Pharm quizzes exam 3
Which medications are included in first-line therapy for heart failure? (Select all that apply.)
-Diuretics -Agents that inhibit the renin-angiotensin-aldosterone system (RAAS) -Beta blockers
A nurse is discussing adenosine with a nursing student. Which statement by the student indicates a need for further teaching?
"Adenosine can be used to prevent paroxysmal supraventricular tachycardia and Wolff-Parkinson-White syndrome."
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?
"Beta blockers block the actions of angiotensin II.
A patient has been taking chlorthalidone a thiazide diuretic to treat hypertension. The patient's prescriber has just ordered the addition of spironolactone a potassium sparing diuretic to the patient's drug regimen. Which statement by the patient indicates a need for further teaching?
"I will need to take potassium supplements when adding this drug."
A patient with gout is given a prescription for colchicine. The patient asks about the purpose of this drug. What is the nurse's best response?
"It is a potent anti-inflammatory agent that targets gout."
An adult male patient has taken medication for management of hypertension for 3 years. He says to the nurse, "I'm not going to take these drugs anymore, because they are interfering with my sex life." Which response by the nurse would be most helpful?
"Let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect."
A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis asks the nurse why the patient must take heparin rather than warfarin. Which response by the nurse is correct?
"The onset of warfarin is delayed."
The nurse understands that colchicine has which distinct applications in gout? (Select all that apply.)
-Used to treat an acute attack -Helps prevent attacks in the chronic phase
A patient with rheumatoid arthritis is starting methotrexate. The patient asks, "When can I expect to begin to see the effects of this medicine?" The nurse would give which response?
2. 3-6 weeks
A patient with rheumatoid arthritis begins therapy with etanercept. The patient must be instructed to avoid:
2. live vaccines.
In which area of the healthy heart is the electrical impulse delayed to provide time for the blood to fill the ventricles?
AV node
A nurse instructs the parent of a child with influenza that which medication or medications may be used safely to reduce fever? (Select all that apply.)
Acetaminophen (Tylenol)
A patient develops supraventricular tachycardia (SVT) and is hypotensive. The nurse anticipates that which medication will be administered?
Adenosine (Adenocard)
A nurse provides discharge instructions for a patient who is taking acetaminophen (Tylenol) after surgery. The nurse should instruct the patient to avoid which product while taking acetaminophen?
Alcoholic drinks
A prescriber has ordered propranolol (Inderal) for a patient with recurrent ventricular tachycardia. The nurse preparing to administer this drug will be concerned about what in the patient's history?
Asthma
Initial therapy for hypertension after a myocardial infarction (MI) includes drugs from which classes?
Beta blocker and ACE inhibito
Which two classes of antidysrhythmic drugs have nearly identical cardiac effects?
Beta blockers and calcium channel blockers
Allopurinol (Zyloprim) is the drug of choice for which type of gout?
Chronic tophaceous gout
The nurse plans to closely monitor for which clinical manifestation after administering Furosemide (Lasix) a loop diuretic?
Decreased blood pressure
A 52-year-old male 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, the nurse understands that which symptom, if present, indicates the most likely adverse reaction to this drug?
Decreasing level of consciousness
A postoperative patient reports pain in the left lower extremity. The nurse notes swelling in the lower leg, which feels warm to touch. The nurse will anticipate giving which medication?
Enoxaparin (Lovenox)
The nurse caring for a patient taking furosemide (Lasix) a loop diuretic is reviewing the patient's most recent laboratory results, which are: sodium, 136 mEq/L; potassium, 2.9 mEq/L; chloride, 100mEq/L; blood urea nitrogen, 15 mg/dL. What is the nurse's best action?
Hold the Lasix and notify the physician
A nurse teaches a patient who takes daily low-dose aspirin for protection against myocardial infarction and stroke to avoid also taking which medication?
Ibuprofen (Motrin) and NSAID agent
The nurse understands that biologic agents used for the treatment of rheumatoid arthritis are what type of drugs?
Immunosuppressive
A nurse administers naloxone (Narcan) an opioid antagonists to a postoperative patient experiencing respiratory sedation. What undesirable effect would the nurse anticipate after giving this medication?
Increased pain
The nurse administers glucocorticoid drugs for rheumatoid arthritis in only one or two affected joints by way of which route?
Intra-articular injection
A patient admitted with atrial fibrillation is receiving a continuous heparin infusion as well as daily warfarin (Coumadin). What is an appropriate action by the nurse?
Notify the healthcare provider that the INR is 3 and anticipate that the heparin will be discontinued.
The nurse is caring for a patient who takes spironolactone (Aldactone) a potassium sparing diuretic and quinapril (Accupril) an ACE inhibitor for treatment of heart failure. Which symptom, if found, would indicate a potential interaction between these two drugs?
Potassium level of 5.7 mEq/L
The nurse is reviewing the patient's current medication list and recognizes that which medication is considered first-line for migraine prevention?
Propranolol (Inderal) a beta blocker
A patient with cancer has been taking an opioid analgesic four times daily for several months and reports needing increased doses for pain. What will the nurse tell the patient?
The patient should discuss increasing the dose with the provider
Increased painA patient takes oxycodone (OxyContin) 40 mg PO twice daily for the management of chronic pain. Which intervention should be added to the plan of care to minimize the gastrointestinal adverse effects?
The patient should increase fluid and fiber in the diet.
The nurse understands that which cytokines are of the greatest importance in the inflammation and joint destruction of rheumatoid arthritis?
Tumor necrosis factor and interleukin-1
A patient who takes warfarin for atrial fibrillation develops hyperuricemia. Allopurinol is prescribed. The nurse should anticipate:
decreasing the warfarin dose.
A nurse caring for a patient receiving heparin therapy notes that the patient has a heart rate of 98 beats per minute and a blood pressure of 110/72 mm Hg. The patient's fingertips are purplish in color. A stat CBC shows a platelet count of less than 100,000 mm3. The nurse will:
discontinue the heparin and notify the provider.
A patient arrives in the emergency department complaining of numbness in the extremities. The nurse notes that the patient's hands and feet are cool and pale. When conducting a health history, the nurse learns that the patient has a history of migraine headaches. The nurse recognizes this patient's symptoms as:
ergotism
A patient is taking enalapril (Vasotec) an ACE inhibitor. The nurse understands that patients taking this type of drug for heart failure need to be monitored carefully for:
hyperkalemia.
A patient who has occasional migraine headaches tells a nurse that the abortive medication works well, but she would like to do more to prevent the occurrence of these headaches. The nurse will suggest that the patient:
keep a headache diary to help determine possible triggers.
A patient who was in a motor vehicle accident sustained a severe head injury and is brought into the emergency department. The provider orders intravenous mannitol (Osmitrol) an osmotic diuretic. The nurse knows that this is given to:
reduce intracranial pressure
A patient who takes daily doses of aspirin is scheduled for surgery next week. The nurse should advise the patient to:
stop using aspirin immediately.
A woman with rheumatoid arthritis has taken leflunomide for 1 year. She telephones a nurse and says that the result of a home pregnancy test was positive. The nurse should:
tell her to immediately stop the drug and notify the prescriber.
