NCLEX Questions for Exam 2
A patient with nonvalvular atrial fibrillation is to be discharged on dabigatran etexilate [Pradaxa]. Which statement should the nurse include in the discharge teaching? A) "The medication must be stored in the manufacturer-supplied bottle." B) "Once a new bottle is opened, the capsules maintain efficacy for 90 days." C) "If you have difficulty swallowing the capsule, you can open it and mix it with food." D) "You will need to learn how to give yourself a subcutaneous injection in your abdomen."
A) "The medication must be stored in the manufacturer-supplied bottle."
A nurse instructs a female patient with peptic ulcer disease who is to start a treatment regimen that includes ranitidine [Zantac] and bismuth subsalicylate [Pepto-Bismol]. Which statement by the patient indicates that the teaching has been effective? A) "While I'm taking these medications, my bowel movements could look black." B) "I have a medicine at home to take when I start having some loose diarrhea stools." C) "I'm so glad that my allergies will be helped while I'm taking these medications." D) "I'll include more calcium and vitamin D in my diet to prevent osteoporosis."
A) "While I'm taking these medications, my bowel movements could look black."
A patient with angina pectoris has been prescribed nifedipine [Procardia].Which possible adverse effects should the nurse expect with this medication? (Select all that apply.) A) Headache B) Constipation C) Nausea and vomiting D) Edema of ankles and feet E) Overgrowth of gum tissue
A) Headache D) Edema of ankles and feet E) Overgrowth of gum tissue
The nurse understands patients receiving nitroglycerin are at risk for which adverse effects? (Select all that apply.) A) Headache B) Wheezing C) Dizziness D) Tachycardia E) Bradycardia
A) Headache C) Dizziness D) Tachycardia
Which discharge instructions should the nurse include for a patient prescribed cholestyramine [Questran]? A) Mix the drug with water or juice. B) Take with all other morning medications. C) Take 325 mg of aspirin 30 minutes before each dose. D) Notify the healthcare provider if upper abdominal discomfort occurs.
A) Mix the drug with water or juice.
The nurse is administering intravenous lidocaine [Xylocaine] to a patient with a ventricular dysrhythmia. What is the priority nursing intervention to prevent a potential complication with this drug? A) Monitor the electrocardiogram (ECG). B) Obtain a complete blood count. C) Instruct to report any chest pain. D) Keep naloxone [Narcan] at the bedside.
A) Monitor the electrocardiogram (ECG).
The healthcare provider prescribes heparin 2500 units subcutaneous daily. The drug is available in 10,000 units per mL. How may milliliters will the nurse give? (Fill in the blank and record your answer using one decimal place.) __________________________
0.25 mL
The patient's heparin is infusing at 11 mL/hr. The bag of fluid is mixed 25,000 units of heparin in 250 mL D5W. What hourly dose is the patient receiving? (Fill in the blank and record your answer.) __________________________
1100 units/hour
he healthcare provider prescribes heparin 900 units/hr. The label on the IV bag reads Heparin 10,000 units in 500 mL D5W. How many mL/hr will deliver the correct dose? (Fill in the blank and record your answer.) _________________________
45 mL
The healthcare provider prescribes lovastatin [Mevacor] for a patient discharged from the hospital post-myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan? (Select all that apply.) A) "Do not start any new medications without first talking to your healthcare provider." B) "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." C) "Take your medication in the morning, with a full glass of water for best results." D) "Take one 325-mg aspirin 30 minutes before your dose to lessen the problem of flushing and itching that can occur with this drug." E) "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains."
A) "Do not start any new medications without first talking to your healthcare provider." B) "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." E) "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains."
The nurse is teaching a patient with essential hypertension who has a new prescription for verapamil [Calan]. Which statements by the patient indicate that the teaching was effective? (Select all that apply.) A) "I will increase my intake of fluid and foods high in fiber." B) "I should stay out of direct sunlight to prevent exposing my skin to the sun." C) "I will call my healthcare provider if I notice swelling in my ankles." D) "I need to avoid salt substitutes and potassium supplements." Incorrect E) "I may notice easy bruising and bleeding with this drug."
A) "I will increase my intake of fluid and foods high in fiber." C) "I will call my healthcare provider if I notice swelling in my ankles."
A patient with angina is being discharged with a prescription for nitroglycerin sublingual tablets. Which instruction should the nurse include? A) "Store the tablets in the original container and tightly close it after use." B) "The tablets are only good for 1 month after the container is opened." C) "Sublingual nitroglycerin tablets are also effective when swallowed whole." Incorrect D) "Effects of sublingual nitroglycerin begin in 5 to 10 minutes."
A) "Store the tablets in the original container and tightly close it after use."
The nurse is caring for a group of patients taking warfarin [Coumadin]. Which patients are at moderate to high risk for harm as a result of warfarin therapy? (Select all that apply.) A) A patient with variant genes that code for VKORC1 and CYP2CP B) A patient with a current INR of 2.2 treated for deep vein thrombosis C) A woman with a new onset of symptoms of a pulmonary embolus D) A patient on day 4 after hip replacement with a new order for warfarin E) A patient with a prosthetic heart valve, for whom an interacting drug is being deleted from the regimen
A) A patient with variant genes that code for VKORC1 and CYP2CP C) A woman with a new onset of symptoms of a pulmonary embolus E) A patient with a prosthetic heart valve, for whom an interacting drug is being deleted from the regimen
The nurse is preparing to administer a daily dose of digoxin [Lanoxin]. What is the priority nursing intervention? A) Analyze heart rate and rhythm. B) Assess for Homans' sign. C) Check blood pressure. D) Palpate the pedal pulses.
A) Analyze heart rate and rhythm.
Which drug is the most effective for lowering LDL cholesterol? A) Atorvastatin [Lipitor] B) Cholestyramine [Questran] C) Gemfibrozil [Lopid] D) Ezetimibe [Zetia]
A) Atorvastatin [Lipitor]
What is the most common sustained dysrhythmia among the U.S. population? A) Atrial fibrillation B) Atrial flutter C) Sustained supraventricular tachycardia (SVT) D) Ventricular premature beats (VPBs)
A) Atrial fibrillation
Which patient symptoms should cause the nurse to be concerned about digoxin [Lanoxin] toxicity? (Select all that apply.) A) Fatigue B) Vomiting C) Dizziness D) Blurred vision E) Muscle weakness
A) Fatigue B) Vomiting D) Blurred vision
The nurse is preparing to administer an oral dose of digoxin [Lanoxin]. The apical pulse rate is 64. What nursing action is most appropriate? A) Give the medication. B) Obtain a serum digoxin level. C) Notify the healthcare provider. D) Assess for signs of digoxin toxicity.
A) Give the medication.
A patient who has gastroesophageal reflux disease (GERD) is taking magnesium hydroxide (milk of magnesia). Which outcome should a nurse expect if the medication is achieving the desired therapeutic effect? A) Neutralized gastric acid B) Reduced stomach motility C) Increased barrier to pepsin D) Reduced duodenal pH
A) Neutralized gastric acid
The nurse is providing discharge teaching for a patient with a new prescription for a nitroglycerin transdermal patch. Which statement by the patient indicates a need for further teaching? A) "I will remove my patch at bedtime each evening." B) "I will limit my alcohol to one drink per day." C) "I will not use Viagra as long as I am on nitroglycerin." D) "I will move slowly when changing positions."
B) "I will limit my alcohol to one drink per day."
In which part of the conduction pathway in a healthy heart is the electrical impulse delayed to provide time for the blood to fill the ventricles? A) Bundle of His B) AV node C) Purkinje system D) Internodal pathways
B) AV node
A patient develops supraventricular tachycardia (SVT) and is hypotensive. Which medication should the nurse anticipate will be administered? A) Lidocaine [Xylocaine] B) Adenosine [Adenocard] C) Amiodarone [Cordarone] D) Phenytoin [Dilantin]
B) Adenosine [Adenocard]
A patient is prescribed hydralazine [Apresoline] for the treatment of essential hypertension. Which expected adverse effects should the nurse discuss with the patient? (Select all that apply.) A) Nausea B) Fatigue C) Dizziness D) Headache E) Joint pain
B) Fatigue C) Dizziness D) Headache
Instruction by the nurse regarding alcohol abstinence is essential when a patient will be discharged taking which medication? A) Tetracycline B) Metronidazole C) Bismuth subsalicylate D) Clarithromycin
B) Metronidazole
The healthcare provider prescribes an intravenous dose of diltiazem [Cardizem] for treatment of a patient with atrial fibrillation. What is the priority nursing intervention? A) Assist with cardioversion. B) Monitor electrocardiogram. C) Obtain baseline coagulation studies. D) Assess for increased urinary output.
B) Monitor electrocardiogram.
The nurse is caring for a patient receiving clopidogrel [Plavix] to prevent blockage of coronary artery stents. Which other drug on the patient's medication administration record may reduce the antiplatelet effects of clopidogrel? A) Aspirin [Bayer] B) Omeprazole [Prilosec] C) Acetaminophen [Tylenol] D) Warfarin [Coumadin]
B) Omeprazole [Prilosec]
The nurse is interpreting an electrocardiogram (ECG). Which component represents the depolarization of the ventricles? A) P wave B) QRS complex C) ST segment D) T wave
B) QRS complex
The nurse is caring for a patient receiving amiodarone [Cordarone]. Which body system should the nurse assess for serious adverse effects of this medication? A) Musculoskeletal B) Respiratory C) Integumentary D) Gastrointestinal
B) Respiratory
The heart undergoes cardiac remodeling during the initial phase of heart failure. Which cardiac geometric change occurs during heart failure? A) Ventricular constriction B) Ventricular wall thickening C) Ventricular atrophy D) Ventricles become more cylindric
B) Ventricular wall thickening
hich needle length and gauge should the nurse choose to administer subcutaneous heparin? A) ½ inch; 20 gauge B) ⅝ inch; 25 gauge C) 1½ inch; 18 gauge D) 1 inch; 26 gauge
B) ⅝ inch; 25 gauge
Which instruction about clopidogrel [Plavix] should the nurse include in the discharge teaching for a patient who has received a drug-eluting coronary stent? A) "Constipation is a common side effect of clopidogrel, so take a stool softener daily." B) "If you see blood in your urine or black stools, stop the clopidogrel immediately." C) "Check with your healthcare provider before taking any over-the-counter medications for gastric acidity." D) "Keep the amount of food containing vitamin K, such as mayonnaise, canola and soybean oil, and green, leafy vegetables, consistent in your diet."
C) "Check with your healthcare provider before taking any over-the-counter medications for gastric acidity."
The nurse is caring for a patient receiving nitrates for relief of angina. What pharmacodynamic action is responsible for the relief of anginal pain with nitrates? A)Vasoconstriction leads to improved cardiac output. B) Decreased force of contraction leads to decreased oxygen demand. C) Vasodilation leads to decreased preload, which decreases oxygen demand. D) Influx of calcium ions leads to relaxation of vascular smooth muscle.
C) Vasodilation leads to decreased preload, which decreases oxygen demand.
he nurse is caring for a patient prescribed digoxin [Lanoxin] for heart failure. Which finding would require immediate attention by the nurse? A) Potassium level of 3.7 mEq/L B) Digoxin level of 0.7 ng/mL C) Vomiting and diarrhea D) Heart rate of 68 beats/min
C) Vomiting and diarrhea
The nurse is caring for a patient who takes warfarin [Coumadin] for prevention of deep vein thrombosis. The patient has an international normalized ratio (INR) of 1.2. Which action by the nurse is most appropriate? A) Administer intravenous (IV) push protamine sulfate. B) Continue with the current prescription. C) Prepare to administer vitamin K. D) Call the healthcare provider to increase the dose.
D) Call the healthcare provider to increase the dose.
A patient with cardiovascular disease is taking rosuvastatin [Crestor]. The nurse is monitoring for potential adverse effects. Which finding indicates a potential adverse effect of this drug? A) Blood pressure of 140/90 mm Hg B) Wheezing and shortness of breath C) Platelet count of 100 × 103/mm3 D) Muscle pain and tenderness
D) Muscle pain and tenderness
The patient's heparin is infusing at 28 mL/hr. The bag of fluid is mixed 20,000 units of heparin in 500 mL D5W. What hourly dose is the patient receiving? (Fill in the blank and record your answer.) _________________________
1120 units/hour
The laboratory calls to report a drop in the platelet count to 90,000/mm3 for a patient receiving heparin for the treatment of postoperative deep vein thrombosis. Which action by the nurse is the most appropriate? A) Notify the healthcare provider to discuss the reduction or withdrawal of heparin. B) Call the healthcare provider to discuss increasing the heparin dose to achieve a therapeutic level. C) Obtain vitamin K and prepare to administer it by intramuscular (IM) injection. D) Observe the patient and monitor the activated partial thromboplastin time (aPTT) as indicated.
A) Notify the healthcare provider to discuss the reduction or withdrawal of heparin.
A patient in a hypertensive crisis is being started on a continuous sodium nitroprusside [Nipride] infusion. Which interventions are essential before the nurse administers nitroprusside [Nipride]? (Select all that apply.) A) Obtain a baseline weight and weigh daily. B) Prepare for arterial line insertion. C) Discontinue the infusion when blood pressure is controlled. D) Observe for signs of hypertrichosis during the infusion. E) Cover the solution with an opaque bag.
A) Obtain a baseline weight and weigh daily. B) Prepare for arterial line insertion. E) Cover the solution with an opaque bag.
A nurse administers which medication to inhibit an enzyme that makes gastric acid in a patient who has a duodenal ulcer? A) Omeprazole [Prilosec] B) Famotidine [Pepcid] C) Misoprostol [Cytotec] D) Ranitidine [Zantac]
A) Omeprazole [Prilosec]
A patient is receiving continuous heparin infusion for venous thromboembolism treatment. Which laboratory results should the nurse monitor? (Select all that apply.) A) Platelets B) Vitamin K C) Prothrombin time (PT) D) International normalized ratio (INR) E) Activated partial thromboplastin time (aPTT)
A) Platelets E) Activated partial thromboplastin time (aPTT)
A nurse should associate which factors with the pathophysiology of peptic ulcer disease? (Select all that apply.) A) Poor submucosal gastric blood flow B) Presence of Zollinger-Ellison syndrome C) Reduced stomach production of bicarbonate D) Increased synthesis of prostaglandins E) Gastrointestinal (GI) tract colonized with Haemophilus influenzae
A) Poor submucosal gastric blood flow B) Presence of Zollinger-Ellison syndrome C) Reduced stomach production of bicarbonate
Which are beneficial effects that can be derived from simvastatin [Zocor] and other drugs in this class? (Select all that apply.) A) Reduction of LDLs B) Elevation of HDLs C) Stabilization of the plaque in coronary arteries D) Reduction of risk of cardiovascular events E) Improvement of liver function
A) Reduction of LDLs B) Elevation of HDLs C) Stabilization of the plaque in coronary arteries D) Reduction of risk of cardiovascular events
The nurse is caring for a patient who has been receiving intravenous sodium nitroprusside [Nitropress] for 3 days. Which assessment data indicate the patient may be experiencing thiocyanate toxicity? A) Sudden confusion B) Difficulty breathing C) Erythematous rash D) Gastrointestinal bleeding
A) Sudden confusion
In the failing heart, arterial pressure falls, stimulating the baroreceptor reflex to increase sympathetic nervous system activity. The nurse understands increased sympathetic activity will produce which response? A) Tachycardia B) Bradypnea C) Hypotension D) Hypoglycemia
A) Tachycardia
A patient is being discharged from the hospital on warfarin [Coumadin] for deep vein thrombosis prevention. Which instructions should the nurse include in the patient's discharge teaching plan? (Select all that apply.) A) Wear a medical alert bracelet. B) Check all urine and stool for discoloration. C) Do not start any new medication without first talking to your healthcare provider. D) Enteric-coated aspirin and any aspirin products can be used unless they cause a gastrointestinal ulcer. E) No laboratory or home monitoring of international normalized ratio (INR) is required after the first 6 months.
A) Wear a medical alert bracelet. B) Check all urine and stool for discoloration. C) Do not start any new medication without first talking to your healthcare provider.
Which instructions should the nurse include when developing a teaching plan for a patient prescribed diltiazem [Cardizem] for atrial fibrillation? (Select all that apply.) A) Weigh yourself daily at the same time each day. B) The medication will not cause dizziness or headache. C) Notify the healthcare provider if a skin rash develops. D) Do not take daily oral calcium supplements. E) Rise slowly from a lying to a sitting position.
A) Weigh yourself daily at the same time each day. C) Notify the healthcare provider if a skin rash develops. E) Rise slowly from a lying to a sitting position.
Which medication is not associated with prolongation of the QT interval? A) Dofetilide [Tikosyn] B) Sotalol [Betapace] C) Diltiazem [Cardizem] D) Dronedarone [Multaq]
C) Diltiazem [Cardizem]
The nurse is teaching a patient who has just been prescribed a vasodilator. Which statement by the patient indicates that the teaching was effective? A) "I can take this medication in the morning to reduce nighttime urination." B) "I will rise slowly when changing from a sitting to a standing position." C) "My heart rate may slow down with this drug. I will call if my pulse is below 60." D) "I need to increase my intake of fluids and foods that are high in fiber."
B) "I will rise slowly when changing from a sitting to a standing position."
The nurse is ready to begin a heparin infusion for a patient with evolving stroke. The baseline activated partial thromboplastin time (aPTT) is 40 seconds. Which aPTT value indicates that a therapeutic dose has been achieved? A) 50 B) 70 C) 90 D) 110
B) 70
About which patient should the nurse notify the healthcare provider immediately? A) A patient who takes digoxin [Lanoxin] 0.125 mg orally daily with a serum digoxin level of 0.8 ng/mL Incorrect B) A patient who takes oral spironolactone [Aldactone] 25 mg daily and enalapril [Vasotec] 5 mg daily with a serum potassium level of 5.5 mEq/L C) A patient who takes digoxin [Lanoxin] 0.25 mg orally daily with a serum potassium level of 4.0 mEq/L D) A patient who takes oral lisinopril [Zestril] 5 mg daily and digoxin 0.125 mg daily with a serum digoxin level of 0.5 ng/mL
B) A patient who takes oral spironolactone [Aldactone] 25 mg daily and enalapril [Vasotec] 5 mg daily with a serum potassium level of 5.5 mEq/L
Which of the following administration techniques would be appropriate when giving a sucralfate [Carafate] tablet to a patient with a duodenal ulcer? (Select all that apply.) A) Crush the tablet into a fine powder before mixing it with water. B) Administer the tablet with sips of water 1 hour before meals. C) Allow the tablet to dissolve in water before administering it. D) Administer the tablet with an antacid for maximum benefit. E) Break the tablet in half so it is easier to swallow.
B) Administer the tablet with sips of water 1 hour before meals. C) Allow the tablet to dissolve in water before administering it. E) Break the tablet in half so it is easier to swallow.
A patient is receiving isosorbide dinitrate [Isordil] 20 mg 3 times/day for management of newly diagnosed stable angina. Which assessment finding would require an immediate nursing intervention? A) A change in blood pressure from 122/70 to 108/66 mm Hg B) An increase in the resting heart rate to 110 beats/min from baseline rates of 68 to 72 beats/min C) A headache the patient rates as a 5 on a pain scale of 0 to 10 Incorrect D) Report of increased frequency of urination
B) An increase in the resting heart rate to 110 beats/min from baseline rates of 68 to 72 beats/min
Which are the main types of drugs used to prevent or relieve anginal pain? (Select all that apply.) A) Platelet inhibitors B) Beta blockers C) Nitrates D) Calcium channel blockers E) Statins
B) Beta blockers C) Nitrates D) Calcium channel blockers
What is the primary benefit of spironolactone [Aldactone] in patients with heart failure? A) Increase in diuresis and fluid loss B) Blockage of aldosterone receptors C) Inhibition of beta activation by norepinephrine D) Stimulation of the renin-angiotensin-aldosterone system
B) Blockage of aldosterone receptors
The nurse is caring for a patient who is receiving enteral feedings because of dysphagia. The healthcare provider prescribes isosorbide mononitrate [Imdur] 60 mg SR daily via the enteral tube. What is the most appropriate action by the nurse? A) Have the patient swallow the pill, because it cannot be crushed. B) Call the healthcare provider about an alternate form of nitrate for administration. C) Crush the Imdur into a fine powder, dilute it with water, and administer it via the enteral tube. Incorrect D) Place the nitrate under the patient's tongue and let it dissolve, because the person has dysphagia.
B) Call the healthcare provider about an alternate form of nitrate for administration.
A nurse assesses a male patient who has developed gynecomastia while receiving treatment for peptic ulcers. Which medication from the patient's history should the nurse recognize as a contributing factor? A) Amoxicillin [Amoxil] B) Cimetidine [Tagamet] C) Metronidazole [Flagyl] D) Omeprazole [Prilosec]
B) Cimetidine [Tagamet]
The nurse is reviewing the prescriber's orders and notes that omeprazole [Prilosec] has been ordered for a patient admitted with acute coronary syndrome (ACS). The nurse should be concerned if this medication is combined with which medication noted on the patient's record? A) Aspirin 81 mg daily B) Clopidogrel [Plavix] 75 mg daily C) Heparin 5000 units subQ every 12 hours D) Metoprolol 50 mg every 8 hours
B) Clopidogrel [Plavix] 75 mg daily
The nurse is caring for a patient prescribed a cholesterol-lowering drug. Which drug is least likely to cause systemic side effects? A) Simvastatin [Zocor] B) Colesevelam [Welchol] C) Nicotinic acid [Niaspan] D) Gemfibrozil [Lopid]
B) Colesevelam [Welchol]
A nurse monitors a patient who has peptic ulcer disease and is taking antibacterial medications. If the treatment has been effective, the patient's breath test result should reveal the absence of what? A) Bicarbonate B) H. pylori C) Histamine2 D) Prostaglandins
B) H. pylori
A patient with deep vein thrombosis receiving an intravenous (IV) heparin infusion asks the nurse how this medication works. What is the nurse's best response? A) Heparin prevents the activation of vitamin K and thus blocks synthesis of some clotting factors. B) Heparin suppresses coagulation by helping antithrombin perform its natural functions. C) Heparin works by converting plasminogen to plasmin, which in turn dissolves the clot matrix. D) Heparin inhibits the enzyme responsible for platelet activation and aggregation within vessels.
B) Heparin suppresses coagulation by helping antithrombin perform its natural functions.
A patient admitted with deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) requires immediate anticoagulation. What medication would be appropriate for this patient who has a history of heparin-induced thrombocytopenia (HIT)? A) Warfarin [Coumadin] B) Lepirudin [Refludan] C) Bivalirudin [Angiomax] D) Eptifibatide [Integrilin]
B) Lepirudin [Refludan]
.ID: 18689985961 The nurse is caring for a patient receiving a nitroprusside [Nipride] intravenous infusion. The patient's wife asks why furosemide [Lasix] is being prescribed along with this drug. The nurse's response is based on which concept? A) Furosemide will help reduce reflex tachycardia. B) Many vasodilators cause retention of sodium and water. C) Thiocyanate may accumulate in patients receiving nitroprusside. D) Vasodilators can cause serious orthostatic hypotension.
B) Many vasodilators cause retention of sodium and water.
The nurse reviews the patient's medication record and notes the following: sucralfate [Carafate] 1 gram orally 4 times daily before meals (7:30 AM, 11:30 AM, and 4:30 PM) and at bedtime (10:00 PM); phenytoin [Dilantin] 200 mg orally daily at 8 AM. Which modifications, if any, should be made to the medication regimen? A) The medications can be administered as ordered. B) The nurse should obtain a prescriber order to administer the phenytoin at 9:30 AM daily. C) The nurse should obtain a prescriber order for intravenous phenytoin to avoid a drug interaction. D) The nurse should administer the phenytoin with the 7:30 AM dose of sucralfate [Carafate], because this is more time efficient.
B) The nurse should obtain a prescriber order to administer the phenytoin at 9:30 AM daily.
A patient diagnosed with a pulmonary embolism is receiving a continuous heparin infusion at 1000 units/hr. Of which findings should the nurse immediately notify the healthcare provider? (Select all that apply.) A) aPTT of 65 seconds B) aPTT of 40 seconds C) Nosebleeds D) aPTT of 100 seconds E) Platelet count of 300,000/mcL
B) aPTT of 40 seconds C) Nosebleeds D) aPTT of 100 seconds
A nurse should give which nonmedication instruction to a patient who has peptic ulcers? A) "Reduce your intake of caffeine-containing beverages, such as coffee and colas." B) "Take a nonsteroidal anti-inflammatory drug once a day to help with pain." C) "It would be better to eat five or six small meals a day instead of three larger ones." D) "An ulcer diet of bland foods with milk and cream products will speed healing."
C) "It would be better to eat five or six small meals a day instead of three larger ones."
The nurse is teaching a group of patients about dietary approaches to reduce cholesterol levels. Which statement is most important to include in the teaching? A) "Lower your cholesterol to 300 mg/day." B) "Eliminate red meat and pork from your diet." C) "Read food labels and reduce your intake of saturated fats." D) "Reduce salt consumption to keep your sodium intake to 2400 mg/day."
C) "Read food labels and reduce your intake of saturated fats."
Which instruction should the nurse give a patient who is to take bismuth subsalicylate for eradication of H. pylori? A) "Nausea and diarrhea are common side effects." B) "Do not drink alcohol while taking this medication." C) "The drug can cause your bowel movements to be black." D) "Take the medication through a straw to prevent staining of your teeth."
C) "The drug can cause your bowel movements to be black."
What should the nurse include in the discharge teaching for a patient prescribed amiodarone [Cordarone]? (Select all that apply.) A) "Take amiodarone with grapefruit juice." B) "Take the medication on an empty stomach." C) "Wear sunblock and protective clothing when you are outdoors." D) "Check your pulse daily and report excessive slowing to your healthcare provider immediately." E) "Immediately notify your healthcare provider of shortness of breath, cough, or chest pain."
C) "Wear sunblock and protective clothing when you are outdoors." D) "Check your pulse daily and report excessive slowing to your healthcare provider immediately." E) "Immediately notify your healthcare provider of shortness of breath, cough, or chest pain."
A patient with an acute myocardial infarction is prescribed an intravenous (IV) bolus of tenecteplase [TNKase]. The patient weighs 160 lb. The nurse will administer what dosage? A) 30 mg B) 35 mg C) 40 mg D) 45 mg
C) 40 mg
A patient who has peptic ulcer disease and is receiving magnesium hydroxide (milk of magnesia) is experiencing an increased number of bowel movements. Which is the nurse's priority action? A) Ask the healthcare provider for a reduction in dose. B) Encourage the patient to increase dietary fiber. C) Administer the drug with an aluminum hydroxide antacid. D) Instruct the patient to keep an accurate stool count.
C) Administer the drug with an aluminum hydroxide antacid.
A patient with an elevated triglyceride level is prescribed a sustained-release form of nicotinic acid [Slo-Niacin]. Which laboratory value is most important for the nurse to monitor for in this patient? A) Blood urea nitrogen (BUN) B) Complete blood count (CBC) C) Alanine aminotransferase (ALT) D) Creatine kinase (CK)
C) Alanine aminotransferase (ALT)
The nurse is caring for several patients. For which patient diagnosis would a prescription for nifedipine [Adalat] be least appropriate? A) Angina pectoris B) Essential hypertension C) Atrial fibrillation D) Vasospastic angina
C) Atrial fibrillation
Calcium channel blockers work by reducing calcium influx into the cells of the heart and blood vessels. Calcium channels are coupled to which type of autonomic nervous system receptors? A) Alpha1 B) Alpha2 C) Beta1 D) Beta2
C) Beta1
Which assessment finding is most important for the nurse to obtain before administering hydralazine [Apresoline]? A) Peripheral pulses B) Homans' sign C) Blood pressure D) Capillary refill
C) Blood pressure
A patient presents to the emergency department with symptoms of acute myocardial infarction. After a diagnostic workup, the healthcare provider prescribes a 15-mg IV bolus of alteplase (tPA), followed by 50 mg infused over 30 minutes. In monitoring this patient, which finding by the nurse most likely indicates an adverse reaction to this drug? A) Urticaria, itching, and flushing B) Blood pressure of 90/50 mm Hg C) Decreasing level of consciousness D) Potassium level of 5.5 mEq/L
C) Decreasing level of consciousness
The nurse is caring for a patient prescribed quinidine [Quinaglute] for a supraventricular dysrhythmia. What is a common adverse effect of this drug? A) Constipation Incorrect B) Urinary retention C) Diarrhea D) Blurred vision
C) Diarrhea
Which medication combination is useful in the treatment of variant angina? A) Metoprolol [Lopressor] and ranolazine [Ranexa] Incorrect B) Isosorbide dinitrate [Isordil] and metoprolol [Lopressor] C) Diltiazem [Cardizem] and isosorbide mononitrate [Imdur] D) Propranolol [Inderal] and diltiazem [Cardizem]
C) Diltiazem [Cardizem] and isosorbide mononitrate [Imdur]
The nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding most likely relates to an adverse effect of heparin? A) Heart rate of 60 beats/min B) Blood pressure of 160/88 mm Hg C) Discolored urine D) Inspiratory wheezing
C) Discolored urine
The nurse is planning care for a patient at risk for dysrhythmias. The nurse understands that the Cardiac Arrhythmia Suppression Trial (CAST) confirmed which finding? A) Most atrial rhythm problems should be treated with medication. B) After a myocardial infarction, all dysrhythmias should be treated. C) Dysrhythmias should be treated only when they are symptomatically significant. D) Most rhythm problems result in bradydysrhythmias.
C) Dysrhythmias should be treated only when they are symptomatically significant.
The nurse knows that which statement is accurate for enoxaparin [Lovenox]? A) It equally reduces the activity of thrombin and factor Xa. B) It has selective inhibition of factor Xa and no effect on thrombin. C) It reduces the activity of factor Xa more than the activity of thrombin. D) It has a lower bioavailability and shorter half-life than unfractionated heparin.
C) It reduces the activity of factor Xa more than the activity of thrombin.
The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis? A) Very-low-density lipoprotein (VLDL) B) Apolipoprotein B-100 C) Low-density lipoprotein (LDL) D) High-density lipoprotein (HDL)
C) Low-density lipoprotein (LDL)
An 80-year-old patient with a history of renal insufficiency recently was started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication? A) +3 pitting edema B) Pain with urination C) New onset of disorientation to time and place D) Heart rate changes from a baseline of 70 to 80 beats/min (bpm) to 110 to 120 bpm
C) New onset of disorientation to time and place
What is the most appropriate nursing consideration for a patient who is prescribed verapamil [Calan] and digoxin [Lanoxin]? A) Restrict intake of oral fluids and high-fiber food. B) Take an apical pulse for 30 seconds before administration. C) Notify the healthcare provider of nausea, vomiting, and visual changes. D) Hold the medications if the heart rate is greater than 110 beats/min.
C) Notify the healthcare provider of nausea, vomiting, and visual changes.
Amiodarone [Cordarone] is prescribed for a patient with atrial fibrillation. What is the most important nursing intervention before administering this medication? A) Document an ophthalmic examination was performed. Incorrect B) Explain a dermatologic evaluation is needed. C) Obtain baseline serum thyroid and liver function studies. D) Maintain NPO for transesophageal echocardiogram (TEE).
C) Obtain baseline serum thyroid and liver function studies.
he nurse is caring for a patient who takes spironolactone [Aldactone] and quinapril [Accupril] for treatment of heart failure. What finding indicates a potential interaction between these two drugs? A) Elevated serum quinapril level B) Heart rate of 58 beats/min C) Potassium level of 5.7 mEq/L D) Glucose level of 180 mg/dL
C) Potassium level of 5.7 mEq/L
The nurse is monitoring a patient receiving ranolazine [Ranexa] for angina. Which assessment finding indicates an adverse effect of this drug? A) Blood pressure of 90/50 mm Hg B) Frequent bloody stools C) QT prolongation on the electrocardiogram D) Respiratory rate of 11 breaths per minute
C) QT prolongation on the electrocardiogram
A patient with hypertensive emergency is admitted to the hospital. Which medication should the nurse be prepared to administer to this patient? A) Minoxidil [Loniten] B) Hydralazine [Apresoline] C) Sodium nitroprusside [Nipride] D) Hydralazine and isosorbide dinitrate [BiDil]
C) Sodium nitroprusside [Nipride]
The nurse provides discharge instructions to a patient prescribed verapamil [Calan] SR 120 mg PO daily for essential hypertension. Which statement by the patient indicates understanding of the medication? A) "I will take the medication with grapefruit juice each morning." B) "I should expect occasional loose stools from this medication." C) "I'll need to reduce the amount of fiber in my diet." D) "I must make sure I swallow the pill whole."
D) "I must make sure I swallow the pill whole."
The nurse is caring for a patient prescribed gemfibrozil [Lopid]. For which patient should the nurse question the use of this drug? A) A patient with cardiovascular disease and elevated triglycerides B) A patient with elevated very-low-density lipoprotein (VLDL) levels C) A patient with elevated triglycerides who has not responded to dietary changes D) A patient with history of gallstones and elevated triglycerides
D) A patient with history of gallstones and elevated triglycerides
The patient is admitted for the management of a hypertensive emergency. The healthcare provider prescribes sodium nitroprusside [Nipride] drug therapy. What is the priority nursing action during this treatment? A) Observe for respiratory depression. B) Monitor the electrocardiogram for tachycardia. C) Initiate oxygen therapy via nasal cannula at 2 L/min. D) Adjust the intravenous infusion rate to the blood pressure response.
D) Adjust the intravenous infusion rate to the blood pressure response.
The home health nurse observes the patient for proper use of topical nitroglycerin ointment. Which action by the patient indicates the need for further teaching? A) Rotates the application sites to minimize skin irritation. B) Uses the applicator paper to measure the prescribed dose. C) Removes ointment from a previous dose before applying the next dose. D) Applies the prescribed ribbon of ointment to the applicator paper and places it on the chest.
D) Applies the prescribed ribbon of ointment to the applicator paper and places it on the chest.
A patient with heart failure has developed a cough while taking an angiotensin-converting enzyme (ACE) inhibitor. The health care provider discontinued the ACE inhibitor and prescribed an angiotensin II receptor blocker (ARB) as an alternative to the ACE inhibitor. The patient continues to have symptoms of heart failure despite using an ARB. Which medication should the nurse anticipate will be prescribed? A) Eplerenone [Inspra] B) Triamterene [Dyrenium] C) Hydrochlorothiazide [Microzide] D) BiDil [Isosorbide Dinitrate and Hydralazine]
D) BiDil [Isosorbide Dinitrate and Hydralazine]
In which situation is dronedarone [Multaq] contraindicated? A) PR intervals of 240 msec B) QT intervals of less than 500 msec C) Resting heart rate of 55 beats/min D) Concomitant administration of amitriptyline [Elavil]
D) Concomitant administration of amitriptyline [Elavil]
Which medication is most likely to cause the side effect of constipation? A) Nifedipine [Adalat] B) Amlodipine [Norvasc] C) Isradipine [DynaCirc] D) Diltiazem [Cardizem]
D) Diltiazem [Cardizem]
A nurse is planning care for a patient who has peptic ulcer disease and is taking amoxicillin [Amoxil]. The nurse is aware that the action of this medication is which of the following? A) Inhibition of an enzyme to block acid secretion B) Coating of the ulcer crater as a barrier to acid C) Selective blockade of parietal cell histamine2 receptors D) Disruption of the bacterial cell wall, causing lysis and death
D) Disruption of the bacterial cell wall, causing lysis and death
Fondaparinux [Arixtra] is not approved for use in which circumstance? A) Prevention of deep vein thrombosis (DVT) after knee replacement B) Treatment of acute pulmonary embolism (PE) (in conjunction with warfarin) C) Prevention of deep vein thrombosis (DVT) after abdominal surgery D) Prevention of ischemic complications in patients with unstable angina
D) Prevention of ischemic complications in patients with unstable angina
The nurse is preparing to administer minoxidil [Loniten] 5 mg orally. What is the only cardiovascular indication for this medication? A) Heart failure B) Myocardial infarction C) Angina pectoris D) Severe hypertension
D) Severe hypertension
A nurse is caring for a patient receiving dronedarone [Multaq] for treatment of atrial fibrillation. What electrocardiogram (ECG) change indicates an adverse effect of this medication? A) Previously upright T waves now are inverted. B) Previously rounded, upright P waves now are notched. C) ST segments previously on the baseline now are depressed. D) The QT-interval measurement changes from 400 to 520 msec.
D) The QT-interval measurement changes from 400 to 520 msec.
The nurse is caring for a patient receiving hydralazine [Apresoline]. The healthcare provider prescribes propranolol [Inderal]. The nurse knows that a drug such as propranolol often is combined with hydralazine for what purpose? A) To reduce the risk of headache B) To improve hypotensive effects C) To prevent heart failure D) To protect against reflex tachycardia
D) To protect against reflex tachycardia