Ch: 30, 31, 42-47 Questions

What dietary recommendation should the nurse provide for a patient on simvastatin? A) Avoid grapefruit juice B) Increase calcium intake C) Eat a high-protein diet D) Limit fluid intake

Answer: A) Avoid grapefruit juice Rationale: Grapefruit juice can increase the risk of toxicity by inhibiting the metabolism of simvastatin.

The nurse is teaching a patient about losartan. Which statement indicates understanding of the medication? A) "I will need to have my blood pressure checked regularly." B) "This medication will lower my cholesterol." C) "I should avoid eating foods high in potassium." D) "I should stop the medication if I feel dizzy."

Answer: A) "I will need to have my blood pressure checked regularly." Rationale: Regular blood pressure monitoring is essential for patients on antihypertensive medications like losartan.

A patient taking nitroglycerin reports a headache. What is the nurse's best response? A) "This is a common side effect, and you can take acetaminophen to relieve it." B) "This is an unusual side effect and should be reported immediately." C) "You should stop taking the medication." D) "Increase your fluid intake to relieve the headache."

Answer: A) "This is a common side effect, and you can take acetaminophen to relieve it." Rationale: Headaches are a common side effect of nitroglycerin due to vasodilation. Acetaminophen can be used to manage the discomfort.

A patient is starting on metoprolol. What is the most important patient teaching point? A) "You may feel dizzy when standing up quickly." B) "This medication will increase your energy levels." C) "You should take this medication with food." D) "This medication will cause weight loss."

Answer: A) "You may feel dizzy when standing up quickly." Rationale: Beta-blockers can cause orthostatic hypotension, leading to dizziness when changing positions.

A patient is prescribed a thiazide diuretic. What should the nurse include in the patient's education? A) "You may need to increase your potassium intake." B) "Avoid potassium-rich foods." C) "This medication may cause hypercalcemia." D) "This medication will decrease your blood sugar."

Answer: A) "You may need to increase your potassium intake." Rationale: Thiazide diuretics can cause potassium loss, so patients may need to consume more potassium-rich foods.

Which drug class is contraindicated in a patient with a history of angioedema related to lisinopril? A) Angiotensin II receptor blockers (ARBs) B) Calcium channel blockers C) Beta-blockers D) Diuretics

Answer: A) Angiotensin II receptor blockers (ARBs) Rationale: ARBs may cause a similar reaction in patients with a history of angioedema from ACE inhibitors.

The nurse is assessing a patient on digoxin. Which of the following findings indicates potential digoxin toxicity? A) Bradycardia B) Tachycardia C) Constipation D) Weight gain

Answer: A) Bradycardia Rationale: Digoxin toxicity can cause bradycardia, visual disturbances, nausea, and confusion.

What is the main therapeutic effect of albuterol in patients with asthma? A) Bronchodilation B) Bronchoconstriction C) Mucous production D) Decreased respiratory rate

Answer: A) Bronchodilation Rationale: Albuterol is a beta-2 agonist that stimulates receptors in the lungs, causing bronchodilation to improve airflow.

Which adrenergic agonist is commonly used to treat shock and hypotension? A) Dopamine B) Acetylcholine C) Propranolol D) Pilocarpine

Answer: A) Dopamine Rationale: Dopamine increases blood pressure and cardiac output, making it effective in treating shock.

A patient with a history of heart failure is prescribed a beta-blocker. Which assessment finding would require the nurse to hold the medication? A) Heart rate of 50 bpm B) Blood pressure of 130/80 mmHg C) Respiratory rate of 16 D) Temperature of 98.6°F

Answer: A) Heart rate of 50 bpm Rationale: Beta-blockers can cause bradycardia, and the medication should be held if the heart rate is below 60 bpm.

A patient with heart failure is prescribed digoxin. Which symptom should prompt the nurse to hold the next dose and notify the healthcare provider? A) Heart rate of 58 bpm B) Blood pressure of 150/90 mmHg C) Serum potassium of 5.0 mEq/L D) Respiratory rate of 16 breaths per minute

Answer: A) Heart rate of 58 bpm Rationale: Digoxin can cause bradycardia, and the medication should be held if the heart rate is below 60 bpm.

Which antiarrhythmic drug can cause blue-gray skin discoloration with long-term use? A) Lidocaine B) Amiodarone C) Quinidine D) Procainamide

Answer: B) Amiodarone Rationale: Long-term use of amiodarone can lead to a unique side effect of blue-gray skin discoloration.

Which adverse effect should the nurse monitor in a patient receiving high doses of epinephrine? A) Hypertension B) Bradycardia C) Diarrhea D) Hypotension

Answer: A) Hypertension Rationale: Epinephrine can cause significant vasoconstriction, leading to elevated blood pressure.

Which electrolyte imbalance should be corrected to prevent digoxin toxicity? A) Hypokalemia B) Hypernatremia C) Hypercalcemia D) Hypocalcemia

Answer: A) Hypokalemia Rationale: Hypokalemia increases the risk of digoxin toxicity.

What is a major concern for a patient taking both warfarin and lovastatin? A) Increased risk of bleeding B) Decreased efficacy of both medications C) Elevated potassium levels D) Hypoglycemia

Answer: A) Increased risk of bleeding Rationale: Warfarin and statins can increase the risk of bleeding when used together.

What is the mechanism of action for clopidogrel? A) It inhibits platelet aggregation. B) It lowers blood pressure. C) It reduces cholesterol levels. D) It acts as a beta-blocker.

Answer: A) It inhibits platelet aggregation. Rationale: Clopidogrel is an antiplatelet agent that prevents clot formation by inhibiting platelet aggregation.

Which of the following should be avoided while taking furosemide? A) Sun exposure B) Potassium-rich foods C) Alcohol D) Exercise

Answer: A) Sun exposure Rationale: Furosemide can increase the risk of photosensitivity, so patients should avoid excessive sun exposure.

A patient receiving lidocaine for a ventricular arrhythmia should be monitored for which side effect? A) Tremors B) Diarrhea C) Tachycardia D) Constipation

Answer: A) Tremors Rationale: Lidocaine toxicity can cause neurological symptoms such as tremors, confusion, and seizures.

A patient using albuterol inhaler reports feeling shaky and nervous. What is the most appropriate response by the nurse? A) "This is a sign of toxicity, and you should stop using the inhaler." B) "These are common side effects and usually decrease over time." C) "These symptoms are not related to the medication." D) "Increase the dose of albuterol for better results."

Answer: B) "These are common side effects and usually decrease over time." Rationale: Tremors and nervousness are common side effects of beta-2 agonists like albuterol.

Which antihypertensive drug class works by blocking the conversion of angiotensin I to angiotensin II? A) Beta-blockers B) ACE inhibitors C) Calcium channel blockers D) Diuretics

Answer: B) ACE inhibitors Rationale: ACE inhibitors prevent the conversion of angiotensin I to angiotensin II, which results in vasodilation and reduced blood pressure.

A patient taking atorvastatin reports muscle pain. What should the nurse do next? A) Suggest stretching exercises B) Assess for signs of rhabdomyolysis C) Increase the statin dose D) Reassure the patient this is normal

Answer: B) Assess for signs of rhabdomyolysis Rationale: Muscle pain while on statins can be a sign of rhabdomyolysis, a rare but serious side effect.

Which receptor is stimulated by adrenergic agonists to increase heart rate? A) Alpha-1 B) Beta-1 C) Beta-2 D) Muscarinic

Answer: B) Beta-1 Rationale: Beta-1 receptors are found in the heart and, when stimulated, they increase heart rate and contractility.

A patient is prescribed epinephrine during an anaphylactic reaction. What is the primary therapeutic effect? A) Decreased heart rate B) Bronchodilation and vasoconstriction C) Increased gastrointestinal motility D) Increased urine output

Answer: B) Bronchodilation and vasoconstriction Rationale: Epinephrine stimulates both beta and alpha receptors, leading to bronchodilation and vasoconstriction, which is critical in managing anaphylaxis.

Which class of antiarrhythmic drugs includes propranolol? A) Class I B) Class II C) Class III D) Class IV

Answer: B) Class II Rationale: Propranolol is a beta-blocker, classified as a Class II antiarrhythmic drug.

A patient on cholestyramine should be advised about which potential side effect? A) Diarrhea B) Constipation C) Muscle pain D) Headache

Answer: B) Constipation Rationale: Cholestyramine can cause constipation due to its bile acid-binding properties in the intestines.

What is the primary action of a muscarinic receptor antagonist? A) Increase heart rate B) Decrease salivation C) Constrict bronchi D) Lower blood pressure

Answer: B) Decrease salivation Rationale: Muscarinic antagonists block the effects of the parasympathetic system, leading to decreased secretions such as saliva.

Nitroglycerin relieves chest pain by which mechanism? A) Increasing heart rate B) Dilating coronary arteries C) Constricting peripheral blood vessels D) Increasing blood pressure

Answer: B) Dilating coronary arteries Rationale: Nitroglycerin dilates blood vessels, including coronary arteries, which improves oxygen delivery to the heart muscle.

The nurse is administering digoxin to a patient with heart failure. What should the nurse assess before giving the medication? A) Blood pressure B) Heart rate C) Respiratory rate D) Temperature

Answer: B) Heart rate Rationale: The nurse should check the patient's apical pulse before administering digoxin. If the heart rate is below 60 bpm, the dose should be held.

Which electrolyte imbalance is a concern with the use of furosemide? A) Hypercalcemia B) Hypokalemia C) Hypernatremia D) Hyponatremia

Answer: B) Hypokalemia Rationale: Furosemide can cause significant potassium loss, leading to hypokalemia.

Which electrolyte imbalance increases the risk for digoxin toxicity? A) Hyperkalemia B) Hypokalemia C) Hypernatremia D) Hyponatremia

Answer: B) Hypokalemia Rationale: Low potassium levels (hypokalemia) increase the risk of digoxin toxicity.

A patient taking isosorbide mononitrate should be educated on the possibility of developing which of the following side effects? A) Hypertension B) Hypotension C) Tachycardia D) Constipation

Answer: B) Hypotension Rationale: Isosorbide mononitrate can cause vasodilation, leading to a drop in blood pressure (hypotension).

Which adverse effect is associated with the use of nitroglycerin?A) Hypertension B) Hypotension C) Tachycardia D) Constipation

Answer: B) Hypotension Rationale: Nitroglycerin dilates blood vessels, which can lead to a drop in blood pressure (hypotension).

How should a patient store nitroglycerin tablets? A) In the refrigerator B) In a dark, tightly sealed container C) In the bathroom cabinet D) In a clear plastic bag

Answer: B) In a dark, tightly sealed container Rationale: Nitroglycerin is sensitive to light and moisture and should be stored in its original dark container to maintain potency.

The nurse is providing teaching for a patient starting on atorvastatin. Which adverse effect should the patient report immediately? A) Nausea B) Muscle pain C) Headache D) Dry mouth

Answer: B) Muscle pain Rationale: Muscle pain could be a sign of rhabdomyolysis, a serious side effect of statins.

Which neurotransmitter is primarily involved in the sympathetic nervous system response? A) Acetylcholine B) Norepinephrine C) Dopamine D) Serotonin

Answer: B) Norepinephrine Rationale: Norepinephrine is the main neurotransmitter that activates the "fight or flight" response in the sympathetic nervous system.

A patient taking amlodipine for hypertension should be monitored for which common side effect? A) Tachycardia B) Peripheral edema C) Bradycardia D) Muscle pain

Answer: B) Peripheral edema Rationale: Calcium channel blockers like amlodipine can cause peripheral edema due to their vasodilatory effects.

Which drug class is contraindicated for patients taking nitroglycerin due to the risk of severe hypotension? A) Beta-blockers B) Phosphodiesterase inhibitors (e.g., sildenafil) C) Calcium channel blockers D) Diuretics

Answer: B) Phosphodiesterase inhibitors (e.g., sildenafil) Rationale: Nitroglycerin and phosphodiesterase inhibitors can cause profound hypotension when taken together.

What should the nurse instruct a patient to do when taking sublingual nitroglycerin for chest pain? A) Swallow the tablet with water B) Place the tablet under the tongue and let it dissolve C) Chew the tablet for faster absorption D) Take the tablet with food

Answer: B) Place the tablet under the tongue and let it dissolve Rationale: Sublingual nitroglycerin should be placed under the tongue for quick absorption.

Which drug class is commonly used to treat hypertension and heart failure and has a significant risk of causing hyperkalemia? A) Loop diuretics B) Potassium-sparing diuretics C) Thiazide diuretics D) Osmotic diuretics

Answer: B) Potassium-sparing diuretics Rationale: Potassium-sparing diuretics can lead to elevated potassium levels (hyperkalemia).

Which drug is commonly used in combination with other diuretics to prevent potassium loss? A) Hydrochlorothiazide B) Spironolactone C) Furosemide D) Mannitol

Answer: B) Spironolactone Rationale: Spironolactone is a potassium-sparing diuretic that helps prevent potassium loss when used with other diuretics.

A patient is prescribed enalapril for heart failure. Which symptom should the nurse instruct the patient to report immediately? A) Dry skin B) Swelling of the face or throat C) Fatigue D) Nausea

Answer: B) Swelling of the face or throat Rationale: Angioedema is a potentially life-threatening side effect of ACE inhibitors like enalapril, characterized by swelling of the face, lips, and throat.

The nurse is caring for a patient on amiodarone. Which assessment finding requires immediate intervention? A) Bradycardia B) Yellow vision C) Difficulty breathing D) Blood pressure of 100/60 mmHg

Answer: C) Difficulty breathing Rationale: Amiodarone can cause pulmonary toxicity, and any sign of respiratory distress should be reported immediately.

A patient is prescribed metoprolol for hypertension. What should the nurse monitor? A) Blood glucose levels B) Serum calcium levels C) Heart rate D) Respiratory rate

Answer: C) Heart rate

A patient with heart failure is prescribed furosemide. The nurse should assess the patient for which electrolyte imbalance? A) Hypercalcemia B) Hyperkalemia C) Hypokalemia D) Hyponatremia

Answer: C) Hypokalemia Rationale: Furosemide, a loop diuretic, can cause potassium loss, leading to hypokalemia.

When should a patient take lovastatin to achieve the best lipid-lowering effect? A) In the morning B) With breakfast C) In the evening D) At bedtime with a snack

Answer: C) In the evening Rationale: Statins are most effective when taken in the evening, as cholesterol synthesis in the liver is highest at night.

The nurse is monitoring a patient on a sympathomimetic drug. Which effect would indicate stimulation of the sympathetic nervous system? A) Hypotension B) Miosis (pupil constriction) C) Increased heart rate D) Increased bowel sounds

Answer: C) Increased heart rate Rationale: Sympathomimetics mimic the action of the sympathetic nervous system, leading to increased heart rate and blood pressure.

A patient on a cholinergic agonist is most likely to experience which of the following effects? A) Decreased gastrointestinal motility B) Bronchodilation C) Increased salivation D) Tachycardia

Answer: C) Increased salivation Rationale: Cholinergic agonists stimulate the parasympathetic system, resulting in increased secretions such as saliva.

What is the primary mechanism of action for milrinone in heart failure management? A) Increasing blood pressure B) Decreasing heart rate C) Increasing cardiac contractility D) Decreasing urine output

Answer: C) Increasing cardiac contractility Rationale: Milrinone increases cardiac contractility, improving the heart's ability to pump blood in heart failure patients.

Which laboratory value should the nurse monitor in a patient taking atorvastatin? A) Serum potassium B) Serum calcium C) Liver function tests D) White blood cell count

Answer: C) Liver function tests Rationale: Statins can cause liver enzyme elevation, so liver function should be monitored regularly.

A patient receiving lisinopril develops a persistent dry cough. What is the best course of action? A) Continue the medication as the cough will subside over time. B) Discontinue the medication immediately without consulting the healthcare provider. C) Notify the healthcare provider as this may require discontinuation of the drug. D) Increase fluid intake to alleviate the cough.

Answer: C) Notify the healthcare provider as this may require discontinuation of the drug. Rationale: A persistent dry cough is a common side effect of ACE inhibitors like lisinopril, and the healthcare provider may switch the patient to another medication.

A patient with angina is prescribed nitroglycerin sublingual tablets. The nurse should instruct the patient to take another dose if chest pain is not relieved in: A) 5 minutes B) 10 minutes C) 15 minutes D) 30 minutes

Answer:A) 5 minutes Rationale:Nitroglycerin can be taken every 5 minutes, up to three doses. If the pain persists after the third dose, the patient should seek emergency medical care as this could indicate a heart attack.

A patient is started on lisinopril. What side effect should the nurse monitor for? A) Dry cough B) Bradycardia C) Hyperglycemia D) Constipation

Answer:A) Dry cough Rationale:Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough due to increased bradykinin levels. If the cough becomes bothersome, another antihypertensive class may be prescribed.

The nurse is teaching a patient about metoprolol. Which statement by the patient indicates a need for further teaching? A) "I will monitor my heart rate regularly." B) "I can stop taking the drug if my blood pressure is normal." C) "I will take the medication at the same time every day." D) "I may feel tired at first, but this will improve."

Answer:B) "I can stop taking the drug if my blood pressure is normal." Rationale:Beta-blockers like metoprolol should not be stopped abruptly, as this can cause rebound hypertension or angina. The patient should continue taking the medication as prescribed, even if blood pressure normalizes.

A patient with chest pain is prescribed nitroglycerin. Which instruction should the nurse provide? A) "Take the medication with food." B) "Lie down before taking the medication." C) "Chew the tablet for faster absorption." D) "Avoid drinking water with the medication."

Answer:B) "Lie down before taking the medication." Rationale:Nitroglycerin causes vasodilation, which can result in dizziness or hypotension. The patient should lie down to prevent fainting or falls due to sudden blood pressure drops.

A patient on furosemide for heart failure asks why they are losing weight. What is the nurse's best response? A) "You're losing fat from the medication." B) "The medication helps your body get rid of excess fluid." C) "Your muscle mass decreases with this medication." D) "Your appetite is reduced due to the drug."

Answer:B) "The medication helps your body get rid of excess fluid." Rationale:Furosemide is a diuretic used in heart failure to remove excess fluid. Weight loss in this context is due to a reduction in fluid volume, not fat or muscle loss.

A patient taking atorvastatin reports muscle pain and weakness. What should the nurse do next? A) Suggest stretching exercises B) Assess for signs of rhabdomyolysis C) Encourage more fluid intake D) Reassure the patient this is a common side effect

Answer:B) Assess for signs of rhabdomyolysis Rationale:Statins like atorvastatin can cause rhabdomyolysis, a serious condition characterized by muscle pain, weakness, and potential kidney damage. The nurse should assess further and contact the healthcare provider.

The nurse is caring for a patient receiving digoxin for heart failure. Which of the following findings indicates digoxin toxicity? A) Increased appetite B) Blurred or yellow vision C) Increased heart rate D) Weight gain

Answer:B) Blurred or yellow vision Rationale:Digoxin toxicity often presents with visual disturbances such as blurred vision, yellow or green halos, nausea, vomiting, and bradycardia. Monitoring digoxin levels and electrolytes, especially potassium, is crucial.

A patient is prescribed an adrenergic agonist. Which of the following effects would the nurse expect to see? A) Decreased heart rate B) Increased bronchodilation C) Increased digestive activity D) Constricted pupils

Answer:B) Increased bronchodilation Rationale:Adrenergic agonists stimulate the sympathetic nervous system (fight or flight response), leading to increased bronchodilation to improve oxygenation. They also increase heart rate and decrease digestive activity.

A patient is receiving dopamine to treat shock. What is the primary action of dopamine in this situation? A) Decrease heart rate B) Increase urine output C) Increase blood pressure D) Decrease respiratory rate

Answer:C) Increase blood pressure Rationale:Dopamine is an adrenergic agonist that increases cardiac output by enhancing contractility and vasoconstriction, which raises blood pressure, especially in shock situations.

The nurse is administering amiodarone to a patient with an arrhythmia. Which assessment finding would require immediate intervention? A) Blood pressure of 110/70 mmHg B) Respiratory rate of 14 breaths/min C) Patient reports difficulty breathing D) Heart rate of 82 beats per minute

Answer:C) Patient reports difficulty breathing Rationale:Amiodarone can cause pulmonary toxicity, leading to symptoms like cough, shortness of breath, or difficulty breathing. This is a serious side effect that requires immediate medical attention.