Pharm exam 2 review

A nurse is teaching a group of nursing students about antidysrhythmic medications. Which statement by a student indicates understanding of the teaching? A. "Antidysrhythmic drugs can cause new dysrhythmias or worsen existing ones." B. "Adverse effects of these drugs are mainly noncardiac in nature." C. "For most antidysrhythmic drugs, there is evidence of reduced mortality." D. "Use of these drugs may be necessary even if the benefits are unknown."

A. "Antidysrhythmic drugs can cause new dysrhythmias or worsen existing ones."

A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. Which statement by the student indicates a need for further teaching? A. "Beta blockers block the actions of angiotensin II." B. "Beta blockers decrease heart rate and contractility." C. "Beta blockers decrease peripheral vascular resistance." D. "Beta blockers decrease the release of renin."

A. "Beta blockers block the actions of angiotensin II."

A patient with diabetes develops hypertension. The nurse will anticipate administering which type of medication to treat hypertension in this patient? A. ACE inhibitors B. Beta blockers C. Direct-acting vasodilators D. Thiazide diuretics

A. ACE inhibitors protect their kidneys

1.) A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do? A. Instruct the patient not to get up without assistance. B. Make sure the patient takes a potassium supplement. C. Report the presence of a dry cough to the prescriber. D. Request an order for a diuretic to counter the side effects of the ACE inhibitor.

A. Instruct the patient not to get up without assistance.

A patient with atrial fibrillation is receiving warfarin [Coumadin]. The nurse notes that the patient's INR is 2.7. Before giving the next dose of warfarin, the nurse will notify the provider and: A. administer the dose as ordered. B. request an order to decrease the dose. C. request an order to give vitamin K (phytonadione). D. request an order to increase the dose.

A. administer the dose as ordered.

Describe how ACE-inhibitors and ARB's work. What are the side effects of these therapies and what electrolyte should be monitored on these medications?

ACE inhibitors block the ACE enzyme from converting to Angiotensen II, which causes vasoconstriction. Therefore, ACE Inhibitors are anti-hypertensives. ARBs work by blocking Angiotensen II from causing vasoconstriction, and therefore are also anti-hypertensives. ARBs are used mainly for patients that can't tolerate ACE inhibitors. Some of the common side effects for both are hypotension and hypokalemia. some of the more serious or adverse effects are renal failure, cough, fetal injury, or angioedema. Potassium levels should be monitored with these meds.

A provider has ordered an ACE inhibitor- captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct? A. Administer the captopril and monitor for adverse effects. B. Hold the dose and notify the provider. C. Request an order to administer fosinopril instead of captopril. D. Reassure the patient that this is not a serious side effect.

B. Hold the dose and notify the provider.

2.) A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom? A. It indicates that a serious side effect has occurred. B. It is a common side effect that occurs in almost all patients taking the drug. C. It may be uncomfortable enough that the drug will need to be discontinued. D. It occurs frequently in patients taking the drug but will subside over time.

C. It may be uncomfortable enough that the drug will need to be discontinued.

18.) A patient has failed lifestyle modifications and LDL cholesterol remains elevated, statin therapy will be initiated, what lab value will need monitored? A. CBC B. Glucose C. Liver enzymes D. INR

C. Liver enzymes

A nurse checks a patient's vital signs in the hospital and notes a blood pressure of 146/98 mm Hg. What will the nurse do? A. Instruct the patient to consume a low-sodium diet. B. Prepare the patient for an electrocardiogram and blood tests. C. Recheck the patient's blood pressure in the other arm. D. Request an order for a thiazide diuretic.

C. Recheck the patient's blood pressure in the other arm.

A patient has had blood pressures of 150/95 and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will expect this patient's provider to order:

C. a thiazide diuretic. this is the only diuretic class we use for hypertension

A patient who is taking a statin- simvastatin [Zocor] develops an infection and the provider orders azithromycin [Zithromax] to treat the infection. The nurse should be concerned if the patient complains of: A. nausea B. tiredness C. muscle pain. D. headache

C. muscle pain.

Explain how coumadin works, patient teaching and what labs should be monitored?

Coumadin is an anti-coagulant that inhibits the clotting factors of vitamin K, which is why the antidote for it is vitamin K. it is a oral, long working drug that has a small theraputic window. if you have a pt on Coumadin, you need to monitor their INR to make sure that it doesn't rise too high because then the pt can bleed out.

A nurse has provided education for a patient newly diagnosed with hypertension who is just beginning therapy with antihypertensive medications. Which statement by the patient indicates a need for further teaching? A. "I may experience serious long-term problems even if I am not having symptoms." B. "I should report side effects to the provider since other drugs may be substituted." C. "I will need to take medications on a long-term basis." D. "When my symptoms subside, I may discontinue the medications."

D. "When my symptoms subside, I may discontinue the medications."

13.) A nurse is instructing a patient receiving a cholesterol-lowering agent. Which information should the nurse include in the patient education? A. "This medication will replace other interventions you have been trying." B. "It is important for you to double your dose if you miss one to maintain therapeutic blood levels." C. "Stop taking the medication if you experience constipation." D. "You should continue your exercise program to increase your HDL serum levels."

D. "You should continue your exercise program to increase your HDL serum levels."

A patient who takes warfarin [Coumadin] is brought to the emergency department after accidentally taking too much warfarin. The patient's heart rate is 78 beats/min, and the blood pressure is 120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not complain of pain. The nurse will anticipate an order for: A. vitamin K (phytonadione). B. protamine sulfate. C. a PTT. D. a PT and an INR.

D. a PT and an INR.

A patient asks a nurse how nitroglycerin works to relieve anginal pain. The nurse correctly states, "Nitroglycerin: A. dilates coronary arteries to increase blood flow to the heart." B. increases the oxygen supply to the cardiac muscle." C. increases ventricular filling to improve cardiac output." D. promotes vasodilation, which reduces preload and oxygen demand."

D. promotes vasodilation, which reduces preload and oxygen demand."

A patient who takes warfarin for atrial fibrillation undergoes hip replacement surgery. On the second postoperative day, the nurse assesses the patient and notes an oxygen saturation of 83%, pleuritic chest pain, shortness of breath, and hemoptysis. The nurse will contact the provider to report possible ____ and request an order for ____. A. congestive heart failure; furosemide [Lasix] B. hemorrhage; vitamin K (phytonadione) C. myocardial infarction; tissue plasminogen activator (tPA) D. pulmonary embolism; heparin

D. pulmonary embolism; heparin

A patient with heart failure who has been taking an ACE inhibitor, a thiazide diuretic, and a beta blocker for several months comes to the clinic for evaluation. As part of the ongoing assessment of this patient, the nurse will expect the provider to evaluate: A. complete blood count. B. ejection fraction. C. maximal exercise capacity. D. serum electrolyte levels.

D. serum electrolyte levels.

What medications are used to treat congestive heart failure and what lab should be monitored on therapy?

For congestive heart failure, we use diuretics, vasodilators, anti-platelets, Beta-Blockers, ACEs, ARBs. we have to monitor renal function as well as the electrolyte levels, particularly potassium.

A patient with chronic hypertension is admitted to the hospital. During the admission assessment, the nurse notes a heart rate of 96 beats/min, a blood pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting edema of the ankles, and distension of the jugular veins. The nurse will contact the provider to request an order for which medication? A. ACE inhibitor B. Digoxin [Lanoxin] C. Furosemide [Lasix] D. Spironolactone [Aldactone]

Furosemide [Lasix]

Explain how nitroglycerin is used for angina management and side effects of this medication.

Nitroglycerin is a strong and fast acting vasodilator. It is used to treat angina because it opens up the arteries and veins, which can relieve the pain the pt is feeling due to a blockage or vasoconstriction by reducing preload and oxygen demand on the heart. side effects are headache, dizziness, and nausea.

Describe 1st line non-medical therapies for cholesterol control. Describe how statins work and what labs should be monitored?

TLC diet, exercise, limit consumption of fatty, fried foods in particular. Statins work to lower LDL, increase HDL, and lower triglycerides. If you have a pt on statins, you have to monitor their liver enzymes, and educate the pt to take these medications at night for them to be most effective.

What is the antidote for heparin?

protamine sulfate

Describe 1st line therapies for blood pressure management prior to initiating drug therapy?

low-sodium diet and exercise (lifestyle changes)

19.) What is the antidote for coumadin?

vitamin K