RSNG Spring 2018 DA and Pharmacology ATI review questions; (* indicates questions from handouts)(karch - questions from pharm book)

The nurse would instruct a patient receiving a loop diuretic to report: (karch) A. yellow vision B. weight loss of 1 pound/day C. muscle cramping D. increased urination

C. muscle cramping pg 891

Which physical assessment data would alert the nurse to a possible mild toxic reaction in a client receiving lithium? A. Vomiting and diarrhea B. Increased appetite C. Seizures D. Hypotension

A. Vomiting and diarrhea Vomiting and diarrhea are signs of mild to moderate lithium toxicity. Hypotension and seizures occur with moderate to severe toxic reactions. Anorexia occurs with mild toxic reactions.

Anticholinergic drugs are used: (karch) A. to allow the sympathetic system to dominate B. to block the parasympathetic system, which is commonly hyperactive C. as the drugs of choice for treating ulcers D. to stimulate GI activity

B. to block the parasympathetic system, which is commonly hyperactive pg 553

The nurse would anticipate administering drugs that generally block all adrenergic receptor sites to treat: (KARCH) A. allergic rhinitis B. COPD C. cardiac-related conditions D. premature labor

C. cardiac-related conditions Pg 519

Diuretics are currently recommended for the treatment of which of the following? (select all that apply) (karch) A. hypertension B. renal disease C. obesity D. severe liver disease E. fluid retention of pregnancy F. heart failure

A. hypertension pg 883 B. renal disease D. severe liver disease F. heart failure

Most diuretics act in the body to cause: (karch) A. loss of calcium B. loss of sodium C. retention of potassium D. retention of chloride

B. loss of sodium pg 883

A nurse would question an order for which of the following if the patient was also receiving verapamil? (karch) A. oral contraceptives B. cyclosporine C. digoxin D. barbituarate anesthetics

C. digoxin pg 798

The nurse would anticipate an order for a loop diurectic as the drug of choice for a patient with: (karch) A. hypertension B. shock C. pulmonary edema D. fluid retention of pregnancy

C. pulmonary edema pg 896

A nurse would expect atropine to be used for which of the following? (select all that apply) (karch) Apg . to depress salivation B. to dry up bronchial secretions C. to increase the heart rate D. to promote uterine contractions E. to treat myasthenia gravis To treat Alzheimer's disease

A. to depress salivation pg 554 B. to dry up bronchial secretions

The beta blocker of choice for a patient who is hypertensive and has angina is: (karch) A. nadolol B. propranolol C. timolol D. carteolol

A. nadolol pg 527

Remembering that anticholinergics block the effects of the parasympathetic nervous system the nurse would question an order for an anticholinergic drug for patients with which of the following conditions? (select all that apply) (karch) A. ulcerative colitis B. asthma C. bradycardia D. inner ear imbalance E. glaucoma F. prostatic hyperplasia

A. ulcerative colitis E. glaucoma pg 556 Glaucoma because of the possibility of increased intraocular pressure with pupil dilation.

Hyperlipidemia is considered to be: (karch) A) A normal finding in adult males B) Related to stress levels C) A treatable CAD risk factor D) A side effect of cigarette smoking

C) A treatable CAD risk factor pg 807

Which of the following would the nurse expect the health care provider to prescribe for a patient who has high lipid levels and cannot take fibrates or HMG-CoA reductase inhibitors? (karch) A) Nicotine B) Vitamin C C) Niacin D) Nitrates

C) Niacin pg 821

Atropine and scopolamine work by blocking: (karch) A. nicotinic receptors only B. muscarinic and nicotinic receptors C. muscarinic receptors only D. adrenergic receptors to allow cholinergic receptors to dominate

C. muscarinic receptors only pg 553

After describing to a community group the ways in which the body uses cholesterol, which of the following, if stated by the group as such as a way, indicates successful teaching? (select all) (Karch) A. the production of water-soluable vitamins B. the formation of steroid hormones C. the mineralization of bones D. the development of dental plaques

B. the formation of steroid hormones Pg 806

A client who has nitroglycerin to avert an acute anginal attack would need to be taught: (select all) (karch) A) To take five or six tablets and then seek medical help if no relief occurs B) To buy the tablets in bulk to decrease the cost C) To protect tablets from light and humidity D) To store the tablets in a clearly marked, clear container in open view E) To use the nitroglycerin before an event or activity that will most likely precipitate an anginal attack F) To discard them if they do not fizzle when placed under the tongue.

C) To protect tablets from light and humidity E) To use the nitroglycerin before an event or activity that will most likely precipitate an anginal attack F) To discard them if they do not fizzle when placed under the tongue

A 22 lb (10 kg) child is diagnosed with Kawasaki disease and started on gamma globulin therapy. The provider orders an IV infusion of gamma globulin, 2 g/kg, to run over 12 hours. What is the correct dose? Record your answer using a whole number.

Use the child's weight in kilograms. 10 kg x 2 g/kg = 20 g

A client receives 12 units of intermediate- or long-acting insulin and 6 units of fast-acting insulin each morning. Place the following actions in chronological order of how the nurse would demonstrate how to mix insulins. Use all options. 1. Inject 12 units of air into the intermediate- or long-acting insulin vial. 2. Withdraw 12 units of intermediate- or long-acting insulin insulin. 3. Inject 6 units of air into the fast-acting insulin vial. 4. Wipe off the vials with an alcohol swab. 5. Withdraw 6 units of fast-acting insulin

4. Wipe off the vials with an alcohol swab. 1. Inject 12 units of air into the intermediate- or long-acting insulin vial. 3. Inject 6 units of air into the fast-acting insulin vial 5. Withdraw 6 units of fast-acting insulin 2. Withdraw 12 units of intermediate- or long-acting insulin insulin. The nurse should wipe the insulin bottles with an alcohol swab before each use to eliminate contamination. Then the nurse should inject 12 units of air into the intermediate- or long-acting insulin vial, without touching the insulin. Next, the nurse should insert 6 units of air into the fast-acting insulin and draw up the insulin into the syringe. Fast-acting insulin should be drawn into the syringe first to avoid the risk of mixing the long-acting insulin into the vial and delaying the onset of action of the regular insulin in an emergency. Lastly, the nurse should draw 12 units of intermediate- or long-acting insulin) into the syringe.

A bile acid sequestrants is a drug of choice for a client who has which of the following? (select all) (karch) A) A high LDL concentration B) A high triglyceride concentration C) Biliary obstruction D) Vitamin K deficiency E) A high high-density lipoprotein (HDL) concentration F) Intolerance to statins

A) A high LDL concentration pg 811 B) A high triglyceride concentration C) Biliary obstruction

When describing the action of antianginal drugs to a patient, which of the following would the nurse include? (select all) (karch) A) Decrease the workload on the heart B) Increase the supply of oxygen to the heart C) Change the metabolic pathway in the heart muscle to remove the need for oxygen D) Restore the supply-and-demand balance of oxygen in the heart E) Decrease venous return to the heart F) Alter the coronary artery filling pathway

A) Decrease the workload on the heart D) Restore the supply-and-demand balance of oxygen in the heart E) Decrease venous return to the heart

An acute myocardial infarction is usually associated with which of the following? (select all) (karch) A) Permanent injury to the heart muscle B) Potentially serious arrhythmias C) Pain D) The development of hypertension E) Loss of consciousness F) A feeling of anxiety

A) Permanent injury to the heart muscle B) Potentially serious arrhythmias C) Pain F) A feeling of anxiety

Teaching a client who is prescribed an HMG-CoA reductase inhibitor to treat high cholesterol and high lipid levels should include which of the following? (karch) A) The importance of exercise B) The need for dietary changes to alter cholesterol levels C) That taking a statin will allow a full, unrestricted diet D) That drug therapy is always needed when these levels are elevated E) The importance of controlling blood pressure and blood glucose levels F) That stopping smoking may also help to lower lipid levels

A) The importance of exercise pg 817 B) The need for dietary changes to alter cholesterol levels E) The importance of controlling blood pressure and blood glucose levels F) That stopping smoking may also help to lower lipid levels

Treating angina involves modifying factors that could decrease myocardial oxygen consumption. It could be expected that this might include: (select all) (karch) A. weight loss B. use of nitrates C. use of angiotensin-converting enzyme inhibitors D. activity modification E. use of a piperazine acetamide agent F. use of a calcium-channel blocker

A) Weight loss B) Use of nitrates D) Activity modification E) Use of a piperazineacetamide agent F) Use of a calcium channel blocker

A client is receiving aspirin. Which statement made by the client needs follow-up? A. "I can take Ginkgo biloba with aspirin." B. "I need to report if I have black stool." C. "I need to report loss of hearing in my ears." D. "I'll take the medication after a meal."

A. "I can take Ginkgo biloba with aspirin." Aspirin, also known as acetylsalicylic acid, is used for mild to moderate pain, fever, inflammation, and atrial fibrillation stroke prevention. Aspirin may increase the bleeding when taken with herbal supplement Ginkgo biloba. The medication can cause gastrointestinal bleeding and ototoxicity. Nausea, vomiting, diaphoresis, and tinnitus are the earliest signs and symptoms of salicylate toxicity. Other early symptoms and signs are vertigo, hyperventilation, tachycardia, and hyperactivity. It should be taken with food especially if it causes stomach upset.

A nurse is teaching a client with glaucoma the proper technique for instilling eye drops. The nurse determines that teaching is effective when the client states: A. "I should instill the drop in the lower conjunctival sac." B. "I should instill the drop directly onto the cornea." C. "I should instill the drop near the opening of the lacrimal duct." D. "I should instill the drop in the outer canthus."

A. "I should instill the drop in the lower conjunctival sac." Eye drops should be placed in the lower conjunctival sac starting at the inner, not outer, canthus. Placing eye drops on the cornea causes discomfort and should be avoided. Eye drops shouldn't be placed by the opening of the lacrimal ducts to avoid systemic absorption.

A client has just started treatment with rifampin for tuberculosis. Which statement indicates that the client has a good understanding of his medication? A. "My urine will look orange because of the medication." B. "I won't go to family gatherings for six months." C. "Now, I don't need to cover my mouth or nose when I sneeze or cough." D. "I told my wife to throw away all the spoons and forks before I come home."

A. "My urine will look orange because of the medication." Rifampin discolors body fluids, such as urine and tears. The client can go to family functions and eat with normal utensils. The client should cover his mouth and nose when coughing and sneezing until he has been on the medication at least two weeks.

2/10/2017 1800 19 year old male with mild concussion after slipping in school parking lot three hours prior. No loss of consciousness. No appreciable neurological deficits. CT scan normal. Client was preparing for discharge. Now reports a 5/10 headache. Acetaminophen PO ordered. When offered acetaminophen, the client's mother tells the nurse that she would like her son to have something stronger. What is the nurse's best response? A. "Opioids are avoided following a head injury because they may hide a deteriorating condition." B. "Acetaminophen is strong enough for your son's mild concussion." C. "We avoid giving aspirin to children and young adults because of the danger of Reye's syndrome." D. "Stronger medications may lead to vomiting, which increases the intracranial pressure (ICP)."

A. "Opioids are avoided following a head injury because they may hide a deteriorating condition." Opioids may mask changes in the level of consciousness (LOC) that indicate increased ICP, and shouldn't be given as a first-line drug. Stating that acetaminophen is strong enough ignores the mother's question and isn't appropriate. Aspirin is contraindicated in conditions that include bleeding, and for children or young adults with viral illnesses due to the danger of Reye's syndrome. Stronger medications may not necessarily lead to vomiting, but will sedate the client, thereby masking changes in his LOC.

A client with a history of asthma is admitted to the emergency department. The nurse notes that the client is dyspneic, with a respiratory rate of 35 breaths/min, nasal flaring, and use of accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. What should the nurse do first? A. Administer bronchodilators as prescribed. B. Encourage the client to relax and breathe slowly through the mouth. C. Draw blood for an arterial blood gas. D. Initiate oxygen therapy as prescribed, and reassess the client in 10 minutes.

A. Administer bronchodilators as prescribed. In an acute asthma attack, diminished or absent breath sounds can be an ominous sign indicating lack of air movement in the lungs and impending respiratory failure. The client requires immediate intervention with inhaled bronchodilators, IV corticosteroids, and, possibly, IV theophylline. Administering oxygen and reassessing the client 10 minutes later would delay needed medical intervention, as would drawing blood for an arterial blood gas analysis. It would be futile to encourage the client to relax and breathe slowly without providing the necessary pharmacologic intervention.

The nurse understands that certain medications protect the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation. Which class of medications serve this function? A. Beta-adrenergic blockers B. Nitrates C. Calcium channel blockers D. Opioids

A. Beta-adrenergic blocke Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the response to catecholamines and sympathetic nerve stimulation. They protect the myocardium, and help reduce the risk of another infarction by decreasing the workload of the heart and decreasing myocardial oxygen demand. Calcium channel blockers reduce the workload of the heart by reducing contractility and vasodilatation; thus, lowering afterload. Opioids reduce myocardial oxygen demand, promote vasodilation, and decrease anxiety. Nitrates reduce myocardial oxygen consumption by decreasing left ventricular end-diastolic pressure and systemic vascular resistance.

Clients with schizophrenia often experience non-adherence to prescribed medication protocols. Nurses collaborate with these clients to develop a program of successful adherence. How are long-acting decanoate injections a helpful treatment option for these clients? A. Decanoate injections improve adherence and sustained therapeutic drug levels despite possible client ambivalence. B. Clients generally do not recognize or report the side effects of injected medications. C. Clients who decline or miss their scheduled injection can receive a double dose the next time. D. Clients report significantly fewer side effects from decanoate injections than from oral versions of the same medicine.

A. Decanoate injections improve adherence and sustained therapeutic drug levels despite possible client ambivalence.

A client calls the clinic worried about experiencing new symptoms after taking antipsychotic medicine. The client reports persistent, uncontrollable restlessness of the limbs and head despite improvement in psychotic symptoms. What is the most appropriate intervention by the nurse? A. Direct the client to see the provider for medication to address these side effects B. Advise the client to experiment with different dosages to see how he feels C. Tell the client to go to the emergency room if blurred vision or fever develops D. Inform the client to ignore these symptoms because they will go away

A. Direct the client to see the provider for medication to address these side effects Symptoms of tardive dyskinesia include tongue protrusion, lip smacking, chewing, blinking, grimacing, choreiform movements of limbs and trunk, and foot tapping. Primary prevention of tardive dyskinesia is achieved by using the lowest effective dose of a neuroleptic for the shortest time. However, with diseases of chronic psychosis such as schizophrenia, this strategy must be balanced with the fact that increased dosages are more beneficial in preventing recurrence of psychosis. If tardive dyskinesia is diagnosed, the causative drug should be discontinued. Blurred vision is a common adverse reaction of antipsychotic drugs and usually disappears after a few weeks of therapy. Restlessness is associated with akathisia. Sudden fever is a symptom of a malignant neurological disorder. The prescribing provider will make appropriate changes to meet the client's need. Clients should not ignore such symptoms, or adjust their own medication dosage.

Which instruction should the nurse give to a client with prostatitis who is receiving double strength co-trimoxazole? A. Drink six to eight glasses of fluid daily while taking this medication B. If a sore mouth or throat develops, take the medication with milk or an antacid C. Don't expect improvement of symptoms for 7 to 10 days D. Use a sunscreen of at least SPF-15 with para-aminobenzoic acid (PABA)

A. Drink six to eight glasses of fluid daily while taking this medication Six to eight glasses of fluid daily are needed to prevent renal problems, such as crystalluria and stone formation. The symptoms should improve in a few days if the drug is effective. Sore throat and sore mouth are adverse effects that should be reported right away. The drug causes photosensitivity, but a PABA-FREE sunscreen should be used because PABA can interfere with the drug's action.

An adolescent client comes to the emergency department with acute asthma. The respiratory rate is 44 breaths/minute, and the client is experiencing severe respiratory distress. What is the priority nursing action by the nurse? A. Give a bronchodilator by nebulizer. B. Take a full medical history. C. Apply a cardiac monitor to the client. D. Provide emotional support to the client.

A. Give a bronchodilator by nebulizer The client having an acute asthma attack needs to increase oxygen delivery to the lung and body. Nebulized bronchodilators open airways and increase the amount of oxygen delivered. The priority at this time is the respiratory status, and the client will be anxious until this is resolved. First, resolve the acute phase of the attack; afterward, obtain a full medical history to determine the cause of the attack and how to prevent attacks in the future. Application of a cardiac monitor is not a priority at this point in the treatment plan.

The nurse is providing discharge instructions for a client who is receiving chemotherapeutic medications. Which intervention is most important to prevent hemorrhagic cystitis? A. Increasing fluid intake B. Increasing calcium intake C. Administering antacids D. Administering antibiotics

A. Increasing fluid intake Sterile hemorrhagic cystitis is an adverse effect of chemical irritation of the bladder from cyclophosphamide. It can be prevented by liberal fluid intake (at least one-and-a-half times the recommended daily fluid requirement). Antibiotics do not aid in the prevention of sterile hemorrhagic cystitis. Increasing calcium intake does not alter the risk of developing cystitis. Antacids would not be indicated for treatment.

A team of nurses is preparing a trauma room for the arrival of a child with partial-thickness burns to both lower extremities and portions of the trunk. Which intravenous fluid should the nurse be prepared to administer to this client? A. Lactated Ringer's solution B. Albumin C. Normal saline with 2 mEq KCl/100 ml D. Dextrose 5% and half-normal saline

A. Lactated Ringer's solution Lactated Ringer's solution is recommended because it replaces the lost sodium and corrects the metabolic acidosis. If albumin is ordered, it's an adjunct therapy and not for primary fluid replacement. The stress from a burn injury affects the glucose metabolism. Dextrose shouldn't be given during the first 24 hours because it can put the client into pseudodiabetes. The client is hyperkalemic from the potassium shift from the intracellular spaces to the plasma, and additional potassium would be detrimental.

What is the nurse's priority action when administering phenytoin to a client intravenously? A. Mix phenytoin with saline solution only B. Withhold other anticonvulsants C. Administer rapidly D. Use only dextrose solution when flushing the IV catheter

A. Mix phenytoin with saline solution only Phenytoin is only compatible with saline solutions. Dextrose will cause an insoluble precipitate to form. Phenytoin should be administered at a rate of less than 50 mg/min. There is no need to withhold additional anticonvulsants.

*The nurse is providing patient education to a patient taking an indirect-acting cholinergic agonist. What drug-to-drug interaction would the nurse include in the patient education? A. NSAIDS B. Direct-acting cholinergic agonist C. Acetylcholinesterase inhibitors D. Direct-acting cholinergic

A. NSAIDS

The health care provider is preparing to write a plan of care for a client with borderline personality disorder. Which medication would the nurse anticipate for this client? A. Selective serotonin reuptake inhibitors (SSRIs), along with an atypical antipsychotic, are used to treat mood instability and impulsivity B. Monoamine oxidase inhibitors (MAOIs) work best because the effects are felt very quickly C. Anxiolytics will reduce the anxiety and cognitive distortions which frequently occur in these clients D. Antipsychotics, along with an antidepressant, will treat illusions, ideas of reference, paranoid thinking, anxiety, and hostility in clients

A. Selective serotonin reuptake inhibitors (SSRIs), along with an atypical antipsychotic, are used to treat mood instability and impulsivity Selective serotonin reuptake inhibitors and atypical antipsychotics are used to treat dysphoria, mood instability, and impulsivity in clients with borderline personality disorder. This is the best choice of medications for a client with borderline personality disorder. Monoamine oxidase inhibitors have food restrictions, and clients with borderline personality disorder would not comply with such restrictions. Antipsychotics are prescribed for psychotic behaviors such as illusions, ideas of reference, and paranoid thinking. Anxiolytics may be prescribed for clients with borderline personality disorder, but these medications are limited to addressing anxiety. Clients with borderline personality disorder experience symptoms other than anxiety.

A nurse would question an order for a cholinergic drug if the patient was also taking which of the following? ) (select all that apply) (karch) A. Theophyylline B. NSAIDs C. Cephalosporin D. Atropine E. Propranolol F. Memantine

A. Theophyylline pg 548 B. NSAIDs

The nurse receives an order to administer morphine to a client with an acute myocardial infarction. What is the purpose of this medication? A. To decrease myocardial oxygen demand B. To decrease cardiac output C. To increase myocardial oxygen demand D. To increase preload and afterload

A. To decrease myocardial oxygen demand Morphine will calm and relax the client and decrease respiratory rate, anxiety, and stress, thus decreasing myocardial oxygen demand. It doesn't have any effect on cardiac output or preload or afterload.

*Which of the following is a primary action of glucose lowering agents? A. accelerate the breakdown of glycogen B. increase insulin release C. improve binding to insulin receptors D. decrease use of incretins

A. accelerate the breakdown of glycogen The action of glucose elevating agents is to increase the blood glucose levels by decreasing insulin release and accelerating the breakdown of glycogen in the liver to release glucose.

A client, diagnosed with asthma, is experiencing an anaphylactic reaction to a medication. After administering initial emergency care, the nurse would: A. administer bronchodilators. B. have the client lie flat in the bed. C. obtain serum electrolyte levels. D. administer beta-adrenergic blockers.

A. administer bronchodilators. Bronchodilators will open the client's airway and improve oxygenation status. Beta-adrenergic blockers aren't indicated in the management of asthma because they may cause bronchospasm. Obtaining laboratory values wouldn't be done during an emergency, and having the client lie flat in bed could impede his ability to breathe.

Coronary artery disease results in: (karch) A. an imbalance in cardiac muscle oxygen supply and demand B. deliver of blood to the heart muscle during systole C. increased pulse pressure D. a decreased workload on the heart

A. an imbalance in cardiac muscle oxygen supply and demand pg 788

A nurse is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? (select all that apply) A. assess for tinnitus B. report urine output 50 mL/hr C. monitor serum potassium levels D. elevate the HOB slowly before ambulation E. recommend eating a banana daily

A. assess for tinnitus C. monitor serum potassium levels D. elevate the HOB slowly before ambulation E. recommend eating a banana daily

A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A. asthma B. glaucoma C. hypertension D. tachycardia

A. asthma Propranolol is a conselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, so it is contraindicated in clients who have asthma.

*What is the action of thazide diuretics? A. blocks chloride pump B. blocks the sodium pump C. blocks the potassium pump D. blocks the carbonic anhydrase pump

A. blocks chloride pump Thiazide and thiazide-like diurectics acts to block the chloride pump. Chloride is actively pumped out of the tubule by cells lining the ascending limb of the loop of Henle and the distal tubule.

*You are caring for a child who has been diagnosed with a heart problem. Propanolol has been ordered for this patient. What would be considered in caluculating a child's dose? A. child's body weight and age B. child's body mass C. child's age in months and height D. child's age and body mass index

A. child's body weight and age Children are at a greater risk for complications associated with the use of adrenergic blocking agents, including bradycardia, difficulty breathing, and changes in glucose metabolism. The safety and efficacy for use of these drugs has not been established for children younger than 18 years of age. If one of these drugs is used, the dosage for these agents needs to be calculated from the child's body weight and age.

A nurse would question an order for a beta-adrengergic blocker if the patient was also receiving what other drugs? (select all that apply) (karch) A. clonidine B. ergot alkaloids C. aspirin D. NSAIDS E. triptans F. epinephrine

A. clonidine pg 528 D. NSAIDS F. epinephrine A paradoxical hypertension occurs when given with clonidine, an increased rebound hypertension occurs with clonidine withdrawal may also occur. A decreased anthihypertensive effect occurs when given with NSAIDs, monitor closely. An initial hypertensive episode followed by bradycardia may occur if these drugs are given with epinephrine.

HF occurs when the heart fails to pump effectively. Which of the following could cause HF? (select all) (karch) A. coronary artery disease (CAD) B. chronic hypertension C. cardiomyopathy D. fluid overload E. pneumonia F. cirrhosis

A. coronary artery disease (CAD) pg 751 B. chronic hypertension C. cardiomyopathy

Routine nursing care of a client receiving a diuretic wouild include which of the following? (karch) A. daily weighing B. tight fluid restrictions C. periodic electrolyte evaluations D. monitoring of urinary output E. regular IOP testing F. teaching the patient to report muscle cramping

A. daily weighing

*What is an indication for use of a non-selective adrenergic blocking agent? A. essential hypertension B. malignant hypertension C. secondary hypertension D. malignant hyperthermia

A. essential hypertension The alpha- and beta-adernergic blocking agents block all of the receptor sites within the SNS, which results in lower blood pressure, slower pulse, and increased renal perfusion with decreased renin levels. These drugs are indicated for the treatment of essential hypertension.

When assessing a patient with right-sided HF, the nurse would expect to find edema: (karch) A. in gravity-dependent areas B. in the hands and fingers C. around the eyes D. when the patient is lying down

A. in gravity-dependent are pg 754

A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following of the following instructions should the nurse include? A. increase the amount of dietary fiber in the diet B. drink grapefruit juice daily to increase vitamin C intake C. decrease the amount of calcium in the diet D. withhold food for 1 hour after the medication is taken

A. increase the amount of dietary fiber in the diet Increasing dietary fiber intake can help prevent constipation, an adverse effect of verapamil

The renin-angiotensin system is associated with which of the following? (select all that apply) (karch) A. intense vasoconstriction and BP elevation B. blood flow through the kidneys C. production of surfactant in the lungs D. release of aldosterone from the adrenal cortex E. retention of sodium and water in the kidneys F. liver production of fibrinogen

A. intense vasoconstriction and BP elevation B. blood flow through the kidneys D. release of aldosterone from the adrenal cortex E. retention of sodium and water in the kidneys pg 726

The beta-adrenergic blocker propranolol is approved for a wide variety of uses. Which of the following are approved indication? (select all that apply) (karch) A. migraine headaches B. stage fright C. bronchospasm D. Reinfarction after an MI E. erectile dysfunction F. hypertension

A. migraine headaches pg 528 B. stage fright D. Reinfarction after an MI F. hypertension

A child with diabetic ketoacidosis is being treated for a blood glucose level of 738 mg/dl (41.0 mmol/L). The nurse should anticipate an order for: A. normal saline with regular insulin. B. 5% dextrose in water with NPH insulin. C. 5% dextrose in water with PZI insulin. D. normal saline with ultralente insulin.

A. normal saline with regular insulin. Short-acting regular insulin is the only insulin used for insulin infusions. Initially, normal saline is used until blood glucose levels are reduced, then a dextrose solution may be used to prevent hypoglycemia. Ultralente, NPH, and PZI insulins have a longer duration of action and shouldn't be used for continuous infusions.

A client develops left-sided HF after an MI. Which of the following would the nurse expect to find during the client assessment? (select all that apply) (karch) A. orthopnea B. polyuria C. tachypnea D. dyspnea E. blood-tinged sputum (hemoptysis) F. swollen ankles

A. orthopnea pg 753 C. tachypnea D. dyspnea E. blood-tinged sputum (hemoptysis)

*In which group of patients would the healthcare provider use caution in prescribing anticholinergic medications? A. patients with spasticity B. patients with myasthenia gravis C. patients with Parkinson's disease D. patients with hyperactive reflexes

A. patients with spasticity Caution: breast feeding; spasticity and brain damage

Pressure within the vascular system is determined by which of the following? (select all that apply) (karch) A. peripheral resistance B. stroke volume C. sodium load D. heart rate E. total intravascular volume F. rate of erythropoietin disease

A. peripheral resistance pg 724, 747 B. stroke volume D. heart rate

A nurse in a provider's office is instructing a parent of a toddler how to administer ear drops. Which of the following instructions should the nurse include? (select all that apply) A. place the child on his unaffected side when you are ready to administer the medication B. warm the medication by gently rolling it between your hands for a few minutes C. gently shake medication that is in suspension form D. keep the child on his side for 5 minutes after instillation of the ear drops E. tightly pack the ear with cotton after instillation of the ear drops

A. place the child on his unaffected side when you are ready to administer the medication B. warm the medication by gently rolling it between your hands for a few minutes C. gently shake medication that is in suspension form D. keep the child on his side for 5 minutes after instillation of the ear drops

The nurse is theaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include? A. rinse your mouth after each use of this medication B. limit fluid intake while taking this medication C. increase your intake of vitamin B12 while taking this medication D. you can take the medication as needed

A. rinse your mouth after each use of this medication Rinse the mouth after each use of this medication to reduce risk of oral fungal infections.

When developing the plan of care for a patient with hyperaldosteronism, the nurse would expect the physician to prescribe which agent? (karch) A. spironolactone B. furosemide C. hydrochlorothiazide D. actazolamide

A. spironolactone pg 894

A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include? A. take the medication with food B. plan to take the medication at bedtime C. expect increased swelling of the ankles D. fluid intake should be limited in the morning

A. take the medication with food The client should take hydrochlorothiazide with or after meals to prevent gastrointestinal upset.

A patient has elected to take the OTC cold preparation that contains phenylephrine. The nurse would advise the patient not to take that drug if the patient has: (KARCH) A. thyroid or CV disease B. a cough or runny nose C. COPD D. hypotension

A. thyroid or CV disease

Phentolamine, an alpha-adrenergic blocker, is most frequently used (Karch) A. to prevent cell death after extravasation of intravenous dopamine or norepinephrine B. to treat COPD in patients with hypertension C. to treat hypertension and BPH in male patients D. to block bronchospasm

A. to prevent cell death after extravasation of intravenous dopamine or norepinephrine pg 524

A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. weight gain B. nervousness C. bradycardia D. constipation

A. weight gain Weight gain and fluid retention are adverse effects of oral prednisone due to the effect of sodium and water retention.

The formation of atheromas in blood vessels precedes the signs and symptoms of: (karch) A) Hepatitis B) Coronary artery disease (CAD) C) Diabetes mellitus D) Chronic obstructive pulmonary disease (COPD).

B) Coronary artery disease (CAD) pg 804

Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors work in the: (karch) A) Process of bile secretion B) Process of cholesterol formation in the cell C) Intestinal wall to block fat absorption D) Kidney to block fat excretion

B) Process of cholesterol formation in the cell pg 815

The nurse is educating the parents of a two-year-old child with neonatal bronchopulmonary dysplasia (chronic lung disease) who is placed on furosemide. Which statement by the parents best indicates an understanding of this medication? A. "I need to make sure my child gets his blood pressure checked twice a year." B. "I need to make sure my child eats foods rich in potassium." C. "I need to make sure my child uses the bathroom at least every six hours." D. "I need to make sure my child wears short sleeves when outside."

B. "I need to make sure my child eats foods rich in potassium." Children should eat foods rich in potassium to replace what is lost through diuresis while taking furosemide. Parents should take their child to the bathroom often if he is toilet trained to prevent accidents. Blood pressure should be checked regularly and sun protection utilized.

A health care provider (HCP) has just inserted nasal packing for a client with epistaxis. The client is taking ramipril for hypertension. What should the nurse instruct the client to do? A. Use 81 mg of aspirin daily for relief of discomfort. B. Avoid rigorous aerobic exercise. C. Remove the packing if there is difficulty swallowing. D. Omit the next dose of ramipril.

B. Avoid rigorous aerobic exercise. Epistaxis, or nosebleed, is a common, sudden emergency. Commonly, no apparent explanation for the bleeding is known. With significant blood loss, systemic symptoms, such as vertigo, increased pulse, shortness of breath, decreased blood pressure, and pallor, will occur. Because aerobic exercise may increase blood pressure and increased blood pressure can cause epistaxis, the client with hypertension should avoid it. Aspirin inhibits platelet aggregation, reducing the ability of the blood to clot. The client should continue to take his antihypertension medication, ramipril. Posterior nasal packing should be left in place for 1 to 3 days.

Which change would the nurse anticipate after administering oxygen to a cyanotic infant with uncorrected tetralogy of Fallot? A. No evidence of cyanosis B. Less agitation C. Disappearance of the murmur D. Improvement of finger clubbing

B. Less agitation Tetralogy of Fallot is a rare condition caused by a combination of four heart defects that are present at birth. Supplemental oxygen will help the infant breathe more easily and feel less anxious or agitated. Disappearance of the murmur, no evidence of cyanosis, and improvement of finger clubbing would not occur as a result of supplemental oxygen administration. Surgery is the definitive treatment for the cyanotic client with tetralogy of Fallot.

The nurse makes initial rounds for his clients. Five medication are scheduled for administration at the same time to five different clients. Which medication should the nurse administer first after initial rounds? A. Naproxen to the client with rheumatoid arthritis B. Morphine sulfate to a client with a myocardial infarction reporting chest pain C. Ondansetron to a diabetic client reporting nausea D. A maintenance dose of digoxin to the client with congestive heart failure

B. Morphine sulfate to a client with a myocardial infarction reporting chest pain Morphine sulfate relieves pain which immediately decreases myocardial oxygen demand and decreases preload and afterload pressure. The digoxin is a maintenance dose and does not elicit an immediate reaction. Though administration of naproxen and ondansetron are next in the order urgency, they are not the priority.

Which medication would the nurse anticipate as the provider's treatment of choice for scarlet fever? A. Prednisone B. Penicillin C. Acyclovir D. Amphotericin B

B. Penicillin The causative agent of scarlet fever is Group A beta-hemolytic streptococci, which is susceptible to penicillin. Erythromycin is used for penicillin-sensitive children. Anti-inflammatory drugs, such as prednisone, are not indicated for these clients. Acyclovir is used in the treatment of herpes infections. Amphotericin B is used to treat fungal infections.

A client who is receiving acetaminophen for osteoarthritis reports continuing pain. The health care provider prescribes celecoxib. What important information regarding this medication, should the nurse share with this client? A. Use a stool softener or fiber laxative daily to prevent constipation B. Report black and tarry stools to the health care provider C. Don't take the medication with dairy products D. If you miss a dose, take a double dose the next day

B. Report black and tarry stools to the health care provider Black and tarry stools are a sign of gastrointestinal (GI) bleeding, and may necessitate a medication change. Dairy products can help reduce GI irritation. The celecoxib dose should never be doubled. Constipation isn't an adverse effect of this medication.

A client, who has just started taking phenytoin, asks the nurse if there are any adverse effects of this medication. What is the nurse's best response? A. Furry tongue B. Somnolence C. Tachycardia D. Dry mouth

B. Somnolence Adverse effects of phenytoin include sedation, somnolence (sleepy), gingival hyperplasia, blood dyscrasia (WBC over 1,000,000), and toxicity. The other symptoms aren't adverse effects of phenytoin.

Which topic is most important to include in the teaching plan for a client newly diagnosed with Addison's disease who will be taking corticosteroids? A. The need to adjust the steroid dose based on dietary intake and exercise. B. The importance of watching for signs of hyperglycemia. C. How to decrease the dose of the corticosteroids when the client experiences stress. D. To notify the health care provider (HCP) when the blood pressure is suddenly high.

B. The importance of watching for signs of hyperglycemia Since Addison's disease can be life threatening, treatment often begins with administration of corticosteroids. Corticosteroids, such as prednisone, may be taken orally or intravenously, depending on the client. A serious adverse effect of corticosteroids is hyperglycemia. Clients do not adjust their steroid dose based on dietary intake and exercise; insulin is adjusted based on diet and exercise. Addisonian crisis can occur secondary to hypoadrenocorticism, resulting in a crisis situation of acute hypotension, not increased blood pressure. Addison's disease is a disease of inadequate adrenal hormone, and therefore the client will have inadequate response to stress. If the client takes more medication than prescribed, there can be a potential increase in potassium depletion, fluid retention, and hyperglycemia. Taking less medication than was prescribed can trigger Addisonian crisis state, which is a medical emergency manifested by signs of shock.

A primipara who is Rho(D) negative has just given birth to a Rh-positive baby. The nurse is developing a plan of care. How should Rho(D) immune globulin be administered? A. To the neonate at the first well-baby visit B. To the client within three days C. To the neonate within three days D. To the client at her first postpartum visit in six weeks

B. To the client within three days Administering Rho(D) immune globulin to the client within 72 hours of birth prevents antibodies from forming that can destroy fetal blood cells in the next pregnancy. Rho(D) immune globulin isn't given to the baby. The client should not wait six weeks to receive Rho(D) immune globulin as antibodies will already have formed.

Prinzmetal angina occurs as a result of: (karch) A. electrolyte imbalance B. a spasm of a coronary vessel C. decreased venous return to the heart D. ventricular arrhythmia

B. a spasm of a coronary vessel pg 787

A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for control of asthma. Which of the following instructions should the nurse include in the teaching? A. take the albuterol at the same time each day B. administer the albuterol inhaler prior to using the beclomethasone inhaler C. use beclomethasone if experiencing an acute episode D. avoid shaking the beclomethasone before use

B. administer the albuterol inhaler prior to using the beclomethasone inhaler When a client is prescribed an inhaled beta2 agonist such as albuterol and an inhaled glucocorticoid such as beclomethasone, the client should take the beta2 agonist first. The beta2 agonist promotes bronchodialation and enhances absorption of the glucocorticoid.

At 11 p.m., a client is admitted to the emergency department. He has a respiratory rate of 44 breaths/minute. He's anxious, and wheezes are audible. The client is immediately given oxygen by face mask and methylprednisolone I.V. At 11:30 p.m., the client's arterial blood oxygen saturation is 86%, and he's still wheezing. The nurse should plan to administer: A. alprazolam. B. albuterol. C. propranolol. D. morphine.

B. albuterol Propranolo is for blood pressure Alprazolam is for anxiety The client is hypoxemic because of bronchoconstriction as evidenced by wheezes and a subnormal arterial oxygen saturation level. The client's greatest need is bronchodilation, which can be accomplished by administering bronchodilators. Albuterol is a beta2 adrenergic agonist, which causes dilation of the bronchioles. It's given by nebulization or metered-dose inhalation and may be given as often as every 30 to 60 minutes until relief is accomplished. Alprazolam is an anxiolytic and central nervous system depressant, which could suppress the client's breathing. Propranolol is contraindicated in a client who's wheezing because it's a beta2 adrenergic antagonist. Morphine is a respiratory center depressant and is contraindicated in this situation.

A client taking an ACE inhibitor is scheduled for surgery. The nurse should: (karch) A. stop the drug B. alert the surgeon and mark the client's chart prominently C. cancel the surgery and consult with the prescriber D. monitor fluid levels and make sure the fluids are restricted before sugery

B. alert the surgeon and mark the client's chart prominently pg 736

Essential hypertension is the most commonly diagnosed form of high BP. Essential hypertension is: (karch) A caused by a tumor in the adrenal gland B. associate with no known cause C. related to renal disease D. caused by liver dysfunction

B. associate with no known cause pg 723

Calcium channel blockers are effective in treating angina because they: (karch) A. prevent any CV exercise, preventing strain on the heart B. block strong muscle contractions, causing vasodilation C. alter the electrolyte balance of the heart, preventing arrhythmias D. increase the heart rate, making it more efficient

B. block strong muscle contractions, causing vasodilation pg 798

Isoproterenol is a nonspecific beta-agonist. The nurse might expect to administer this drug for which of the following conditions? (select all that apply) (KARCH) A. preterm labor B. bronchospasm C. cardiac standstill D. shock E. heart block in transplanted heart F. heart failure

B. bronchospasm C. cardiac standstill D. shock E. heart block in transplanted heart

Which medication should be available to provide emergency treatment if a client develops tetany after a subtotal thyroidectomy? A. sodium bicarbonate B. calcium gluconate C. echothiophate iodide D. sodium phosphate

B. calcium gluconate The client with tetany is suffering from hypocalcemia, which is treated by administering an IV preparation of calcium, such as calcium gluconate or calcium chloride. Oral calcium is then necessary until normal parathyroid function returns. Sodium phosphate is a laxative. Echothiophate iodide is an eye preparation used as a miotic for an antiglaucoma effect. Sodium bicarbonate is a potent systemic antacid.

Before giving digoxin to an infant, the nurse should: (karch) A. notify the prescriber that the dose is about to be given ad recheck the ordered dose. B. check the apical pulse and have another nurse double-check the dose. C. make sure that the infant has eaten, has a full stomach, and has been given an antacid D. check the apical pulse and give the drug very slowly

B. check the apical pulse and have another nurse double-check the dose. pg 761

A nurse assessing a patient with HF would expect to find which of the following: (karch) A. cardiac arrest B. congestion of blood vessels C. an MI D. a pulmonary embolism

B. congestion of blood vessels pg 750

*The mechanism of action of an ACE inhibitor is the blocking of ACE from converting angiotensin I to angiotensin II. What does this cause? A. decrease in serum potassium levels B. decrease in aldosterone production C. sodium and fluid loss D. increase in blood pressure

B. decrease in aldosterone production Blocks ACE fro converting to angiotensin I to angiotensin II, leading to a decrease in blood pressure, a decrease in aldosterone production, and a small increase in serum potassium levels along with sodium and fluid loss.

Adverse effects associated with the use of cholinergic drugs include: (karch) A. constipation and insomnia B. diarrhea and urinary urgency C. tachycardia and hypertension D. dry mouth and tachycardia

B. diarrhea and urinary urgency pg 539

A nurse would question the order for an adrenergic agonist for a patient who is also receiving which of the following: (KARCH) (select all that apply) A. anticholinergic drugs B. halogenated hydrocarbon anesthetics C. beta-blockers D. benzodiazepines E. MAOIs F. TCAs

B. halogenated hydrocarbon anesthetics C. beta-blockers E. MAOIs F. TCAs

A nurse is planning to administer a first dose of captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (select all that apply) A. simvastatin B. hydrochlorothiazide C. phenytoin D. clonidine E. aliskiren

B. hydrochlorothiazide D. clonidine E. aliskiren Hydrochlorothiazide is a thiazide diuretic. It is often used to treat hypertension. Diuretics can intensify first dose orthostatic hypotension caused by captopril and can continue to interact with antihypertensive medications to cause hypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril and keep the client safe from injury. Clonidine is a centrailly acting alpha2 agonist. It is an antihypertensive medication that can interact with captopril to intensify first dose orthostatic hypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril, and keep the client safe from injury. Aliskiren, a direct renin inhibitor, is an antihypertensive medication that can interact with captopril to intensify its first dose orthostatic hypotension. The nurse should monitor clients carefully for hypotension, especially after the first dose of captopril, and keep the client safe from injury. Simvastation lower cholesterol. Phenytoin is an antiseizure medication.

A patient with which of the following would most likely be prescribed an alpha1-selective adrenergic blocking agent? (Karch) A. COPD and hypotension B. hypertension and BPH C. erectile dysfunction and BPH D. shock states and bronchospasm

B. hypertension and BPH pg 525

A nurse is planning care for a client who has a new prescription for torsemide. The nurse should plan to monitor for which of the following adverse reactions of this medication? (select all that apply) A. respiratory acidosis B. hypokalemia C. hypotension D. ototoxicity E. ventricular dysrhythmias

B. hypokalemia C. hypotension D. ototoxicity E. ventricular dysrhythmias Torsemide is a loop diuretic.

Angina: (karch) A. causes death of heart muscle cells B. is pain due to lack of oxygen to myocardial cells C. cannot occur at rest D. is not treatable

B. is pain due to lack of oxygen to myocardial cells pg 789

Alzheimer's disease is marked by a progressive loss of memory and is associated with: (karch) A. degeneration of dopamine-producing cells in the basal ganglia B. loss of acetylcholine producing neurons and their target neurons in the CNS C. loss of acetylcholine receptor sites in the parasynpathetic nervous system D. increased levels of acetylcholinesterase in the CNS

B. loss of acetylcholine producing neurons and their target neurons in the CNS pg 543

A nurse is instructing a client who has a new prescription for timolol how to insert eye drops. The should instruct the client to press on which areas to prevent systemic absorption of the medication? A. bony orbit B. nasolacrimal duct C. conjunctival sac D. outer canthus

B. nasolacrimal duct Pressing on the nasolacrimal duct blocks the lacrimal punctum and prevents systemic absorption of the medication

*When providing care for a patient receiving alpha and beta adrenergic agonists, which of the following would be important to assess in order to prevent the systemic overload of catecholamines? A. hypotension B. phenochromocytoma C. hypovolemia D. allergic rhinitis

B. phenochromocytoma Phenochromocytoma is a small vascular tumor of the adrenal medulla, causing irregular secretion of epinephrine and norepinephrine, leading to attacks of raised blood pressure, palpitations, and headache. Assess for contraindications or cautions including pheochromocytoma which could lead to fatal reactions due to systemic overload of catecholamines.

The adrenergic agent of choic for treating the s/s of allergic rhinitis is: (Karch) A. norepinephrine B. phenylephrine C. dobutamine D. dopamine

B. phenylephrine

An alert and oriented older adult female with metastatic lung cancer is admitted to the medical-surgical unit for treatment of heart failure. She was given 80 mg of furosemide in the emergency department. Although the client is ambulatory, the unlicensed assistive personnel (UAP) are concerned about urinary incontinence because the client is frail and in a strange environment. The nurse should instruct the UAP to assist with implementing the nursing plan of care by: A. prescribing adult diapers for the client so she will not have to worry about incontinence B. placing a commode at the bedside and instructing the client in its use C. padding the bed with extra absorbent linens D. requesting an indwelling urinary catheter to avoid incontinence

B. placing a commode at the bedside and instructing the client in its use A bedside commode should be near the client for easy, safe access. Measurement of urine output is also important in a client with heart failure. Putting diapers on an alert and oriented individual would be demeaning and inappropriate. Indwelling catheters are associated with increased risk of infection and are not a solution to possible incontinence. There is no reason to think that the client would not be able to use the bedside commode.

Indirect-acting cholinergic agents: (karch) A. react with acetylcholine receptor sites on the membranes of effector cells B. react chemically with acetylcholinesterase to increase acetylcholine concentrations C. are used to increase bladder tone and urinary excretions D. should be given with food to slow absorption

B. react chemically with acetylcholinesterase to increase acetylcholine concentrations pg 542

A nurse would instruct a patient taking Lanoxin (digoxin) for the treatment of HF to do which of the following? (karch) A. make up any missed doses the next day B. report changes in heart rate C. avoid exposure to the sun D. switch to generic tables if less expensive

B. report changes in heart rate pg 760

The baroreceptors are the most important factor in continual control of BP. The baroreceptors: (karch) A. are evenly distributed throughout the body to maintain pressure in the system B. sense pressure and immediately send that information to the medulla in the brain C. are directly connected to the sympathetic nervous system D. are as sensitive to oxygen levels as to pressure changes

B. sense pressure and immediately send that information to the medulla in the brain pg 724 Control of BP involves baroreceptor (pressure receptor) stimulation of the medulla to activate the sympathetic nervous system, which causes vasoconstriction and increased fluid retention when pressure is low in the aorta and carotid arteries, and vasodilation and loss of fluid when pressure is too high. pg 747

Thiazide diurectics are considered mile diurectics because: (karch) A. they block the sodium pump in the loop of Henle B. they cause loss of sodium and chloride but little water C. they do not cause fluid rebound when they work in the kidneys D. they have little or no effect on electrolyte levels

B. they cause loss of sodium and chloride but little water pg 896

*What would cause a drug-drug interaction with bile acid sequestrants? A. loop diurectics B. thyroid hormones C. water soluble vitamins D. mineralocorticoids

B. thyroid hormones Drug-to-drug interactions: malabsorption of fat-soluble vitamins; thiazide diurectics; digoxin, warfarin, thyroid hormones, and corticosteroids

A nurse is providing instructions to the parent of an adolescent client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include? A. you can take this medication to abort an acute asthma attack B. tremors are an adverse effect of this medication C. prolonged use of this medication can cause hyperglycemia D. this medication can slow skeletal growth rate

B. tremors are an adverse effect of this medication

Hydrocodone with acetaminophen has been prescribed for a client with metastatic prostate cancer. What information is essential for the nurse to include in the teaching plan? A. "You may feel more relaxed and calm." B. "You may develop blurred vision." C. "Constipation may develop with constant use." D. "Nausea may occur."

C. "Constipation may develop with constant use." Constipation commonly develops with constant use of hydrocodone. The nurse should teach the client about constipation, and tell the client ways to decrease this risk, such as increasing fiber and liquids in the diet. Nausea may occur on occasion, however, it is not a severe problem, and could be related to constipation. Blurred vision and diarrhea are not associated with the use of hydrocodone with acetaminophen. Feeling relaxed and calm is a common side effect does not need medical attention. As the body adjusts to the medicine during treatment these side effects may go away.

When teaching parents about signs that indicate levothyroxine overdose, which comment from a parent would indicate an accurate understanding? A. "I'll be concerned if I can feel my baby's heart rate in her arm or wrist." B. "I should suspect an overdose if my baby's suddenly lethargic." C. "I should be concerned if my baby loses weight." D. "I shouldn't worry if my baby does not sleep very much."

C. "I should be concerned if my baby loses weight Parents need to be aware of the signs that indicate overdose; including rapid pulse, dyspnea, irritability, insomnia, fever, sweating, and weight loss. Parents should be given acceptable parameters for heart rate and weight loss or gain. If the heart rate or weight loss is outside the acceptable parameters, the health care provider should be called. A palpable pulse is expected, and does not suggest an overdose of levothyroxine.

The nurse is checking the blood sugar level of a client who is at 33-weeks' gestation. This client has had type 1 diabetes since she was 12 years old. Which value would indicate to the nurse that this client's disease is controlled? A. 136 mg/dl (7.6 mmol/L) B. 120 mg/dl (6.7 mmol/L) C. 85 mg/dl (4.7 mmol/L) D. 45 mg/dl (2.5 mmol/L)

C. 85 mg/dl (4.7 mmol/L)

The laboratory has just notified the nurse that a client on the unit has a phenytoin level of 32 mg/dl. Which symptoms should the nurse anticipate from this client? A. Urinary incontinence B. Tonic-clonic seizure C. Ataxia and confusion D. Sodium depletion .

C. Ataxia and confusion A level of 32 mg/dl indicates phenytoin toxicity. Symptoms of toxicity include confusion and ataxia. Phenytoin doesn't cause hyponatremia, seizure, or urinary incontinence. Incontinence may occur during or after a seizure. Ataxia is the loss of full control of bodily movements.

The nurse is teaching the family of a client with a psychiatric disorder about traditional anti-psychotic drugs and their effect on symptoms. Which symptom would be most responsive to these types of drugs? A. Social withdrawal B. Apathy C. Delusions D. Attention impairment

C. Delusions Positive symptoms, such as delusions, hallucinations, thought disorder, and disorganized speech, respond to traditional antipsychotic drugs. The other options belong in a category of negative symptoms, including affective flattening, restricted thought and speech, apathy, anhedonia, asociality, and attention impairment. Negative symptoms are more responsive to the new atypical antipsychotics, such as clozapine risperidone, and olanzapine.

A depressed client has been taking a selective serotonin reuptake inhibitor (SSRI) in the evening, and is upset because he cannot perform sexually due to erectile problems. What is the nurse's best response? A. Monitor for low blood pressure on a daily basis B. Stop taking the drug and notify the prescriber C. Engage in sexual activity prior to taking the drug D. Take the drug with food or 8 oz of water

C. Engage in sexual activity prior to taking the drug A viable option is for the client to engage in sexual activity before taking his daily antidepressant medication. It is not appropriate to suggest stopping the medication. Monitoring the client's blood pressure and taking the drug with food or 8 oz of water will not address the erectile dysfunction experienced by the client.

A client with joint pain, tenderness and swelling has been admitted to the hospital. A disease modifying anti-rheumatic drug (DMARD) is prescribed by the health care provider. Which medication should the nurse expect to administer? A. Aspirin B. Prednisone C. Methotrexate D. Ferrous sulfate

C. Methotrexate Methotrexate is considered a first-line DMARD for most clients with rheumatoid arthritis (RA). NSAIDs, such as aspirin, cannot be tolerated. Ferrous sulfate is not used to treat RA. Prednisone may be used to control inflammation when NSAIDs cannot be used.

A nursing coordinator calls the intensive care unit (ICU) to inform the department that a client with a suspected pheochromocytoma will be admitted from the emergency department. The ICU nurse should prepare to administer which drug to the client? A. Insulin B. Lidocaine C. Nitroprusside D. Dopamine

C. Nitroprusside Excess catecholamine release occurs with pheochromocytoma and causes hypertension. The nurse should prepare to administer nitroprusside to control the hypertension until the client undergoes adrenalectomy to remove the tumor. Dopamine is used to treat hypotension, which is not associated with pheochromocytoma. Pheochromocytoma does not affect blood glucose levels, so insulin is not indicated in this client unless there is an underlying diagnosis of diabetes mellitus. Lidocaine is sometimes used to treat ventricular arrhythmias, which are not associated with pheochromocytoma.

A patient with severe glaucoma who is about to undergo eye surgery would benefit from a decrease in intraocular fluid. This is often best accomplished by giving the patient: (karch) A. a loop diuretic B. a thiazide diuretic C. a carbonic anhydrase inhibitor D. an osmotic diuretic

C. a carbonic anhydrase inhibitor pg 896

A patient who is hypertensive becomes pregnant. The drug of choice for this patient is: (karch) A. an angiotensin II receptor blocker B. an ACE inhibitor C. a diuretic D. a calcium-channel blocker

C. a diuretic Angiotensin II receptor blocker, ACE inhibitors and calcium-channel blocker are not recommended for use during pregnancy

Diuretics cause a loss of fluid volume in the body. The drop in volume activates compensatory mechanisms to restore the volume, including: (karch) A. suppression of ADH release and stimulation of the countercurrent mechanism B. suppression of aldosterone release and increased ADH release C. activation of the renin-angiotensin-aldosterone system with increased ADH and aldosterone D. stimulation of the countercurrent mechanism with reflex drop in renin release.

C. activation of the renin-angiotensin-aldosterone system with increased ADH and aldosterone

A nurse would question an order for beta 1-selective adrenergic block for a patient with (karch) A. cardiac arrhythmias B. hypertension C. cardiogenic shock D. open-angle glaucoma

C. cardiogenic shock pg 532

ACE inhibitors and other vasodilators are used in the early treatment of HF. They act to: (karch) A. cause loss of volume B. increase arterial pressure and prefusion C. cause pooling of the blood and decreased venous return to the heart D. increase the release of aldosterone and improve fluid balance

C. cause pooling of the blood and decreased venous return to the heart pg 754 Vasodilators decrease cardiac workload, relax vascular smooth muscle to decrease afterload, and allow pooling in the veins, thereby decreasing preload of the heart and helping to improve function.

A nurse in an acute care facility is caring for a client who is receiving IV nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication? A. intestinal ileus B. delirium C. delirium D. hyperthermia

C. delirium Delirium and other mental status changes can occur in thiocyanate toxicity when IV nitroprusside is infused at a high dosage. Monitor thiocyanate level during therapy to remain below 10 mg/dL.

Nitrates are commonly used antianginal drugs that act to: (karch) A. increase the preload on the heart B. increase the afterload on the heart C. dilate coronary vessels to increase the delivery of oxygen through those vessels D. decrease venous return to the heart, decreasing the myocardial workload

C. dilate coronary vessels to increase the delivery of oxygen through those vessels pg 789

A nurse is caring for a client who has increased intracranial pressure and is receiving mannitol. Which of the following findings should the nurse report to the provider? A. blood glucose 150 mg/dL B. urine output 40 mL/hr C. dyspnea D. bilateral equal pupil size

C. dyspnea This could indicate heart failure, an adverse effect of mannitol.

Adverse effects associated with adrenergic agonists are related to the generalized stimulation of SNS and could include: (Karch) A. slowed heart rate B. constriction of the pupils C. hypertension D. increased GI secretions

C. hypertension

A nurse is providing teaching to a client who will start alfuzosin for treatment of benigh prostatic hyperplasia (BPH). The nurse should instruct the client that which of the following is an adverse effect of this medication? A. bradycardia B. edema C. hypotension D. tremor

C. hypotension Alfuzosin relaxes muscle tone in veins and cardiac output decreases, which leads to hypotension. Clients taking this medication are advised to rise slowly from a sitting or lying position.

*Which of the following is a clinical manifestation of hyperglycemia? A. edema B. lack of thirst C. itchy skin D. hyperexcitability

C. itchy skin s/s of hyperglycemia: fatigue; lethargy; irritation; glycosuria; polyphagia; polydipsia; itchy skin

A nurse is caring for a client who has a new prescription for captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication? A. kypokalemia B. hypernatremia C. neutropenia D. bradycardia

C. neutropenia Neutropenia is a serious adverse effect that can occur in clients taking an ACE inhibitor. The nurse should monitor the client's CBC and teach the client to report indications of infection to the provider Neutropenia - low WBC (neutrophils)

You would caution a patient who is taking an adrenergic blocker: (karch) A to avoid exposure to infection B. to stop the drug if he or she experiences flu-like symptoms C. never to stop the drug abruptly D. to avoid exposure to the sun

C. never to stop the drug abruptly pg 528 If these drugs are stopped abruptly, there is a risk of angina, MI, hypertension and stroke because the receptor site becomes hypersensitive to catecholamines after being blocked by the drugs.

A client with acute pulmonary edema has been taking an angiotensin-converting enzyme (ACE) inhibitor. The nurse explains that this medication has been ordered to: A. decrease contractility. B. promote diuresis. C. reduce blood pressure. D. increase cardiac output.

C. reduce blood pressure. ACE inhibitors are given to reduce blood pressure by inhibiting aldosterone production, which in turn decreases sodium and water reabsorption. ACE inhibitors also reduce production of angiotensin II, a potent vasoconstrictor. Diuretics are given to increase urine production. Vasodilators increase cardiac output. Negative inotropic agents decrease contractility.

An adrenergic agent being used to treat shock infiltrates into the tissue with intravenous administration. Which action by the nurse would be appropriate? (Karch) A. watch the area for any signs of necrosis and report it to the physician B. notify the physician and decrease the rate of infusion C. remove the VI and prepare phentolamine for administration to the area. D. apply ice and elevate the arm

C. remove the VI and prepare phentolamine for administration to the area.

A nurse is about to administer digoxin to a patient whose apical pulse is 48 beats/min. She should: (karch) A. give the drug and notify the prescriber that the heart rate is low B. retake the pulse in 15 minutes and give the drug if the pulse has not changed D. withhold the drug and notify the prescriber that the heart rate is below 60 beats/min

C. retake the pulse in one hour and withhold the drug if the pulse is still less than 60 beats/min . pg 761 Monitor apical pulse for one full minute before administering the drug. Hold the dose if the pulse is less than 60 beats/min in an adult or less than 90 beats/min in an infant; retake the pulse in one hour. If the pulse remains low, document it, withhold the drug, and notify the prescriber because the pulse rate could indicate digoxin toxicity.

*Which of the drugs used to treat Alzheimer's disease is available in solution for swallowing ease? A. tacrine (Cognex) B. galantamine (Razadyne) C. rivastigmine (Exelon) D. (Aricept)

C. rivastigmine (Exelon) tacrine (Cognex) was the first drug to treat Alzheimer's disease. galantamine (Razadyne) is used to stop progression of Alzheimer's disease. donepezil (Aricept) is qd.

A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider? A. serum sodium 144 B. urine output 120 mL/4hr C. serum potassium 5.2 D. blood pressure 140/90

C. serum potassium 5.2 This indicates hyperkalemia because spironolactone causes potassium retention, the nurse should withhold the medication and notify the provider.

A nurse in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings are indicative of this condition? A. insidious onset of painless loss of vision B. gradual reduction in peripheral vision C. severe pain around eyes D. intraocular pressure 12 mm Hg

C. severe pain around eyes Severe pain around eyes that radiates over the face is a manifestation of acute angle-closure glaucoma.

A patient is to receive pilocarpine. The nurse understands that this drug would be most likely used to treat which of the following? (karch) A. myasthenia gravis B. neurogenic bladder C. sjogrens disease dry mouth D. Alzeimer's disease

C. sjogrens disease dry mouth pg 539 Sjogrens disease is an immune system disorder characterized by dry eyes and dry mouth.

The instructor determines that teaching about adrenergic drugs has been successful when the class identifies the drugs as also being called: (Karch) A. sympatholytic agents B. cholinergic agents C. sympathomimetic agents D. anticholinergic agents

C. sympathomimetic agents

Which of the following would the nurse include when teaching a patient about HMG-CoA reductase inhibitors? (karch) A. the patient will not have a heart attack B. the patient will not develop CAD C. the patient might develop cataracts as a result D. the patient might stop absorbing fat-soluble vitamins

C. the patient might develop cataracts as a result pg 815

A nurse is teaching a client who has a new prescription for brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching? A. this medication can stain your contacts B. this medication can cause your pupils to constrict C. this medication can absorb into your contacts D. this medication can slow your heart rate

C. this medication can absorb into your co Brimonide can absorb into soft contact lenses. The client should remove his contacts then instill the medication and wait at least 15 minutes before putting his contacts back in.

*Alpha1-selective adrenergic blocking agents are to be used with caution in what population of patients? A. those with hepatic disease B. those with hypotension C. those with congestive heart failure D. those with respiratory distress

C. those with congestive heart failure Used with caution in those with those with congestive heart failure or renal failure.

Calcium is needed in the cardiac muscle: (karch) A. to break apart actin-myosin bridges B. to activate troponin C. to promote contraction via sliding D. to maintain the electrical rhythm

C. to promote contraction via sliding pg 751 Calcium inactivates troponin, allowing the actin and myosin to form actomyosin bridges.

ACE inhibitors work on the renin-angiotension system to prevent the conversion of angiotensin I to angiotensin II. Because this blocking occurs in the cells in the lung, which is usually the site of this conversion, the use of ACE inhibitors often results in : (karch) A. spontaneous pneumothorax B. pneumonia C. unrelenting cough D. respiratory depression

C. unrelenting cough pg 735

Which of the following would alert the nurse to suspect that a patient receiving HMG-CoA reductase inhibitors is developing rhabdomyolysis? (karch) A) Flatulence and abdominal bloating B) Increased bleeding and bruising C) The development of cataracts and blurred vision D) Muscle pain and weakness

D) Muscle pain and weakness pg 816 Rhabdomyolysis is a breakdown of muscles whose waste products can injure the glomerulus and cause acute renal failure.

The bile acid sequestrants: (karch) A) Are absorbed into the liver B) Take several weeks to show an effect C) Have no associated adverse effects D) Prevent bile salts from being reabsorbed

D) Prevent bile salts from being reabsorbed pg 815

A nurse is providing in-home management instructions to the parents of a child who is receiving desmopressin acetate (DDAVP). What is the most important instruction the nurse to include? A. Give DDAVP only when urine output begins to decrease B. Cleanse skin with alcohol before application of the DDAVP dermal patch C. Increase the DDAVP dose if polyuria occurs just before the next scheduled dose D. Call the healthcare provider if the child has an upper respiratory infection or allergic rhinitis

D. Call the healthcare provider if the child has an upper respiratory infection or allergic rhinitis Excessive nasal mucus, associated with upper respiratory infection or allergic rhinitis, may interfere with DDAVP absorption because it is given intranasally. Parents should be instructed to contact the health care provider for advice in altering the hormone dose during times when nasal mucus may be increased. The DDAVP dose should remain unchanged, even if the child is experiencing polyuria just before the next dose to avoid over medicating the child.

The nurse in the emergency department is administering a prescription for 20 mg intravenous furosemide, which is to be given immediately. The nurse scans the client's identification band and the medication barcode. The medication administration system does not verify that furosemide is prescribed for this client; however, the furosemide is prepared in the accurate unit dose for intravenous infusion. What should the nurse do next? A. Administer the medication now, knowing the medication is labeled and the client is identified. B. Ask another nurse to verify the medication and the client so the medication can be given now. C. Report the problem to the information technology team to have the barcode system recalibrated. D. Contact the pharmacist immediately to check the order and the barcode label for accuracy.

D. Contact the pharmacist immediately to check the order and the barcode label for accuracy. The nurse should contact the pharmacist first to be sure the medication is labeled for administration to this client. The nurse should not administer the drug until all safety precautions have been observed; the nurse should also not ask another nurse to verify the medication or client. Later, if the problem cannot be resolved with relabeling the medication, the nurse or pharmacist can contact the information technology team to check the barcode system.

A client is admitted with an acute inferior-wall myocardial infarction (MI). During the admission interview, the client states that he stopped taking his metoprolol five days ago because he was feeling better. For which complication should the nurse monitor this client? A. Anxiety B. Sudden, acute pain C. Hypertension D. Ineffective myocardial tissue perfusion

D. Ineffective myocardial tissue perfusion Myocardial infarction results from prolonged myocardial ischemia caused by reduced blood flow through the coronary arteries. The priority for this client is to monitor for signs of ineffective myocardial tissue perfusion. While monitoring for anxiety, sudden and acute pain, as well as hypertension may be appropriate, such interventions are not the priority.

A nurse in the emergency department is caring for a client with acute heart failure. Which laboratory value is most important for the nurse to check before administering medications to treat heart failure? A. Platelet count B. White blood cell (WBC) count C. Calcium D. Potassium

D. Potassium Diuretics, such as furosemide, are commonly used to treat acute heart failure. Most diuretics increase the renal excretion of potassium. The nurse should check the client's potassium level before administering diuretics, and obtain an order to replace potassium if the level is low. Other medications commonly used to treat heart failure include angiotensin-converting enzyme inhibitors, digoxin, and beta-adrenergic blockers. Although checking the platelet count, calcium level, and WBC count are important, these values don't affect medication administration for acute heart failure.

How should the nurse proceed when instilling neomycin and polymyxin B sulfates and hydrocortisone optic suspension, two drops in the right ear? A. Warm the solution to prevent dizziness B. Hold an emesis basin under the client's ear C. Position the client in the semi-Fowler's position D. Verify the proper client and route

D. Verify the proper client and route When giving medications, a nurse should follow the five "Rs" of medication administration: right client, right drug, right dose, right route, and right time. The drops may be warmed to prevent pain or dizziness, but this action isn't essential. An emesis basin would be used for irrigation of the ear. The client should be placed in the lateral position for five minutes, not semi-Fowler's position, to prevent the drops from draining.

Which oral medication would the nurse anticipate being prescribed to prevent further thrombus formation? A. Furosemide B. Heparin C. Metoprolol D. Warfarin

D. Warfarin Warfarin prevents vitamin K from synthesizing certain clotting factors. This oral anticoagulant can be given long term. Heparin is a parenteral anticoagulant that interferes with coagulation by readily combining with antithrombin. It cannot be administered orally. Neither furosemide nor metoprolol affects anticoagulation.

A smoker who is being treated for hypertension with a beta-blocker is most likely receiving (karch) A. a nonspecific beta-blocker B. an alpha 1-specific beta-blocker C. beta - and alpha-blockers D. a beta 1 - specific blocker

D. a beta 1 - specific blocker pg 531

Hypertension is associate with: (karch) A. loss of vision B. strokes C. atherosclerosis D. all of the above

D. all of the above pg 727

The stepped care approach to the treatment of hypertension includes: (karch) A. lifestyle modification, including exercise, diet, and decreased smoking and alcohol intake B. use of a diuretic, beta-blocker, or ACE inhibitor to supplement lifestyle changes C. a combination of antihypertensive drug classes to achieve desired control D. all of the above

D. all of the above pg 734

A client has been prescribed corticosteroids. The nurse would also anticipate an order for: A. serum platelet counts every 12 hours. B. lactulose 40 g in 4 oz (118 ml) of water daily. C. fluid restriction to 1,000 ml in 24 hours. D. blood glucose checks every 6 hours.

D. blood glucose checks every 6 hours. Corticosteroids cause elevated blood glucose levels; insulin may be necessary to maintain normal blood glucose levels. Corticosteroids can cause edema, but fluid restrictions are generally unnecessary unless the client also has renal or cardiac disease. Lactulose is given for constipation and to treat hepatic encephalopathy. Platelet count every 12 hours is not necessary when monitoring clients undergoing corticosteroid therapy.

The nurse auscultates inspiratory and expiratory wheezes with a decreased forced expiratory volume in a client with asthma. Which class of medication would the nurse expect to administer immediately? A. inhaled steroids B. oral steroids C. beta blockers D. bronchodilators

D. bronchodilators Bronchodilators are the first line of treatment for asthma because bronchoconstriction is the cause of reduced airflow. Inhaled or oral steroids may be given to reduce the inflammation but aren't used for emergency relief. Beta blockers aren't used to treat asthma and can cause bronchoconstriction

Phenylephrine, an alpha-specific agonist, is found in many cold and allergy preparations. The nurse instructs the patient to be alert for which adverse effects? (Karch) A. urinary retention and pupil constriction B. hypotension and slow heart rate C. personality changes and increased appetite D. cardiac arrhythmias and difficulty urination

D. cardiac arrhythmias and difficulty urination

The nurse would expect to administer donepezil to a patient with Alzheimer's disease who: (karch) A. cannot remember family members' name B. is mildly inhibited and can still follow medical dosing regimens C. is able to carry on normal activities of daily living D. has memory problems and would benefit from once-a-day dosing

D. has memory problems and would benefit from once-a-day dosing pg 545

Which of the following suggestions would the nurse make to help a patient who is receiving an anticholinergic agent reduce the risks associated with decreased sweating? (Karch) A. covering the head and using sunscreen B. ensuring hydration and temperature control C. changing position slowly and protecting from the sun D. monitoring for difficulty swallowing and breathing

D. monitoring for difficulty swallowing and breathing pg 559

Nerve gas is an irresversible acetylcholinesterase inhibitor that can cause muscle paralysis and death. An antidote to such an agent is: (karch) A. atropine B. propranolol C. pralidoxime D. neostigmine

D. neostigmine pg 544 Irresversible acetylcholinesterase inhibitors are used in warfare to cause paralysis and death by prolonged muscle contraction and parasympathetis crisis and to reverse the effects of nondepolarizing neuromuscular junction blockers used to cause paralysis in surgery.

Which of the following would the nurse be least likely to include when developing a teaching plan for a patient who is receiving an anticholinergic agent? (karch) A. encouraging the patient to void before dosing B. setting up a bowel program to deal with constipation C. encouraging the patient to use sugarless lozenges to combat dry mouth D. performing exercises to increase the heart rate

D. performing exercises to increase the heart rate pg 559

When providing care to a patient who is receiving a loop diuretic the nurse would determine the need to regularly monitor which of the following? (karch) A. sodium levels B. bone marrow function C. calcium levels D. potassium levels

D. potassium levels pg 892

*How do carbonic anhydrase inhibitors work? A. slows down the reabsorption of sodium B. speeds up creation of sodium bicarbonate C. balances acidic and alkaline solutes in urine D. slows down the movement of hydrogen ions

D. slows down the movement of hydrogen ions Diuretics that block the effects of carbonic anhydrase slow down the movement of hydrogen ions. As a result, more sodium and bicarbonate are lost in the urine.

Adrenergic blocking drugs, because of their clinical effects, are also known as: (KARCH) A. anticholinergics B. sympathomimetics C. parasympatholytics D. sympatholytics

D. sympatholytics lyse, or block, the effects of SNS

A nurse is preparing to administer a prescribed cardiotonic drug to a patient based on the understanding that this group of drugs act in which way? (karch) A. they block the sympathetic nervous system B. they block the renin-angiotension system C. they block the parasympathetic influence on the heart muscle D. they affect intracellular calcium levels in the heart muscle

D. they affect intracellular calcium levels in the heart muscle pg 755 This leads to increased contractility.

Droxidopa, an antihypotensive drug, should be used: (karch) A. only with patient who are confined to bed B. in the treatment of acute shock C. in patients with known pheochromocytoma D. to treat orthostatic hypotension in patient whose lives are impaired by the disorder

D. to treat orthostatic hypotension in patient whose lives are impaired by the disorder pg 746

*True or False An indication for the use of bethanechol (Duvoid) is to diagnose and treat esophageal varices.

False Bethanechold (Duvoid) treats urinary retention; neurogenic bladder atony, diagnose and treat reflux esophagitis. Esophageal varices are abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus). This condition occurs most often in people with serious liver diseases. Esophageal varices develop when normal blood flow to the liver is blocked by a clot or scar tissue in the liver.

*True or False The loop diuretics cause the body to excrete a copious amount of potassium-rich urine.

False The loop diuretics have a similar effect in the descending loop of Henle and in the distal convoluted tubule, resulting in the production of a copious amount of sodium-rich urine.

*True or False Another name for an adrenergic agonist drug is a sympathomimetic drug.

True An adrenergic agonist is also called a sympathomimetic drug because it mimics the effects of the sympathetic nervous system (SNS)