Pharm Exam 4
Which drug is the most effective for lowering LDL cholesterol? A. Atorvastatin [Lipitor] B. Cholestyramine [Questran] C. Gemfibrozil [Lopid] D. Ezetimibe [Zetia]
A
In assessing a patient with a vitamin A deficiency, the nurse should determine whether the patient has which manifestation? A. Tender, bleeding gums B. Impaired night vision C. Disturbed sleep patterns D. Excessive sweating
B
Which product did the U.S. Food and Drug Administration (FDA) ban in the United States because of the serious adverse effects of myocardial infarction, stroke, and death? A. Ma huang (Ephedra) B. Valerian (Valeriana officinalis) C. St. John's wort (Hypericum perforatum) D. Saw palmetto (Serenoa repens)
A
The healthcare provider ordered thiamine solution 100 mg in 50 mL IV piggyback for a patient with a history of alcohol abuse. The dose is ordered to run at 100 mL per hour. The nurse knows that the infusion will require how much time? A. 15 minutes B. 30 minutes C. 50 minutes D. 60 minutes
B
A nurse is caring for four clients who have peptic ulcer disease. The nurse should recognize misoprostol is contraindicated for which of the following clients? A. A client who is pregnant B. A client who has osteoarthritis C. A client who has a kidney stone D. A client who has a urinary tract infection
A
A nurse is providing instructions about the use of laxatives to a client who has heart failure. The nurse should tell the client he should avoid which of the following laxatives? A. Sodium phosphate B. Psyllium C. Bisacodyl D. Polyethylene glycol
A
A nurse is providing instructions to a client who has a prescription for amoxicillin and clarithromycin to treat a peptic ulcer. Which of the following information should the nurse include in the teaching? A. "Take these medications with food." B. "These medications can turn your stool black" C."These medications can cause photosensitivity." D."The purpose of these medications is to decrease the ph of gastric juices in the stomach."
A
A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in the teaching? A. Take this medication in the evening. B. Change position slowly when rising from a chair. C. maintain a steady intake of green leafy vegetables. D. Consume no more than 1 L/day of fluid.
A
A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A. Asthma B. Glaucoma C. hypertension D. Tachycardia
A
A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching? A.Contact provider if heart rate is less than 60/min. B. Check pulse rate for 30 seconds and multiply result by 2. C. Increase intake of sodium D. Take with food if nausea occurs.
A
A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following instructions should the nurse include? A. Increase the amount of dietary fiber in the diet. B. Drink grapefruit juice daily to increase vitamin C intake. C. Decrease the amount of calcium in the diet. D. Withhold food for 1 hr after the medication is taken.
A
A patient asks the nurse for a supplement that can be used to prevent motion sickness during a vacation cruise. The nurse suggests which supplement? A. Ginger root (Zingiber officinale) B. Garlic (Allium sativum) C. Coenzyme Q-10 (CoQ-10) D. Feverfew (Tanacetum parthenium)
A
A patient who has pellagra is taking niacin. Which outcome would be most appropriate for a nurse to establish with the patient? A. Smooth, intact skin in sun-exposed areas B. Regulation of heart rate and rhythm C. Increased dexterity of fine motor skills D. Improvement in coordination and gait stability
A
A patient with nonvalvular atrial fibrillation is to be discharged on dabigatran etexilate [Pradaxa]. Which statement should the nurse include in the discharge teaching? A. "The medication must be stored in the manufacturer-supplied bottle." B. "Once a new bottle is opened, the capsules maintain efficacy for 90 days." C. "If you have difficulty swallowing the capsule, you can open it and mix it with food." D. "You will need to learn how to give yourself a subcutaneous injection in your abdomen."
A
In the failing heart, arterial pressure falls, stimulating the baroreceptor reflex to increase sympathetic nervous system activity. The nurse understands increased sympathetic activity will produce which response? A. Tachycardia B. Bradypnea C. Hypotension D. Hypoglycemia
A
The laboratory calls to report a drop in the platelet count to 90,000/mm3 for a patient receiving heparin for the treatment of postoperative deep vein thrombosis. Which action by the nurse is the most appropriate? A. Notify the healthcare provider to discuss the reduction or withdrawal of heparin. B. Call the healthcare provider to discuss increasing the heparin dose to achieve a therapeutic level. C. Obtain vitamin K and prepare to administer it by intramuscular (IM) injection. D. Observe the patient and monitor the activated partial thromboplastin time (aPTT) as indicated.
A
The nurse is caring for a pregnant patient experiencing a new episode of hypertension. Which medication does the nurse anticipate will be prescribed for this patient? A. Methyldopa [Aldomet] B. Propranolol [Inderal] C. Captopril [Capoten] D. Valsartan [Diovan]
A
The nurse is preparing to administer a daily dose of digoxin [Lanoxin]. What is the priority nursing intervention? A. Analyze heart rate and rhythm. B. Assess for Homans' sign. C. Check blood pressure. D. Palpate the pedal pulses.
A
The nurse is preparing to administer an oral dose of digoxin [Lanoxin]. The apical pulse rate is 64. What nursing action is most appropriate? A. Give the medication. B. Obtain a serum digoxin level. C. Notify the healthcare provider. D. Assess for signs of digoxin toxicity.
A
The nurse reviews the medication treatment regimen for a patient with chronic hypertension. To promote optimal medication adherence, which frequency of drug dosing should the nurse advocate for this patient? A. Once a day B. Three times a day C. Four times a day D. Every 8 hours
A
Which discharge instructions should the nurse include for a patient prescribed cholestyramine [Questran]? A. Mix the drug with water or juice. B. Take with all other morning medications. C. Take 325 mg of aspirin 30 minutes before each dose. D. Notify the healthcare provider if upper abdominal discomfort occurs.
A
A nurse is planning to administer ondansetron IV for an older adult client who has a history of diabetes mellitus and cardiac myopathy and is receiving chemotherapy for cancer. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply.) A. headache B. Diarrhea C. Shortened PR interval D. hyperglycemia E. Prolonged QT interval
A, B, E
A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation digoxin toxicity? (Select all that apply.) A. Fatigue B. Constipation C. Anorexia D. Rash E. Diplopia
A, C, E
A nurse reviewing a client's medication history notes an allergy to sulfonamides. This allergy is a contraindication for taking which of the following medications? (Select all that apply.) A. hydrochlorothiazide B. metoprolol C. Acetaminophen D. Glipizide E. Furosemide
A, D, E
A patient is receiving a continuous heparin infusion for venous thromboembolism treatment. Which laboratory results should the nurse monitor? Select all that apply. A. Platelets B. Vitamin K C. Prothrombin time (PT) D. International normalized ratio (INR) E. Activated partial thromboplastin time (aPTT)
A, E
A nurse is teaching a client who has a new prescription for nitrofurantoin. Which of the following information should the nurse include? (Select all that apply.) A. Observe for bruising on the skin. B. Take the medication with milk or meals. C. Expect brown discoloration of urine. D. Crush the medication if it is dif cult to swallow. E. Expect insomnia when taking it.
A,B,C
A patient is being discharged from the hospital on warfarin [Coumadin] for deep vein thrombosis prevention. Which instructions should the nurse include in the patient's discharge teaching plan? Select all that apply. A. Wear a medical alert bracelet. B. Check all urine and stool for discoloration. C. Do not start any new medication without first talking to your healthcare provider. D. Enteric-coated aspirin and any aspirin products can be used unless they cause a gastrointestinal ulcer. E. No laboratory or home monitoring of international normalized ratio (INR) is required after the first 6 months.
A,B,C
Which are beneficial effects that can be derived from simvastatin [Zocor] and other drugs in this class? Select all that apply. A. Reduction of LDLs B. Elevation of HDLs C. Stabilization of the plaque in coronary arteries D. Reduction of risk of cardiovascular events E. Improvement of liver function
A,B,C,D
has anemia and a new prescription for a liquid iron supplement. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. "Add foods that are high in fiber to your diet." B."Rinse your mouth after taking the medication." C."Expect stools to be green or black in color." D."Take the medication with a glass of milk." E. "Add red meat to your diet."
A,B,C,E
A nurse is providing information about probiotic supplements to a male client. Which of the following information should the nurse include? (Select all that apply.) A. "Probiotics are micro‐organisms that are normally found in the GI tract." B. "Probiotics are used to treat Clostridium dif cile." C."Probiotics are used to treat benign prostatic hyperplasia." D."You can experience bloating while taking probiotic supplements." E. "If you are prescribed an antibiotic, you should take it at the same time you take your probiotic supplement."
A,B,D
A nurse is teaching a female client who has a severe UTI about cipro oxacin. Which of the following information about adverse reactions should the nurse include? (Select all that apply.) A. Observe for pain and swelling of the Achilles tendon. B. Watch for a vaginal yeast infection. C. Expect excessive nighttime perspiration. D. Inspect the mouth for cottage cheese‐like lesions. E. Take the medication with a dairy product.
A,B,D
Which medications should be used with caution in a hypertensive diabetic patient? Select all that apply. A. Furosemide [Lasix] B. Metoprolol [Lopressor] C. Diltiazem [Cardizem] D. Hydrochlorothiazide [HCTZ] E. Enalapril [Vasotec]
A,B,D
Which patient symptoms should cause the nurse to be concerned about digoxin [Lanoxin] toxicity? Select all that apply. A. Fatigue B. Vomiting C. Dizziness D. Blurred vision E. Muscle weakness
A,B,D
The healthcare provider prescribes lovastatin [Mevacor] for a patient discharged from the hospital post-myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan? Select all that apply. A. "Do not start any new medications without first talking to your healthcare provider." B. "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." C. "Take your medication in the morning, with a full glass of water for best results." D. "Take one 325-mg aspirin 30 minutes before your dose to lessen the problem of flushing and itching that can occur with this drug." E. "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains."
A,B,E
The nurse is caring for a group of patients taking warfarin [Coumadin]. Which patients are at moderate to high risk for harm as a result of warfarin therapy? Select all that apply. A. A patient with variant genes that code for VKORC1 and CYP2CP B. A patient with a current INR of 2.2 treated for deep vein thrombosis C. A woman with a new onset of symptoms of a pulmonary embolus D. A patient on day 4 after hip replacement with a new order for warfarin E. A patient with a prosthetic heart valve, for whom an interacting drug is being deleted from the regimen
A,C,E
A nurse is preparing to administer potassium chloride IV to a client who has hypokalemia. Which of the following actions should the nurse take? (Select all that apply.) A. Infuse medication through a large‐bore needle. B. monitor urine output to ensure at least 20 mL/hr. C. Administer medication via direct IV bolus. D. Implement cardiac monitoring. E. Administer the infusion using an IV pump.
A,D,E
A patient with a malabsorption disease is at risk for low levels of fat-soluble vitamins. The nurse is aware that which vitamins are fat soluble? Select all that apply. A. Vitamin A B. Vitamin B12 C. Vitamin C D. Vitamin D E. Vitamin E
A,D,E
About which patient should the nurse notify the healthcare provider immediately? A. A patient who takes digoxin [Lanoxin] 0.125 mg orally daily with a serum digoxin level of 0.8 ng/mL B. A patient who takes oral spironolactone [Aldactone] 25 mg daily and enalapril [Vasotec] 5 mg daily with a serum potassium level of 5.5 mEq/L C. A patient who takes digoxin [Lanoxin] 0.25 mg orally daily with a serum potassium level of 4.0 mEq/L D. A patient who takes oral lisinopril [Zestril] 5 mg daily and digoxin 0.125 mg daily with a serum digoxin level of 0.5 ng/mL
B
A nurse is administering a dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication? A. Lowered heart rate B. Increased myocardial contractility C. Decreased conduction through the AV node D. Vasoconstriction of renal blood vessels
B
A nurse is caring for a client who has diabetes and is experiencing nausea due to gastroparesis. The nurse should anticipate a prescription for which of the following medications? A. Lubiprostone B. metoclopramide C. Bisacodyl D. Loperamide
B
A nurse is caring for a client who requests information on the use of feverfew. Which of the following responses should the nurse make? A. "It is used to treat skin infections." B. "It can decrease the frequency of migraine headaches." C."It can lessen the nasal congestion in the common cold." D."It can relieve nausea of morning sickness during pregnancy."
B
A nurse is caring for an older adult client who has a new prescription for digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for digoxin toxicity? A. Phenytoin B. Verapamil C. Warfarin D. Aluminum hydroxide
B
A nurse is completing an assessment of a client's current medications. The client states she also takes gingko biloba. Which of the following medications is contraindicated for a client taking gingko biloba? A. Acetaminophen B. Warfarin C. Digoxin D. Lisinopril
B
A nurse is planning to administer IV alteplase to a client who is demonstrating manifestations of a massive pulmonary embolism. Which of the following interventions should the nurse plan to take? A. Administer Im enoxaparin along with the alteplase dose. B. hold direct pressure on puncture sites for up to 30 min. C. Administer aminocaproic acid IV prior to alteplase infusion. D. Prepare to administer alteplase within 8 hr of manifestation onset.
B
A nurse is planning to administer ciprofloxacin IV to a client who has cystitis. Which of the following actions should the nurse take? A. Administer a concentrated solution. B. Infuse the medication over 60 min. C. Infuse the solution through the primary IV fluid's tubing. D. Choose a small peripheral vein for administration.
B
A nurse is planning to administer subcutaneous enoxaparin 40 mg using a pre lled syringe of enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take? A. Expel the air bubble from the pre lled syringe before injecting. B. Insert the needle completely into the client's tissue. C. Administer the injection in the client's thigh. D. Aspirate carefully after inserting the needle into the client's skin.
B
A nurse is teaching a client who has a new prescription for omeprazole for management of heartburn. Which of the following information should the nurse include in the teaching? A. Take this medication at bedtime. B. This medication decreases the production of gastric acid. C. Take this medication 2 hr after eating. D. This medication can cause hyperkalemia.
B
A patient admitted with deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) requires immediate anticoagulation. What medication would be appropriate for this patient who has a history of heparin-induced thrombocytopenia (HIT)? A. Warfarin [Coumadin] B. Lepirudin [Refludan] C. Bivalirudin [Angiomax] D. Eptifibatide [Integrilin]
B
A patient is admitted to the unit in a hypertensive emergency and examination reveals papilledema. The nurse should expect which IV medications to be administered to achieve rapid, controlled reduction of the patient's blood pressure? A. Furosemide [Lasix] B. Sodium nitroprusside [Nitropress] C. Metoprolol [Lopressor] D. Diltiazem [Cardizem]
B
A patient is taking black cohosh (Cimicifuga racemosa) for relief of menopausal symptoms. The nurse should caution her about adverse interactive effects with which conventional medication? A. Docusate sodium [Colace] B. Insulin C. Furosemide [Lasix] D. Aspirin
B
A patient with a deep vein thrombosis receiving an intravenous (IV) heparin infusion asks the nurse how this medication works. What is the nurse's best response? A. Heparin prevents the activation of vitamin K and thus blocks synthesis of some clotting factors. B. Heparin suppresses coagulation by helping antithrombin perform its natural functions. C. Heparin works by converting plasminogen to plasmin, which in turn dissolves the clot matrix. D. Heparin inhibits the enzyme responsible for platelet activation and aggregation within vessels.
B
In a patient with a thiamine deficiency, which finding would indicate the development of Wernicke-Korsakoff syndrome? A. Pedal edema B. Nystagmus C. Angular stomatitis D. Peripheral neuritis
B
The heart undergoes cardiac remodeling during the initial phase of heart failure. Which cardiac geometric change occurs during heart failure? A. Ventricular constriction B. Ventricular wall thickening C. Ventricular atrophy D. Ventricles become more cylindric
B
The nurse is caring for a patient prescribed a cholesterol-lowering drug. Which drug is least likely to cause systemic side effects? A. Simvastatin [Zocor] B. Colesevelam [Welchol] C. Nicotinic acid [Niaspan] D. Gemfibrozil [Lopid]
B
The nurse is caring for a patient receiving clopidogrel [Plavix] to prevent blockage of coronary artery stents. Which other drug on the patient's medication administration record may reduce the antiplatelet effects of clopidogrel? A. Aspirin [Bayer] B. Omeprazole [Prilosec] C. Acetaminophen [Tylenol] D. Warfarin [Coumadin]
B
The nurse is caring for a patient who has diabetes and hypertension. Which medication is most likely to be prescribed to treat this patient's hypertension? A. Hydrochlorothiazide [HCTZ] B. Enalapril [Vasotec] C. Propranolol [Inderal] D. Methyldopa [Aldomet]
B
The nurse is completing an admission assessment for a patient who requires treatment of an anxiety disorder. The patient states "I take the dietary supplement kava every day to help my anxiety and stress." The nurse understands the patient is at risk for which serious adverse effect? A. Stroke B. Hepatoxicity C. Suicidal behavior D. Acute renal failure
B
The nurse is ready to begin a heparin infusion for a patient with evolving stroke. The baseline activated partial thromboplastin time (aPTT) is 40 seconds. Which aPTT value indicates that a therapeutic dose has been achieved? A. 50 B. 70 C. 90 D. 110
B
What is the primary benefit of spironolactone [Aldactone] in patients with heart failure? A. Increase in diuresis and fluid loss B. Blockage of aldosterone receptors C. Inhibition of beta activation by norepinephrine D. Stimulation of the renin-angiotensin-aldosterone system
B
Which classes of medications are prescribed as initial therapy for hypertension after a myocardial infarction (MI)? A. Diuretic and beta blocker B. Beta blocker and ACE inhibitor C. ACE inhibitor and calcium channel blocker D. Diuretic and calcium channel blocker
B
Which needle length and gauge should the nurse choose to administer subcutaneous heparin? A. ½ inch; 20 gauge B. 3/8 inch; 25 gauge C. 1 inch; 26 gauge D. 1½ inch; 18 gauge
B
A nurse is evaluating a group of clients at a health fair to identify the need for folic acid therapy. Which of the following clients require folic acid therapy? (Select all that apply.) A. 12‐year‐old child who has iron deficiency anemia B. 24‐year‐old female who has no health problems C. 44‐year‐old male who has hypertension D. 55-year‐old female who has alcohol use disorder E. 35‐year‐old male who has type 2 diabetes mellitus
B, D
A nurse is caring for a client who has a new prescription for niacin to reduce cholesterol. The nurse should monitor for which of the following ndings as an adverse effect of niacin? (Select all that apply.) A. muscle aches B. hyperglycemia C. hearing loss D. Flushing of the skin E. Jaundice
B, D, E
A nurse is planning to administer a rst dose of captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply.) A. Simvastatin B. hydrochlorothiazide C. Phenytoin D. Clonidine E. Aliskiren
B, D, E
A patient diagnosed with a pulmonary embolism is receiving a continuous heparin infusion at 1000 units/hr. Of which findings should the nurse immediately notify the healthcare provider? Select all that apply. A. aPTT of 65 seconds B. aPTT of 40 seconds C. Nosebleeds D. aPTT of 100 seconds E. Platelet count of 300,000/mcL
B,C,D
The patient is prescribed warfarin [Coumadin] to treat deep vein thrombosis. The nurse is teaching the patient about dietary supplements that have the potential to interfere with coumadin therapy. What herbs should the nurse include in the teaching? Select all that apply. A. Echinacea B. Garlic C. Ginger root D. Gingko biloba E. Valerian
B,C,D
A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify which of the following manifestations as adverse effects of daily aspirin therapy? (Select all that apply.) A. hypertension B. Coffee‐ground emesis C. Tinnitus D. Paresthesias of the extremities E. Nausea
B,C,E
A nurse in a provider's of ce is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity? A. Calcium 9.2 mg/dL B. Calcium 10.3 mg/dL C. Potassium 3.4 mEq/L D. Potassium 4.8 mEq/L
C
A nurse in an acute care facility is caring for a client who is receiving IV nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication? A. Intestinal ileus B. Neutropenia C. Delirium D. hyperthermia
C
A nurse is caring for a client who has a new prescription for captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication? A. hypokalemia B. hypernatremia C. Neutropenia D. Bradycardia
C
A nurse is caring for a client who has atrial fibrillation and a new prescription for dabigatran to prevent development of thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of dabigatran? A. Vitamin k1 B. Protamine C. Omeprazole D. Probenecid
C
A nurse is caring for a client who has increased liver enzymes and is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider? A. Glucosamine B. Saw palmetto C. kava D. St. John's wort
C
A nurse is caring for a hospitalized client who is receiving IV heparin for a deep‐vein thrombosis. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer? A. Vitamin k1 B. Atropine C. Protamine D. Calcium gluconate
C
A nurse is collecting data from a client who is taking gemfibrozil. Which of the following assessment findings should the nurse identify as an adverse reaction to the medication? A. mental status changes B. Tremor C. Jaundice D. Pneumonia
C
A nurse is completing a nursing history for a client who takes simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client's medications? A. history of severe constipation B. history of hypertension C. Active hepatitis C D. Type 2 diabetes mellitus
C
A nurse is planning discharge teaching for a female client who has a new prescription for trimethoprim‐sulfamethoxazole. Which of the following information should the nurse include? A. Take the medication even if pregnant. B. maintain a fluid restriction while taking it. C. Take it on an empty stomach. D. Stop taking it when manifestations subside.
C
A nurse is teaching a client who is taking sucralfate PO for peptic ulcer disease has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include? A. Take an antacid with the sucralfate. B. Take sucralfate with a glass of milk. C. Allow a 2‐hr interval between these medications. D. Chew the sucralfate thoroughly before swallowing.
C
A patient has an international normalized ratio [INR] that is elevated to an unsafe level. A nurse administers vitamin K, expecting which therapeutic result? A. Increase in red blood cell [RBC] indices B. Decrease in pulse pressure C. Decrease in bleeding tendency D. Increase in mental alertness
C
A patient presents to the emergency department with symptoms of acute myocardial infarction. After a diagnostic workup, the healthcare provider prescribes a 15-mg IV bolus of alteplase (tPA), followed by 50 mg infused over 30 minutes. In monitoring this patient, which finding by the nurse most likely indicates an adverse reaction to this drug? A. Urticaria, itching, and flushing B. Blood pressure of 90/50 mm Hg C. Decreasing level of consciousness D. Potassium level of 5.5 mEq/L
C
A patient with an acute myocardial infarction is prescribed an intravenous (IV) bolus of tenecteplase [TNKase]. The patient weighs 160 pounds. The nurse will administer what dosage? A. 30 mg B. 35 mg C. 40 mg D. 45 mg
C
A patient with an elevated triglyceride level is prescribed a sustained-release form of nicotinic acid [Slo-Niacin]. Which laboratory value is most important for the nurse to monitor for in this patient? A. Blood urea nitrogen (BUN) B. Complete blood count (CBC) C. Alanine aminotransferase (ALT) D. Creatine kinase (CK)
C
An adult male patient is taking medication for blood pressure management. The patient states to the nurse, "I'm not going to take these drugs anymore, because they are interfering with my sex life." What is the most appropriate response by the nurse? A. "It is unfortunate these drugs can cause erectile dysfunction but managing your blood pressure is more important than your sexual performance." B. "I understand how discouraging it must be to live with this adverse effect, but you could have a stroke if you do not take your blood pressure medications." C. "Let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect." D. "I am glad you told me about your experience with this common side effect. Sexual performance can be a difficult subject to discuss."
C
The nurse is caring for a patient prescribed digoxin [Lanoxin] for heart failure. Which finding would require immediate attention by the nurse? A. Potassium level of 3.7 mEq/L B. Digoxin level of 0.7 ng/mL C. Vomiting and diarrhea D. Heart rate of 68 beats per minute
C
The nurse is caring for a patient who takes spironolactone [Aldactone] and quinapril [Accupril] for treatment of heart failure. What finding indicates a potential interaction between these two drugs? A. Elevated serum quinapril level B. Heart rate of 58 beats per minute C. Potassium level of 5.7 mEq/L D. Glucose level of 180 mg/dL
C
The nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding most likely relates to an adverse effect of heparin? A. Heart rate of 60 beats per minute B. Blood pressure of 160/88 mm Hg C. Discolored urine D. Inspiratory wheezing
C
The nurse is preparing the discharge teaching plan for a patient who had a mechanical valve replacement and has been prescribed coumadin. The nurse reviews the patient's medication history and notes the patient is taking the herbal supplement glucosamine to treat osteoarthritis. Which instructions should the nurse give to this patient? A. Increase consumption of foods high in vitamin K. B. Do not take any dietary or herbal supplements. C. Notify the healthcare provider immediately if you experience any signs of bleeding. D. Research studies have shown there is no benefit in using herbs to treat medical conditions.
C
The nurse is teaching a group of patients about dietary approaches to reduce cholesterol levels. Which statement is most important to include in the teaching? A. "Lower your cholesterol to 300 mg/day." B. "Eliminate red meat and pork from your diet." C. "Read food labels and reduce your intake of saturated fats." D. "Reduce salt consumption to keep your sodium intake to 2400 mg/day."
C
The nurse knows that which statement is accurate for enoxaparin [Lovenox]? A. It equally reduces the activity of thrombin and factor Xa. B. It has selective inhibition of factor Xa and no effect on thrombin. C. It reduces the activity of factor Xa more than the activity of thrombin. D. It has a lower bioavailability and shorter half-life than unfractionated heparin.
C
The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis? A. Very-low-density lipoprotein (VLDL) B. Apolipoprotein B-100 C. Low-density lipoprotein (LDL) D. High-density lipoprotein (HDL)
C
Which action should a nurse take when preparing to administer vitamin D to a patient diagnosed with hyperparathyroidism? A. Assess deep tendon reflexes. B. Give the vitamin with 8 ounces of milk. C. Hold the vitamin and consult the prescriber. D. Determine whether the patient takes nonsteroidal anti-inflammatory drugs (NSAIDs).
C
Which factor in a patient's history is most likely related to the development of thiamine (vitamin B1) deficiency? A. Exposure to asbestos B. Heart transplant recipient C. Chronic alcohol abuse D. Gastric resection surgery
C
Which information on the product label of an herbal supplement would comply with the regulations established by the Dietary Supplement Health and Education Act (DSHEA)? A. Lowers cholesterol B. Relieves menopausal hot flashes C. Supports the immune system D. Reduces pain of arthritis
C
Which instruction about clopidogrel [Plavix] should the nurse include in the discharge teaching for a patient who has received a drug-eluting coronary stent? A. "Constipation is a common side effect of clopidogrel, so take a stool softener daily." B. "If you see blood in your urine or black stools, stop the clopidogrel immediately." C. "Check with your healthcare provider before taking any over-the-counter medications for gastric acidity." D. "Keep the amounts of foods containing vitamin K, such as mayonnaise, canola and soybean oil, and green, leafy vegetables, consistent in your diet."
C
A nurse is teaching a client who is taking digoxin and has a new prescription for colesevelam. Which of the following instructions should the nurse include in the teaching? A. "Take digoxin with your morning dose of colesevelam." B. "Your sodium and potassium levels will be monitored periodically while taking colesevelam." C."Watch for bleeding or bruising while taking colesevelam." D."Take colesevelam with food and at least one glass of water."
D
A patient is scheduled to start taking vitamin C. The nurse should teach the patient to observe for which side effect? A. Delayed healing B. Bone and joint pain C. Loosening of the teeth D. Nausea and diarrhea
D
A patient tells the nurse that she is thinking about becoming pregnant. The nurse teaches the patient that which vitamin should be her priority for supplementation before planning a pregnancy? A. Vitamin B12 B. Riboflavin C. Vitamin D D. Folic acid
D
A patient with cardiovascular disease is taking rosuvastatin [Crestor]. The nurse is monitoring for potential adverse effects. Which finding indicates a potential adverse effect of this drug? A. Blood pressure of 140/90 mm Hg B. Wheezing and shortness of breath C. Platelet count of 100 × 103/mm3 D. Muscle pain and tenderness
D
Fondaparinux [Arixtra] is not approved for use in which circumstance? A. Prevention of deep vein thrombosis (DVT) after knee replacement B. Treatment of acute pulmonary embolism (PE) (in conjunction with warfarin) C. Prevention of deep vein thrombosis (DVT) after abdominal surgery D. Prevention of ischemic complications in patients with unstable angina
D
The nurse is caring for a patient prescribed gemfibrozil [Lopid]. For which patient should the nurse question the use of this drug? A. A patient with cardiovascular disease and elevated triglycerides B. A patient with elevated very-low-density lipoprotein (VLDL) levels C. A patient with elevated triglycerides who has not responded to dietary changes D. A patient with history of gallstones and elevated triglycerides
D
The nurse is caring for a patient who takes warfarin [Coumadin] for prevention of deep vein thrombosis. The patient has an international normalized ratio (INR) of 1.2. Which action by the nurse is most appropriate? A. Administer intravenous (IV) push protamine sulfate. B. Continue with the current prescription. C. Prepare to administer vitamin K. D. Call the healthcare provider to increase the dose.
D
A nurse is caring for a client who received prochlorperazine 4 hr ago. The client reports spasms of his face. The nurse should anticipate a prescription for which of the following medications? A. Fomepizole B. Naloxone C. Phytonadione D. Diphenhydramine
D
The nurse is teaching a patient about the side effects associated with doxazosin [Cardura]. Which statement by the patient indicates an understanding of the nurse's instructions? A. "I may experience an increase in hair growth as a side effect." B. "I'll notify the healthcare provider if I develop a persistent cough." C. "I'll make sure I include extra sources of potassium in my diet, such as bananas and baked potatoes." D. "When getting out of bed in the morning, I will sit on the side of the bed for several minutes before standing."
D
The nurse recognizes that the supplement echinacea (Echinacea angustifolia) should not be taken as prolonged therapy for patients with which condition? A. Peptic ulcer disease B. Diabetes C. Glaucoma D. Tuberculosis
D
Which laboratory result may be a consequence of therapy with a thiazide diuretic? A. Serum glucose level of 58 mg/dL B. Serum potassium level of 5.3 mEq/L C. Serum sodium level of 135 mEq/L D. Serum uric acid level of 10.4 mg/dL
D
A nurse is providing a client who has peptic ulcer disease with instructions about managing his condition. Which of the following instructions should the nurse include? (Select all that apply.) A. "Eat a bedtime snack." B. "Drink decaffeinated coffee" C."Low‐dose aspirin therapy should be avoided." D."Seek measures to reduce stress." E. "Avoid smoking."
D, E
A patient with heart failure has developed a cough while taking an angiotensin-converting enzyme (ACE) inhibitor. The health care provider discontinued the ACE inhibitor and prescribed an angiotensin II receptor blocker (ARB) as an alternative to the ACE inhibitor. The patient continues to have symptoms of heart failure despite using an ARB. Which medication should the nurse anticipate will be prescribed? A. Eplerenone [Inspra] B. Triamterene [Dyrenium] C. Hydrochlorothiazide [Microzide] E. BiDil [Isosorbide Dinitrate and Hydralazine]
E