Pharm Quiz 2: Prep U ?'s
Which patient statement indicates the need for additional teaching about propranolol?
"I can stop the drug once my blood pressure is controlled."
Why is it important for a nurse to encourage client to control his or her blood pressure?
- Hypertension increases the build up of atherosclerotic plaque. - Hypertension increases risk of stroke. - Hypertension increases the work load of the heart.
A patient is receiving digoxin. The nurse monitors the patient's digoxin level. Which finding would the nurse interpret as therapeutic?
1.5 ng/mL
Most clients with Stage 2 hypertension will require how many antihypertensives to lower blood pressure to goal initially?
2
A nurse must immediately report serum digoxin levels greater than?
2.0 nanograms/mL
Which of the following patients should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?
A 47-year-old female with hypertension
Which of the following patients is most likely to benefit from the administration of an adrenergic agonist?
A man who is in cardiogenic shock following a myocardial infarction
Mr. Emmeott is seen by the physician for follow-up for diabetic nephropathy. The physician prescribed losartan for the treatment of this condition because the medication has been shown to reduce the rate of end-stage renal disease. Which drug class does this drug belong to?
Angiotensin II receptor blockers
A female patient diagnosed with chronic atrial flutter has been prescribed verapamil in conjunction with digoxin to control ventricular rate. To enhance the therapeutic effect of the drug, the nurse will instruct the patient to
Avoid grapefruit and grapefruit juice.
Which of the following would a nurse expect to administer if a client who is receiving isoproterenol develops a severe reaction?
Beta-adrenergic blockers
The nurse knows that which class of drugs prevents epinephrine and norepinephrine from occupying receptor sites on the cell membranes?
Beta-adrenergic blocking drugs
A patient with type 1 diabetes is prescribed acebutolol. Which of the following would be most important to monitor?
Blood glucose levels
Epinephrine causes relaxation of:
Bronchioles
The nurse would instruct a client receiving acebutolol about which of the following adverse effects?
Bronchospasm
A nurse is educating a patient with hypertension who is prescribed losartan on the mechanism of action of the drug. Which of the following modes of action helps losartan to bring about its antihypertensive effect?
By blocking the angiotensin II receptors
A 46-year-old man with a high body-mass index and a sedentary lifestyle has been diagnosed with hypertension by his primary care provider after serial blood pressure readings. The clinician has opted to begin the patient on captopril (Capoten). The patient's nurse should recognize that the therapeutic effect of this drug is achieved in what way?
By inhibiting the transformation of angiotensin I to angiotensin II
When describing the drugs classified as class IV antiarrhythmics, the nurse would identify these as which of the following?
Calcium channel blockers
A patient has been administered dobutamine HCL. Which of the following adverse reactions should the nurse monitor for in the patient?
Cardiac arrhythmias
The nurse knows that what physiologic changes will effect a client's stroke volume?
Changes in heart contraction
A nurse is caring for an elderly patient who is to be administered isoproterenol. Which of the following changes monitored in the patient should the nurse report immediately to the primary healthcare provider?
Changes in pulse rate
A client has been prescribed a beta blocker. The nurse knows that beta blockers can have which of the following effects on the heart?
Decrease the heart rate.
A patient is being treated for heart failure. Which of the following is indicative of improved heart failure status?
Decreased pedal edema
Your 71-year-old male patient has recently been diagnosed with hypertension. Which of the following measurements is a partial indication of effective treatment and management?
Diastolic blood pressure below 90 mm Hg
Key behavioral determinants of blood pressure are related to what factor?
Dietary consumption of calories and salt
A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs?
Digoxin immune fab
An instructor is preparing a teaching plan for a group of students about adrenergic agonists. Which of the following would the nurse include as an alpha- and beta-adrenergic agonist?
Epinephrine
The nurse is educating a client with hypertension about dietary changes that help to decrease blood pressure. Which of the following menu selections indicates the need for further client education?
Ham sandwich with mustard, carrots and cheesy dip
A client is receiving a diuretic as the first-line treatment of mild hypertension. The nurse monitors the client for signs and symptoms of hypokalemia with which agent?
Hydrochlorothiazide
A nurse in the intensive care unit is caring for a patient in shock and has started IV administration of dopamine (Intropin). For a patient in shock, dopamine helps to....
Increase blood pressure.
Adrenergic drugs produce which of the following effects?
Increased heart rate
A patient is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce?
Increased vasoconstrictive effects
The patient has been placed on a nitroprusside drip for the treatment of a hypertensive crisis. Which mechanism of action does the nurse know is true for nitroprusside?
It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins.
The nurse would contact the physician before administering an adrenergic drug to a client who is also taking which drug?
MAO inhibitor
A male client is diagnosed with cirrhosis of the liver. He also takes digoxin for a diagnosis of atrial fibrillation. The nurse anticipates that the physician will order what in connection with the digoxin medication?
Maintain the current digoxin dose
A patient has been diagnosed with narrow-angle glaucoma. What ocular effect will be produced if the patient is prescribed an adrenergic agent?
Mydriasis
After receiving the results of his echocardiogram, your patient has many questions regarding results and their impact on his lifestyle. He is a 57-year-old Hispanic man with a 10-year history of hypertension. Disturbed by all the dietary changes proposed by the cardiologist, he questions what effect hypertension has on his heart. What is your reply?
Myocardium hypertrophy
The nurse recognizes that which of the following medications may be used to treat a hypertensive crisis?
Nitroprusside
A client is started on captopril, an ACE inhibitor. The client should be informed of the possibility of what adverse effect?
Persistent cough
Which agent would the nurse expect to find when reviewing over-the-counter allergy products?
Phenylephrine
The pharmacology instructor is describing medications that increase the contractile force of the heart. Which of the following terms describes this effect?
Positive inotropic
A nurse checks a client's blood pressure and finds it to be 130/82. This client should be classified as having which stage of hypertension?
Prehypertension
Your patient has questions about the new medication prescribed for her cardiac rhythm after having cardioversion performed. You explain how the sodium channel blocker decreases the likelihood of dysrhythmias by:
Prolonging the refractory period.
A patient, admitted to a health care facility with cardiac arrhythmia, is prescribed propranolol. Which of the following factors should the nurse closely monitor as a part of the ongoing assessment during the therapy?
Pulse rate
A provider chooses to treat an African American client suffering from hypertension with a beta blocker and diuretic instead of an ACE inhibitor. The nurse knows that the provider did this for what reason?
Research has shown beta blockers, in combination with diuretics, treat hypertension in African Americans better than ACE inhibitors
A patient is experiencing orthostatic hypotension that is due to his antihypertensive therapy. Which nursing diagnosis would be most appropriate?
Risk for injury
The adrenergic branch of the autonomic nervous system is also known by which of the following names? (Choose one)
SNS
When describing the action of calcium channel blockers, which of the following would be an expected effect?
Slowed impulse formation
A client with a blood pressure of 165/95 mmHg would be in classified as which stage of hypertension?
Stage 2
A nurse is monitoring the vital signs of a patient who has been administered epinephrine. Which of the readings should nurse report immediately to the primary healthcare provider?
Systolic blood pressure below 100 mm Hg
A patient has had multiple blood pressure readings that indicate he is hypertensive. How is hypertension defined?
Systolic pressure above 140 mm Hg or diastolic pressure above 90 mm Hg
A patient has an elevated BUN (meaning somethings wrong w/ renal). The patient has been prescribed digoxin (Lanoxin) for heart failure. What factor is important regarding this patient?
The dose should be decreased in this patient.
Mrs. Houston is a 78-year-old woman who resides in an assisted living facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the assisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston?
The importance of having required laboratory work performed on time
A triage nurse in the emergency department suspects that a 78-year-old patient is experiencing severe digoxin toxicity with significant cardiac dysrhythmia. If she is correct, which of the following actions is likely to be taken?
The patient will be given digoxin immune fab.
Which of the following observations might indicate that timolol is achieving the desired effect in a patient?
The patient's intraocular pressure decreases.
The use of an alpha-adrenergic blocker will result in which of the following patient outcomes? (Choose one)
Vasodilation
A priority nursing assessment for a patient who is to receive an alpha- or beta-adrenergic agonist would be to....
assess heart rate.
