Pharmacology Exam 3 Workbook and PowerPoint Questions
when taking a history from a patient who is prescribed an ACE inhibtor, ARB, or eplerenone (inspra), which question would be most important for the nurse to ask? (44)
"what do you use to season your food"
the prescriber writes an order to switch a patient from intravenous (IV) to oral procainamide. The IV drug was discontinued at 11:30AM. What is the earliest that the nurse should adminster the first dose of oral procainamide? (49)
2:30PM
Which patient would the nurse expect to have the highest risk for postural hypotension? (review of hemodynamics)
A patient who is prescribed a drug that promotes venous vasodilation
It is a priority for the nurse to evaluate which laboratory test result before administering alfuzosin (Uroxatral) to a patient? (17/18)
AST/ALT
a patient is receiving a vasodilator that has a high incidence of othostatic hypotension. Before administering the medication and after the patient has rested supine for 10 minutes, the nurse assesses the BP and pulse. Results are BP 145/80 mmHg, P 68 beats/min. The nurse assists the patient to stand, ensuring safety, and after 1 minute reassesses the BP and pulse. Which reading would be of most concern to the nurse (43)
BP 110/70 mmHg, pulse 92 beats/min
The nurse is researching a drug. The handbook states that it decreases afterload. Before the nurse administers this medication to a patient, which assessment would be most critical? (43)
BP for hypotension
The nurse has administered epinephrine IM to a patient with a history of asthma and T1DM. It's a priority to assess for which possible effect of this drug? (17/18)
Hot, dry, flushed skin
The nurse teaches a patient about benazepril (lotensin). Which statement by the patient requires an intervention by the nurse? (chapter 44 powerpoint)
I use NoSalt instead of salt to season foods
which lab result for international normalized ratio (INR), if identified in a patient with atrial fibrillation who is receiving warfaring (coumadin), would indicate that warfarin therapy has achieved the desired effect (49)
INR between 2-3
A patient's cardiac output is 8 L per minute. Which hemodynamic effect would the nurse effect? (review of hemodynamics)
Increased stroke volume
when a patient is prescribed an ACE inhibitor, it is a priority to teach the patient not to take which OTC drug without connsulting the prescriber (44)
NSAID
A patient is prescribed a medication that causes venous dilation. It is most important for the nurse to teach the patient about what? (review of hemodynamics)
Postural hypotension
A patient diagnosed with systemic lupus erythematosus (SLE) develops a dysrhythmia. Which medication, if ordered by the physician, should the nurse question? (49)
Procainamide (procanbid)
A patient is prescribed a medication that lowers the arterial blood pressure. The nurse should assess for which response by the body to restore the blood pressure? (review of hemodynamics)
Reflex tachycardia
The nurse instructs a patient about taking nifedipine (procardia XL). Which statement made by the patient indicates an understanding of medication teaching? (chapter 45 powerpoint)
The pill should be swallowed whole
which patient is the most appropriate candidate for both lifestyle changes and drug therapy with an antihypertensive medication? (47)
a 32 year old patient with blood pressure of 142/94 mmHg who is sedentary
which patient would most likely be prescribed sodium nitropursside (nitropress)? (46)
a patient with a hypertensive crisis in the intensive care unit
when assessing a patient who is scheduled to receive the second dose of newly prescribed sustained-release nitroglycerin, the patient complains of a headache. What should the nurse do? (51)
administer a prescribed PRN analgesic such as acetaminophen
a patient is scheduled for a below-the knee amputation at 1000 AM. heparin 5000 units is scheduled to be administered subQ at 2100 the evening prior to surgery and 0900 the morning of surgery. which action by the nurse is appropriate (52)
administer both doses of the medication as ordered
the nurse is administering nitroprusside (nitropress) in a cardiac care unit. The presciber also orders adminstraion of oral antihypertensives. the patient's blood pressure is still elevated, but dropping slowly. The nurse should do what (46)
administer both medications
A patient who is taking spironolactone (Aldactone) is prescribed losartan (cozaar). The nurse should take which action? (chapter 44 powerpoint)
administer for medications as scheduled
a patient who is prescribed an ACE inhibitor complains of tongue swelling and is experiencing obvious dyspnea. What is the priority action by the nurse? (44)
administer the prescribed PRN epinephrine
what is the priority nursing diagnosis for a patient with a dysrhythmia (49)
alteration in cardiac output
what is the most significant difference between amiodarone and dronedrone (49)
aminodarone has a different risk of death
when a patient with HF is prescribed digoxin and furosemide, the nurse should carefully assess the patient for which symptoms of digoxin toxicity. (48)
anorexia and nausea
which drug prescribed for acute STEMI should be withheld and the prescriber consulted immediately if the patient's pulse is 118 beats/min (53)
aspirin
what do multple P waves before the QRS complex on an ECG indicate (49)
atria are depolarizing faster than the ventricles
instructing a patient on the Valsalva maneuver is asking the patient to do what (49)
bear down as if having a bowel movement
a patient has hypertension, type 2 diabetes, and chronic kidney disease. which blood pressure goal would be most beneficial for this patient? (47)
blood pressure less than 130/80 mmHg
A patient diagnosed with heart failure has stage 1 hypertension. Which medication, if ordered by the health care provider, should the nurse question? (47)
calcium channel blocker
which adverse effect, if noted in a patient who has recently been prescribed ticlopidine would be a reason for the nurse to contact the presciber immediately (52)
change in level of consciousness
A patient is prescribed verapamil (calan). The nurse should assess the patient for which common adverse effects? (chapter 45 powerpoint)
constipation, headache and edema of the ankles and feet
the nurse is caring for a patient who is scheduled to recieve verapamil (calan SR) 180 mg and atenolol (tenormin) 50 mg at 0900. The patient has had a gastric tube (g-tube) inserted, and drugs are to be administered via the tube. Which action should the nurse take before administering these two drugs (45)
consult the prescriber
a patient is prescribed a nitroglycerin patch that is to be applied at 0900 and removed at 2100. When preparing to administer the 0900 patch, the nurse notes that a nitroglycerin patch is still in place. What should the nurse do? (51)
consult with the prescriber regarding application of a new patch
A patient with stage 2 hypertension has been prescribed a thiazide diuretic and an angiotensin-converting enzyme inhibitor. It is most appropriate for the nurse to do what? (47)
contact the health care provider
the nurse is administering medications on a medical-surgical unit in a hospital. The medication administration record states that the patient should receive Cardizem LA 120 mh once a day. The parient's drug supply includes Cardizem SR. What should the nurse do? (45)
contact the pharmacy
The nurse is reassessing a patient 1 hour after administering a vasodilator to treat hypertension. Asssessment findings include BP 116/70 mmHg (down from 145/88 mmHg), pulse 88 (up from 80 beats/min), and respirations 22 (up from 20). What should the nurse do? (43)
continue collecting additional assessment data document the findings explain orthostatic BP precautions reassess the vital signs within 1 hour
the nurse is monitoring the ECG of a patient who recived the first dose of quinidine 45 minutes ago. The nurse notes that the QRS complex was widened 25% from pre-drug therapy findings. What should the nurse do (49)
continue nursing care
The nurse is assessing a patient who is receiving medication for acute HF. Which assessment would be a priority to report to the prescriber? (43)
cough with frothy sputum
Which of these new assessment findings, if identified within 1 hour after administering metoprolol (lopressor), would be a priority to report to the prescriber? (17/18)
crackles throughout lung fields
when the nurse is scheduled to administer lisinopril to a patient, which laboratory values should be reviewed? (44)
creatinine sodum potassium uric acid
a patient has been receiving long-term high-dose heparin therapy. what nursing teaching would be best to prevent a common adverse effect of this type of therapy (52)
develop a plan for weight-bearing exercise as approved by the health care provider
what findings in a patient with HF would warrant the nurse not administer digoxin and notify the prescriber? (48)
digoxin 2.4 ng/mL
a patient with severe hypertension is prescribed minoxidil (loniten). the nurse should contact the prescriber STAT if assessment findings include what? (46)
distended neck veins, muffled heart sounds, and narrow pulse pressure
which adverse effect of propafenone, if occurring for 3-4 days, would be of most concern to the nurse (49)
dizziness
it would be a priority to assess for cardiac effects and toxicity in a patient who is reciving nifedipine (procardia) if labratory test results include (45)
eGFR 32 mL/min
it is a nursing priority to report which of these laboratory test results, if identified in a patient who is prescribed metoprolol (lopressor), to the prescriber? (17/18)
ejection fraction on echocardiogram of 20%
which dermatologic finding in an older adult would warrant consultation with the prescriber regarding administration of diltiazem (cardizem) (45)
erythematous, oozing vesicles on the chin and inside the elbows
the nurse is preparing to administer hydralazine (apresoline) for HF. Because the drug has been associated with drug-induced lupus-like syndrome, it would be a priority to report what symptom to the prescriber? (48)
facial rash joint pain fever
a patient has been prescibed an anyidysrhythmic drug that prolongs the QT interval on ECG. The nurse hsould teach the patient the importance of reporting which symptom that sugests that a dangerous adverse effect, torsades de pointes, may be occuring (49)
feeling faint
a patient with severe hypertension is prescribed minoxidil. Which medications will the nurse expect to be administered to reduce adverse responses to minoxidil? (46)
furosemide (lasix) and propranolol (inderal)
The nurse is preparing to administer adenosine [Adenocard] to a patient to treat paroxysmal supraventricular tachycardia (SVT). Which action by the nurse is most appropriate? (49)
give the medication through the central line catheter
a 38 y.o. female patient has been diagnosed with hypercholesterolemia. The presciber has ordered simvastatin (zocor) 20 mg, once a day at hour of sleep, to be started after lab results are obtained. Which lab result would be of greatest priority to report to the prescriber? (50)
hCG 287 international units/L
an accident victim is prescribed heparin after open reduction and internal fixation (ORIF) of multiple fractures. which symptoms would be of greatest concern to the nurse after beginning subQ heparin therapy to prevent DVT (52)
headache and faintness
the nurse has reviewed hte lab results for a patient who is scheduled to receive lovastatin (mevacor) 40 mg. Results iclude AST 122 units/L. ALT 155 units/L. CK 250 units/L, HDL 45 mg/dL and LDL 245 mg/dL. What should the nurse do? (50)
hold the drug and notify the prescriber of the laboratory results
The nurse administers an intravenous infusion of amiodarone [Coredarone] to a patient to prevent recurrent episodes of ventricular fibrillation. It is most important for the nurse to assess the patient for which condition? (49)
hypotension
a nurse instructs a patient about signs and symptoms of digoxin toxicity. The nurse determins that teaching is successful if the patient makes which statement? (48)
i should report any muscle weakness or nausea
a patient who has been prescribed quinapril (accupril) for hypertension has not had the expected reduction in blood pressure. Regular use of which over-the-counter medications may be contributing to lack of therapeutic effect of the ACE inhibitor (44)
ibuprofen
the nurse cares for a patient receiving digoxin (lanoxin). what indicates to he nurse that treatment with this medication is effective? (48)
improved cardiac output
A patient with coronary artery disease is receiving terazosin for hypertension. It would be a priority for the nurse to report to the prescriber which effect of the drug? (17/18)
increase in pulse of 20 beats/min
what is the priority nursing concern for a patient with angina pectoris (51)
ineffective tissue perfusion: cardiopulmonary
what should the nurse teach a patient about precautions before dental surgery when the patient is prescribed long-term warfarin therapy (52)
inform the dentist of the most recent international normalized ratio (INR) results
A patient who is hospitalized for an infection takes eplerenone (inspra) for heart failure. Which medication, if ordered by the physician, should the nurse question? (chapter 44 powerpoint)
itraconazole (sporanox)
a patient who is receiving lovastatin experiences chest pain. CK level is 580 units/mL (CK-MM 99%) and troponin T 0.02 g/mL. It is of greatest priority for the nurse to monitor the functioning of whichc organ? (50)
kidneys
a focused nursing assessment of a patient with atrial fibrillation should always include assessment of changes in what (49)
mental status
The health care provider prescribes sustained-release verapamil (calan SR) to an 82 year old patient who takes digoxin (lanoxin) daily. Which action is most appropriate for the nurse to take? (chapter 45 powerpoint)
monitor the patient's cardiac rhythm continuously
the nurse would be most concerned if a patient with HF exhibits which symptom (48)
peripheral edema distention of the jugular veins weight gain
which of these lab results (which are flagged on he lab sheet as abnormal) would be a priority to report to the prescriber if a patient is prescribed heparin? (52)
platelet count 40,000/mm3
which lab result would be of greates tconcern if noted in a patient who is prescribed ezetimibe (zetia) (50)
platelets 75,000/mm3
which laboratory results should be reported to the prescriber if a patient is receiving a thiazide or loop diuretic (47)
potassium (K+) 3.2 mEq/L
the nurse is reviewing the lab tests of a patient who has been prescribed ticlopidine for the past week. the WBC count is 3000/mm3, and the neutrophil count is 30%. what is a priority for this patient (52)
preventing infection
a patient is prescribed hydralazine. What is most important for the nurse to teach the patient (46)
prevention of reflex tachycardia
A nurse administers quinidine sulfate to a patient with atrial fibrillation. The nurse should assess the electrocardiogram (ECG) tracing knowing that quinidine sulfate has what effect on the ECG? (49)
prolongation of the QT interval
how does cigarette smoking cause coronary artery disease (51)
promotes atherosclerosis
which would be a priority to report to the prescriber of hydralazine (apresoline) (46)
pulse 120 beats/min
a patient is prescribed diltiazem (cardizem). It would be a priority to withhold the drug and contact the prescriber if which assessment finding is present? (45)
pulse 50 beats/min
a patient is prescribed digoxin (lanoxin) and furosemide (lasix). It is most important for the nurse to assess which value before administering these medications (48)
serum potassium
A patient who is prescribed an alpha1-adrenergic antagonist for high blood pressure is brought into the ED after taking sildenafil (viagra) supplied by a friend. The priority for the nurse is to assess for and follow orders to prevent what effects? (17/18)
severe hypotension and vascular collapse
when caring for a patient who is prescribed minoxidil, it is most important for the nurse to assess for what? (46)
shortness of breath
it would be a priority to teach orthostatic BP recautions to a patient before the first dose of an ACe inhibitor if lab tests include which result (44)
sodium 132 mg/dl
a 79 year old, 143 lb female patient was admitted with a hip fracture and is scheduled for an ORIF of the hip tomorrow. what would be a priority to report to the prescriber if the patient is prescribed enoxaparin (lovenox) (52)
spinal anesthesia has been recommended for the surgery scheduled for tomorrow
the nurse cares for a patient with a digoxin level of 1.9 ng/ml. which action would be most appropriate for the nurse to take initially (48)
start continuous heart monitoring
because verapamil (calan) can cause blockade of calcium channels in vascular smooth muscle, a priority is for the nurse to teach a patient who is prescribed this drug to do what (49)
take orthostatic BP precautions
which of these ECG findings would suggest hyperkalemia in a patient who is prescribed an ACE inhibitor and who was using a salt substitute (44)
tall, peaked T waves
laboratory test results on a patient reciving hydralazine (apresoline) include elevated antinuclear antibodies (ANA). when notifiying the prescriber of these lab results, it is a priority to include which assessment finding? (46)
temperature 101 F (38.3)
A patient is to receive a scheduled dose of diltiazem (cardizem). The nurse should hold the medication and contact the prescriber if which of the following is noted? (chapter 45 powerpoint)
the patient is in second-degree heart block
its important for the nurse to discuss adverse effects of the antihypertensive drugs that are prescribed because the nurse knows what about the drugs' adverse effects (47)
they affect adherence
which of these assessment findings, if identified in a patient who is receiving quinnidine, is of greates priority to report to the prescriber? (49)
tinnitus
the ED triage nurse asnwers the call of a patient who has a history of angina pectoris and COPD. The patient reports chest pain that has not been relieved by three doses of nitroglycerin. The patient had been told by his physician that he should take chewable aspirin should this occur but he does not have any aspirin what should the nurse tell the patient to do (53)
turn on his home oxygen and rest
recent lab results for a patient include HDL 85 mg/dL, LDL 145 mg/dL, and triglycerides 630 mg/dL. The nurse should assess the patient for what? (50)
upper abdominal pain and nausea
what is a priority assessment when administering dopamine (48)
urine output
a maintenance intravenous (IV) infusion of inamrinone is prescribed for a patient who has a current infusion of 5% dextrose and 0.45% NaCl running at 45 mL/hr. How should the nurse administer the inamrinone (48)
using a second IV site
it is a priority for the nurse to monitor for excessive cardiosuppression when a patient is prescribed metoprolol and what other drug? (17/18)
verapamil (calan)
a patient with HF is prescribed spironolactone (aldactone) and enalapril (vasotec). it would be a priority to consult the prescriber regarding evaluation of the patient's potassium levels if the patient exhibited (48)
weakness
which of these findings would be of most concern to the nurse if a patient is prescribed propranolol (inderal)? (17/18)
wheezing