Clinical Pharmacology: Cardiac - Chapter 33,35, 36

A nurse is preparing to administer nitrate to a client. The nurse will carefully monitor the client for severe hypotension if the client is also prescribed which additional medication(s)? Select all that apply A. Alcohol B. Beta2 agonists C. HMG-CoA reductase inhibitors D. Angiotensin-converting enzymes inhibitors E. Phosphodiesterase inhibitors

A. Alcohol E. Phosphodiesterase inhibitors

A client is prescribed verapamil as treatment for angina. Which information should the nurse point out in the teaching plan for this client? Select all that apply A. Capsules may be opened and sprinkled on food B. Drug should be administered without regard to meals C. Tablet coverings can be expelled in the stool D. Capsules should be swallowed whole E. Drug should be administered with a meal

A. Capsules may be opened and sprinkled on food C. Tablet coverings can be expelled in the stool E. Drug should be administered with a meal

A nurse is preparing to teach a client about the prescribed verapamil. The nurse would alert the client to the possibility of which adverse reaction(s) most common? Select all that apply A. Constipation B. Tachycardia C. Tachypnea D. Hypotension E. Headache

A. Constipation E. Headache

A client arrives at the urgent care center reporting chest pain and is diagnosed with angina pectoris. Which drug would the nurse expect to be prescribed? A. Nicardipine B. Hydralazine C. Minoxidil D. Nimodipine

A. Nicardipine

The nurse is scheduled to administer the following medications at 0900: heparin subcutaneous, cefazolin IVPB, and atenolol PO. The morning labs are platelets 150,000 mcL, WBC 10,000 mcL, and APTT 100 second. Which is the nurse's priority in this situation? A. Place the client in supine position with legs elevated for BP 88/50 B. Instruct client to use an electric razor and soft toothbrush C. Call primary care provider with APTT, BP 88/50 mm Hg, and recent void of red urine D. Determine if there has been an improvement in the infection

A. Place the client in supine position with legs elevated for BP 88/50

After teaching a client how to properly use trans lingual nitroglycerin spray, the nurse determines that the teaching was successful when the client makes which statement(s)? Select all that apply A. "I need to shake the canister before use" B. "I will place one to two metered doses under my tongue at the start of an attack" C. "I'm not used to this form to prevent an attack" D. "I should not exceed three metered doses in 15 minutes" E. "I can spray the drug onto or under the tongue"

B. "I will place one to two metered doses under my tongue at the start of an attack" D. "I should not exceed three metered doses in 15 minutes" E. "I can spray the drug onto or under the tongue"

The nurse is preparing to administer an abtianginal medication. The nurse should question administering the medication and contact the health care provider first if which assessment(s) is noted? Select all that apply A. Heart rate above 50 bpm B. Heart rate below 50 bpm C. Systolic blood pressure below 90 mm Hg D. Diastolic blood pressure below 90 mm Hg E. Respiratory rate below 20 breaths per minute

B. Heart rate below 50 bpm C. Systolic blood pressure below 90 mm Hg

The nurse is preparing to administer protamine emergently to a client per instructions from the health care provider. The nurse concludes this is necessary due to an adverse reaction to which drug? A. Clopidogrel B. Heparin C. Altepase D. Warfarin

B. Heparin

A client receiving amlodipine for angina is now reporting dizziness. Which intervention should the nurse prioritize to help alleviate the condition? A. Apply a cold cloth over the forehead B. Instruct the client to lie down C. Instruct the client to drink more water D. Reduce the dosage of amlodipine

B. Instruct the client to lie down

A nurse instructor has completed a teaching session explaining abtianginal drugs. The instructor determines the session is successful when the student correctly chooses which drug(s) can be administered for the prevention of angina pectoris? Select all that apply A. Diltiazem B. Isosorbide mononitrate C. Topical introglycerin D. Oral nitroglycerin E. Amlodipine

B. Isosorbide mononitrate C. Topical introglycerin D. Oral nitroglycerin

The student nurse is preparing to administer heparin subcutaneously to a client. The instructor determines the student is well prepared by articulating which step(s)? Select all that apply A. Hold the needle at a 45-degree angle B. Pinch a fold of skin C. Aspirate before injecting the drug D. Apply firm pressure after injection E. Change sites for each dose

B. Pinch a fold of skin D. Apply firm pressure after injection E. Change sites for each dose

A nurse is conducting an assessment on a client who has recently undergone exploratory laparotomy. The nurse notes the continued order for enoxaparin. The nurse predicts this is to accomplish which goal? A. Repair damage to a blood vessel B. Prevent formation of a blood clot C. Encourage cessation of bleeding D. Prevent coagulation cascade

B. Prevent formation of a blood clot

The nurse is assessing the medical record of a client who is prescribed warfarin. After the client reports occasionally using herbal supplements, which herb(s) should the nurse caution the client to avoid? Select all that apply A. Aloe vera B. St. John's wort C. Ginkgo biloba D. Ginger E. Arnica

B. St. John's wort C. Ginkgo biloba D. Ginger

The nurse educates a client diagnosed with atrial fibrillation about the prescribed warfarin. Which client statement establish the need for further clarification? A. "I will keep my lab appointments for a prothrombin and INR levels" B. "I will take the warfarin the same time each day" C. "I will not eat green leafy vegetables, broccoli, yogurt, or cheese" D. "I will not drink alcohol unless alright with my primary health care provider"

C. "I will not eat green leafy vegetables, broccoli, yogurt, or cheese"

When caring for a client with angina, the nurse instructs the client to place the nitroglycerin tablet between the cheek and the gums. Which form of nitroglycerin in the nurse administering> A. Sublingual B. Transdermal C. Buccal D. Translingual

C. Buccal

The nurse is teaching a client about dietary concerns related to the administration of warfarin. The nurse determines the teaching session is successful when the client correctly points out that a consistent intake of which foods is necessary when using warfarin? A. Dairy products B. Root vegetables C. Green leafy vegetables D. Fruits and cereals

C. Green leafy vegetables

The nurse is preparing to administer cholestyramine to a client. On preadministration assessment, the nurse discovers the client is currently taking propranolol, glipizide, and acetaminophen. Which potential interaction(s) should the nurse prioritize? Select all that apply A. Hypoglycemia B. Decreased analgesia C. Increase in blood pressure D. Hypotension E. Hyperglycemia

C. Increase in blood pressure E. Hyperglycemia

The nurse is preparing to administer warfarin to a female client, who also uses oral contraceptives. Which assessment finding(s) should the nurse prioritize? Select all that apply A. Bruising B. Blood in the stool C. Subtherapeutic INR D. Supratherapeutic INR E. Calf pain and warmth

C. Subtherapeutic INR E. Calf pain and warmth

The nurse is preparing to administer colestipol to the client. Which method should the nurse prioritize to administer this medication? A. Mix the granules in 2-6 fluid ounces of water B. Take care not to crush the granules C. Give the granules once or twice daily with meals D. Mix the drug in 90 mL of liquid

D. Mix the drug in 90 mL of liquid

After teaching a group of nursing students about antianginal drugs, the nurse instructor determines that the teaching was successful when the student correctly choose which drugs as a calcium channel blocker? A Minoxidil B. Hydralazine C. Isosorbide D. Nifedipine

D. Nifedipine

The nurse is preparing a teaching session for a client prescribed gemfibrozil. The nurse will point out the drug operates via which mechanism(s)? Select all that apply A. Increases excretion of cholesterol B. Reduces VLDLs C. Increases breakdown of VLDLs D. Reduces production of triglycerides E. Inhibits cholesterol formation

A. Increases excretion of cholesterol D. Reduces production of triglycerides

The nurse is preparing a teaching session for a client who is being discharged with a prescription for clopidogrel. Which potential adverse reaction(s) should the nurse point out is associated with this drug? Select all that apply A. Skin rash B. Bleeding C. Heart palpitations D. Nausea E. Constipation

A. Skin rash E. Constipation

The nurse is preparing to administer niacin to a client with hyperlipidemia. Which adverse reaction should the nurse prioritize? A. Tingling B. Constipation C. Diarrhea D. Cholethiasis

A. Tingling

A client prescribed niacin reports significant skin flushing and itching, stating, "I almost stopped taking the drug." The nurse anticipates the health care provider will prescribe which drug in address this issue? A. Prednisone B. Aspirin C. Ibuprofen D. Hydrocortisone

B. Aspirin

A nurse is preparing to administer the first dose of warfarin to a client. Which assessment should the nurse prioritize for this client? A. Observe for signs of thrombus formation B. Assess PT and INR C. Assess for signs of bleeding D. Monitor for hypersensitivity reaction

B. Assess PT and INR

The health care provider has prescribed pravastatin for a client. The nurse should question this order if the client is currently prescribed which additional medication(s)? Select all that apply A. Quinapril B. Niacin C. Clarithromycin D. Albuterol E. Verapamil

B. Niacin C. Clarithromycin E. Verapamil

The nurse is finishing a teaching session with a client who is prescribed gemfibrozil. The nurse determines the session is successful when the client correctly chooses which instruction? A. Take the drug along with meals B. Observe caution while driving C. Take a single dose once daily in the evening D. Be alert for mild to severe facial flushing

B. Observe caution while driving

The nurse is teaching a young female about prescribed anticoagulant. The nurse determines the session is successful when the client correctly indicated they will apply which recommendation? A. Avoid caffeinated drinks B. Take the drug on an empty stomach C. Use a reliable contraceptive D. Take the drug with a glass of milk

C. Use a reliable contraceptive

A client is being discharged after being treated with nitroglycerin for an acute anginal attack. The nurse should include which instructions when providing the client with discharge instructions concerning how to properly administer nitroglycerin ointment at home? A. Apply a thick layer of the ointment B. Rub the ointment onto the skin C. Use an applicator for applying the ointment D. Apply on the same site during every application

C. Use an applicator for applying the ointment

A nursing instructor is teaching a class on the action of statin drugs. The nurse instructor determines the class is successful after the students correctly choose which actions? Select all that apply A. Decrease cholesterol absorption in the GI Tract B. Promote cholesterol breakdown C. Formation of a substance excreted in the feces D. Decrease breakdown of fat to cholesterol E. Inhibit cholesterol production

A. Decrease cholesterol absorption in the GI Tract B. Promote cholesterol breakdown E. Inhibit cholesterol production

A client is prescribed warfarin. The client also takes a diuretic for the treatment of cardiac problems. The nurse will monitor the client for which potential interaction? A. Decreased effectiveness of the anticoagulant B. Increased effectiveness of the diuretic C. Increased absorption of the anticoagulant D. Increased absorption of the diuretic

A. Decreased effectiveness of the anticoagulant

After teaching a group of nursing students about heparins, the instructor determines that the teaching was successful when the students correctly choose which drug(s) as an example of a low-molecular-weight-heparin (LMWH)? Select all that apply A. Deltaparin B. Streptokinase C. Enoxaparin D. Warfarin E. Desirudin

A. Deltaparin C. Enoxaparin

The nurse has completed a teaching session with a client who is prescribed nicotinic acid. The nurse determines the session is successful when the client correctly chooses which reaction(s) as a normal response to this drug? Select all that apply A. Flushing B. Sensations of warmth C. Tingling D. Uticaria E. Pustule formation

A. Flushing B. Sensations of warmth C. Tingling

The nurse is preparing to administer an anticoagulant to several clients. The nurse should question this order if which disorder(s) is noted in the client's medical record? Select all that apply A. Leukemia B. Hypotension C. Atrial Fibillation D. GI Ulcers E. Tuberculosis

A. Leukemia D. GI Ulcers E. Tuberculosis

The nurse is conducting the ongoing assessment of a client who is prescribed an anticoagulant. Which assessment(s) will the nurse prioritize? Select all that apply A. Urinalysis B. Platelet count C. Blood count D. Stool analysis E. Ultrasound

B. Platelet count C. Blood count D. Stool analysis

A nurse is teaching a client who is diagnosed with angina how to properly administer transdermal nitroglycerin. The nurse instructs the client to apply the pack for how long? A. 4-6 hours B. 6-8 hours C. 10-12 hours D. 12-14 hours

C. 10-12 hours

The nurse is preparing to teach discharge instructions to a client with angina. Which instruction should the nurse prioritize giving the client when teaching about the prescribed oral nitroglycerin? A. Store the nitroglycerin capsules in a plastic container B. Place the nitroglycerin capsules along with other tablets. C. Recap the container tightly after taking out the capsules D. Do not store nitroglycerin in a dark container

C. Recap the container tightly after taking out the capsules

The healthcare provider has prescribed ezetimibe for a client diagnosed with hyperlipidemia. The nurse is prepared to prioritize which assessment to evaluate the drug's effectiveness? A. Taking a dietary history of the client B. Inspecting skin and eyelids for evidence of zanthomas C. Obtaining reports of fasting blood sugar levels D. Frequently monitoring blood cholesterol

D. Frequently monitoring blood cholesterol

The nurse is monitoring a client who is receiving heparin by continuous IV infusion. Which action should the nurse prioritize? A. Perform a complete blood count B. Perform baseline PT/INR C. Perform a PTT test 4-6 hours after injection D. Perform blood coagulation tests every 4 hours

D. Perform blood coagulation tests every 4 hours

A nurse is assessing a client with angina who has received diltiazem. Which finding should the nurse prioritize and notify the health care provider for further instructions? A. Systolic pressure 110 mm Hg B. Significant weight loss C. Lightheadedness D. Pulse rate is 45 beats per minute

D. Pulse rate is 45 beats per minute

The client presents for a routine clinic visit to evaluate the long-term use of cholestyramine. The health care provider determines vitamin A and D should be prescribed at this time. The nurse determines which nursing diagnosis is the most appropriate at this time? A. Risk for impaired skin integrity B. Constipation C. Risk for injury D. Risk for imbalanced nutrition: less than body requirements

D. Risk for imbalanced nutrition: less than body requirements

The nurse is preparing to teach a client with hyperlipidemia about the prescribed cholestyramine. Which instructions should the nurse prioritize for the client? A. "Eat foods high in dietary fiber" B. "Follow a complete liquid diet" C. "Be sure to stay on complete bed rest" D. "Take the water-soluble form of vitamin D"

A. "Eat foods high in dietary fiber"

A client is prescribed oral nitrate for occasional anginal pain. The nurse should point out that nitrates must be stored in which manner(s)? Select all that apply A. In its original container B. With the container lid tightly sealed C. With other medications in the container D. In a plastic pull box so doses are not missed E. Away from light exposure

A. In its original container B. With the container lid tightly sealed E. Away from light exposure

The nurse is teaching a client about the heparin which has been prescribed for a thrombus formation. Which information should the nurse prioritize in this teaching? Select all that apply A. Onset of action is almost immediate B. Maximum effect occurs within 10 minutes C. It is preferably given intramuscularly D. Clotting time returns to normal within 4 hours E. It causes fewer adverse reactions that the oral form

A. Onset of action is almost immediate B. Maximum effect occurs within 10 minutes D. Clotting time returns to normal within 4 hours

The nurse is conducting the ongoing assessment on a client who is prescribed an anticoagulant. The nurse will alert the health care provider if which finding(s) is noted on the assessment? Select all that apply A. PT exceeds 1.5 times the control value B. PT is less than 1.5 times the control value C. There is evidence of bleeding D. INR is less than 3.0 E. INR is greater than 3.0

A. PT exceeds 1.5 times the control value C. There is evidence of bleeding E. INR is greater than 3.0

The nurse is preparing to teach a client about HMG-CoA Reductase Inhibitors. The nurse should prepare to point out which instruction(s)? Select all that apply A. Photosensitivity can occur B. The drug should be continued even if the client feels better C. Muscle pain and weakness are normal D. Juices other than grapefruit juice are okay to use E. Statins should be administered in the evening

A. Photosensitivity can occur B. The drug should be continued even if the client feels better D. Juices other than grapefruit juice are okay to use E. Statins should be administered in the evening

A nurse is assessing a client who is prescribed warfarin and notes a positive occult blood screen, petechia on both legs, and blood-tinged toothbrush. The nurse anticipates the health care provider will prescribe which antidote to counteract these findings? A. Phytonadione (Vitamin K) B. Protamine C. Ticlopidine D. Tenecteplase

A. Phytonadione (Vitamin K)

The nurse is caring for a postoperative client receiving dalteparin prophylactically to prevent deep vein thrombosis. The nurse should perform which ongoing assessment(s) for safe administration of the drug? Select all that apply A. Presence of dark tarry stools or melena B. Presence of pain, edema, redness in leg C. Nasogastric drainage for presence of blood D. Presence of dry mucous membranes E. Ability to transfer from bed to chair

A. Presence of dark tarry stools or melena B. Presence of pain, edema, redness in leg C. Nasogastric drainage for presence of blood

A nurse instructor is teaching a class about the actions of anticoagulants. The instructor determines the class is successful when the students correctly choose which as action(s) of anticoagulants? Select all that apply A. Prevent formation of a thrombus B. Prevent extension of a thrombus C. Dissolve existing thrombi D. This the blood E. Can reverse the damage cause by a thrombus

A. Prevent formation of a thrombus B. Prevent extension of a thrombus

A nursing instructor overhears a group of nursing students comparing various drugs used for cardiac disorders. The instructor determines the previous class was successful when the students correctly determine antianginals provide which action(s)? Select all that apply A. Relief of pain of acute anginal attacks B. Reduction in serum triglyceride levels C. Prevention of anginal attacks D. Elevation of high-density lipoprotein (HDLs) E. Treatment of chronic stable angina pectoris

A. Relief of pain of acute anginal attacks C. Prevention of anginal attacks E. Treatment of chronic stable angina pectoris

The nurse is caring for a client diagnosed with coronary artery disease and a history of angina receiving the medication nitroglycerin ointment 2%, 2 in every 8 hours. The nurse should perform which assessment(s) for safe administration of the nitroglycerin? Select all that apply A. Remove previous nitroglycerin ointment and paper applicator and fold in half before disposing in the trash. B. Apply a new nitroglycerin ribbon of 2 inches on applicator paper and apply in the same location as the previous dose C. Do not massage area of nitroglycerin ointment, and secure the applicator paper with tape with date, time, and initials D. Wear gloves when removing old application and applying new application to prevent the development of headache. E. Squeeze the nitroglycerin tube gently and smear a very thin layer to the 2-inch mark on the applicator paper.

A. Remove previous nitroglycerin ointment and paper applicator and fold in half before disposing in the trash. C. Do not massage area of nitroglycerin ointment, and secure the applicator paper with tape with date, time, and initials E. Squeeze the nitroglycerin tube gently and smear a very thin layer to the 2-inch mark on the applicator paper.

A nurse has completed a teaching session with a client who is prescribed nitrate therapy. The nurse determines the session is successful when the client correctly chooses which factor(s) related to the potential of headaches and nitrate therapy? Select all that apply A. Should decrease with continued therapy B. May be relieved with the use of aspirin or acetaminophen C. Should be avoided by altering the dosage schedule D. Are a serious adverse reaction and should be reported immediately E. May be a marker of the drug's effectiveness

A. Should decrease with continued therapy B. May be relieved with the use of aspirin or acetaminophen E. May be a marker of the drug's effectiveness

A client is questioning the new prescription for a statin. The nurse should point out that statin will reduce the risk of which disorder(s) for the client? Select all that apply A. Stroke B. Transient ischemic attack C. Kidney disease D. Hepatic disease E. Cancer

A. Stroke B. Transient ischemic attack

A nurse is analyzing the chemistry profile of a client diagnosed with hyperlipidemia. Which measurement(s) will the nurse prioritize on the lipid profile? Select all that apply A. Total cholesterol B. Triglycerides C. LDL D. ALT E. AST

A. Total cholesterol B. Triglycerides C. LDL

The nurse instructor is illustrating the proper technique for applying nitroglycerin ointment. Which instruction(s) should the instructor point out as essential to the correct application? Select all that apply A. Wear disposable gloves B. Apply 2 inches of ointment to client's skin C. Use the same application site each time ointment is applied D. Cleanse the area of skin before application E. Use the upper arms and legs for application

A. Wear disposable gloves D. Cleanse the area of skin before application E. Use the upper arms and legs for application

A nurse is preparing to administer lovastatin to a client. The nurse should question this order if which disorder(s) is noted in the client's history? Select all that apply A. Kidney disease B. Pregnancy C. Serious hepatic disease D. Carcinoma of the breast E. Lactation

B. Pregnancy C. Serious hepatic disease E. Lactation

The healthy care provider has prescribed fenofibrate for a client discovered to have a very high serum triglyceride levels. The nurse should question this order if the client has a history of which additional disorder? A. Endocrine Disorder B. Primary biliary cirrhosis C. Arterial bleeding D. Respiratory depression

B. Primary biliary cirrhosis

The nurse is conducting an ongoing assessment on a client who was administered an antihyperlipidemic medication. Which assessment(s) should the nurse prioritize? Select all that apply A. Blood glucose B. Vital signs C. Assessment of bowel function D. Input and output E. Stool sample

B. Vital signs C. Assessment of bowel function

The nurse is teaching a client and caregiver the proper technique for administering the prescribed nitroglycerin ointment. Which method should the nurse point out is the best way to determine the amount of ointment to apply? A. A teaspoon B. Length of a finger C. A paper applicator D. A ruler

C. A paper applicator

A nurse is conducting a seminar on thrombosis. The nurse should point out that arterial thrombus can occur related to which situation? A. Decreased blood flow B. Injury to the vessel wall C. Arrhythmias D. Altered blood coagulation

C. Arrhythmias

The nurse instructor has completed a teaching session on bile acids with a group of nursing students. The instructor determines the session is successful when the students correctly choose which fact(s) as true about bile? Select all that apply A. Manufactured by the gallbladder B. Stored in the liver C. Emulsifies fats and lipids D. Secreted by the liver E. Classified as a hormone

C. Emulsifies fats and lipids D. Secreted by the liver

The nurse is administering pravastatin and amiodarone to a client with cardiac issues. Which potential interaction will the nurse carefully monitor the client for? A. Increased anticoagulant effect B. Increased hypoglycemia effect C. Increased risk of myopathy D. Decreased effects of pravastatin

C. Increased risk of myopathy

A nurse is preparing to administer colesevelam to a client with hyperlipidemia. The nurse determines cautious administration is warranted alternating which condition in the client's history? A. Hypotension B. Acute infection C. Liver disease D. Unstable angina

C. Liver disease

A nurse is conducting a community presentation on heart disease, cholesterol, and risk factors. The nurse determines the the class has been successful when the class correctly chooses which point as true? A. Low-fat diet raises LDL cholesterol B. Being overweight causes HDL levels to go up C. Physical activity raises HDL cholesterol levels D. Excess body weight causes LDL cholesterol to go down

C. Physical activity raises HDL cholesterol levels

A client with intermittent claudication is prescribed cilostazol by the primary health care provider. The nurse will administer this drug cautiously if the client's history reveals which disorder? A. Intermittent claudication B. Pulmonary emboli C. Myocardial Infarcation D. Pancytopenia

D. Pancytopenia