pharm Review questions w5

A nurse is reviewing laboratory results. of a client who has atrial fibrillation and is taking warfarin. For which of the following results should the nurse notify the provider? a. INR 5.2 b. Hgb 16 c. Hct 44% d. platelets 190,000

a

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

b

A nurse is assessing a client who is taking enalapril to treat HTN. Which of the following is a priority to report? a. dry cough b. swelling of the tongue c. nausea d. nasal congestion

b

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances? a. hypernatremia b. hypokalemia c. hypercalcemia d. hyperchloremia

b

Which statement is true regarding enoxaparin and delteparin? a. their method of action is to interrupt vitamin K-dependent clotting factors b. they do not require clotting-time monitoring c. they are administered deep IM d. They have thrombolytic properities

b

A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? a. hemoglobin (Hgb) b. INR c. bleeding time d. activated partial thromboplastin time (aPTT)

b - INR IS 2-3 Sec

During thrombolytic therapy, the nurse monitors for bleeding. Which symptoms may indicate a serious bleeding problem? SATA a. HTN b. hypotension c. decreased level of consciousness d. increased pulse rate e. restlessness

b, c, d, e

A nurse is assessing a client who has heart failure and is prescribed furosemide. What of the following findings is an adverse effect of this medication? SATA a. weight gain b. hypotension c. hypoglycemia d. leg cramps e. tinnitus f. dry mucus membranes

b, d, e, f

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take the heparin to dissolve the clot. Which of following responses should the nurse give? a. "it useally takes heparin at least 2 to 3 days to reach a therpeutic blood level." b. "A pharmacist is the person to answer that question." c. " Heparin does not dissolve clots. It stops new clots from forming." d. "the oral medication you will take after this IV will dissolve the clot"

c

A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse plan to take? a. insert the needle at a 25 degree angle b. aspirate for a blood return before depressing the plunger c. The nurse should not expel the air bubble in the prefilled syringe d. Administer the medication 2.54cm (1in) from the umbilicus

c

A nurse is preparing to administer heparin subcutaneously to a client who has a deep vein has a deep vein thrombosis. Which of the following techniques should the nurse use? a. cleans the skin with an alcohol swab, insert the needle, aspirate, and inject the heparin. b. cleans the skin with an alcohol swab, insert the needle, aspirate, inject the heparin, and massage the site c. cleanse the skin with an alcohol swab, insert the needle, inject the heparin, and observe for bleeding d. cleanse the skin with an alcohol swab, insert the needle, inject the heparin, aspirate, and observe for bleeding

c

A nurse is providing teaching to a client who has hypertension and a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse provide? a. weigh weekly to monitor therapeutic effect b. take the medication on an empty stomach c. take the medicatoin early in the day d. muscle pain is an expected adverse effect

c

A nurse is teaching a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following client food choices reflects the client's understanding of these dietary instructions? a. liver b. milk c. beans d. eggs

c

When administering subcutaneous heparin, the nurse will remember to perform which action? a. use the same sites for injection to reduce trauma b. use a 1in needle for subcutaneous injections c. inject the medication without aspirating for blood return d. massage the site after the injection to increase absorption

c

A nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. Which of the following findings should the nurse recognize as a potential adverse effect? SATA a. blurred vision b. orthostatic hypotension c. anorexia, nausea, and vomiting d. muscle weakness e. urinary retention f. tea colored urine

c, d, f

A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following should the nurse take? SATA a. offer the client a light b. measure the client's blood presssure c. measure the client's apical pulse d. weigh the client e. check potassium and digoxin levels

c, e

A nurse is preparing to administer dabigatran to a client who has atrial fibrillation. The nurse should explain that the purpose of this medication is which of the following? a. to convert atrial fibillation to sinus rhythm b. to dissolve clots in the bloodstream c. to slow the response of the ventricles to the fast atrial impulses d. to reduce the risk of stroke in clients who have atrial fibillation

d

A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication? a. orange juice b. coffee c. milk d. grapefruit juice

d - also statins

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of n/v. Which of the following actions should the nurse take fist? a. check the client's vital signs b. request a dietitian consult c. suggest that the client rests before eating the meal d. request an order for an antiemetic

a

A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? a. "warfarin takes several days the work, so the heparin will be used until the warfarin reaches a therapeutic level." b. "I will call the provider to get a prescription for discontinuing the IV heparin today." c. "both heparin and warfarin work together to dissolve clots." d. the IV heparin increases the effect of the warfarin and decreases the length of your hospital stay. "

a

A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? a. decreased blood pressure b. increase of HDL cholesterol c. prevention of bipolar manic episodes d. improved sexual function

a

A nurse is teaching about necessary baseline examinations with a female client who is start taking atorvastin. Which of the following baseline examinations should the nurse include in the teaching? a. liver function tests b. hearing test c. papanicolaou test d. dental examination

a

A nurse on a telemetry unit is caring for a client who has unstable angina and is reporting chest pain with a severity of 6 on a 0-10 scale. The nurse administers 1 sublingual nitroglycerin tablet. After 5 min, the client states that his chest pain is now severity of 2. Which of the following actions should the nurse take? a. administer another nitroglycerin tablet b. initiate a peripheral IV c. call the rapid response team d. obtain an ECG

a

A patient is at risk for a stroke. Which drug is recommended to prevent platelet aggregation for stroke prevention by the American stroke society? a. aspirin b. warfarin sodium c. heparin d. alteplase

a

A nurse is assessing an older adult client who is receiving digoxin. The nurse should recognize that which of the following findings is a manifestation of digoxin toxicity? SATA a. anorexia b. blurry vision c. ataxia d. photosensitivity e. n/v f. jaundice

a, b, e - also bradycardia

A nurse is preparing to administer clonidine 0.3 mg at bedtime to a client. The nurse remembers that the indications for use of this medication are: SATA a. HTN b. tachycardia c. management of withdrawal symptoms d. heart failure e. angina

a, c

The nurse is providing teaching to a client on his new medication carvedilol. Which instructions should the nurse include in the teaching? SATA A. change positions slowly b. you don't have to monitor your blood pressure c. this medication may lower your heart rate d. report any side effects like difficultly breathing or edema e. you can take two tablets if your heart rate is above 100 beats/min

a, c, d

The nurse is reviewing the use of anticoagulants. Anticoagulant therapy is appropriate for which conditions? a. atrial fibrillation b. thrombocytopenia c. myocardial infarction d. presence of mechanical heart valvue e. aneurysm f. leukemia

a, c, d

A nurse is teaching a client about dietary restrictions related to his medications. The nurse advises the client to avoid grapefruit juice with which of his medications? a. amlodipinie b. metoprolol c. calcium channel blockers d. atorvastain e. enalapril f. statins

a, c, d, f

A nurse is reviewing the laboratory results of a client who has liver failure and is receiving spironolactone. Which of the following findings should the nurse report to the HCP? SATA a. decreased sodium level b. weigh loss c. decreased potassium level d. increased potassium level

a, d