Pharm EXAM 2 EAQ and knowledge checks

which instruction would the nurse include when preparing discharge instructions for a client who will take enalapril for hypertension? a. "change to a standing position slowly" b. "this may color your urine green" c. "this medication may cause a sore throat for the first few days" d. "schedule blood tests weekly for the first 2 months"

a. "change to a standing position slowly"

Which food would the nurse instruct a client taking Losartan (ARBs) to avoid? Select all that apply. One, some, or all responses may be correct. a. Alcohol b. Dark green Vegetables c. Grapefruit Juice d. Cheddar cheese

a. Alcohol c. Grapefruit Juice

Which dosage form of nitroglycerin has the longest duration of action? a. Transdermal patch b. Sublingual tablets c. Immediate release tablets. d. Intravenous infusion

a. Transdermal patch

which sign of hypokalemia will the nurse monitor for in a client receiving furosemide? a. chvostek sign b. muscle weakness c. anxious behavior d. abdominal cramping

b. muscle weakness

___ are the drugs of choice to prevent angina

beta blockers

which medication requires the nurse to monitor the client for signs of hyperkalemia? a. furosemide b. metolazone c. spironolactone d. hydrochlorothiazide

c. spironolactone

____ is the drug of choice for terminating angina

nitroglycerin

Digoxin is part of what family of drugs? a. Cardiac glycoside b. Angiotensin-converting enzyme inhibitors c. Angiotensin II receptor blockers d. Beta-blockers

a. Cardiac glycoside

____ is the resistance the ventricles must overcome to eject blood

afterload

which adverse effect would a nurse monitor for when caring for a client with hypertension who is prescribed metoprolol? a. hirsutism b. bradycardia c. restlessness d. angina

b. bradycardia

which important nursing action would be taken after a HCP prescribes losartan for a client? a. assess the client for hypokalemia b. administer the medication with food c. monitor the clients BP d. monitor serum glucose levels

c. monitor the clients BP

Non-pharmacological techniques can help lower blood pressure. Which of the following is Not considered one of these types of techniques? a. Dietary changes b. Limiting cafeine c. Smoking cessation d. Multivitamins

d. Multivitamins

Organic nitrates have multiple mechanisms of action that include: Select all that apply a. Arterial and venous dilatation b. increased myocardial oxygen demand c. Increased peripheral resistance d. Decreased afterload

a. Arterial and venous dilatation d. Decreased afterload

A client is receiving furosemide to relieve edema. The nurse will monitor the client for which responses? Select all that apply a. Excessive loss of potassium ions b. Retention of sodium ions c. Weight loss d. Increased urine specific gravity

a. Excessive loss of potassium ions c. Weight loss

Which food would the nurse instruct a client taking diltiazem to avoid? a. Grapefruit juice b. Cheddar cheese c. Dark green vegetables d. Potatoes

a. Grapefruit juice

which response would the nurse monitor for when a client is receiving furosemide to relieve edema? Select all that apply a. weight loss b. negative nitrogen balance c. increased urine specific gravity d. excessive loss of potassium ions e. pronounced retention of sodium ions

a. weight loss d. excessive loss of potassium ions

Which statement by a patient taking Metoprolol requires the nurse to re-educate the patient about this drug? a. I will change positions slowly while I'm taking this medication." b. After I stop taking this medication I will let my physician know." c. I take this medication with my breakfast every morning. d. While I'm taking this medication I will monitor my heart rate.

b. "After I stop taking this medication I will let my physician know."

Officially, hypertension stage one is diagnosed when the patient demonstrates a systolic blood pressure greater than ______ mm Hg and a diastolic blood pressure greater than _____ mm Hg over a sustained period. a. 110/60 b. 120/70 c. 130/80 d. 140/90

c. 130/80

which data collection assessment would be preformed to evaluate the effectiveness of furosemide administered to a client with congestive heart failure? Select all that apply a. daily weight b. intake and output c. monitor for edema d. daily pulse oximetry e. auscultate breath sounds

a. daily weight b. intake and output c. monitor for edema d. daily pulse oximetry e. auscultate breath sounds

which medication is the likely cause of the symptoms in a client with hypokalemia reporting nausea, vomiting, and seeing a yellow light around objects? a. digoxin b. furosemide c. propranolol d. spironolactone

a. digoxin

which medication would the nurse suspect is the cause of severe nausea and a heartbeat that is irregular and slow in a client who takes multiple medications? a. digoxin b. captopril c. furosemide d. morphine sulfate

a. digoxin

which information will the nurse include when teaching a client with hypertension about metoprolol? a. do not abruptly discontinue this medication b. consume alcoholic beverages in moderation c. report a heart rate of less than 70 beats per minute d. increase the medication dosage if chest pain occurs

a. do not abruptly discontinue this medication

Which diuretic medication would the nurse anticipate administering to a client admitted with acute pulmonary edema? a. furosemide b. chlorothiazide c. spironolactone d. acetazolamide

a. furosemide

Which manifestation in a client with heart failure indicates digoxin toxicity? Select all that apply a. nausea b. yellow vision c. irregular pulse d. increased urine output e. heart rate of 64 bpm

a. nausea b. yellow vision c. irregular pulse

Which response would a nurse give to a client who takes furosemide and digoxin and reports that everything looks yellow? a. "this is related to your heart problems, not to the medication" b. "I will hold the medication until i consult with your health care provider" c. "it is a medication that is necessary, and that side effect is only temporary" d. "take this dose, and when i see your health care provider, I will ask about it."

b. "I will hold the medication until i consult with your health care provider"

Which instruction would the nurse include in a teaching plan for nitroglycerin patches? a. "apply the patch on a distal extremity" b. "remove a previous patch before applying the next one" c. "massage the area gently after applying the patch to the skin" d. "apply a warm compress to the site before attaching the patch"

b. "remove a previous patch before applying the next one"

Which family of drugs are the following medications considered: Amlodipine, Nefedipine, Diltiazem? a. Angiotension Receptor Blockers (ARBs) b. Calcium Channel Blockers (CCBs) c. ACE Inhibitors (ACEI) d. Beta blockers (BB)

b. Calcium Channel Blockers (CCBs)

Which of the following systems of the body can be seriously affected by hypertension a. Cardiovascular, gastrointestinal, reproductive, and kidney b. Cardiovascular, brain, kidney, and eyes c. Brain, musculoskeletal, kidney, cardiovascular

b. Cardiovascular, brain, kidney, and eyes

Which diuretic would the nurse anticipate administering to a client admitted with acute pulmonary edema? a. Spironolactone. b. Furosemide c. Hydralazine

b. Furosemide

The action exhibited by simvastatin, a cholesterol lowering agent ,is accomplished by: a. reducing the very low density lipoprotein (VLDL) with an increase in high density lipoprotein (HDL) b. Inhibiting the enzyme responsible for making cholesterol (HMG-COa reductase) c. binding with the bile acids containing cholesterol in the intestines to be excreted in feces

b. Inhibiting the enzyme responsible for making cholesterol (HMG-COa reductase)

Which category of beta blockers block beta 1 and beta 2 receptors? a. Selective beta blockers b. Nonselective beta blockers

b. Nonselective beta blockers

Which of the following should a nurse teach a patient on Furosemide (Lasix). Select all that apply a. Restrict the consumption of bananas b. Rise slowly from sitting position c. Take early in the day d. Report tinnitus or hearing loss

b. Rise slowly from sitting position c. Take early in the day d. Report tinnitus or hearing loss

which nursing action will best evaluate the effectiveness of the furosemide in managing a client with heart failure and acute pulmonary edema? a. preforming daily weights b. auscultating breath sounds c. monitoring intake and output d. assessing for dependent edema

b. auscultating breath sounds

which instruction will the nurse include in a teaching plan for a client taking a calcium channel blocker such as nifedipine? Select all that apply a. reduce calcium intake b. report peripheral edema c. expect temporary hair loss d. avoid drinking grapefruit juice e. change to a standing position slowly

b. report peripheral edema d. avoid drinking grapefruit juice e. change to a standing position slowly

which clinical indicator would the nurse monitor to determine if the client's simvastatin is effective? a. heart rate b. triglycerides c. blood pressure d. international normalized ratio (INR)

b. triglycerides

which symptom will the nurse include as a reason to withhold the medication when teaching a client about digoxin therapy? a. fatigue b. yellow vision c. persistant hiccups d. increased urinary output

b. yellow vision

A patient is admitted with a dysrhythmia. The physician prescribes Propranolol. Which statement by the patient requires the nurse to hold the ordered dose and notify the physician for further orders? a. "I smoke 2 packs of cigarettes per day" b. "I had caffeine this morning with" c. "I use an inhaler at home for asthma". d. "My heart feels like it is racing, and I feel very weak."

c. "I use an inhaler at home for asthma".

Which statements below verbalized by the patient on digoxin demonstrates they understand how to properly take this medication? Select all that apply a. "I will limit my intake of foods high in potassium." b. "I will measure my pulse rate before every dose I take" c. "It is important that I immediately report any vision changes I may experience while taking this medication." d. "I will not take this medication and notify the physician if my heart rate is more than 70 bpm."

c. "It is important that I immediately report any vision changes I may experience while taking this medication."

which instructions about the use of nitroglycerin to prevent angina will the nurse provide to a client? a. "at the point when pain first occurs, place two tablets under the tongue" b. "place one tablet under the tongue before activity, and swallow another if pain occurs" c. "before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs" d. "place one tablet under the tongue when the pain occurs and use an addition tablet after the attack to prevent recurrence"

c. "before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs"

Which statement by a patient taking Metoprolol requires the nurse to re-educate the patient about this drug? a. I take this medication with my breakfast every morning b. While I'm taking this medication I will monitor my heart rate. c. After I stop taking this medication I will let my physician know. d. I will change positions slowly while I'm taking this medication

c. After I stop taking this medication I will let my physician know.

Which family of drugs are the following medications considered: Amlodipine, Verapamil, Diltiazem a. Angiotensin Receptor Blockers (ARBs) b. ACE Inhibitors (ACEI) c. Calcium Channel Blockers (CCBs) d. Beta blockers (BB)

c. Calcium Channel Blockers (CCBs)

Digoxin is part of what family of drugs? a. ACE Inhibitors b. Calcium Channels Blockers c. Cardiac Glycosides d. Beta Blockers

c. Cardiac Glycosides

A 59 yo man with a history of angina is given a prescription for an oral nitrate formulation (isosorbide dinitrate) 20 mg bid. A second agent that this patient should be warned "NOT" to take while on this oral nitrate formulation is: a. Aspirin b. Metoprolol c. Sildenafil d. St. John's wort

c. Sildenafil

which adverse effect would a nurse monitor for when caring for a client receiving furosemide to relieve edema? a. hypernatremia b. elevated blood urea nitrogen c. hypokalemia d. increase in urine specific gravity

c. hypokalemia

Which information is important for the nurse to include in the teaching plan of a client who will be taking furosemide and digoxin after discharge from the hospital? a. maintenance of a low potassium diet b. avoidance of foods high in cholesterol c. signs and symptoms of digoxin toxicity d. importance of monitoring output

c. signs and symptoms of digoxin toxicity

which statement by a client who received a prescription of digoxin leads the nurse to conclude that the teaching was effective? a. "I will avoid foods high in potassium" b. " i must increase my intake of vitamin K" c. " I should adjust the dosage according to my activities" d. "It will be important to check my pulse rate daily"

d. "It will be important to check my pulse rate daily"

Which antihypertensive medication class would the nurse identify as the likely cause of the cough in a client taking multiple medications for hypertension who develops a persistent, hacking cough? a. thiazide diuretics b. calcium channel blockers c. direct renin inhibitors d. ACE inhibitors

d. ACE inhibitors

A patient is prescribed a beta adrenergic blocker for a cardiac condition. You know this medication blocks the beta receptors in the body so ____________ and __________ cannot bind to the receptor site and elicit a sympathetic nervous system response. a. Dopamine and acetylcholine b. Epinephrine and Dopamine c. Angiotensin II and Angiotensin I d. Epinephrine and Norepinephrine

d. Epinephrine and Norepinephrine

The statement that best explains why furosemide (Lasix) is administered to treat hypertension is: a. It inhibits the angiotensin-converting enzymes b. It decreases sympathetic stimulation c. It dilates peripheral blood vessels. d. It inhibits reabsorption of sodium and water in kidney

d. It inhibits reabsorption of sodium and water in kidney

Your patient, who is 55-years-old, is prescribed to take Digoxin. What patient finding requires that the nurse hold the dose of Digoxin and notify the physician? a. Blood Glucose of 95 b. Digoxin level of 1.1ng/mL c. Heart Rate of 68 bpm d. Potassium level 2.1mEq/L

d. Potassium level 2.1mEq/L

An infant with a diagnosis of heart failure is being given furosemide twice a day. Which laboratory value would the nurse report to the HCP? a. sodium of 140mEq/ L b. Ionized Calcium of 2.35mEq/L c. Chloride of 102 mEq/L d. Potassium of 3.0mEq/L

d. Potassium of 3.0mEq/L

which complication will occur as the result of administering sildenafil to a client who takes isosorbide dinitrate? a. constipation b. protracted vomiting c. respiratory distress d. severe hypotension

d. severe hypotension

Angiotensin II causes ___________ of the vessels and triggers the release of ____________. a. vasodilation- aldosterone b. vasodilation -angiotensin I c. vasoconstriction - Renin d. vasoconstriction - aldosterone

d. vasoconstriction - aldosterone

____ is the degree of stretch of cardiac mdyocytes at the end of ventricular filling

preload

A patient is taking Losartan for hypertension. Select all the pharmacological effects of this drug. a. Sodium excretion b. sodium retention c. Vasodilation d. Water excretion

a. Sodium excretion c. Vasodilation d. Water excretion

What is the main effect of Digoxin on the heart? a. Positive inotropic effect b. Positive chronotropic effect c. Negative inotropic effect

a. Positive inotropic effect

A patient is prescribed Pravastatin. This medication is known as a a. HMG-CoA Reductase Inhibitor b. Cholesterol Absorption Inhibitor c. Fibric Acid Derivative d. Bile-acid Sequestrate

a. HMG-CoA Reductase Inhibitor

What signs and symptoms below would demonstrate a patient is experiencing an overdose of a beta blocker medication? Selectall that apply: a. Heart rate 35 beats per minute b. Patient is maniac and agitated c. Dyspnea d. Patient is severely drowsy

a. Heart rate 35 beats per minute c. Dyspnea d. Patient is severely drowsy

A patient is ordered a scheduled dose of Digoxin. The patient's apical pulse rate is 58 bpm. The nurse would: a. Hold the dose and inform the physician b. Hold the dose c. Skip this dose but administer the next scheduled dose d. Give the dose as scheduled

a. Hold the dose and inform the physician

Which statement made by the client demonstrates a need for further instruction regarding the use of nitroglycerin? a. I can take up to five tablets at 3-minute intervals for chest pain if necessary b. If I get a headache, I should keep taking nitroglycerin and use Tylenol for pain relief. c. i should keep my nitroglycerin in a cool, dry place d. I should change positions slowly to avoid getting dizzy.

a. I can take up to five tablets at 3-minute intervals for chest pain if necessary

When teaching a relative about Hydrochlorothiazide (Microzide), which of the following you should include in your teaching: (Select all that apply) a. It can increase uric acid levels and precipitate gout attacks b. Take the drug evening time c. consume food rich in potassium d. it can cause gynecomastia in men

a. It can increase uric acid levels and precipitate gout attacks c. consume food rich in potassium

The statement that best explains why furosemide (Lasix) is administered to treat hypertension is: a. It inhibits reabsorption of sodium and water in kidney b. It dilates peripheral blood vessels. c. It decreases sympathetic stimulation d. It inhibits the angiotensin-coverting enzymes

a. It inhibits reabsorption of sodium and water in kidney

What signs and symptoms below would demonstrate a patient is experiencing an overdose of a beta adrenergic blocker medication? Select all that apply: a. Patient is severely drowsy b. Heart rate 55 beats per minute c. Hypotension d. Patient is maniac and agitated

a. Patient is severely drowsy b. Heart rate 55 beats per minute c. Hypotension

What is the main effect of Digoxin on the heart? a. Positive Inotropic b. Positive Chronotropic c. Negative Inotropic

a. Positive Inotropic