Pharm quiz 4

The nurse is reviewing discharge teaching for a patient who will be taking digoxin (Lanoxin) therapy. The nurse will teach the patient to avoid which foods when taking the digoxin? a. Leafy green vegetables b. Dairy products c. Grapefruit juice d. Bran muffins

Bran muffins

When monitoring a patient who has diabetes and is receiving a carbonic anhydrase inhibitor for edema, the nurse will monitor for which possible adverse effect? a. Metabolic alkalosis b. Elevated blood glucose c. Hyperkalemia d. Mental alertness

Elevated blood glucose

A patient with altered cardiac function is being assessed by the nurse. When auscultating lung sounds, the nurse will assist this patient into a _____ position. a. prone b. supine c. Sims' d. Fowler's

Fowler's

5. The nurse monitors a patient receiving digoxin closely for toxicity when which other medication is prescribed? a. Potassium supplements b. Furosemide (Lasix) c. Acetylsalicylic acid (aspirin) d. Antibiotics

Furosemide (Lasix)

On admission, a patient with a history of cardiac insufficiency complains of shortness of breath. The nurse auscultates the lungs and notes bilateral crackles throughout both fields. In addition, there is bilateral +2 edema of the lower extremities. Which medication does the nurse anticipate that the health care provider will prescribe? a. Allopurinol (Zyloprim) b. Diphenhydramine (Benadryl) c. Mannitol d. Furosemide (Lasix)

Furosemide (Lasix)

Which are common signs and symptoms of dehydration? (Select all that apply.) a. Furrowed tongue b. Decreased intake and output levels c. Bounding pulse rate d. Mental confusion e. Elastic skin turgor

Furrowed tongue b. Decreased intake and output levels d. Mental confusion

The nurse is reviewing lab work received on a patient admitted with the diagnosis of dehydration. The nurse will notify the physician of which lab value? a. Serum sodium level: 115 mEq/L b. Serum potassium level: 5.0 mEq/L c. Serum sodium level: 140 mEq/L d. Serum potassium level: 3.5 mEq/L

Serum sodium level: 115 mEq/L

The nurse notes in a patient's medical record that nesiritide (Natrecor) has been ordered. Based on this order, the nurse interprets that the patient has which disorder? a. Atrial fibrillation b. Severe, life-threatening heart failure c. Class II heart failure d. Acute hypertensive crisis

Severe, life-threatening heart failure

Which medication is a potassium sparing diuretic? a. Acetazolamide (Diamox) b. Spironolactone (Aldactone) c. Furosemide (Lasix) d. Bumetanide (Bumex)

Spironolactone (Aldactone)

Which medical condition(s) may contribute to fluid volume excess? (Select all that apply.) a. Hypertension b. Liver disease c. Pregnancy d. Use of corticosteroids e. Skin disorders

a. Hypertension b. Liver disease c. Pregnancy d. Use of corticosteroids

The nurse is monitoring a patient who is taking a potassium-sparing diuretic. Which of the drugs or drug classes may have an interaction with this type of diuretic? (Select all that apply.) a. Lithium b. Vancomycin c. Potassium supplements d. NSAIDs e. Antidiabetic drugs f. ACE inhibitors ANS: A, C, D, F

a. Lithium c. Potassium supplements d. NSAIDs f. ACE inhibitors

A patient who has heart failure and difficulty breathing is being admitted. Which physical assessment(s) indicate(s) fluid volume excess? (Select all that apply.) a. Rapid, bounding, irregular pulse rate b. Clear lung sounds c. 3+ pitting ankle edema d. Neck vein engorgement e. Shortness of breath ANS: A, C, D, E

a. Rapid, bounding, irregular pulse rate c. 3+ pitting ankle edema d. Neck vein engorgement e. Shortness of breath

Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct? a. "Take this medication in the evening." b. "Avoid foods high in potassium, such as bananas, oranges, fresh vegetables, and dates." c. "If you experience weight gain, such as 5 pounds or more per week, be sure to tell your physician during your next routine visit." d. "Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes."

"Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes."

A patient has a new order for the adrenergic drug doxazosin (Cardura). When providing education about this drug, the nurse will include which instructions? a. "Weigh yourself daily, and report any weight loss to your prescriber." b. "Increase your potassium intake by eating more bananas and apricots." c. "The impaired taste associated with this medication usually goes away in 2 to 3 weeks." d. "Be sure to lie down after taking the first dose, because first-dose hypotension may make you dizzy."

"Be sure to lie down after taking the first dose, because first-dose hypotension may make you dizzy."

The nurse has provided patient teaching about potassium sparing diuretic therapy. Which statement by the patient indicates a need for further teaching? a. "I will take my medication in the morning." b. "I will report a weight gain of 2 pounds in 2 days." c. "I will rise slowly when I get up from a sitting position." d. "I will use a salt substitute because I limit my salt intake."

"I will use a salt substitute because I limit my salt intake."

Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for management of heart failure? a. "Report nausea and vomiting to your healthcare provider." b. "Decrease the amount of high potassium foods you eat." c. "Omit your dose of digoxin if your pulse is 60 beats/min." d. "Visual disturbances are common adverse effects."

"Report nausea and vomiting to your healthcare provider."

During a follow-up visit, the health care provider examines the fundus of the patient's eye. Afterward, the patient asks the nurse, "Why is he looking at my eyes when I have high blood pressure? It does not make sense to me!" What is the best response by the nurse? a. "We need to monitor for drug toxicity." b. "We must watch for increased intraocular pressure." c. "The provider is assessing for visual changes that may occur with drug therapy." d. "The provider is making sure the treatment is effective over the long term."

"The provider is making sure the treatment is effective over the long term."

A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab (Digifab). The patient asks the nurse why the medication is ordered. What is the nurse's best response? a. "It will increase your heart rate." b. "This drug helps to lower your potassium levels." c. "It causes your heart to beat at a slower rate." d. "This drug is an antidote to digoxin and will help your heart to return to normal functioning.

"This drug is an antidote to digoxin and will help your heart to return to normal functioning.

The nurse is providing teaching to a patient with heart failure who has been prescribed nifedipine, a calcium channel blocker. Which statement by the nurse is accurate? a. "This medication dilates your coronary arteries." b. "This medication will help your kidneys get rid of fluid." c. "This medication reduces volume returning to your heart so it doesn't overstretch." d. "This medication reduces the resistance your heart has to pump against."

"This medication reduces the resistance your heart has to pump against."

When teaching a patient about antihypertensive drug therapy, which statements by the nurse are correct? (Select all that apply.) a. "You need to have your blood pressure checked once a week and keep track of the readings." b. "If you notice that the symptoms have gone away, you should be able to stop taking the drug." c. "An exercise program may be helpful in treating hypertension, but let's check with your doctor first." d. "If you experience severe side effects, stop the medicine and let us know at your next office visit." e. "Most over-the-counter decongestants are compatible with antihypertensive drugs." f. "Please continue taking the medication, even if you are feeling better."

"You need to have your blood pressure checked once a week and keep track of the readings." "Please continue taking the medication, even if you are feeling better." "An exercise program may be helpful in treating hypertension, but let's check with your doctor first."

The nurse is to administer digoxin to an 18-month-old patient who weighs 16.5 lb. Guidelines for administration read as follows: 0.0075 to 0.010 mg/kg/day. Which is a safe medication dosage? a. 0.05 mg b. 0.12 mg c. 0.074 mg d. 0.75 mg

0.074 mg

When administering digoxin immune Fab (Digibind) to a patient with severe digoxin toxicity, the nurse knows that each vial can bind with how much digoxin? a. 0.5 mg b. 5 mg c. 5.5 mg d. 15 mg

0.5 mg

A patient's blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside (Nipride) drip to be titrated per his response. With this medication, the nurse knows that the maximum dose of this drug should be infused for how long? a. 10 minutes b. 30 minutes c. 1 hour d. 24 hours

10 minutes

In assessing a patient before administration of a cardiac glycoside, the nurse knows that which lab result can increase the toxicity of the drug? a. Potassium level 2.8 mEq/L b. Potassium level 4.9 mEq/L c. Sodium level 140 mEq/L d. Calcium level 10 mg/dL

A. Potassium level 2.8 mEq/L Rationale: Hypokalemia increases the chance of digitalis toxicity. The other levels listed are incorrect.

8. Which drug is used to obtain vasodilation in the treatment of chronic heart failure? a. ACTH b. ACE inhibitors c. ARBs d. ANB agents

ACE inhibitors

A patient is in the intensive care unit and receiving an infusion of milrinone (Primacor) for severe heart failure. The prescriber has written an order for an intravenous dose of furosemide (Lasix). How will the nurse give this drug? a. Infuse the drug into the same intravenous line as the milrinone. b. Stop the milrinone, flush the line, and then administer the furosemide. c. Administer the furosemide in a separate intravenous line. d. Notify the prescriber that the furosemide cannot be given at this time.

Administer the furosemide in a separate intravenous line.

The nurse is caring for a 3-year-old girl who has a congenital heart anomaly. The patient's current medications include digoxin and furosemide (Lasix). The apical pulse rate is 100 beats/min. Which action will the nurse take? a. Administer the medication. b. Contact the pediatric cardiologist for further orders. c. Hold the digoxin. d. Request that another unit nurse assess the child.

Administer the medication.

The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which is a potential human needs statement for the patient taking antihypertensive medications? a. Altered GI elimination (diarrhea) b. Altered sexual function c. Altered urinary elimination (urge incontinence) d. Need for effective perception

Altered sexual function

patient who has been taking antihypertensive drugs for a few months states that a new, persistent dry cough is very bothersome. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs? a. Beta blockers b. Angiotensin-converting enzyme (ACE) inhibitors c. Angiotensin II receptor blockers (ARBs) d. Calcium channel blockers

Angiotensin-converting enzyme (ACE) inhibitors

A patient is taking digoxin (Lanoxin) and a loop diuretic daily. When the nurse enters the room with the morning medications, the patient states, "I am seeing a funny yellow color around the lights." What is the nurse's next action? a. Assess the patient for symptoms of digoxin toxicity. b. Withhold the next dose of the diuretic. c. Administer the digoxin and diuretic together as ordered. d. Document this finding, and reassess in 1 hour.

Assess the patient for symptoms of digoxin toxicity.

6. Which is the initial manifestation of digoxin toxicity in children? a. Hallucinations b. Weakness c. Atrial dysrhythmia d. Diuresis

Atrial dysrhythmia

When reviewing the mechanisms of action of diuretics, the nurse knows that which statement is true about loop diuretics? a. They work by inhibiting aldosterone. b. They are very potent, having a diuretic effect that lasts at least 6 hours. c. They have a rapid onset of action and cause rapid diuresis. d. They are not effective when the creatinine clearance decreases below 25 mL/min.

C. They have a rapid onset of action and cause rapid diuresis.

patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which class is likely to be used initially? a. Loop diuretics b. Osmotic diuretics c. Thiazide diuretics d. Potassium-sparing diuretics

C. thiazide diuretics.

The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines, antihypertensive drug therapy for a newly diagnosed hypertensive African-American patient would most likely include which drug or drug classes? a. Vasodilators alone b. ACE inhibitors alone c. Calcium channel blockers with thiazide diuretics d. Beta blockers with thiazide diuretics

Calcium channel blockers with thiazide diuretics

Which medication, if administered with spironolactone (Aldactone), will alert the nurse to assess the patient for signs and symptoms of hyperkalemia? a. Propranolol (Inderal) b. Captopril (Capoten) c. Furosemide (Lasix) d. Ibuprofen (Motrin)

Captopril (Capoten)

A patient with severe liver disease is receiving the angiotensin-converting enzyme (ACE) inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this patient is which characteristic? a. Captopril rarely causes first-dose hypotensive effects. b. Captopril has little effect on electrolyte levels. c. Captopril is a prodrug and is metabolized by the liver before becoming active. d. Captopril does not need to be metabolized by the liver before becoming active because it is not a prodrug.

Captopril does not need to be metabolized by the liver before becoming active because it is not a prodrug

A patient has been placed on a milrinone (Primacor) infusion as part of the therapy for end-stage heart failure. What adverse effect of this drug will the nurse watch for when assessing this patient during the infusion? a. Hypertension b. Hyperkalemia c. Nausea and vomiting d. Cardiac dysrhythmias

Cardiac dysrhythmias

The nurse is preparing for a community education program on hypertension. Which of these parameters determine the regulation of arterial blood pressure? a. Cardiac output and systemic vascular resistance b. Heart rate and peripheral resistance c. Blood volume and renal blood flow d. Myocardial contractility and arteriolar constriction

Cardiac output and systemic vascular resistance

12. Which nursing assessment is most important to determine fluid status for a patient with heart failure? a. Auscultation of lungs b. Daily weights c. Intake and output d. Measurement of abdominal girth

Daily weights

While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic effect. How would this drug effect be evident in the patient? a. Decreased blood pressure b. Decreased heart rate c. Decreased conduction d. Decreased ectopic beats

Decreased heart rate

When monitoring a patient who is taking hydrochlorothiazide (HydroDIURIL), the nurse notes that which drug is most likely to cause a severe interaction with the diuretic? a. Digitalis b. Penicillin c. Potassium supplements d. Aspirin

Digitalis

Which drug will be administered to a patient being admitted with severe digoxin intoxication? a. Amiodarone (Cordarone) b. Spironolactone (Aldactone) c. Digoxin immune Fab (Digibind) d. Digitalis glycoside

Digoxin immune Fab (Digibind

The nurse is assessing an emergency department patient who was recently discharged following a myocardial infarction (MI). Which symptom(s) would the nurse observe in this patient with left ventricular systolic failure? (Select all that apply.) a. Reports of recent weight loss b. Complaints of peripheral edema c. Diminished exercise tolerance d. Shortness of breath with activity e. Blood pressure elevation

Diminished exercise tolerance Shortness of breath with activity

79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very independent and wants to continue to live at home. The nurse will know that which teaching point is important for this patient? a. He should take the diuretic with his evening meal. b. He should skip the diuretic dose if he plans to leave the house. c. If he feels dizzy while on this medication, he needs to stop taking it and take potassium supplements instead. d. He needs to take extra precautions when standing up because of possible orthostatic hypotension and resulting injury from falls.

He needs to take extra precautions when standing up because of possible orthostatic hypotension and resulting injury from falls.

Individuals with which disorder(s) are particularly susceptible to the development of electrolyte disturbances during diuretic therapy? (Select all that apply.) a. History of cardiac disease b. History of renal disease c. History of hormonal disorders d. History of psychiatric illness e. Massive trauma f. Serious burns g. Overhydration

History of cardiac disease b. History of renal disease c. History of hormonal disorders e. Massive trauma f. Serious burns ANS: A, B, C, E, F

Which contributing factor(s) to heart failure is/are modifiable? (Select all that apply.) a. Hypertension b. Addiction to smoking c. Genetic history d. Exercise tolerance e. Age

Hypertension Addiction to smoking Exercise tolerance

An older adult patient will be taking a vasodilator for hypertension. Which adverse effect is of most concern for the older adult patient taking this class of drug? a. Dry mouth b. Restlessness c. Constipation d. Hypotension

Hypotension

When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem? a. Impotence b. Bradycardia c. Increased libido d. Weight gain

Impotence

A patient is being discharged to home on a single daily dose of a diuretic. The nurse instructs the patient to take the dose at which time so it will be least disruptive to the patient's daily routine? a. In the morning b. At noon c. With supper d. At bedtime

In the morning

The nurse transcribes a new order for a daily diuretic on a patient diagnosed with congestive heart failure. The nurse will schedule this medication: a. in the morning. b. after lunch. c. with dinner. d. at bedtime.

In the morning

1. What would the nurse anticipate if a patient with a history of type 2 diabetes is prescribed a thiazide diuretic? a. No change in the antidiabetic regimen b. Decreased need for antidiabetic medication c. Increased blood sugar levels d. Less frequent monitoring of blood sugar level

Increased blood sugar levels

9. Which action of ACE inhibitors results in effective treatment of heart failure? a. Increased afterload b. Increased aldosterone c. Increased preload d. Increased cardiac output

Increased cardiac output

The nurse administering the phosphodiesterase inhibitor milrinone (Primacor) recognizes that this drug will have a positive inotropic effect. Which result reflects this effect? a. Increased heart rate b. Increased blood vessel dilation c. Increased force of cardiac contractions d. Increased conduction of electrical impulses across the heart

Increased force of cardiac contractions

Which condition warrants the use of acetazolamide (Diamox) as a diuretic? a. Increased intracranial pressure b. Increased extravascular fluid pressure c. Increased intraocular pressure d. Periorbital edema

Increased intraocular pressure

7. Which agents stimulate the heart to increase the force of contractions, thereby increasing cardiac output? a. Inotropic b. Chronotropic c. Isotonic d. Isopropyl

Inotropic

Which patient assessment would alert the nurse to withhold a loop diuretic? a. Crackles in the lung bases b. +2 pitting peripheral edema c. Serum potassium of 2.6 mEq/L d. Weight gain of 2 pounds in 2 days

Serum potassium of 2.6 mEq/L

When a patient is receiving diuretic therapy, which of these assessment measures would best reflect the patient's fluid volume status? a. Blood pressure and pulse b. Serum potassium and sodium levels c. Intake, output, and daily weight d. Measurements of abdominal girth and calf circumference

Intake, output, and daily weight

Mannitol (Osmitrol) has been ordered for a patient with acute renal failure. The nurse will administer this drug using which procedure? a. Intravenously, through a filter b. By rapid intravenous bolus c. By mouth in a single morning dose d. Through a gravity intravenous drip with standard tubing

Intravenously through a filter

A patient has a digoxin level of 1.1 ng/mL. Which interpretation by the nurse is correct? a. It is below the therapeutic level. b. It is within the therapeutic range. c. It is above the therapeutic level. d. It is at a toxic level.

It is within the therapeutic range. ANS: B The normal therapeutic drug level of digoxin is between 0.5 and 2 ng/mL. The other options are incorrect.

The nurse would expect to assess which serum potassium level in a patient who has severe vomiting and diarrhea? a. Less than 3.5 mEq/L b. Between 3.5 and 4.5 mEq/L c. Between 4.6 and 5 mEq/L d. Higher than 5.5 mEq/L

Less than 3.5 mEq/L

A pregnant woman is experiencing hypertension. The nurse knows that which drug is used for a pregnant patient who is experiencing hypertension? a. Mannitol (Osmitrol) b. Enalapril (Vasotec) c. Hydrochlorothiazide (HydroDIURIL) d. Methyldopa (Aldomet)

Methyldopa (Aldomet)

The nurse is reviewing the orders for a patient and notes a new order for an angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class? a. Calcium channel blockers b. Diuretics c. Nonsteroidal anti-inflammatory drugs d. Nitrates

Nonsteroidal anti-inflammatory drugs

A patient in the neurologic intensive care unit is being treated for cerebral edema. Which class of diuretic is used to reduce intracranial pressure? a. Loop diuretics b. Osmotic diuretics c. Thiazide diuretics d. Vasodilators

Osmotic diuretics

When teaching a patient who is taking thiazide diuretics, the nurse will encourage the patient to increase the intake of which electrolyte? a. Calcium b. Sodium c. Potassium d. Magnesium

Potassium

Which foods will the nurse recommend for a patient taking loop diuretics? a. Protein-rich foods such as poultry, whole grains, and fish b. Fiber-rich foods such as yellow vegetables, nuts, and lentils c. Potassium-rich foods such as raisins, figs, and bananas d. Sodium-rich foods such as canned vegetables and processed foods

Potassium-rich foods such as raisins, figs, and bananas

3. An older adult male patient with long-term heart failure has presented for an office visit. The nurse obtains information that he has recently begun taking St. John's wort. What results with the use of this herbal supplement? a. Digoxin toxicity b. Altered potassium electrolyte balance c. Reduced therapeutic benefits of digoxin d. Enhanced digoxin effectiveness without producing toxicity

Reduced therapeutic benefits of digoxin

patient with type 2 diabetes mellitus has been found to have trace proteinuria. The prescriber writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the main reason for prescribing this class of drug for this patient? a. Cardioprotective effects b. Renal protective effects c. Reduces blood pressure d. Promotes fluid output

Renal protective effects

Before administering digoxin (Lanoxin), the nurse takes the adult patient's apical pulse for 1 full minute. What additional nursing consideration(s) will be taken before administration of the medication? (Select all that apply.) a. Review of the digoxin blood level b. Administration of the medication with pulse less than 60 beats/min c. Review of serum electrolytes, liver, and kidney function studies d. Administration of the medication with a pulse of 110 beats/min e. Obtaining baseline patient assessment data, including lung sounds, vital signs, and weight

Review of the digoxin blood level Review of serum electrolytes, liver, and kidney function studies e. Obtaining baseline patient assessment data, including lung sounds, vital signs, and weight

Which premedication assessment(s) would the nurse obtain prior to the initiation of bumetanide (Bumex)? (Select all that apply.) a. Serum potassium b. Bowel sounds c. Lung sounds d. Orientation level e. Blood pressure

Serum potassium c. Lung sounds d. Orientation level e. Blood pressure

A patient with primary hypertension is prescribed drug therapy for the first time. The patient asks how long drug therapy will be needed. Which answer by the nurse is the correct response? a. "This therapy will take about 3 months." b. "This therapy will take about a year." c. "This therapy will go on until your symptoms disappear." d. "Therapy for high blood pressure is usually lifelong."

Therapy for high blood pressure is usually lifelong

5. How soon will diuresis be expected to occur after the nurse has administered 20 mg of furosemide (Lasix) intravenously (IV) to a patient with heart failure? a. As soon as injected b. Within 10 minutes c. After 2 hours d. After 4 hours

Within 10 minutes

Which drug classes are considered first-line treatment for heart failure? (Select all that apply.) a. Angiotensin-converting enzyme (ACE) inhibitors b. Angiotensin II receptor blockers (ARBs) c. Digoxin (cardiac glycoside) d. Beta blockers e. Nesiritide (Natrecor), the B-type natriuretic peptide

a. Angiotensin-converting enzyme (ACE) inhibitors b. Angiotensin II receptor blockers (ARBs) d. Beta blockers

Which nursing intervention(s) would be performed for a patient who is on diuretic therapy? (Select all that apply.) a. Auscultation of lung sounds b. Assessment of skin turgor c. Initiation of electrolyte supplements d. Positioning techniques e. Monitoring of intake and output

a. Auscultation of lung sounds b. Assessment of skin turgor d. Positioning techniques e. Monitoring of intake and output

The nurse transcribes a new order for ethacrynic acid (Edecrin) on a patient with edema resulting from cirrhosis of the liver. Which currently prescribed medication(s) should the nurse report to the ordering health care provider? (Select all that apply.) a. Digoxin b. Prednisone c. Tobramycin d. Lipitor e. Zofran

a. Digoxin b. Prednisone c. Tobramycin

Which statement(s) about vasodilators is/are true? (Select all that apply.) a. They reduce systemic vascular resistance. b. They increase afterload. c. They reduce preload. d. They decrease pulmonary congestion. e. They increase tissue perfusion to muscles and organs.

a. They reduce systemic vascular resistance. c. They reduce preload. d. They decrease pulmonary congestion. e. They increase tissue perfusion to muscles and organs.

3. Which action(s) will the nurse take when caring for a patient with heart failure? (Select all that apply.) a. Administer diuretics at bedtime. b. Assess electrolyte levels. c. Report daily weight fluctuations. d. Encourage sodium intake. e. Maintain skin hygiene.

b. Assess electrolyte levels. c. Report daily weight fluctuations. e. Maintain skin hygiene.

patient with heart failure has been prescribed nesiritide (Natrecor). Which statement(s) is/are true regarding this medication? (Select all that apply.) a. It increases preload. b. Cardiac ventricles secrete this hormone in response to fluid overload. c. It suppresses aldosterone. d. It promotes norepinephrine secretion. e. It causes vasodilation.

b. Cardiac ventricles secrete this hormone in response to fluid overload. c. It suppresses aldosterone. e. It causes vasodilation.

Which sign(s) and/or symptom(s) of dehydration may occur as a result of a diuretic? (Select all that apply.)apply.) a. Decreased urine specific gravity b. Skin remains peaked on turgor assessment c. Bounding peripheral pulses d. Neck vein engorgement e. Soft, sunken eyeballs

b. Skin remains peaked on turgor assessment Soft, sunken eyeballs

When a patient is experiencing digoxin toxicity, which clinical situation would necessitate the use of digoxin immune Fab (Digifab)? (Select all that apply.) a. The patient reports seeing colorful halos around lights. b. The patient's serum potassium level is above 5 mEq/L. c. The patient is experiencing nausea and anorexia. d. The patient is experiencing severe sinus bradycardia that does not respond to cardiac pacing. e. The patient has received an overdose of greater than 10 mg of digoxin. f. The patient reports fatigue and headaches.

b. The patient's serum potassium level is above 5 mEq/L. d. The patient is experiencing severe sinus bradycardia that does not respond to cardiac pacing. e. The patient has received an overdose of greater than 10 mg of digoxin.

7. The nurse is providing education to a patient with altered cardiac function. When instructing this patient the nurse will encourage: (Select all that apply.) a. alcohol consumed in moderation. b. use of salt substitute. c. regular, mild exercise. d. good skin care. e. stress reduction.

c. regular, mild exercise. d. good skin care. e. stress reduction.

2. When assessing a patient who is receiving a loop diuretic, the nurse looks for the manifestations of potassium deficiency, which would include what symptoms? (Select all that apply.) a. Dyspnea b. Constipation c. Tinnitus d. Muscle weakness e. Anorexia f. Lethargy

d. Muscle weakness e. Anorexia f. Lethargy

A patient about to receive a morning dose of digoxin has an apical pulse of 50 beats/min. What will the nurse do next? a. Administer the dose. b. Administer the dose, and notify the prescriber. c. Check the radial pulse for 1 full minute.

d. Withhold the dose, and notify the prescriber. ANS: D Digoxin doses are held and the prescriber notified if the apical pulse is 60 beats/min or lower or is higher than 100 beats/min. The other options are incorrect.

The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics? a. Hydrochlorothiazide (HydroDIURIL) b. Furosemide (Lasix) c. Acetazolamide (Diamox) d. Spironolactone (Aldactone)

d. spironolactone (Aldactone)

A 37-year-old male presents at the emergency department reporting severe vomiting for the past 48 hours. When assessing skin turgor, the nurse will a. exert pressure against the shin. b. gently pinch the skin together over the sternum. c. assess for vein distention. d. inspect oral mucous membranes.

gently pinch the skin together over the sternum.