NCLEX-PN (Elsevier): Cardiovascular & Respiratory

A client has been started on long-term therapy with rifampin. Which information about this medication would the nurse provide to the client? 1. Should always be taken with food or antacids 2. Should be double-dosed if one dose is forgotten 3. Causes red-orange discoloration of sweat, tears, urine, and feces 4. May be discontinued independently if symptoms are gone in 3 months

3. Causes red-orange discoloration of sweat, tears, urine, and feces

A hospitalized client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, the nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My chest still hurts." Which appropriate actions would the nurse take? Select all that apply. 1. Call a code blue 2. Contact the client's family 3. Check the client's pain level 4. Check the client's blood pressure 5. Administer a second nitroglycerin, 0.4 mg, sublingually.

3. Check the client's pain level 4. Check the client's blood pressure 5. Administer a second nitroglycerin, 0.4 mg, sublingually.

A client who has begun taking fosinopril is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. Which suggestion would provide the best support for the client? 1. Tell the client not to take the medication with food 2. Suggest that the client taper the dose until taste returns to normal 3. Inform the client that impaired taste is expected and generally disappears in 2 to 3 months 4. Tell the client that a request will be made to the primary health care provider (PHCP) to change the prescription.

3. Inform the client that impaired taste is expected and generally disappears in 2 to 3 months

The nurse is reinforcing dietary instructions to a client who is taking spironolactone. The nurse instructs the client to avoid which food in the daily diet? 1. Rice 2. Salad 3. Oatmeal 4. Citrus fruits

4. Citrus fruits

The nurse is assisting in preparing a plan of care for a client who will be receiving a calcium antagonist to prevent preterm delivery. Which action does the nurse include in the plan of care for the client to detect a side effect of the medication? 1. Monitor for hypertension 2. Monitor for pale and dry skin 3. Monitor for fluid volume deficit 4. Monitor for increases in maternal and fetal heart rates

4. Monitor for increases in maternal and fetal heart rates.

A client has a new prescription to take guaifenesin every 4 hours as needed. Which medication instructions would the nurse reinforce? 1. Be aware of irritability as a side effect 2. Take the tablet with a full glass of water 3. Take an extra dose if the cough is accompanied by fever 4. Crush the sustained-release tablet if immediate relief is needed.

2. Take the tablet with a full glass of water

The nurse is caring for a client with chronic heart failure who is taking digoxin 0.125 mg daily. Before administering the medication, the nurse reviews the serum digoxin level that was drawn earlier in the day. The result is 1 ng/mL. Which action would the nurse take based on this laboratory result? 1. Notify the health care provider 2. Check the client's last pulse rate 3. Administer the dose of the medication as scheduled 4. Obtain another serum digoxin level to verify the results.

3. Administer the dose of the medication as scheduled

A client who was recently prescribed warfarin is being instructed on diet changes necessary with this medication. The client reports enjoying all of these food items. Which items would the nurse instruct the client to limit consuming? Select all that apply. 1. Giblet gravy 2. Spinach salad 3. Fried chicken 4. Banana pudding 5. Mustard greens 6. Fresh orange juice

2. Spinach salad 5. Mustard greens

The nurse is scheduled to administer a dose of digoxin to a client with atrial fibrillation. The client has a potassium level of 4.6 mEq/L. Which would be the nurse's next action? 1. The dose should be omitted for that day 2. The dose should be administered as prescribed 3. The client needs a dose of potassium before receiving the digoxin 4. The dose should be withheld and the primary health care provider notified.

2. The dose should be administered as prescribed

A client with heart failure is being discharged to home and will be taking furosemide. The nurse determines that teaching has been effective if the client makes which statement? 1. "I will take my pulse every day." 2. "I will measure my urine output." 3. "I will weigh myself every day." 4. "I will check my ankles every day for swelling."

3. "I will weigh myself every day."

A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium. The nurse is told that the client's prothrombin time is 18 seconds with a control of 11 seconds. Which action would the nurse plan? 1. Double the next dose of warfarin sodium 2. Withhold the next dose of warfarin sodium 3. Administer the next dose of warfarin sodium 4. Cut the next dose of warfarin sodium in half

3. Administer the next dose of warfarin sodium

A client is diagnosed with pulmonary embolism and is to be treated with thrombolytic therapy. The nurse would report which priority data collection finding to the registered nurse before initiating this therapy? 1. Adventitious breath sounds 2. Temperature of 99.4°F orally 3. Blood pressure of 198/110 mm Hg 4. Respiratory rate of 28 breaths per minute

3. Blood pressure of 198/110 mm Hg

A client with aldosteronism has been instructed on spironolactone treatment. Which client statement indicates that the client needs further teaching about the medication? 1. "My potassium level will increase." 2. "This medication will make me void frequently." 3. "My blood pressure should get back to normal." 4. "This medication will decrease my blood glucose."

4. "This medication will decrease my blood glucose."

A client is experiencing impotence after taking an antihypertensive medication. The client states, "I would sooner have a stroke than keep living with the side effects of this medication." The nurse would make which appropriate response to the client? 1. "I can understand completely" 2. "You wouldn't really want to have a stroke" 3. "That health care provider should change your prescription" 4. "You are concerned about the side effects of your medication?"

4. "You are concerned about the side effects of your medication?"

The nurse is caring for a client who has been prescribed furosemide and is monitoring for adverse effects associated with this medication. Which would the nurse recognize as potential adverse effects? Select all that apply. 1. Nausea 2. Tinnitus 3. Hypotension 4. Hypokalemia 5. Photosensitivity 6. Increased urinary frequency

2. Tinnitus 3. Hypotension 4. Hypokalemia

Cycloserine is added to the medication regimen for a client with tuberculosis. Which instruction would the nurse reinforce in the client-teaching plan regarding this medication? 1. To take the medication before meals 2. To return to the clinic weekly for serum drug-level testing 3. It is not necessary to restrict alcohol intake with this medication 4. It is not necessary to call the primary health care provider (PHCP) if a skin rash occurs.

2. To return to the clinic weekly for serum drug-level testing

The nurse is caring for the client diagnosed with tuberculosis (TB). Rifampin, 600 mg by mouth daily is prescribed for the client. The nurse reinforces instructions to the client regarding the administration of this medication. Which statement by the client indicates an understanding of the instructions? 1. "I need to limit alcohol intake" 2. "I need to take the medication with meals" 3. "I will need to take the medication for months" 4. "I need to call the primary health care provider if the color of my urine turns red-orange"

3. "I will need to take the medication for months"

Warfarin sodium has been prescribed for a client, and the nurse teaches the client and family about the medication. Which statement by the client indicates a need for further teaching? 1. "I won't participate in games such as football anymore." 2. "I'll use an electric shaver until the anticoagulant is discontinued." 3. "I will not take any over-the-counter medications except aspirin." 4. "I will buy a Medic-Alert tag that indicates I'm on anticoagulants."

3. "I will not take any over-the-counter medications except aspirin."

Nifedipine has been prescribed for a client with Raynaud's disease, and the nurse reinforces medication instructions with the client about the medication. Which statement by the client indicates a need for further teaching? 1. "I will contact my doctor if I get short of breath." 2. "I will call my doctor if I get headaches that worsen." 3. "Nausea and drowsiness are expected, and if they occur, I don't really need to worry about it." 4. "I need to get up slowly when I change positions because the medicine causes hypotension."

3. "Nausea and drowsiness are expected, and if they occur, I don't really need to worry about it."

The nurse is reinforcing discharge teaching to a client who was given a prescription for nifedipine for blood pressure management. Which instructions would the nurse reinforce? Select all that apply. 1. "Increase water intake." 2. "Increase calcium intake." 3. "Take pulse rate each day." 4. "Weigh at the same time each day." 5. "Palpitations may occur early in therapy." 6. "Be careful when rising from sitting to standing."

3. "Take pulse rate each day." 4. "Weigh at the same time each day." 5. "Palpitations may occur early in therapy." 6. "Be careful when rising from sitting to standing."

The nurse is checking a client who is taking theophylline for possible toxicity. Which signs and symptoms indicate theophylline toxicity? Select all that apply. 1. Flushing 2. Insomnia 3. Headache 4. Decreased wheezing 5. Nausea and vomiting 6. Serum theophylline level of 19 mcg/mL

1. Flushing 2. Insomnia 3. Headache 5. Nausea and vomiting

The nurse provides medication instructions to an older hypertensive client who is taking 20 mg of lisinopril orally daily. The nurse evaluates the need for further teaching when the client makes which statement? 1. "I can skip a dose once a week." 2. "I need to change my position slowly." 3. "I take the pill after breakfast each day." 4. "If I get a bad headache, I should call my health care provider immediately."

1. "I can skip a dose once a week."

The nurse is reinforcing dietary instructions to a client who is taking triamterene. The nurse instructs the client that it is acceptable to consume which food item daily? 1. Apple 2. Banana 3. Avocado 4. Baked potato

1. Apple

The nurse is preparing to administer furosemide to a client with a diagnosis of heart failure. Which is the most important laboratory test result for the nurse to review before administering this medication? 1. Potassium level 2. Creatinine level 3. Cholesterol level 4. Blood urea nitrogen (BUN)

1. Potassium level

A hospitalized client with angina continues to have chest pain after the initial administration of a sublingual nitroglycerin tablet. The nurse would take which action? 1. Provide a second sublingual dose in 5 minutes 2. Continue dosing at 10-minute intervals for 1 hour 3. Instruct the client to swallow the next tablet whole 4. Use distraction techniques such as deep breathing and imagery

1. Provide a second sublingual dose in 5 minutes

A client with angina pectoris who was given a first dose of newly prescribed nitroglycerin sublingual tablets complains of slight dizziness and headache. The nurse takes which action first? 1. Takes the client's blood pressure 2. Tells the client not to worry about it 3. Reports the findings to the health care provider 4. Gives the client a dose of acetaminophen prescribed as needed (PRN).

1. Takes the client's blood pressure

A client with no history of heart disease has experienced an acute myocardial infarction and been given thrombolytic therapy with tissue plasminogen activator (tPA). The nurse interprets that the client is likely experiencing a complication of this therapy if which occurs? 1. Tarry stools 2. Orange-colored urine 3. Nausea and vomiting 4. Decreased urine output

1. Tarry stools

A client has begun therapy with theophylline. The nurse tells the client to limit the intake of which while taking this medication? 1. Oranges and pineapple 2. Coffee, cola, and chocolate 3. Oysters, lobster, and shrimp 4. Cottage cheese, cream cheese, and dairy creamers

2. Coffee, cola, and chocolate

A child is being sent home on digoxin after being diagnosed with a congenital heart defect. The medication needs to be given once a day. Which would the nurse reinforce in the teaching plan for the family? 1. "You may give the medication using a medication dropper." 2. "Give the medication in the morning 20 to 30 minutes before a feeding." 3. "If your child vomits the dose, repeat the dose and then resume the schedule in the morning." 4. "If you forget to give the medication in the morning, omit the dose and resume it the following morning."

2. "Give the medication in the morning 20 to 30 minutes before a feeding."

The nurse has reinforced instructions to a client receiving enalapril maleate. Which statement by the client indicates a need for further teaching? 1. "I need to rise slowly from a lying to sitting position." 2. "I need to notify the primary health care provider if nausea occurs." 3. "I need to notify the primary health care provider if a sore throat occurs." 4. "I know that several weeks of therapy may be required for the full therapeutic effect."

2. "I need to notify the primary health care provider if nausea occurs."

A client has a prescription to take guaifenesin every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client makes which statement? 1. "I will watch for irritability as a side effect." 2. "I will take the tablet with a full glass of water." 3. "I will take an extra dose if the cough is accompanied by fever." 4. "I will crush the sustained-release tablet if immediate relief is needed."

2. "I will take the tablet with a full glass of water."

The nurse caring for a child with nephrotic syndrome reviews the medication record. The nurse notes that prazosin hydrochloride is prescribed for the child. The nurse determines that this medication has been prescribed to achieve which result? 1. Reduce proteinuria 2. Control hypertension 3. Decrease inflammation 4. Suppress the autoimmune response

2. Control hypertension

A client arrives at the health care clinic for follow-up care and evaluation of the effectiveness of prazosin. Which finding indicates a therapeutic effect related to the use of this medication? 1. Increased platelet count 2. Decrease in blood pressure 3. Increased red blood cell count 4. Decrease in blood glucose level

2. Decrease in blood pressure

A hospitalized client states he has chest pain, and the nurse notes a prescription for "sublingual nitroglycerin 1 tablet every 5 minutes times 3 to relieve chest pain prn." How would the nurse administer the medication? 1. Place 3 pills under the tongue and reassess for relief in 5 minutes 2. Place one pill under the tongue and reassess for relief in 5 minutes 3. Administer one pill with a sip of water and reassess for relief in 5 minutes 4. Place one pill in the mouth against the mucous membranes of the cheek and assess for relief in 5 minutes

2. Place one pill under the tongue and reassess for relief in 5 minutes

The nurse is providing instructions to a client taking ethambutol about the medication. The nurse instructs the client to contact the primary health care provider immediately if which occurs? 1. Orange urine 2. Visual disturbances 3. Hearing disturbances 4. Distressing gastrointestinal (GI) side effects

2. Visual disturbances

The nurse is monitoring a client receiving spironolactone by mouth daily. Which data would indicate to the nurse that the client is experiencing a side effect related to the medication? 1. Client complaints of dry skin 2. A sodium level of 140 mEq/L 3. A potassium level of 5.2 mEq/L 4. Client complaints of constipation

3. A potassium level of 5.2 mEq/L

A client is taking brompheniramine. The nurse reinforces instructions to the client to expect which side effect of this medication? 1. Diarrhea 2. Excitability 3. Drowsiness 4. Excess salivation

3. Drowsiness

A physician tells the nurse that a potassium-retaining diuretic is being prescribed for the client with heart failure. The nurse reviews the health care physician's prescriptions expecting that which medication will be prescribed? 1. Furosemide 2. Ethacrynic acid 3. Spironolactone 4. Hydrochlorothiazide

3. Spironolactone

A client who takes a diuretic every evening expresses frustration with the medication and wants to stop therapy. When the nurse explores the reasoning, the client says, "It keeps me up all night. I feel as though I should bring my pillow into the bathroom!" Which action can the nurse suggest to assist the client in successfully adapting to this therapy? 1. Limiting oral fluids before bedtime 2. Taking a sleep aid with the medication 3. Switching to a morning administration of the medication 4. Asking the primary health care provider for a new brand of medication

3. Switching to a morning administration of the medication

Isosorbide mononitrate is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. Which action would the nurse suggest to the client? 1. Cut the dose in half 2. Discontinue the medication 3. Take the medication with food 4. Contact the primary health care provider (PHCP)

3. Take the medication with food

A 1-year-old child has been prescribed digoxin to treat heart failure (HF). When would the nurse plan on withholding the prescribed dose of the medication? 1. A dose is missed by more than 1 hour 2. The child has a fever greater than 101°F 3. The child's pulse is less than 80 beats per minute 4. The child's pulse is more than 100 beats per minute.

3. The child's pulse is less than 80 beats per minute

A client has arrived at the emergency department complaining of weakness, an irregular heartbeat, and lethargy. The nurse is attempting to discover what caused these symptoms. The nurse asks the client "Have you been prescribed any new medications?" The client tells the nurse "About 2 weeks ago I was prescribed a drug to make me pee, but I don't know the name." The nurse determines that the client is referring to which medication? 1. Lanoxin 2. Metoprolol 3. Oxybutynin 4. Furosemide

4. Furosemide

The nurse is monitoring a client who is receiving a dose of an adrenergic bronchodilator. The nurse plans to monitor for which side effect of this medication? 1. Drowsiness 2. Hypokalemia 3. Hyperglycemia 4. Increased pulse and blood pressure

4. Increased pulse and blood pressure

A client with chronic atrial fibrillation is being started on maintenance therapy with atenolol for dysrhythmia suppression. The nurse determines that the client needs further teaching about this medication when making which statement? 1. "I will take the dose at the same time each day." 2. "I will avoid sudden discontinuation of this medication." 3. "I will take the medication with food if GI upset occurs." 4. "I can stop taking the prescribed digoxin after starting this new medication."

4. "I can stop taking the prescribed digoxin after starting this new medication."

A client takes digoxin 0.25 mg by prescription every day. When the nurse enters the client's room with the medication, the client's meal tray is untouched and the client says he has no appetite. Which action is the most appropriate? 1. Check the client's temperature, radical pulse rate, and respiratory rate 2. Administer one half the prescribed amount to avoid digoxin toxicity 3. Offer to bring back the digoxin to the client when his appetite improves 4. Listen to the client's apical pulse. If it is less than 60 beats per minute, withhold the medication

4. Listen to the client's apical pulse. If it is less than 60 beats per minute, withhold the medication

The nurse has completed client teaching about heart failure and prescribed medications that include digoxin and furosemide. The nurse documents that the teaching goals have been met if the client states knowing to report which symptom? 1. Sudden increase in appetite 2. Cough that accompanies a cold 3. High urine output during the day 4. Weight gain of 2 to 3 pounds in a few days

4. Weight gain of 2 to 3 pounds in a few days

A client with a prescription to take theophylline daily has been given medication instructions by the nurse. The nurse determines that the client needs further teaching about the medication if the client makes which statement? 1. "I will take the daily dose at bedtime" 2. "I will drink at least 2 L of fluid per day" 3. "I will avoid over-the-counter (OTC) cough and cold medications unless approved by the PHCP" 4. "I will avoid changing brands of the medication without primary health care provider (PHCP) approval"

1. "I will take the daily dose at bedtime"

A client is scheduled to receive digoxin 0.125 mg by mouth. The licensed practical nurse (LPN) reads the medication label and notes that each tablet contains 0.25 mg. The LPN would perform which action? 1. Administer half of a medication tablet 2. Administer two tablets of the medication 3. Withhold the medication and call the pharmacy regarding the medication 4. Withhold the medication and notify the registered nurse regarding the medication.

1. Administer half of a medication tablet

A client has been given a prescription for gemfibrozil. The nurse plans to instruct the client to limit intake of which food while taking this medication? 1. Fish 2. Beef 3. Spicy foods 4. Citrus products

2. Beef

The nurse is reinforcing medication instructions to a client who has been prescribed simvastatin. Which is the action of simvastatin? 1. It inhibits hepatic synthesis of cholesterol 2. It increases lipid metabolism of cholesterol 3. It sequesters fat in the colon, promoting fecal excretion of cholesterol 4. It increases glomerular filtration promoting renal excretion of cholesterol

1. It inhibits hepatic synthesis of cholesterol

The nurse is monitoring a client receiving furosemide 40 mg orally daily. Which indicator would inform the nurse that a therapeutic effect has occurred? 1. A sodium level of 130 mEq/L 2. A potassium level of 3.1 mEq/L 3. The presence of dependent edema 4. A blood pressure of 128/80 mm Hg

4. A blood pressure of 128/80 mm Hg

A client has a prescription to receive albuterol, two puffs and beclomethasone dipropionate, two puffs by metered-dose inhaler. Which would the nurse plan when administering these medications? 1. Administering the albuterol before the beclomethasone dipropionate 2. Administering the beclomethasone dipropionate before the albuterol 3. Alternating a single puff of each hourly, beginning with the albuterol 4. Alternating a single puff of each hourly, beginning with the beclomethasone dipropionate

1. Administering the albuterol before the beclomethasone dipropionate

A potassium-retaining diuretic is prescribed for a client with heart failure. Which foods would the nurse instruct the client to avoid? 1. Plums 2. Bananas 3. Cranberry juice 4. Cheddar cheese

2. Bananas

A client is being discharged with a prescription for propranolol. When reinforcing instructions to the client about the medication, the nurse would include which information? 1. Gentle exercising will prevent orthostatic hypotension 2. Hot baths and showers are advised to increase vasodilation 3. Medication should be taken on an empty stomach to enhance absorption 4. Medication should be withheld if the pulse rate drops below 60 beats per minute.

4. Medication should be withheld if the pulse rate drops below 60 beats per minute.

The nurse is discharging a client from the hospital who was given a prescription for atorvastatin. The nurse would tell the client to report which adverse effect to the primary health care provider immediately? 1. Tiredness and fatigue 2. Flushing and redness 3. Flatulence and constipation 4. Muscle pain and weakness

4. Muscle pain and weakness

A client is taking cetirizine hydrochloride. The nurse would check for which side effect of this medication? 1. Diarrhea 2. Excitability 3. Drowsiness 4. Excess salivation

3. Drowsiness

The nurse is giving discharge instructions to a client concerning theophylline. Which client statement indicates a need for further teaching? 1. "I need to learn how to take my pulse." 2. "I will start a smoking cessation program." 3. "I will take my pill in the morning at breakfast." 4. "I need to drink plenty of fluids, so I will drink more coffee and tea."

4. "I need to drink plenty of fluids, so I will drink more coffee and tea."

A client is taking ticlopidine hydrochloride. The nurse tells the client to avoid which substance while taking this medication? 1. Vitamin C 2. Vitamin D 3. Acetaminophen 4. Acetylsalicylic acid

4. Acetylsalicylic acid

A client with heart failure who is taking furosemide and digoxin calls the nurse and complains of anorexia and nausea. The nurse would take which action? 1. Administer an antiemetic 2. Hold the morning dose of furosemide 3. Administer the daily dose of digoxin 4. Check the result of the potassium level drawn 3 hours ago

4. Check the result of the potassium level drawn 3 hours ago

The nurse is administering a dose of a prescribed diuretic to an assigned client. The nurse would plan to monitor the client for hypokalemia as a side effect of therapy if the client is receiving which medication? 1. Bumetanide 2. Triamterene 3. Amiloride HCL 4. Spironolactone

1. Bumetanide

The nurse is collecting data from a client with hypertension being treated with diuretic therapy. The nurse would monitor the client for hypokalemia if the client is receiving which diuretic? 1. Bumetanide 2. Triamterene 3. Amiloride HCl 4. Spironolactone

1. Bumetanide

Levalbuterol via inhalation is prescribed for a client with a diagnosis of emphysema. The nurse reinforces instructions to the client regarding the medication and teaches the client about the dietary restrictions that must be implemented while taking this medication. The nurse determines that the client understands the dietary instructions when the client states he will avoid which food choice? 1. Cocoa 2. Bananas 3. Orange juice 4. Baked potatoes

1. Cocoa

A client is being treated with atenolol for hypertension. The client tells the nurse, "I am very tired and weak since I began taking the medication." Based on the client's statement, the nurse determines that the client is experiencing which problem? 1. Common side effect 2. Signs and symptoms of the flu 3. Difficulty with clearing the airway 4. Lack of support services for assistance at home

1. Common side effect

The nurse is reviewing laboratory results of a digoxin level for the client taking digoxin. The digoxin level is 2.5 ng/mL, which indicates digoxin toxicity. Which signs and symptoms would the nurse note? Select all that apply. 1. Nausea 2. Syncope 3. Polyphagia 4. Bradycardia 5. Constipation

1. Nausea 2. Syncope 4. Bradycardia

A client is receiving digoxin daily. The nurse suspects digoxin toxicity after noting which signs and symptoms? Select all that apply. 1. Visual disturbances 2. Nausea and vomiting 3. Apical pulse rate of 63 beats per minute 4. Serum digoxin level of 2.3 ng/mL (2.93 nmol/L) 5. Serum potassium level of 3.9 mEq/L (3.9 mmol/L)

1. Visual disturbances 2. Nausea and vomiting 4. Serum digoxin level of 2.3 ng/mL (2.93 nmol/L)

A client with angina pectoris has just been started on medication therapy with nitroglycerin. In planning care for this client, the nurse would place priority on measuring which data? 1. Vital signs 2. Serum glucose 3. Intake and output 4. Therapeutic serum drug levels

1. Vital signs

The nurse is preparing to administer digoxin to an infant with heart failure (HF). Before administering the medication, the nurse double-checks the dose, counts the apical heart rate for 1 full minute, and obtains a rate of 88 beats per minute. Based on this finding, which is the appropriate nursing action? 1. Withhold the medication 2. Administer the medication 3. Double-check the apical heart rate and administer the medication 4. Check the blood pressure and respirations and administer the medication.

1. Withhold the medication

A client with tuberculosis (TB) will be treated with isoniazid and rifampin. The nurse is reinforcing instructions for the client regarding these medications. Which statement would the nurse plan to provide to the client? 1. "You must take the medication with meals." 2. "The entire prescribed course of the medication needs to be completed." 3. "You must discontinue the medication if gastrointestinal (GI) irritation occurs." 4. "Fluids must be increased while taking this medication to prevent renal failure."

2. "The entire prescribed course of the medication needs to be completed."

The nurse prepares to administer digoxin to a 3-year-old with a diagnosis of heart failure and notes that the apical heart rate is 120 beats per minute. Which nursing action is appropriate? 1. Hold the medication. 2. Administer the digoxin. 3. Notify the registered nurse. 4. Recheck the apical heart rate in 15 minutes.

2. Administer the digoxin.

A client is being treated for heart failure and is receiving digoxin. The client's vital signs are blood pressure 85/50 mm Hg, pulse 96 beats per minute, and respirations 26 breaths per minute. To evaluate therapeutic effectiveness of this medication, the nurse would expect which change in the client's vital signs? 1. Blood pressure 85/50 mm Hg, pulse 60 beats per minute, respirations 26 breaths per minute 2. Blood pressure 98/60 mm Hg, pulse 80 beats per minute, respirations 24 breaths per minute 3. Blood pressure 130/70 mm Hg, pulse 104 beats per minute, respirations 20 breaths per minute 4. Blood pressure 110/40 mm Hg, pulse 110 beats per minute, respirations 20 breaths per minute

2. Blood pressure 98/60 mm Hg, pulse 80 beats per minute, respirations 24 breaths per minute

A client is being treated for moderate hypertension and has been taking diltiazem for several months. The client is seen by the primary health care provider, and Prinzmetal's angina is diagnosed. The nurse is instructing the client about diltiazem. Which client statement indicates a need for further teaching? 1. "I have to be careful getting out of my recliner." 2. "I need to avoid hazardous activities until I don't get dizzy." 3. "I have to limit my coffee, but I can drink all the fruit juice I want." 4. "I will take and record my blood pressure and pulse every morning."

3. "I have to limit my coffee, but I can drink all the fruit juice I want."

A client is being discharged following treatment for left-sided heart failure. The nurse is reinforcing teaching the client the purpose, actions, adverse effects, and use of digoxin and hydrochlorothiazide prescribed for daily use. Which statement by the client indicates a need for further teaching? 1. "These medications will cause an increase in urine output." 2. "I should take my radial pulse before taking these medications." 3. "I should decrease my intake of foods high in potassium such as bananas." 4. "These medications should be taken in the morning rather than in the evening."

3. "I should decrease my intake of foods high in potassium such as bananas."

The nurse has a prescription to give a client albuterol (two puffs) and beclomethasone dipropionate (two puffs) by metered-dose inhaler. How much time would the nurse place between administering the albuterol and the beclomethasone dipropionate? 1. 1 minute 2. 2 minutes 3. 5 minutes 4. Administer immediately

3. 5 minutes

A client with an exacerbation of chronic obstructive pulmonary disease (COPD) has been on oral glucocorticoids and is being weaned to triamcinolone by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change when the client states to monitor for which? 1. Chills, fever, generalized rash 2. Blurred vision, headache, and insomnia 3. Anorexia, nausea, weakness, and fatigue 4. Vomiting and diarrhea and increased thirst

3. Anorexia, nausea, weakness, and fatigue

A client with a history of hypertension has been prescribed triamterene. The nurse determines that the client understands the effect of this medication on the diet if the client states to avoid which fruit? 1. Pears 2. Apples 3. Bananas 4. Cranberries

3. Bananas

A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which vital sign is most important for the nurse to check before administering a second dose of the medication? 1. Temperature 2. Respirations 3. Blood pressure 4. Radial pulse rate

3. Blood pressure

The nurse is reviewing the medication profile of a client taking theophylline. Which medications can increase the risk of theophylline toxicity? Select all that apply. 1. Rifampin 2. Phenytoin 3. Cimetidine 4. Corticosteroids 5. Fluoroquinolones

3. Cimetidine 4. Corticosteroids 5. Fluoroquinolones

A client is being discharged home, and the health care provider has prescribed spironolactone for the client. The nurse reinforces instructions to the client about the medication. Which statement by the client indicates a need for further teaching by the nurse? 1. "I know I should contact my doctor if I develop a rash while taking this medication." 2. "My doctor told me that I should sit on the side of the bed in the morning before standing up." 3. "I know I need to weigh myself every day when I get home because of the medication." 4. "I know I need to eat foods that are high in potassium because of the diuretic effect of the medication."

4. "I know I need to eat foods that are high in potassium because of the diuretic effect of the medication."

A client with chronic atrial fibrillation is being started on amiodarone as maintenance therapy for dysrhythmia suppression. The nurse reinforces instructions to the client about the medication. Which statement by the client indicates a need for further teaching? 1. "I will need to have routine follow-up with my ophthalmologist." 2. "I will need to use sunscreen and protective clothing when outside." 3. "I will periodically have blood drawn to monitor my thyroid function." 4. "I will stop taking the prescribed anticoagulant after starting this new medication."

4. "I will stop taking the prescribed anticoagulant after starting this new medication."

Albuterol, two puffs and fluticasone propionate, two puffs by metered-dose inhaler have been prescribed for a client with chronic obstructive pulmonary disease. The nurse caring for the client provides instructions regarding administration of the medication. Which statement by the client indicates an understanding of how to take these medications? 1. "I will alternate a single puff of each, beginning with the albuterol." 2. "I will alternate a single puff of each, beginning with the fluticasone propionate." 3. "I will take the two puffs of the fluticasone propionate first and then the two puffs of the albuterol." 4. "I will take the two puffs of the albuterol first and then the two puffs of the fluticasone propionate."

4. "I will take the two puffs of the albuterol first and then the two puffs of the fluticasone propionate."

The nurse is reviewing the postoperative prescriptions for a client who has just returned from surgery and notes that the surgeon has prescribed lepirudin. Which is this medication prescribed to prevent? 1. Pain 2. Nausea 3. Respiratory complications 4. Thromboembolic complications

4. Thromboembolic complications

The nurse is reviewing the primary health care provider's (PHCP) prescriptions for a client scheduled for a cardiac catheterization and notes that the PHCP has prescribed tirofiban. The nurse understands that this medication has been prescribed for which purpose? 1. To prevent infection 2. To prevent bleeding 3. To prevent dysrhythmias 4. To inhibit thrombus formation

4. To inhibit thrombus formation

The nurse is planning to administer amlodipine to a client. The nurse would plan to check which before giving the medication? 1. Respiratory rate 2. Blood pressure and heart rate 3. Heart rate and respiratory rate 4. Level of consciousness and blood pressure

2. Blood pressure and heart rate

The nurse is assisting in preparing a diet plan for a client who is taking the anticoagulant, warfarin. The nurse instructs the client to limit which food from the diet? 1. Pasta 2. Broccoli 3. Oranges 4. Potatoes

2. Broccoli

A hospitalized client with allergic asthma has been started on cromolyn sodium inhaler. The nurse assists in preparing a plan of care and includes monitoring for undesirable side effects associated with the use of this medication. The nurse places the highest priority on monitoring for which side effect? 1. Cough 2. Bronchospasm 3. Throat irritation 4. Nasal congestion

2. Bronchospasm

A client has taken his first dose of lisinopril about 2 hours ago and begins to develop fullness in his face and hoarseness. Which action would the nurse take first? 1. Ask the client when the hoarseness first developed 2. Determine the client's ability to breathe effectively 3. Determine the client's blood pressure to determine effectiveness 4. Instruct the client to stay in the resting position to prevent dizziness

2. Determine the client's ability to breathe effectively

The nurse is planning to administer hydrochlorothiazide to a client. Which are concerns related to the administration of this medication? 1. Hypouricemia, hyperkalemia 2. Hypokalemia, hyperglycemia, sulfa allergy 3. Hypokalemia, increased risk of osteoporosis 4. Hyperkalemia, hypoglycemia, penicillin allergy

2. Hypokalemia, hyperglycemia, sulfa allergy

A child with a right-to-left cardiac shunt is receiving propranolol. The health care provider visits the child and writes prescriptions in the child's record. The licensed practical nurse (LPN) reviews the prescriptions and notes that the child is placed on a nothing-by-mouth (NPO) status. The LPN consults with the registered nurse and prepares to monitor which parameter closely? 1. Sodium level 2. Glucose level 3. Blood urea nitrogen 4. White blood cell count

2. Glucose level

A client has been taking isoniazid for 2 months. The client complains to the nurse about numbness, paresthesia, and tingling in the extremities. The nurse interprets that the client is experiencing which problem? 1. Hypercalcemia 2. Peripheral neuritis 3. Small blood vessel spasm 4. Impaired peripheral circulation

2. Peripheral neuritis

A primary health care provider (PHCP) writes a prescription for digoxin, 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to do which? 1. Count the radial and carotid pulses every morning 2. Check the blood pressure every morning and evening 3.Stop taking the medication if the pulse is higher than 100 beats per minute 4. Withhold the medication and call the PHCP if the pulse is less than 60 beats per minute.

4. Withhold the medication and call the PHCP if the pulse is less than 60 beats per minute.

A client is receiving acetylcysteine, 20% solution diluted in 0.9% normal saline by nebulizer. The nurse would have which item available for a possible adverse event after giving this medication? 1. Ambu bag 2. Intubation tray 3. Nasogastric tube 4. Suction equipment

4. Suction equipment

The nurse is attending an in-service education session on the therapeutic use of calcium-channel blockers. The instructor of the session determines that teaching has been effective when the nurse correctly identifies that these medications are used for which disorders? Select all that apply. 1. Angina 2. Glaucoma 3. Hypertension 4. Dysrhythmias 5. Acute kidney injury 6. Glomerulonephritis

1. Angina 3. Hypertension 4. Dysrhythmias

The nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states to report which occurrence immediately? 1. Impaired sense of hearing 2. Problems with visual acuity 3. Gastrointestinal (GI) side effects 4. Red-orange discoloration of body secretions

2. Problems with visual acuity

The client is to begin a 6-month course of therapy with isoniazid. The nurse would plan to provide which information to the client? 1. Drink alcohol in small amounts only 2. Report yellow eyes or skin immediately 3. Increase intake of Swiss or aged cheeses 4. Avoid vitamin supplements during therapy.

2. Report yellow eyes or skin immediately

A client with tuberculosis is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse ensures that which baseline study has been completed? 1. Electrolyte levels 2. Coagulation times 3. Liver enzyme levels 4. Serum creatinine level

3. Liver enzyme levels

A client is being treated for acute heart failure with intravenously administered bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats per minute; and respirations, 24 breaths per minute. After the initial dose, which is the priority assessment? 1. Monitoring weight loss 2. Monitoring temperature 3. Monitoring blood pressure 4. Monitoring potassium level

3. Monitoring blood pressure

Warfarin sodium is prescribed for a client. The nurse expects that the primary health care provider will prescribe which laboratory tests to monitor for a therapeutic effect of the medication? Select all that apply. 1. D-dimer 2. Platelet count 3. Prothrombin time (PT) 4. International normalized ratio (INR) 5. Activated partial thromboplastin time (aPTT)

3. Prothrombin time (PT) 4. International normalized ratio (INR)

A client is monitoring a client receiving theophylline to treat symptoms of chronic obstructive pulmonary disease (COPD). Which adverse effects require immediate consultation with the primary health care provider? Select all that apply. 1. Anxiety 2. Diarrhea 3. Seizures 4. Insomnia 5. Irregular heartbeat

3. Seizures 5. Irregular heartbeat

The client has been prescribed nifedipine. The nurse is instructing the client about nifedipine. Which client statement indicates a need for further teaching? 1. "I need to avoid alcohol and grapefruit juice." 2. "My doctor will taper my dosage before stopping it." 3. "I need to change my position slowly so I won't get dizzy." 4. "If I see empty tab shells in my stool, I need to report it to my doctor."

4. "If I see empty tab shells in my stool, I need to report it to my doctor."

A client who is taking hydrochlorothiazide has also been prescribed triamterene. The client asks the nurse why both medications are required. Which response is the most accurate to give to the client? 1. Both are weak potassium-excreting diuretics 2. The combination of these medications prevents renal toxicity 3. Hydrochlorothiazide is an expensive medication, so using a combination of diuretics is cost-effective 4. Triamterene is a potassium-retaining (sparing) diuretic, whereas hydrochlorothiazide is a potassium-excreting diuretic

4. Triamterene is a potassium-retaining (sparing) diuretic, whereas hydrochlorothiazide is a potassium-excreting diuretic