Patho Pharm II Exam I
1. Which teaching point should the nurse convey to a client being educated on the ability of the heart to generate an electrical impulse? A) "There are many different parts of your heart that can initiate an electrical impulse." B) "Electrical signals travel along the blood vessels that provide oxygen to your heart." C) "Your heart depends on your brainstem to initiate electrical signals." D) "The lining of your left ventricle is the site where electrical signals usually originate."
A
10. A client with a long-standing diagnosis of asthma is prescribed a beta-blocker for the treatment of angina. The nurse should consequently prioritize assessment for what health problem? A) bronchospasm B) hyperglycemia C) pleural effusion D) pneumonia
A
11. A client has been reading about the use of flax seed to lower cholesterol. What should the client be taught about the use of oat bran and cholestyramine? A) Cholestyramine absorption will be increased with oat bran. B) Cholestyramine absorption will be decreased with oat bran. C) Bleeding will be increased with oat bran and cholestyramine. D) Hypoglycemia will result from oat bran and cholestyramine.
A
12. In some cases, low-dose amiodarone may be used to prevent recurrence of what cardiac disorder? A) atrial fibrillation B) angina pectoris C) ventricular hypertrophy D) mitral valve regurgitation
A
13. A 1-year-old child will receive scheduled MMR vaccination shortly. The nurse should teach the child's parents that the child may develop what possible adverse effect related to the administration of this medication? A) cough and fever B) pallor and listlessness C) serum sickness D) nausea and vomiting
A
13. Which nonpharmacological intervention will best assist in long-term maintenance of a normal sinus rhythm after successful treatment for atrial flutter? A) implantation of a cardioverter-defibrillator B) initiation of an isometric exercise program C) a high-potassium diet D) surgical intervention with a new mitral valve
A
14. A 70-year-old client is seen in the family practice clinic. Which vaccine should be administered to prevent shingles? A) zoster vaccine B) Haemophilus influenzae type b (Hib) vaccine C) human papillomavirus (HPV) D) pneumococcal polyvalent
A
15. The nurse should administer bisoprolol with an understanding that it achieves a therapeutic effect in what way? A) decreasing heart rate B) increasing the force of myocardial contractions C) prolonging the QT interval D) shortening the time required for repolarization
A
16. A client who is recovering in hospital from a bilateral mastectomy has developed minor bleeding at one of the incision sites. During the process of clot formation, plasminogen will become part of a clot by which means? A) by binding with fibrin B) by binding with platelets C) by activating plasmin D) by activating factor VII
A
16. A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of: A) muscle pain. B) dry mouth. C) pruritus (itching). D) increased thirst.
A
17. A 59-year-old client with a long history of heavy alcohol use and angina was diagnosed with liver cirrhosis several months ago. When considering the use of nifedipine, what consideration should the nurse be aware of? A) The client is likely to experience an increased effect of the medication. B) This client will require a higher dose than a client without this medical history. C) Nifedipine is contraindicated because it is highly hepatotoxic. D) The client's increased albumin levels will negate the therapeutic effect.
A
18. A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, "We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk." How should the nurse respond to this family's concerns? A) "Vaccinations are not without some risks, but these are far exceeded by the potential benefits." B) "The potential risks of vaccinations have been investigated and determined to be nonexistent." C) "Unfortunately, state laws mandate that your child receive the full schedule of vaccines." D) "Vaccines indeed cause several serious adverse effects, but these are usually treated at the site where your child receives the vaccination."
A
19. A 59-year-old client with a history of coronary artery disease is undergoing cardiac catheterization. What drug should the nurse most likely prepare for administration when the client suddenly begins exhibiting ventricular tachycardia? A) lidocaine B) magnesium sulfate (MgSO4) C) digoxin D) epinephrine
A
2. A client being treated with warfarin after cardiac surgery is found to have an INR of 9.0. Which medication will be administered to assist in the development of clotting factors? A) vitamin K B) vitamin E C) protamine sulfate D) acetylsalicylic acid (aspirin)
A
2. What is the mechanism of action for medications prescribed to treat a rapid dysrhythmia? A) reducing automaticity B) increasing conduction C) repolarizing myocardial cells D) reducing refractory period
A
2. When teaching clients about the effect of nicotine on the cardiovascular system, the nurse should include what information? A) It increases catecholamines that increase heart rate. B) It diminishes the blood's ability to clot. C) It increases myocardial contractility of the heart. D) It increases high-density lipoproteins.
A
3. A client is to be administered an immunization. The serum contains aluminum phosphate. What route is the most appropriate to administer this immunization? A) intramuscularly B) subcutaneously C) intravenously D) orally
A
4. A client has been administered heparin to prevent thromboembolism development status postmyocardial infarction. The client develops heparin-induced thrombocytopenia. Which medication will be administered? A) argatroban 9 B) vitamin K C) calcium gluconate D) aminocaproic acid
A
4. A client is taking atorvastatin to reduce serum cholesterol. Which aspect of client teaching is most important? A) Call the health care provider if muscle pain develops. B) It is unacceptable to eat dietary fats. C) Decrease the dose if lethargy occurs. D) Eat two eggs per day to increase protein stores.
A
5. A client has begun taking cholestyramine. Which are noted as the most common adverse effects? A) nausea, flatulence, and constipation B) increased appetite and blood pressure C) fatigue and mental disorientation D) hiccups, nasal congestion, and dizziness
A
5. A client is receiving low molecular weight heparin to prevent thromboembolic complications. The nursing student asks the nursing instructor the reason why this treatment is given instead of heparin. What is the instructor's best explanation of the rationale for LMWH over heparin? A) "LMWH is associated with less thrombocytopenia than standard heparin." B) "LMWH is associated with stronger anticoagulant effects than standard heparin." C) "LMWH is given to clients who have a history of blood dyscrasia." D) "LMWH is more effective than standard heparin for clients with hypertension."
A
6. A client, diagnosed with erectile dysfunction, is taking nitroglycerin for chest pain. What is the best explanation for why a nitrate-like sildenafil would be contraindicated? A) "Nitroglycerin and sildenafil cause a severe decrease in blood pressure." B) "Nitroglycerin and sildenafil can lead to prostate cancer." C) "Nitroglycerin decreases the effect of sildenafil for erectile dysfunction." D) "Nitroglycerin and sildenafil will diminish the effectiveness of chest pain relief."
A
7. A client is experiencing chest pain and self-administers nitroglycerin sublingually. When should the client expect to notice relief of the chest pain? A) 1 to 3 minutes B) 5 to 10 minutes C) 15 to 20 minutes D) 30 to 60 minutes
A
7. A client is taking cholestyramine to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which medication? A) digoxin B) ibuprofen C) aspirin D) acetaminophen
A
8. A client is admitted with thrombophlebitis and sent home on enoxaparin therapy. Which statement indicates a good understanding of why enoxaparin is being administered? A) Enoxaparin inhibits the formation of additional clots. B) Enoxaparin eliminates certain clotting factors. C) Enoxaparin decreases the viscosity of blood. D) Enoxaparin will dissolve the existing clots.
A
9. Which single drug class is known to be most effective in reducing the major types of dyslipidemia? A) statins B) bile acid sequestrants C) fibrates D) niacin
A
1. An infant is being administered an immunization. Which statement provides an accurate description of an immunization? A) It should be administered to a pregnant woman prior to the infant's birth. B) It is the administration of an antigen for an antibody response. C) It produces many adverse reactions, particularly autism, in the infant. D) It protects the infant from exposure to infectious antibodies.
B
1. An obese client who has an elevated triglyceride level and reduced high-density lipoprotein cholesterol is seen by the primary care provider. What do these data suggest in this client? A) the development of arthritic syndrome B) the development of metabolic syndrome C) the development of Reye's syndrome D) the development of Tay-Sachs disease
B
10. A client is discharged from the hospital with a prescription of warfarin. Which statement indicates successful client teaching? A) "If I miss a dose, I will take two doses." B) "I will avoid herbal remedies." C) "I will eat spinach or broccoli daily." D) "I will discontinue my other medications."
B
11. Which assessment would be considered a priority for a client receiving amiodarone? A) urine outputs B) heart rate checks C) lung sounds D) muscle rigidity
B
12. A client asks the nurse what dose of acetylsalicylic acid is needed each day for antiplatelet effects to prevent heart attacks. What dose is most appropriate to reduce platelet aggregation? A) 10 mg B) 30 mg C) 625 mg D) 1000 mg
B
13. What principle should guide the nurse's follow-up assessment after administering an oral dose of 30 mg of long-lasting nifedipine? A) Nifedipine has the potential to induce prodysrhythmic effects. B) Nifedipine does not affect heart rate, so assessment after administration is not normally necessary. C) The client's heart rate will be at its lowest approximately 45 minutes to 1 hour after oral administration of nifedipine. D) The client's blood pressure, heart rate, and oxygen saturation level should be assessed 30 minutes after administration of nifedipine.
B
16. A client is seen in the emergency room for a laceration sustained on broken glass. The nurse assesses the client for the last tetanus toxoid he or she received. How often should the client be administered a tetanus toxoid? A) every year B) every 8 years C) every 2 years D) every 5 years
B
16. An older adult client, diagnosed with angina pectoris, has been prescribed nifedipine. After administering a dose of the drug at 08:00, the nurse should anticipate maximum effect at what time? A) between 08:30 and 09:00 B) 09:00 to 10:00 C) between 12:00 and 14:00 D) 11:30 to 12:30
B
17. A 55-year-old man has been diagnosed with coronary artery disease and begun antiplatelet therapy. The man has asked the nurse why he is not taking a "blood thinner like warfarin." What is the most likely rationale for the clinician's use of an antiplatelet agent rather than an anticoagulant? A) Antiplatelet agents do not require the man to undergo frequent blood work; anticoagulants require constant blood work to ensure safety. B) Antiplatelet agents are more effective against arterial thrombosis; anticoagulants are more effective against venous thrombosis. C) Antiplatelet agents are most effective in large vessels; anticoagulants are most effective in the small vessels of the peripheral circulation. D) Antiplatelet agents have fewer adverse effects than anticoagulants.
B
17. The nurse should prepare to facilitate what intervention when a client is prescribed adenosine for the treatment of paroxysmal supraventricular tachycardia? A) cardiac catheterization B) inserting a central venous catheter C) Holter monitoring D) nonstress testing
B
19. A 66-year-old woman's most recent physical assessment and diagnostic workup reveal the presence of dyslipidemia. The woman is a candidate for monotherapy with a statin, and she will soon begin treatment with atorvastatin. The nurse should anticipate what order? A) "atorvastatin 150 mg PO BID" B) "atorvastatin 10 mg PO OD" C) "atorvastatin 50 mg PO TID with meals" D) "atorvastatin 75 mg PO BID"
B
19. A health care worker has received her annual influenza vaccination and has remained at the clinic after administration so that the nurse may observe for adverse reactions. The worker complains of pain at the site of IM injection. The nurse should recommend which of the following? A) ASA B) acetaminophen C) meperidine D) heat application
B
19. When teaching the client to safely administer nitroglycerin ointment, the nurse should convey which instruction? A) "The backs of your hands and the tops of your feet are ideal sites for applying the ointment." B) "Make sure you squeeze the ointment on to a paper measuring scale before applying it." C) "Massage the ointment into your skin for 10 to 15 seconds after applying it." D) "Don't apply the ointment unless you're experiencing chest pain at the time."
B
2. A client has an elevated total serum cholesterol of 260 mg/dL. Which aspect of client teaching of lifestyle changes is most important for the client? A) Eat organic foods. B) Stop smoking. C) Increase rest periods. D) Drink whole milk.
B
20. A 50-year-old man has undergone a bunionectomy and has been admitted to the postsurgical unit. What aspect of the man's medical history would contraindicate the use of heparin for deep vein thrombosis (DVT) prophylaxis? A) The man is morbidly obese. B) The man has a diagnosis of ulcerative colitis (UC). C) The man had a myocardial infarction (MI) 18 months ago. D) The man has a diagnosis of type 2 diabetes mellitus (DM).
B
20. An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy? A) complete blood count (CBC) B) liver panel C) INR and aPTT D) reticulocyte count
B
20. Following the administration of a scheduled dose of 50-mg atenolol PO, the nurse should prioritize what assessment? A) level of consciousness (LOC) B) blood pressure (BP) C) oxygen saturation levels (SaO2) D) oral temperature
B
3. A client with a history of clot formation is scheduled for bowel resection due to colorectal cancer. What anticoagulant agent will be administered prophylactically? A) acetylsalicylic acid B) heparin C) warfarin D) streptokinase
B
4. What medication will most likely be prescribed for a client whose chest pain is not relieved with sublingual organic nitrate? A) intravenous morphine sulfate B) intravenous nitroglycerin C) oral nonsteroidal anti-inflammatory agents D) fentanyl topical patch
B
5. The college health nurse is providing health education for freshmen. Which piece of information about immunizations is applicable to individuals of this age group? A) The oral polio should be updated. B) The yearly administration of flu vaccine is recommended. C) The tetanus toxoid must be within 2 years. D) The administration of hepatitis A vaccine is mandatory.
B
6. A nursing student is scheduled to receive the hepatitis B series. What type of immunity will this immunization provide? A) active immunity B) passive immunity C) innate immunity D) natural immunity
B
7. A client has experienced the formation of clots and has bruising. It is determined that there is a depletion of the client's coagulation factors and widespread bleeding. Which medication will be administered? A) aminocaproic acid B) heparin C) warfarin D) protamine sulfate
B
7. A client is receiving an antidysrhythmic medication intravenously. How often should the client's blood pressure be assessed? A) once per shift B) every 1 to 5 minutes C) every 15 minutes D) every 2 hours
B
8. A client is prescribed fenofibrate. When providing client teaching, which accurately describes the action of fenofibrate? A) It binds to bile acids in the intestinal lumen. B) It increases oxidation of fatty acids in the liver. C) It inhibits an enzyme required for hepatic synthesis. D) It inhibits mobilization of free fatty acids from peripheral tissues.
B
8. Intravenous verapamil has been ordered immediately (STAT) in the treatment of a client experiencing supraventricular tachycardia. In order to ensure client safety, the nurse should be aware that concurrent use of which medication is absolutely contraindicated? A) sodium bicarbonate B) propranolol C) diltiazem D) lidocaine
B
9. An adult client with a long-standing dysrhythmia has been taking oral propranolol for the last several months, resulting in acceptable symptom control. What is a priority teaching point for the nurse to communicate to this client? A) the need to measure his radial pulse for 1 minute prior to each dose of propranolol B) the importance of not stopping the medication abruptly C) the need to avoid taking over-the-counter antacids D) the need to limit his intake of high-potassium foods
B
14. Which assessment findings would prompt the nurse to withhold a scheduled dose of oral atenolol? Select all that apply. A) heart rate of 68 beats per minute B) blood pressure of 88/49 mm Hg C) heart rate of 54 beats per minute D) blood pressure of 141/92 mm Hg E) oxygen saturation of 90% on room air
B, C
20. When teaching new parents about the benefits of adhering to the recommended vaccination schedule for their infant, the nurse should cite protection against which diseases? Select all that apply. A) shingles B) measles C) varicella D) poliomyelitis E) hepatitis B
B, C, D, E
15. A male client has been diagnosed with moderately increased LDL, and his primary care provider wishes to begin him on a statin. What is a potential disadvantage of statins that the care provider should consider? Select all that apply. A) Statins are nephrotoxic. B) Statins are expensive. C) Statins are contraindicated in clients with a history of myocardial infarction. D) Statins require regularly scheduled blood work. E) Statins have an immunosuppressive effect.
B, D
11. A client is being administered heparin IV and has been started on warfarin. The client asks the nurse why she is taking both medications. What is the nurse's most accurate response? A) "After a certain period of time, you must start warfarin and heparin together." B) "You will need both warfarin and heparin for several days." C) "Warfarin takes 3 to 5 days to develop anticoagulant effects, and you still need heparin." D) "Warfarin cannot be given without heparin due to the amount of clotting you need."
C
11. A public health nurse is responsible for the administration of numerous immunizations. Which guideline regarding anaphylaxis should the nurse adhere to? A) The client should be observed for anaphylaxis for 1 minute after administration. B) The client should be observed for anaphylaxis for 5 minutes after administration. C) The client should be observed for anaphylaxis for 30 minutes after administration. D) The client should be observed for anaphylaxis for 90 minutes after administration.
C
12. Which herbal and dietary supplement has shown proven success in lowering LDL and total cholesterol in research studies? A) soy B) flaxseed oil C) red yeast rice D) garlic
C
13. A client is scheduled to have serum triglyceride level assessed. How long should the client be without food or fluids prior to the serum triglyceride test? A) 6 hours B) 8 to 10 hours C) 12 hours D) 24 hours
C
14. Which class IV calcium channel blocker is exclusively administered to treat acute supraventricular tachycardia? A) bethanechol chloride B) chlorambucil C) diltiazem D) midazolam hydrochloride
C
15. A client is taking warfarin to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin monitored? A) RBC B) aPTT C) PT and INR D) platelet count
C
16. A client, diagnosed with digitalis-induced dysrhythmia, has been prescribed magnesium sulfate IV to resolve a low potassium level. What cardiac characteristic should the nurse monitor for to determine if the medication has produced its desired effect? A) decreased QRS complex B) increased stroke volume C) decreased myocardial irritability D) elevated ST segment
C
17. An older adult client is being treated in the hospital for a stroke and is undergoing an extended stay on a rehabilitation unit. The client's spouse has been participating actively in the client's care and performs much of the feeding and hygiene needs. This evening, the spouse has brought in a number of healthy snacks to keep at the client's bedside. Knowing that the client's medication regimen includes simvastatin, the nurse would remove which item? A) purple grapes B) cranberry cocktail C) grapefruit juice D) trail mix (salted nuts and seeds)
C
2. A client is scheduled to receive an immunization. In which client may the administration of a live vaccine be contraindicated? A) client with renal insufficiency B) client with hepatic failure C) client taking steroid therapy D) client over the age of 65 years
C
20. Oral quinidine is prescribed for a client with a diagnosis of chronic ventricular tachycardia without heart block. In order to assess for the safety and efficacy of this treatment, the nurse should prioritize which assessment? A) radial and brachial pulse B) level of consciousness C) serum drug levels D) blood pressure
C
3. The nurse should advocate for a lower-than-normal dose if the client prescribed quinidine has a history of what medical diagnosis? A) type 1 or type 2 diabetes B) primary hypertension C) liver disease D) chronic obstructive pulmonary disease
C
5. A client with a history of angina has sustained a mild head injury in a motor vehicle accident. When the client reports chest pain, what explanation should the nurse provide to support the decision not to treat the angina-related pain with nitroglycerin tablets? A) Nitroglycerin will raise the client's blood pressure. B) Nitroglycerin will cause decreased cerebral edema. C) Nitroglycerin will increase intracranial pressure. D) Nitroglycerin will decrease blood glucose.
C
6. A client experiencing a ventricular dysrhythmia has received a bolus of lidocaine. What is the recommended rate for continuous infusion of lidocaine IV now prescribed for this client? A) 0.27 to 0.75 mg/min B) 10 to 20 mg/min C) 1 to 4 mg/min D) 6 to 8 mg/min
C
6. A client who has been taking a statin has seen an improvement in cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medication regimen? A) digoxin B) vitamin D C) cholestyramine D) calcium carbonate
C
8. What should the client be taught regarding the advantage of the nitroglycerin patch? A) It is only administered one time per week. B) It requires rotation of application site. C) It has a longer duration of action. D) It has a faster action than the tablets.
C
9. The nurse is preparing to administer a vaccine to a newborn. Before administering the vaccine, the nurse should: A) warm the vaccine to well above room temperature. B) vigorously massage the chosen injection site. C) check the infant's temperature. D) divide the dose for administration to three injection sites.
C
9. When will the nurse know that the client has maximal tolerance of isosorbide dinitrate? A) when nausea develops B) when halos are seen around lights C) when a headache develops D) when the heart rate increases to 100
C
1. A client reports substernal chest pain that radiates to the neck. The pain lasts 5 minutes and then subsides with relaxation. What is the most likely cause of the chest pain? A) myocardial infarction B) intermittent claudication C) hypertension D) angina pectoris
D
1. A client, taking warfarin after open heart surgery, tells the home care nurse she has pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of her medications and the report of pain, what should the nurse suspect is the cause of the pain? A) joint thrombosis B) torn medial meniscus C) degenerative joint disease caused by her medication D) bleeding
D
10. A client is taking cholestyramine and ezetimibe. What administration guideline is most important to teach this client? A) The two medications should be taken together. B) The ezetimibe inhibits cholesterol in the liver. C) The cholestyramine is administered 1 hour after ezetimibe. D) The administration of ezetimibe is 1 hour before cholestyramine.
D
10. A nurse is administering a mumps vaccine to an adolescent. Which medication should be available when administering an immunization? A) diphenhydramine B) hydroxyzine C) physostigmine D) epinephrine
D
10. What is a major effect of amiodarone when prescribed for ventricular fibrillation? A) It produces skeletal muscle relaxation. B) It decreases automaticity in the ventricles. C) It stimulates the sympathetic nervous system. D) It slows the process of repolarization.
D
11. A client with angina is prescribed propranolol. Following absorption of the drug, the nurse should monitor the client for what desired effect? A) relief of fatigue B) increased oxygen saturation levels C) mild to moderate drowsiness D) decreased heart rate
D
12. When instructing the parents of a child who has received immunization in the vastus lateralis, which reaction is most common in the days after the administration? A) nausea, vomiting, and diarrhea B) rash and edema C) weakness and difficulty walking D) tenderness and redness at the site
D
12. Which electrocardiogram change should prompt the nurse to question the use of ranolazine for the treatment of a client diagnosed with chronic angina? A) normal ST segment B) inverted P wave C) shortened QRS D) QT prolongation
D
13. A client is prescribed eptifibatide, which inhibits platelet aggregation by preventing activation of GP IIb/IIIa receptors on the platelet surface and the subsequent binding of fibrinogen and von Willebrand factor to platelets. Which syndrome is treated with eptifibatide? A) blocked carotid arteries B) intermittent claudication C) hypertension D) unstable angina
D
14. A client is receiving IV heparin every 6 hours. An activated partial thromboplastin time (aPTT) is drawn 1 hour before the 08:00 dose. The PTT is 92 seconds. What is the most appropriate action by the nurse? A) Give the next two doses at the same time. B) Give the dose and chart the client response. C) Check the client's vital signs and give the dose. D) Hold the dose and call the aPTT result to the health care provider's attention.
D
14. An older adult client, who leads a sedentary lifestyle, has recently been diagnosed with dyslipidemia. The client is disappointed to learn about this condition, stating, "First it was the diabetes and then the arthritis, now this." The nurse has performed health education with the client and has described metabolic syndrome. In addition to the elevated cholesterol levels, what aspect of the client's health is congruent with a diagnosis of metabolic syndrome? A) sedentary lifestyle B) age over 65 C) arthritis D) diabetes mellitus
D
15. A client is administered diltiazem IV, followed by propranolol IV. The nurse should assess for what potential side effect of this medication combination? A) hypertensive crisis B) anaphylaxis C) valve regurgitation D) impaired myocardial contractility
D
15. When providing client teaching to parents regarding measles, mumps, and rubella vaccine administration, which is most important regarding the schedule for administration? A) It is administered at 1 to 2 months. B) It is administered at 3 to 4 months. C) It is administered at 5 to 6 months. D) It is administered at 12 to 15 months.
D
17. When providing a health promotion presentation to a group of seniors, how often should the nurse instruct the senior group to obtain influenza vaccines? A) one time only B) every 10 years C) two times per year D) yearly
D
18. A 48-year-old client with no known history of cardiovascular disease presents with atrial flutter. The client is prescribed propafenone PO 150 mg every 8 hours for 24 hours. What is the cardiac care nurse's priority assessment during this period? A) every 1-hour monitoring of potassium levels B) blood pressure monitoring every 10 minutes C) echocardiography D) continuous ECG monitoring
D
18. A client has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the client has been prescribed cholestyramine. What change in this client's lipid profile will the nurse identify as the most likely goal of therapy? A) reduction in triglycerides B) reduction in total serum cholesterol levels C) increase in HDL levels D) reduction in LDL cholesterol levels
D
18. A nurse at a long-term care facility is conducting a medication reconciliation for a man who has just moved into the facility. The man is currently taking clopidogrel. The nurse is most justified suspecting that this man has a history of: A) hemorrhagic cerebrovascular accident. B) hemophilia A. C) idiopathic thrombocytopenic purpura (ITP). D) myocardial infarction.
D
18. An older adult client whose medical history includes angina experiences a sudden onset of chest pain. This client would most likely administer a dose of nitroglycerin by what route? A) subcutaneous injection B) oral sustained-release tablet C) nebulized inhalation D) transmucosal spray
D
19. A 79-year-old woman has been brought to the emergency department by ambulance with signs and symptoms of ischemic stroke. The care team would consider the immediate (STAT) administration of what drug? A) low molecular weight heparin B) vitamin K C) clopidogrel D) alteplase
D
3. A client with a diagnosis of cardiovascular disease is taking atorvastatin to reduce serum cholesterol. What is the goal of therapy for LDL cholesterol for a client taking atorvastatin calcium? A) 100 to 115 mg/dL B) 75 to 85 mg/dL C) less than 60 mg/dL D) less than 130 mg/dL
D
3. The nurse is teaching the client about coronary artery disease (CAD). Which statement by the client indicates that he or she has understood the teaching? A) "I will avoid exercise because it will precipitate my angina." B) "As long as I take my medicines, I will not need to decrease my fat intake." C) "My high blood pressure has no effect on my episodes of chest pain." D) "High fat in the diet and smoking can cause my episodes of chest pain."
D
4. A client has received a rubella immunization. The client was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this client? A) risk of development of the disease in the newborn B) risk of low infant birth weight C) risk of preterm labor D) risk of birth defects
D
4. The nurse's subsequent cardiac assessments and monitoring of a client prescribed disopyramide should be planned in the knowledge that this drug increases the client's risk for developing what health problem? A) new-onset chest pain B) mitral valve regurgitation C) acute renal failure D) new dysrhythmias
D
5. A client is admitted to the emergency room with a ventricular dysrhythmia associated with an acute myocardial infarction. What assessment should the nurse make prior to administering a bolus of lidocaine IV? A) Assess for lidocaine administration in the client's history. B) Determine the client's ability to swallow. C) Assess the client's nutritional history for allergies. D) Determine if the client has had a reaction to local anesthesia.
D
6. A client who is receiving warfarin has blood in his urinary catheter drainage bag. What medication will likely be ordered by the health care provider? A) aminocaproic acid B) platelets C) protamine sulfate D) vitamin K
D
7. It is important for the nurse to stay informed of the most current recommendations for immunizations. Which source is most accurate regarding immunization guidelines? A) American Academy of Pediatrics B) American Academy of Family Physicians C) American Academy of Infectious Disease Physicians D) Centers for Disease Control and Prevention
D
8. An infant is seen in the clinic for his or her first immunizations. When providing client teaching to the parent, which is no longer recommended for administration? A) rubella and mumps vaccine B) polio vaccine C) diphtheria, pertussis, and tetanus vaccine D) smallpox vaccine
D
9. A client is being discharged from the hospital with warfarin to be taken at home. Which food should the client be instructed to avoid in the diet? A) eggs B) dairy products C) apples D) spinach
D
