterload
C
19. The nurse is discharging a client home on HMG-CoA inhibitor therapy. What statement by the client demonstrates that they have a clear understanding of the teaching? a. "This drug will protect me from having a heart attack or stroke." b. "I won't need to follow that diet any more because this drug will take care of my lipids." c. "I should take this drug at bedtime, since my body makes lipids mostly at night." d. "I should take this drug first thing in the morning with a full glass of water."
C
23. A client is taking cholestyramine. The nurse will assess for which common adverse effect of the drug? a. Headache b. Indigestion c. Constipation d. Abdominal pain
C
23. A student asks the physiology instructor how bicarbonate is replaced by the body when a patient loses it from the body. What should the instructor answer? a. The renal tubules secrete new bicarbonate into the urine b. The juxtaglomerular cells secrete new bicarbonate into the blood c. Renal tubular cells generate new bicarbonate d. The juxtaglomerular cells generate new bicarbonate
C
23. Beta-adrenergic blockers help to control angina but can cause: a. Increased heart rate b. Increased oxygen consumption c. Decreased contraction of the heart d. Decreased urinary output
C
6. After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)? a. Colesevelam b. Niacin c. Gemfibrozil d. Ezetimibe
C
6. Ms. Quinn is admitted to the surgical intensive care unit after open heart surgery. The health care provider prescribes IV nitroglycerin, according to a hospital protocol for titration of the drug. Which factor would be most important when determining increases or decreases in the dose? a. Susceptibility of the client to renal insufficiency b. Current respiratory rate c. Current blood pressure d. Susceptibility of the client to intracranial pressure
C
30. A nurse is providing patient teaching to a patient who has been experiencing unstable angina. What will the nurse's explanation of this condition include? a. The pain is caused by a spasm of a blood vessel, not just from the vessel narrowing. b. Your body's response to a lack of oxygen in the heart muscle is pain. c. A coronary vessel has become completely occluded and unable to deliver blood to your heart. d. There is a pronounced narrowing of the coronary arteries, and the heart is experiencing episodes of ischemia or lack of oxygen even when you are resting.
D
38. What is the most serious side effect of lovastatin? a. Muscle aches b. Headache c. Liver damage d. Rhabdomyolysis
D
10. A male client is having angina. As the nurse prepares to administer sublingual nitroglycerin, it is noted that the client's blood pressure is 82/54. What is the best action of the nurse? a. Notify the health care provider. b. Withhold medication until blood pressure increases. c. Ask the client how he feels. d. Administer the medication.
A
11. Diuretics increase the production and output of urine. Which statement helps explain how diuretics achieve these effects? a. Diuretics reduce the reabsorption of water in the kidneys. b. Diuretics have no effect on reabsorption. c. Diuretics increase the reabsorption of electrolytes in the kidneys. d. Diuretics increase production of nephrons.
A
24. The nurse is caring for a woman who has been prescribed ranolazine. The patient asks the nurse why this drug is different from a beta blocker. What would be the nurse's best response? a. "This drug does not slow your heart rate." b. "This drug does not reduce the effectiveness of other medications." c. "This drug increases blood flow to the mesenteric area." d. "This drug does not cause vasoconstriction of the heart."
A
26. 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? a. "It's a good idea to keep your intake of saturated fat to a bare minimum." b. "Try to get most of your food energy from protein sources rather than carbohydrates." c. "A low-fat diet is a good idea, and the animal sources of fat are always preferable to plant sources." d. "I'll give you the names of some salt substitutes that you can start using to season your food."
A
What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.) a.Anti-inflammatory b.Analgesic c. Antipyretic d. Antibacterial e. Antipruritic
A, B, C
13. The nurse provided client teaching related to medication and lifestyle changes to reduce serum lipid levels. One month later, the client returns to the clinic and the nurse evaluates the effectiveness of the client teaching as being effective, based on what data? Select all that apply. a. Weight loss of 8 pounds b. Decreased total cholesterol level c. Decreased blood pressure d. Decreased high density lipoprotein (HDL) e. Decreased low density lipoprotein (LDL)
A, B, C, E
27. The nurse knows that part of the education plan for a client with the diagnosis of hyperlipidemia needs to include which lifestyle changes? (Select all that apply.) a. Increased physical activity b. Weight loss c. Reduction in the intake of carbohydrates d. Reduction of the intake of saturated fats
A, B, D
8. After teaching a group of students about drugs used to treat hyperlipidemia, the instructor determines that the teaching was successful when the students identify which of the following? Select all that apply. a. Bile acid resins b. HMG-CoA reductase inhibitors c. Angiotensin II receptor blockers d. Fibric acid derivatives e. Calcium channel blockers
A, B, D
9. What should the nurse review about an antihyperlipidemic medication with the client when completing discharge counseling? (Select all that apply.) a. Frequency of administration b. Drug name c. Dosage form d. Reason for taking the prescribed drug e. Correct dose
All
10. A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication: a. in the early morning. b. at bedtime. c. in the evening. d. in the afternoon.
B
11. A female client is taking a large dose of nicotinic acid to treat hyperlipidemia. She calls the clinic and reports that her face, neck, and chest are red. Which would be an appropriate response by the nurse? a. "You need to stop taking the medication immediately. I will notify the health care provider." b. "This is an expected adverse effect of the drug. It should subside in time." c. "Don't worry about it. I'm sure it's not really noticeable." d. "You need to decide if you want to take this medication. The flushing will be present as long as you take the medication."
B
12. The nurse teaches the client that antacids when taken with digoxin may have which interactions? a. Nausea and vomiting b. Decreased digoxin levels c. Anorexia d. Increased digoxin levels
B
12. Which would be classified as a bile acid sequestrant? a. Lovastatin b. Cholestyramine c. Ezetimibe d. Gemfibrozil
B
2. What sign is indicative of improved heart failure status? a. Improved mental status b. Decreased pedal edema c. Heart rate regular d. Increased skin turgor
B
21. Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema? a. hydrochlorothiazide b. furosemide c. spironolactone d. mannitol
B
22. A nurse in a health care facility is caring for patients receiving the bile acid sequestrant colesevelam. In which category of patients is colesevelam administered with caution? a. Patients with peptic ulcer disease b. Patients with liver disease c. Patients with diabetes d. Patients with unstable angina
B
25. 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? a. A resident of a long-term care facility whose Alzheimer disease is being treated with donepezil (Aricept) b. An obese male client who is a heavy alcohol user and who has cirrhosis of the liver c. A 72-year-old man who has emphysema and a long history of cigarette smoking d. A female client who had a laparoscopic cholecystectomy (gall bladder removal) earlier this year
B
3. The pharmacology instructor is discussing medications used in the treatment of dyslipidemia. Which drug class would the instructor identify as the most widely used dyslipidemia drugs? a. Fibrates b. HMG-CoA reductase inhibitors c. Bile acid sequestrants d. Niacin
B
1. A client with chronic alcoholism has been admitted to the health care center for acute angina management and is started on nitrates. The nurse emphasizes the need for the client to avoid alcohol use to prevent which reaction? a. Decreased effectiveness of nitrates b. Increased risk of hypoglycemia c. Severe hypotension d. Increased hypersensitivity reactions
C
1. A patient receives furosemide intravenously at 9 AM. The nurse would expect to assess peak effects of the drug at which time? a. 9:15 AM b. 10:30 AM c. 9:30 AM d. 10:00 AM
C
4. A patient arrives at the community health care center reporting chest pain and is diagnosed with angina pectoris. Which drug is administered for treating angina? a. Papaverine b. Cilostazol c. Nicardipine d. Isoxsuprine
C
4. The nurse recognizes that treatment for digitalis toxicity includes which of the following? a. Decreasing the dosage b. Intravenous potassium c. Holding the medication d. Intravenous magnesium
C
5. Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin? a. Decreased saliva production will inhibit the absorption of the drug in her mucosa. b. The woman may experience paradoxical vasoconstriction when taking nitroglycerin. c. The woman will be more susceptible to hypotension than a younger patient. d. The woman will need to allow more time between doses in order to facilitate absorption.
C
13. What is a goal of spironolactone therapy for a client being treated for heart failure (HF)? a. The client will resume prediagnosis levels of stamina. b. The client will exhibit increased serum potassium levels. c. The client will not require inotropes or beta-blockers. d. The client will experience a decrease in edema
D
25. A client is prescribed metoprolol extended-release PO for heart failure. What assessment finding would suggest an exacerbation of the client's underlying diagnosis? a. Chest pain on exertion b. Bradycardia c. Upward trend in blood pressure d. Adventitious breath sounds
D
25. What substance is reabsorbed in the ascending limb of the loop of Henle? a. amino acids b. glucose c. water d. sodium
D
25. When prescribed for angina, how does oral nifedipine achieve a therapeutic effect? a. preventing the outflow of intracellular potassium b. potentiating the effect of B-type natriuretic peptide c. binding extracellular sodium ions with chloride ions d. inhibiting the influx of calcium through slow channels
D
28. Alpha/beta blockers block both alpha-adrenergic and beta-adrenergic receptors. Which antiadrenergic drug is an alpha/beta blocker? a. Propranolol b. Phentolamine c. Sotalol d. Carvedilol
D
29. A client asks how ezetimibe will help to treat high lipid levels. The nurse explains that: a. Its mechanism of action is not understood. b. It stimulates the breakdown of triglycerides. c. It reduces the production of triglycerides by the liver. d. It decreases the absorption of cholesterol in the small intestine.
D
29. The health care provider orders furosemide for a pediatric client. The nurse knows that the established dose of the drug should not exceed how many milligrams per kilogram of body weight per day? a. 4 b. 8 c. 10 d. 6
D
19. Which would be considered a therapeutic effect of digoxin? a. Increased force of contraction b. Decreased renal perfusion c. Increased heart rate d. Decreased cardiac output
A
22. The students are discussing the electrolytes in the body. What should the students know has the greatest influence on potassium loss from the body? a. Aldosterone b. Antidiuretic hormone c. Renin d. Carbonic anhydrase
A
26. A client arrives at the urgent care center complaining of chest pain. After diagnosis, the health care provider prescribes amlodipine for the client's condition. The nurse understands that this drug is indicated for which condition? a. Prinzmetal angina b. Cardiogenic shock c. Atrioventricular (AV) block d. Sick sinus syndrome
A
27. A nurse is caring for a patient who is in renal failure. When reviewing the patient's laboratory values, what would the nurse expect to find? a. Decreased hemoglobin b. High white blood cell count c. Increased platelet count d. Increased hematocrit
A
27. A recent episode of chest pain while doing yard work prompted a 70-year-old man to seek care and he has been subsequently diagnosed with chronic stable angina. The nurse should recognize what guiding principle in the treatment of this client's angina? a. The client's angina may necessitate the use of a calcium channel blocker. b. The client will likely have a trial of antiplatelet drugs before being prescribed nitrates. c. The client would benefit from a weekly intravenous dose of a beta blocker. d. The client indicates a need for daily low-molecular weight heparin therapy
A
29. A client is diagnosed with angina pectoris. What would the nurse include when explaining this condition to the client? a. "The heart muscle isn't getting enough oxygen." b. "The heart muscle has become damaged due to blocked blood flow." c. "The heart muscle has grown larger to compensate." d. "The arteries are narrowed due to fatty deposits."
A
30. What is the expected result of a lack of aldosterone on the composition of urine? a. A decrease in potassium levels b. Traces of blood c. An abnormal presence of antidiuretic hormone (ADH) d. An increase in choline levels
A
36. You are caring for a client who has been prescribed hydrochlorothiazide. When you interviewed the client earlier, you learned that he frequently eats items that are very high in sodium. What effect will his current diet have on his drug therapy? a. He may require an increased dose. b. He may require a decreased dose. c. He is at greater risk for hyperkalemia. d. He is at greater risk for hypermagnesemia.
A
4. A client who had a total cholesterol-to-HDL cholesterol ratio of 5.3 has been losing weight and participating in an exercise program. His total cholesterol-to-HDL ratio is now 3.9. What LDL reading is also important to further decrease his risk of coronary artery disease? a. 95 mg/dL b. 105 mg/dL c. 120 mg/dL d. 140 mg/dL
A
4. 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? a. Thiazide diuretics b. Potassium-sparing diuretics c. Carbonic anhydrase inhibitors d. Osmotic diuretics
A
8. The client is taking a calcium-channel blocker. What adverse effects might the client experience? a. Headache and dizziness b. Flushing and rash c. Fever and bronchospasm d. Hypertension and tachycardia
A
9. The nurse is teaching a 63-year-old client about sustained-release oral nitrates which has been prescribed for treatment of angina. Which instructions would the nurse offer to the client when teaching how to properly self-administer the medication? a. Take the medication on an empty stomach. b. Crush the medication and dissolve it in water. c. Take the medication immediately following a meal
A
9. Which is true about digoxin? a. The therapeutic range for digoxin is 0.5 to 2 ng/mL. b. Digoxin improves the quality of life for patients with heart failure in the absence of atrial fibrillation. c. Digoxin decreases the mortality associated with heart failure. d. Digoxin is used to treat paroxysmal atrial fibrillation
A
19. What are the home care nurse's responsibilities in the care of clients who are receiving antianginal medications? (Select all that apply.) a. Assisting clients to modify factors that contribute to angina b. Monitoring the client's response to antianginal medications c. Discussing the benefits of exercise to decrease the oxygen demands of the heart d. Teaching clients and caregivers how to use, store, and replace medications to ensure a constant supply e. Discussing circumstances for which the client should seek emergency care
A, B, D, E
13. The nurse needs to follow which of the following when administering nitroglycerin ointment? Select all that apply: a. Wear plastic disposable gloves. b. The upper arms and legs are areas for appropriate application. c. Apply entire tube of ointment to client's skin. d. Use the same application site each time ointment is applied. e. Cleanse the area of skin before application
A, B, E
36. Prior to administering an antihyperlipidemic to a client, what information does the nurse need to gather? (Select all that apply.) a. Dietary history b. Blood glucose c. Weight d. Vital signs e. Input and output
A, C, D
10. Which of the following clients are at the highest risk of developing hyperkalemia with the use of amiloride (Midamor)? Select all that apply: a. Clients with renal disease b. Clients with asthma c. Clients with hypertension d. Clients with epilepsy e. Clients with diabetes
A, E
23. A nurse is caring for a patient who is admitted into the cardiac care unit with acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered. When preparing for administration of the drug, the nurse will a. use the reconstituted solution within a 36-hour period. b. administer the initial IV bolus over approximately 60 seconds. c. add the reconstituted vial of medication to a 1,000 mL IV bag. d. shake the vial vigorously to mix the medication for reconstitution
B
27. A group of nursing students are reviewing information about adrenergic blockers. The students demonstrate understanding when they identify which as an example of an alpha/beta-adrenergic blocking drug? a. Prazosin b. Carvedilol c. Reserpine d. Metoprolol
B
3. A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? a. The man's potassium and sodium levels remain with reference ranges. b. The man's chest sounds are clear and his ankle edema is lessened. c. The man's heart rate is between 60 and 70 beats per minute with a regular rhythm. d. The man's glomerular filtration rate and creatinine levels are within reference ranges.
B
30. A male client presents to the health care provider's office with symptoms of hyperglycemia. He is taking his oral antidiabetic medication and has not modified his diet or exercise program in any way. When the nurse interviews the client, he states that he now takes flax seed to reduce his cholesterol level. What may occur as a result of taking flax seed? a. Increased liver metabolism b. Decreased absorption of his drugs c. the kidneys d. Decreased excretion of the drug through the kidneys
B
30. A nurse providing medication education to a client with a new prescription for digoxin should identify which herb as having the tendency to decrease the effects of the medication? a. hawthorn b. St. John's wort c. ginseng d. Licorice
B
31. Which would a nurse identify as responsible for causing the release of antidiuretic hormone? a. Parasympathetic stimulation b. Falling blood volume c. Decreasing sodium levels d. Increasing potassium levels
B
31. You are teaching a patient about his new prescription for oral propranolol. If the patient asks you how long it will take for the medication to relieve pain, what will you say in response? a. "It will start working in about ten minutes." b. ""It will start working in about a half hour." c. "It will start working in about a minute." d. "It will start working in about fifteen minutes."
B
32. A client with coronary artery disease has been prescribed fluvastatin. When reviewing this client's more recent laboratory values, what finding should the nurse attribute to adverse effects of this medication? a. Decreased serum potassium levels b. Increased liver enzyme levels c. Decreased hemoglobin and hematocrit d. Increased neutrophil levels
B
35. The nurse is preparing to hang an intermittent infusion of furosemide. To prevent accelerated degradation of furosemide, the nurse knows that the medication should be mixed in what IV solution? a. D5W b. Lactated Ringer's solution c. D51/2 NS d. D51/4 NS
B
37. A patient with very high serum triglyceride levels is prescribed the fibric acid derivative clofibrate. In which of the following categories of patients is the use of clofibrate contraindicated? a. Patients with respiratory depression b. Patients with primary biliary cirrhosis c. Patients with endocrine disorder d. Patients with arterial bleeding
B
9. A client is receiving hydrochlorothiazide. The nurse would expect this drug to begin acting within which time frame? a. 1 hour b. 2 hours c. 3 hours d. 4 hours
B
1. A group of students are reviewing the drugs used to treat heart failure. The students demonstrate understanding of the information when they identify which agent as a phosphodiesterase inhibitor? a. Hydrochlorothiazide b. Captopril c. Milrinone d. Digoxin
C
10. Which adverse effect might occur in a client receiving milrinone? a. Confusion b. Hypoglycemia c. Hypotension d. Hyperkalemia
C
11. The client has been started on nitroglycerin ointment for angina. The nurse identifies that the nitroglycerin ointment has been effective if the client reports: a. minimal episodes of angina. b. that he gets a headache each time the ointment is applied. c. no episodes of angina since ointment was initiated. d. dizziness after each application.
C
12. A 75-year-old client is diagnosed with atrial fibrillation and chronic congestive heart failure. The health care provider orders a combination of digoxin and diuretics to treat the client's diseases. Recent laboratory results indicate that the client's potassium level is 2 mEq/L. This client is at risk for which problem? a. Subtherapeutic levels of serum digoxin b. Exacerbation of the atrial fibrillation c. Digoxin toxicity d. Congestive heart failure
C
14. A nurse is giving an IV dose of digoxin to a patient in the Emergency Department. The nurse would expect this medication to take effect in what period of time? a. 1 hour b. 2 hours c. 15 minutes d. 1 minute
C
14. Clients who are taking nifedipine should be monitored for which of the following adverse effects? a. Asthma b. Tetany c. Peripheral edema d. Hyperkalemia
C
15. What should the nurse teach an older adult client about the potential adverse effects of atorvastatin? a. "Most people who experience side effects from atorvastatin report stiffness in their joints or calves." b. "Some clients get some mild chest pain initially, but rest assured that this does not indicate a heart attack." c. "The most common side effects of atorvastatin involve some mild gastrointestinal upset." d. "The more serious side effects of atorvastatin involve a risk of bleeding, but this is quite rare."
C
16. A group of students are reviewing the function of the kidneys and demonstrate understanding when they identify that the kidneys receive what portion of the cardiac output? a. ½ b. 1/5 c. ¼ d. 1/10
C
16. HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category? a. Pregnancy Category A b. Pregnancy Category B c. Pregnancy Category X d. Pregnancy Category C
C
16. Which electrolyte imbalance can precipitate digoxin toxicity? a. Hypernatremia b. Hyponatremia c. Hypokalemia d. Hyperkalemia
C
17. In heart failure, by what mechanism does the body compensate for decreased circulating blood volume? a. Increasing preload b. Increasing stroke volume c. Activation of the renin-angiotensin-aldosterone system d. Decreasing afterload
C
2. A nurse understands that loop diuretics are considered high ceiling diuretics because they: a. require large doses to achieve effect. b. are associated with more adverse effects. c. cause a greater diuresis. d. cause a greater loss of potassium
C
2. The nurse is caring for a patient who is taking a sustained-release oral nitrate. How would the nurse instruct this patient to take their medication? a. 1 hour after eating b. With milk or milk products c. With water d. With grapefruit juice
C
20. A male client does not respond to traditional treatment for his chronic angina. The health care provider orders ranolazine (Ranexa) and orders a baseline ECG prior to medication administration. Three months later, the health care provider orders a repeat ECG. For what reason is the provider monitoring the client? a. Dose-dependent ectopic beats b. Dose-dependent ST elevation c. Dose-dependent QT prolongation d. Dose-dependent premature ventricular beats
C
22. A female client's drugs include a furosemide, digoxin, and hydralazine. She is unable to afford all of her medications, so she takes them intermittently to make them last longer. In addition to making a referral to social service, what should the home care nurse tell this client? a. "Your plan is acceptable if the health care provider is aware and laboratory studies are done more frequently." b. "Changes in doses may be better than alternating medications." c. "Different types of drugs have different actions and produce different responses." d. "Over-the-counter drugs may be viable substitutes for the more expensive medications."
C
33. In addition to being synthesized in the liver and intestine, from where are blood lipids derived? a. exercise b. kidneys c. diet d. medications
C
34. 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? a. Black cohosh b. Ginseng c. Garlic d. Feverfew
C
34. Some drugs can increase the effects of diuretics. Drugs from what category, when taken concomitantly with some diuretics, increase the risk of hearing loss? a. Corticosteroids b. Oral contraceptives c. Aminoglycoside antibiotics d. Antihypertensive agents
C
8. What is a priority nursing assessment for a client who is about to begin digoxin therapy? a. Blood glucose levels b. Liver function c. Renal function d. Neurological function
C
A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider? A. Work environment B. Typical daily fluid intake C.Dietary habits D. Ethnicity
C
3. What should a client be told in regards to the pain relief anti-anginal drugs provide? (Select all that apply.) a. Pain will worsen with continued use. b. Pain will only occur during prolonged exercise. c. Pain may be less intense. d. Pain may be less frequent. e. Pain will be completely relieved.
C, D
14. 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? a. increased first-pass effect b. faster excretion c. increased metabolism d. decreased absorption
D
14. A client with renal impairment has been receiving hydrochlorothiazide, and lately it has been less effective than usual. The nurse knows that thiazide drugs become ineffective when the GFR is less than what level? a. 60 mL/min b. 50 mL/min c. 40 mL/min d. 30 mL/min
D
15. A male client asks the nurse why the health care provider has added combined aspirin, antilipemics, and antihypertensives to his medication regimen when he feels fine and hasn't experienced an anginal episode in a year. The nurse explains that this combination of drugs is given for what reason? a. Prevents episodic hypertensive crisis and subsequent CVA b. Reduces afterload that fosters an MI c. Prevents cerebral edema and subsequent CVA d. Prevents progression of myocardial ischemia to MI
D
15. What are cardiac glycosides used for? a. Increase ventricular rate b. Decrease afterload c. Decrease cardiac output d. Increase the force of the contraction of the heart
D
16. Upon her visit to the primary care provider's office, a female client presents with 14 pounds of additional weight since her visit 3 weeks ago. Her lower extremities are quite swollen, and her facial features are puffy. The provider prescribes a diuretic and requests a follow-up visit in 3 days. Two days later, the client contacts the office and is so dyspneic that she is hard to understand over the phone. An ambulance is dispatched, and she is admitted to the hospital for rapid diuresing. Which diuretic will most likely be the initial drug of choice? a. Thiazide b. Potassium-sparing diuretic c. Osmotic diuretic d. Loop diuretic
D
17. 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? a. Nitroglycerin b. Triglycerides c. Phospholipids d. Cholesterol
D
18. A client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating: a. "I need to take both drugs at the same time of the day." b. "I'll take the cholestyramine at 8 AM and the digoxin at 9 AM." c. "I'll take the digoxin about 15 minutes before the cholestyramine." d. "I will take the digoxin about an hour before the cholestyramine
D
19. Which substances are moved from the glomerulus into the tubule due to hydrostatic pressure? a. Lipids b. Blood cells c. Proteins d. Water
D
20. What is the result of the dysfunctional affect of aldosterone on of the kidneys' distal tubular system? a. Increased transfer of chloride b. Ineffective filtration of potassium c. Decreased reabsorption of calcium d. Ineffective retention of sodium
D
21. A 35-year-old female has been recently diagnosed with hyperthyroidism. Her health care provider has prescribed propranolol (Inderal) for what effect? a. To decrease systolic blood pressure b. To prevent respiratory depression c. To promote bronchodilation d. To decrease heart rate
D
21. In which client would the use of a beta-blocker most likely be contraindicated? a. A client with angina who recently completed a course of moxifloxacin for pneumonia b. A client who takes a bisphosphonate for osteoporosis and who has angina c. A client who has angina and diabetic retinopathy d. A client with angina pectoris who is trying to become pregnant
D
22. A current patient, an overweight, 61-year-old man with a history of diabetes mellitus, is status post-MI 1 month and has returned for his cardiology follow-up. Included with his dietary changes, the cardiologist recommended which nonpharmacological lifestyle changes to reduce microvascular changes? a. Maintaining weight b. Increased cholesterol consumption c. Increased nicotine use d. Glucose control
D
24. A nurse is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for a(n): a. decrease in LDL. b. decrease in plasma concentration of lovastatin. c. increase in the statin tolerance level. d. increase in plasma concentration of lovastatin
D
24. The nurse administers an adrenergic blocking agent to a client. When assessing the client after administration, the nurse should expect evidence of what physiologic effect? a. Increased levels of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) b. Antagonism of epinephrine binding sites c. Delayed reuptake of serotonin d. Inhibition of norepinephrine release
D
24. The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide? a. The two diuretics act in different parts of the nephron. b. Potassium losses are greater with spironolactone than with hydrochlorothiazide. c. Spironolactone is more likely to be taken with a potassium supplement. d. Potassium losses are greater with hydrochlorothiazide than with spironolactone.
D
26. An elderly client reports fatigue. Upon evaluation, the nurse notes decreased breath sounds, JVD and 2+ pedal edema. The nurse suspects which complication? a. Unstable angina b. Acute inferior wall MI c. Pulmonary edema d. Symptomatic decompensated heart failure
D
26. Much of the sodium in the filtrate is reabsorbed in the proximal convoluted tubule to the peritubular capillaries. As the sodium is moved out of the filtrate, what does it take with it? a. Potassium ions b. Calcium c. Magnesium d. Chloride ions
D
29. The nurse providing care for a client experiencing acute-onset heart failure (HF) would question a prescription for what medication? a. furosemide b. digoxin c. hydrochlorothiazide d. propranolol hydrochloride
D
31. Which of the following best reflects the action of ezetimibe? a. Stimulates the breakdown of lipoproteins from tissues b. Blocks the enzyme involved in cholesterol synthesis c. Binds with bile acids to form an insoluble complex for excretion d. Decreases the absorption of dietary cholesterol from the small intestine
D
32. The pharmacology instructor is discussing the various diuretic agents and their sites of action in the nephron. In what part of the nephron do thiazide diuretics act? a. Ascending limb of the loop of Henle b. Descending limb of the loop of Henle c. Proximal tubule d. Distal tubule
D
33. 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? a. Triamterene b. Furosemide c. Metolazone d. Mannitol
D
35. After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic? a. Blood pressure below 130/85 mm Hg b. Waist measurement over 40 inches in women c. Fasting blood glucose below 110 mg/dL d. Triglyceride level above 150 mg/dL
D
37. The client in the ER has increased intracranial pressure. The nurse has just administered 150 g of mannitol IV . What assessment should the nurse prioritize when monitoring the client? a. Weight and abdominal girth b. Apical heart rate and rhythm c. Respiratory rate and oxygen saturation d. Blood pressure
D
40. The nurse is providing medication teaching to a client who will begin taking niacin with a bile acid sequestrant. How should the nurse instruct the client to take these two medications? a. "Both medications should be taken in the morning." b. "Both medications can be taken at once just before going to bed." c. "One medication should be taken in the morning but the other is taken at bedtime." d. "The medications should be taken 4 to 6 hours apart."
D
7. What is the first drug of choice for treatment of a client with a history of a myocardial infarction (MI) 2 years ago? a. cardiac glycosides b. angiotensin II receptor blockers (ARBs) c. calcium channel blockers (CCBs) d. beta-blockers
D
7. Which statement correctly distinguishes between the therapeutic effects of sublingual isosorbide and sublingual nitroglycerin? a. Sublingual isosorbide has a lesser sustained effect than sublingual nitroglycerin. b. Sublingual isosorbide is not as effective as sublingual nitroglycerin. c. Sublingual isosorbide has a faster onset and a shorter duration of action than sublingual nitroglycerin. d. Sublingual isosorbide has a slower onset and a longer duration of action than sublingual nitroglycerin.
D
8. What sign is most indicative of dehydration in a patient taking diuretics? a. Dry cough b. Decreased hematocrit c. Bradycardia d. Body weight
D
A client with chronic pain has been prescribed a salicylate. The nurse should expect what medication on this client's medication administration record? a. Celecoxib b. Indomethacin c. Piroxicam d. Diflunisal
D