Introductory Clinical Pharmacology Unit 8

The nursing instructor is illustrating the proper technique for applying nitroglycerin ointment. Which instructions should the instructor point out as essential to the correct application? Select all that apply.

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

The nurse is conducting an ongoing assessment after the administration of an antihypertensive. Which findings should the nurse prioritize? Select all that apply.

Weight gain of 2 lb or more per day Edema

A nursing student is preparing a presentation discussing hypertension. Which factors should the student explain can increase the risk of someone developing hypertension? Select all that apply.

advancing age family history cigarette smoking chronic alcohol consumption

The nurse is preparing to teach a client with hyperlipidemia about the prescribed cholestyramine. Which instruction should the nurse prioritize for the client?

"Eat foods high in dietary fiber."

After teaching a client how to properly use translingual nitroglycerin spray, the nurse determines that the teaching was successful when the client states which statement? Select all that apply.

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

A nurse is preparing to administer IV digoxin to a client. The nurse prepares to administer the drug over which time frame?

5 minutes

A nurse is studying a journal article about propranolol. Which factors would the nurse expect to find explained? Select all that apply.

Acts by blocking beta-adrenergic receptors of the heart and kidney Reduces the release of renin Has membrane-stabilizing effects

The nurse identifies a nursing diagnosis of Nausea after the administration of antiarrhythmic therapy. Which instructions would the nurse prioritize in the client's plan of care? Select all that apply.

Administering the drug with food Offering small, frequent meals

A nurse is preparing to administer an antiarrhythmic and determines the drug is a class III potassium channel blocker. Which drug would the nurse be most likely to administer?

Amiodarone

The nurse is preparing to administer digoxin to a client. Which physical assessments should the nurse prioritize before administering this drug? Select all that apply.

Apical-radial pulse rate Respiratory rate Weight measurement Blood pressure

A client is admitted to the emergency department with reports of anginal pain. Which assessments should the nurse prioritize? Select all that apply.

Blood pressure Apical pulse Radial pulse Respiratory rate

After teaching a group of nursing students on the mechanism of action of angiotensin-converting enzyme inhibitor (ACEI) drugs, the instructor determines the session is successful after the students correctly choose which action as the result of aldosterone?

Causes sodium and water retention

A client is admitted to the emergency department with a severe headache, nausea, shortness of breath, and blood pressure of 200/120 mm Hg. Which response should the nurse prioritize?

Continuously monitor the client's status.

A client is receiving fosinopril. Which adverse effect would the nurse caution the client about to help to promote compliance?

Cough

The nurse is conducting a preadministration assessment on a client prescribed simvastatin. Which factors should the nurse prioritize? Select all that apply.

Dietary history Vital signs Weight

A nursing student is preparing a presentation detailing verapamil. The student should be prepared to explain which effects verapamil has on the cardiovascular system? Select all that apply.

Dilates coronary arteries Dilates peripheral arteries Slows conduction through the SA and AV nodes

After teaching a group of nursing students about digoxin, the instructor determines that the teaching was successful when the students correctly choose which factor as necessary to monitor serum digoxin levels? Select all that apply.

Draw immediately before the next dose. Draw 6 to 8 hours after the last dose. A toxic Level is greater than 2 ng/mL

A group of nursing students are analyzing the various triggers for arrhythmias. The instructor concludes the students grasp the information by correctly choosing which factors as a potential trigger for an arrhythmia? Select all that apply.

Emotional stress Heart disease Electrolyte imbalance Hypoxia

A client has a nursing diagnosis of Activity Intolerance related to fatigue and weakness. Which actions would be appropriate for the nurse to include in the client's plan of care?

Encouraging ambulation as tolerated Promoting rest periods throughout the day as necessary

The nurse is preparing to complete a preadministration assessment on a client who has presented to the clinic with reports of chest pain. Which information should the nurse prioritize in this assessment? Select all that apply.

Events that relieve anginal pain Events that trigger anginal pain Description of the pain Whether the pain radiates

A client with hypertension comes to the clinic for a follow-up visit. Which activities would be appropriate for the nurse to do when assisting the client in managing his hypertension? Select all that apply.

Find local resources in the community for taking blood pressure. Teach client how to properly record weight and blood pressure. Schedule regular monitoring of weight and blood pressure.

The health care provider has prescribed ezetimibe for a client diagnosed with hyperlipidemia. The nurse is prepared to prioritize which assessment to evaluate the drug's effectiveness?

Frequently monitoring blood cholesterol

The nurse is preparing to administer an antianginal medication. The nurse should question administering the medication and contact the health care provider first if which assessments are noted? Select all that apply.

Heart rate below 50 bpm Systolic blood pressure below 90 mm Hg

A client is receiving a diuretic for the treatment of hypertension. Which assessment finding on the laboratory reports should the nurse prioritize?

Hyponatremia

A nursing instructor is teaching a group of students about cardiotonics. The instructor determines the session is successful when the students correctly relate which as actions of the cardiotonics? Select all that apply.

Improves myocardial contractility Increases myocardial efficiency Improves profusion to all body tissues

A client is prescribed oral nitrate for occasional anginal pain. The nurse should point out that nitrates must be stored in which manner? Select all that apply.

In its original container With the container lid tightly sealed Away from light exposure

The nurse is preparing a teaching session for a client prescribed gemfibrozil. The nurse will point out the drug operates via which mechanisms?(SATA)

Increases excretion of cholesterol Reduces production of triglycerides

The health care provider has prescribed digoxin for a client diagnosed with heart failure. The nurse will prepare to assess which laboratory results before administering this medication? Select all that apply.

Liver function tests Renal function tests Complete blood count Electrolyte levels

The nurse is preparing to administer digoxin to an elderly client with heart failure. The nurse will also prepare to administer which additional drugs as part of this client's overall therapy? Select all that apply.

Loop diuretics Angiotensin-converting enzyme inhibitors (ACEIs) Beta blockers

The nurse is preparing to teach a group of middle-aged client's ways to reduce hypertension. Which instructions should the nurse point out during this session? Select all that apply.

Lose weight. Stop smoking. Reduce stress.

The client asks the nurse if garlic will truly help improve cardiovascular health. The nurse can point out that garlic is recognized to produce which effects? Select all that apply.

Lower serum triglyceride levels Lower blood pressure Prevention of atherosclerosis

A nurse is caring for a client who has been prescribed cholestyramine powder for pruritus treatment. What instructions should the nurse include in the teaching plan for the client? Select all that apply.

Mix the drug in 2 to 6 fluid ounces of water. Mix the drug with fluid soups or pulpy fruits. Do not ingest the drug in the dry form.

The nurse is preparing to administer colestipol to the client. Which method should the nurse prioritize to administer this medication?

Mix the drug in 90 mL of liquid.

The nursing instructor is teaching a class on the actions of antiarrhythmic medications. The instructor determines the class is successful when the students correctly choose which results as indicators of therapeutic response? Select all that apply.

No evidence of injury is seen. No evidence of infection is seen. Oral mucous membranes are intact and moist.

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?

Observe caution while driving

A nurse is preparing to administer the prescribed digoxin. After appraising the morning laboratory results, the nurse determines caution is warranted with which result? Select all that apply.

Potassium 3 mEq/L Calcium 4.3 mEq/L Magnesium 1.0 mEq/L

A client is admitted to the cardiac unit for ventricular arrhythmias. The nurse predicts the client will be prescribed an antiarrhythmic medication due to which source of the arrhythmia?

Premature ventricular contraction

A client admitted to a health care facility with cardiac arrhythmia is prescribed propranolol. Which signs should the nurse prioritize on the ongoing assessment?

Pulse rate

The nurse is preparing to teach discharge instructions to a client who is prescribed an antihyperlipidemic medication. Which information about the drug should the nurse prioritize in the teaching? Select all that apply.

Reason for taking the prescribed drug Drug name Correct dose

A client presents to the urgent care clinic reporting severe dizziness. On assessment, the nurse learns the client was recently prescribed losartan and quit taking it thinking it was responsible for the dizziness. Which assessment should the nurse prioritize?

Rebound hypertension

The nursing instructor is teaching a group of students about the various medications used to treat hypertension. After the session the instructor determines the session is successful when the students correctly connect which actions with calcium channel blockers? Select all that apply.

Relaxation of blood vessels Increased oxygen supply to the heart Reduced workload on the heart Decreased blood pressure

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? Select all that apply.

Relief of pain of acute anginal attacks Prevention of anginal attacks Treatment of chronic stable angina pectoris

A nursing instructor is conducting a class on heart failure and the events that occur. The instructor should point out that the increase in neurohormonal activity will result in which changes? Select all that apply.

Remodeling of the cardiac muscle cells Hypertrophy of the heart Increased need for oxygen Cardiac necrosis

An older client with hypertension is prescribed furosemide and atenolol. The client reports perspiring a lot lately and having diarrhea. Which nursing diagnosis would the nurse most likely prioritize?

Risk for Deficient Fluid Volume

The nurse is assessing a client with renal disease and discovers the client's blood pressure has increased since the last visit. The nurse suspects the client has developed which concern?

Secondary hypertension

A client is admitted with arrhythmias and placed on cardiac monitoring and prescribed an antiarrhythmic. Which finding on ongoing assessment should the nurse immediately notify the primary health care provider? Select all that apply.

Sudden change in mental state

The nurse is preparing to administer niacin to a client with hyperlipidemia. Which adverse reaction should the nurse prioritize on ongoing assessment?

Tingling

A nurse is analyzing the chemistry profile of a client diagnosed with hyperlipidemia. Which measurements will the nurse prioritize on the lipid profile? Select all that apply.

Total cholesterol Triglycerides LDL

A client has been prescribed a sodium channel blocker following cardioversion. How would the nurse explain the action by which the drug decreases the likelihood of dysrhythmias?

by prolonging the heart's refractory period

The nurse is preparing a presentation for a local health fair to explain various aspects of hypertension. Which factors should the nurse include when pointing out various risk factors which can increase the potential of developing hypertension? Select all that apply.

lack of potassium in the diet chronic alcohol use obesity

Which instructions would be appropriate to include in the teaching plan for a client taking digoxin at home? (Select all that apply.)

"Weigh yourself each day at the same time and wearing the same amount of clothing." "Check your pulse every day before taking the medication." "Notify the doctor if your pulse is below 60 beats per minute." "Call your doctor if you notice an irregular heart rhythm or you feel nauseated."

A nurse is assessing the serum digoxin level of a client who is receiving treatment for atrial fibrillation. Which result should the nurse prioritize and report to the primary health care provider?

2.2 ng/mL

A male client has called the clinic because he is taking digoxin and is concerned about his pulse rate. The nurse should tell the client to hold the medication if he reports a pulse rate of:

52 beats/minute.

A nurse is caring for a client receiving an oral antiarrhythmic drug. Which apical pulse rate would lead the nurse to withhold the drug and notify the health care provider immediately?

58 beats/min

A nurse is monitoring the response of a 4-year-old child to digoxin. Which apical pulse rate should the nurse prioritize and notify the primary health care provider?

66 beats per minute

A client is prescribed clonidine as a transdermal patch. After instructing the client about this drug, the nurse determines that the teaching was successful when the client states that the patch should remain in place for how long?

7 days

The nursing mentor is supervising a group of nursing students in the clinic. The mentor determines the students are well prepared when they prioritize which assessment with clients receiving medications such as doxazosin?

Blood pressure monitoring

A client with hypertension is prescribed atenolol. Which assessment findings on the ongoing assessment should the nurse evaluate first? Select all that apply.

Bradycardia Dizziness

The nurse is preparing the discharge teaching for client who is prescribed digoxin. The nurse will point out the client may be receiving the digoxin in which form depending on the pharmaceutical company? Select all that apply.

Capsule Tablet

The nurse instructs a client suffering from frequent anginal attacks to keep a record of each attack. What information would the nurse instruct the client to record? Select all that apply.

Date of attack Time of attack Drug used to relieve the acute pain Dose of drug used to relieve the acute pain

The nurse is caring for a client admitted to the telemetry unit with atrial fibrillation on the electrocardiogram (ECG) monitor. The nurse should perform which assessment(s) for safe administration of the first dose of quinidine? Select all that apply.

Obtain a history of allergies to medications and specific reactions. Assess if the client has systemic lupus erythematosus or myasthenia gravis. Check baseline renal and hepatic function before administering drug. After administration, assess for tinnitus, hearing loss, headache, and vertigo.

A client has been admitted to a health care center with reports of dyspnea. The nurse suspects left-sided heart failure based on which assessment finding?

Orthopnea

The nurse is preparing to administer an antianginal drug to a client. Which assessment should the nurse prioritize before administering this drug? Select all that apply.

Pain Physical appearance Lung sounds Vital signs

A client is prescribed a bile acid resin and has been taking this therapy long term. The primary health care provider has prescribed vitamins A and D in water-soluble form. Which nursing diagnosis would be most likely?

Risk for Imbalanced Nutrition: Less Than Body Requirements

A client is to be discharged with a prescribed antiarrhythmic. Which point should the nurse point out in the client discharge instructions?

Take frequent sips of water or chew gum.

The nurse is conducting the ongoing assessment of a client with heart failure who was administered digoxin. Which additional medication does the nurse anticipate the health care provider to prescribed after reporting a heart rate of 48 bpm, muscle weakness, anorexia, and reports of generalized headache?

Atropine

The nurse is assessing a client diagnosed with left ventricular dysfunction. Which symptoms would the nurse most likely assess? Select all that apply.

Dyspnea Moist cough

A client is being discharged after being treated with nitroglycerin for an acute anginal attack. The nurse should include which instruction when providing the client with discharge instructions concerning how to properly administer nitroglycerin ointment at home?

Use an applicator for applying the ointment.