Pharmacology Exam 3

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.) "Take one 325-mg aspirin 30 minutes before your dose to lessen the problem of flushing and itching that can occur with this drug." "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." "Do not start any new medications without first talking to your healthcare provider." "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains." "Take your medication in the morning, with a full glass of water for best results."

"Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." "Do not start any new medications without first talking to your healthcare provider." "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains."

What is the priority nursing diagnosis for a patient with a dysrhythmia? Imbalance of fluid and electrolytes inadequate peripheral tissue perfusion ineffective breathing pattern alteration in cardiac output

alteration in cardiac output

Potentially life threatening reaction to ACE inhibitors dyspepsia hyperglycemia cough angioedema

angioedema

All antidysrhythmic drugs are: given by mouth given parenterally are prodysrhythmic cause diarrhea

are prodysrhythmic

Instructing a patient on the Valsalva maneuver is asking the patient to do what? Pant like a dog Bear down as if having a bowel movement Tighten the pelvic floor muscles Breathe through pursed lips

Bear down as if having a bowel movement

Beta blockers produce most of their beneficial effects by blocking which receptors in the heart? Beta 1 Alpha 1 Alpha 2 Beta 2

Beta 1

What baseline data should be collected before giving an alpha1-adrenergic antagonist? liver function studies kidney function studies blood pressure and heart rate fasting lipid panel

blood pressure and heart rate

A patient with deep vein thrombosis receiving an intravenous (IV) heparin infusion asks the nurse how this medication works. What is the nurse's best response? Heparin suppresses coagulation by helping antithrombin perform its natural functions. Heparin inhibits the enzyme responsible for platelet activation and aggregation within vessels. Heparin prevents the activation of vitamin K and thus blocks the synthesis of some clotting factors. Heparin works by converting plasminogen to plasmin, which in turn dissolves the clot matrix.

Heparin suppresses coagulation by helping antithrombin perform its natural functions.

The ___________________ is used to monitor warfarin therapy. Platelet count aPPT INR no test required

INR

The nurse is teaching a patient who has had an ST-segment elevation myocardial infarction (STEMI) about home medications. Which agent represents a drug category that should be taken by all post-MI patients? Metoprolol Lovastatin Diltiazem Hydrochlorothiazide

Metoprolol

Your type 1 diabetic patient is on a beta-blocker. Which is the best way to determine if your patient is hypoglycemic? Monitor capillary blood glucose watch for S&S of hypoglycemia check blood glucose 1/week don't worry they won't become hypoglycemic on a beta-blocker

Monitor capillary blood glucose

Which are beneficial effects that can be derived from simvastatin [Zocor] and other drugs in this class? (Select all that apply.) Reduction of risk of CV events improvement in liver function elevation of HDLs Stabilization of plaque in coronary arteries reduction of LDLs

Reduction of risk of CV events elevation of HDLs Stabilization of plaque in coronary arteries reduction of LDLs

In a healthy heart what is the pacemaker? AV node ventricle Bundle of His SA node

SA node

The nurse is caring for a patient receiving nitrates for relief of angina. What pharmacodynamic action is responsible for the relief of anginal pain with nitrates? Vasoconstriction leads to improved cardiac output Decreased force of contraction leads to decreased oxygen demand. Influx of calcium ions leads to relaxation of vascular smooth muscle. Vasodilation leads to decreased preload, which decreases oxygen demand.

Vasodilation leads to decreased preload, which decreases oxygen demand.

What drug is the oldest oral anticoagulant? Clopidogrel Enoxaparin Heparin Warfarin

Warfarin

The most common reason for discontinuing ACE inhibitors is: hypokalemia a cough excessive diuresis first-dose hypertension

a cough

A patient recently began taking a loop diuretic for hypertension related to heart failure. He is complaining about dizziness and lightheadedness when standing. What advice can the nurse give him to keep him safe? take medication before bed take medication earlier in day change positions slowly reduce dosage of medication

change positions slowly

drugs that dilate capacitance vessels (veins) decrease cardiac afterload decrease cardiac preload increase cardiac preload increase cardiac afterload

decrease cardiac preload

postural hypotension is caused by water retention decreased venous return vasoconstriction increased cardiac output

decreased venous return

An abnormality in the rhythm of the heartbeat is called a cardiac cycle bruit dysrhythmia baroreceptor reflex

dysrhythmia

drugs that are toxic to the same organ can be combined without caution (true or false)

false

Digoxin and other inotropic agents increase heart rate increase force of contraction decrease cardiac output decrease urine production

increase the force of myocardial contraction

Statins may cause brain damage kidney damage heart damage liver damage

liver damage

Cardiac afterload is primarily determined by systemic filling pressure peripheral resistance stroke volume myocardial contractility

peripheral resistance

When caring for a patient who is prescribed a vasodilator, it is important to monitor for which adverse effects associated with vasodilation? (select all that apply) lowering of BP to target levels postural hypotension bradycardia tachycardia fluid volume overload

postural hypotension tachycardia fluid volume overload

Calcium channel blockers are useful in treating hypertension and angina pectoris because they: cause vasoconstriction promote excretion of sodium promote vasodilation increase myocardial contractility

promote vasodilation

What is the most beneficial treatment for patients who have an ST elevated MI (STEMI)? giving a statin aspirin therapy administering a beta blocker reperfusion

reperfusion

Which lifestyle modifications are strongly encouraged in patients with primary hypertension? (select all that apply) sodium restriction alcohol intake restriction smoking cessation aerobic exercise weight loss

sodium restriction alcohol intake restriction smoking cessation aerobic exercise weight loss

The balance between the pulmonary and systemic circulations in a healthy heart is maintained in accordance with venous pump starling's law of the heart amount of peripheral resistance baroreceptor reflex

starling's law of the heart

untreated hypertension can lead to (select all that apply) Type 1 diabetes mellitus stroke kidney disease heart disease

stroke kidney disease heart disease

The nurse is aware that which nitroglycerin preparation has a rapid onset? Sublingual tablets topical ointment transdermal patch sustained release capsule

sublingual tablets

Aspirin and other antiplatelet drugs: suppress thrombus formation in arteries bind to plasma proteins prevent activation of vitamin K dissolve existing thrombi

suppress thrombus formation in arteries

Your heart failure patient has been started on digoxin. What is the most important patient teaching consideration regarding this medication? Teach pt to take medication at the same time every day teach pt to take the BP before each dose teach pt the S&S of digoxin toxicity teach pt to keep scheduled appt with their healthcare provider

teach pt the S&S of digoxin toxicity

It is important for the nurse to discuss the adverse effects of the antihypertensive drugs that are prescribed because the nurse knows what about the drugs' adverse effects? they reflect the cause of hypertension they are necessary of the antihypertensive is at an effective dose they are life-threatening they affect adherence

they affect adherence

Which drug classification is the first-line drug treatment for primary hypertension? loop diuretics thiazide diuretics beta blockers aldosterone antagonists

thiazide diuretics

What is a major use of epinephrine? treatment of anaphylaxis control of superficial bleeding delay of local anesthetic absorption management of cardiac arrest (asystole)

treatment of anaphylaxis

Therapy with cholesterol-lowering drugs must continue lifelong. ( true or false)

true

_________ is used to treat warfarin overdose protamine sulfate vitamin K aspirin adenosine diphosphate

vitamin K

The kidneys provide long-term control of arterial pressure by regulating Potassium peripheral resistance water angiotensin II

water