Pharmacology(term 4)

Sertraline (Zoloft) class

is an antidepressant belonging to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Sertraline affects chemicals in the brain that may be unbalanced in people with depression, panic, anxiety, or obsessive-compulsive symptoms.

Mirtazapine

it is classified as a noradrenergic and specific serotonergic antidepressant (NaSSA).

Plant-based sources of tryptophan

leafy greens, sunflower seeds, watercress, soybeans, pumpkin seeds, mushrooms, broccoli, and peas.

A patient is prescribed an antibiotic and states that they go to the beach almost every day. What patient teaching should the nurse implement?

Avoid the sun as much as you can and apply sun block.

The HCP informs the nurse the patient has thrombocytopenia. What nurse knows this is?

is a condition in which you have a low blood platelet count. Risk for bleeding.

Which element is formed in the presence of vitamin K and is concluded by the nurse to be the purpose of administering vitamin K prior to cholecystectomy? 1 Bilirubin 2 Prothrombin 3 Thromboplastin 4 Cholecystokinin

2 Prothrombin

Where are beta 1 receptors located?

primarily the HEART, but also kidneys

What is the antidote for heparin?

protamine sulfate

Which assessment finding indicates that a client is experiencing an allergic reaction to antibiotic therapy? Select all that apply. One, some, or all responses may be correct. 1 Pruritus 2 Confusion 3 Wheezing 4 Muscle aches 5 Bronchospasm

1 Pruritus 3 Wheezing 5 Bronchospasm

How does SNRIs effect the body?

raise levels of serotonin and norepinephrine, two neurotransmitters in the brain that play a key role in stabilizing mood.

What is amitriptyline?

tricyclic antidepressant

A client asks the nurse how long it will take for chest pain to subside after sublingual nitroglycerin is taken. Which time period will the nurse tell the client? 1 1 to 3 minutes 2 4 to 5 seconds 3 30 to 45 seconds 4 20 to 45 minutes

1 1 to 3 minutes

What suffix does Beta Blockers end in?

"Lol"

suffix for thrombolytics medication?

"ase"

Dihydropyridine suffix ending?

"pine"

ACE inhibitors end with which suffix?

"pril"

Suffix for lowering cholesterol medication?

"statin"

Name the 5 types of antidepressants

-Serotonin and noradrenaline reuptake inhibitors (SNRIs) -Selective serotonin reuptake inhibitors (SSRIs) -Tricyclic antidepressants (TCAs) -Monoamine oxidase inhibitors (MAOIs) -Noradrenaline and specific serotoninergic antidepressants (NASSAs)

An infant who is prescribed phenobarbital for seizures is lethargic and sleeps excessively. The infant's mother asks what is happening to her baby. Which response is best to give the mother? 1 "This is a response to the medication that will subside eventually." 2 "The doctor will prescribe another medication to counteract this side effect." 3 "Your baby is getting too much medication, and the dosage will be reduced." 4 "This is a common side effect, but the medication must be continued to prevent seizures."

1 "This is a response to the medication that will subside eventually."

Which medication would the nurse anticipate the health care provider to prescribe to relieve the pain experienced by a client with rheumatoid arthritis? 1 Acetylsalicylic acid 2 Hydromorphone 3 Meperidine 4 Alprazolam

1 Acetylsalicylic acid

Which medication is associated commonly with upper gastrointestinal (GI) bleeding? Select all that apply. One, some, or all responses may be correct. 1 Acetylsalicylic acid 2 Methylprednisolone 3 Acetaminophen 4 Ibuprofen 5 Ciprofloxacin

1 Acetylsalicylic acid 2 Methylprednisolone 4 Ibuprofen

A newborn is admitted to the pediatric unit with a suspected herpesvirus infection. Which medication would the nurse anticipate that the practitioner will prescribe? 1 Acyclovir 2 Ribavirin 3 Prednisone 4 Gentamycin

1 Acyclovir

Which collaborative intervention can the nurse perform to help relieve a client's nausea after cataract surgery? 1 Administer the prescribed antiemetic drug. 2 Provide some dry crackers for the client to eat. 3 Explain that this is expected following surgery. 4 Teach how to breathe deeply until the nausea subsides.

1 Administer the prescribed antiemetic drug.

A nurse is caring for an older adult who is taking acetaminophen for the relief of chronic pain. Because it intensifies the most serious adverse effect of acetaminophen, which substance is most important for the nurse to determine if the client is taking it? 1 Alcohol 2 Caffeine 3 Saw palmetto 4 St. John's wort

1 Alcohol

Which therapy is considered palliative care in the end stage of human immunodeficiency virus (HIV) disease? Select all that apply. One, some, or all responses may be correct. 1 Antibiotic therapy 2 Blood transfusion 3 Intravenous therapy 4 Photochemotherapy 5 Monoclonal antibody therapy

1 Antibiotic therapy 2 Blood transfusion 3 Intravenous therapy

A client who is 6 weeks pregnant has gonorrhea. Which medication will the health care provider prescribe? 1 Ceftriaxone 2 Levofloxacin 3 Sulfasalazine 4 Trimethoprim/sulfamethoxazole

1 Ceftriaxone

Which effect does naloxone provide when administered for a heroin overdose? 1 Competes with opioids for receptors that control respiration 2 Prevents excessive withdrawal symptoms as heroin wears off 3 Accelerates metabolism of heroin and stimulates respiratory centers 4 Stimulates cortical sites that control consciousness and cardiovascular function

1 Competes with opioids for receptors that control respiration

A client reports nausea, vomiting, and seeing a yellow light around objects. A diagnosis of hypokalemia is made. Upon a review of the client's prescribed medication list, which medication would the nurse determine is the likely cause of the clinical findings? 1 Digoxin 2 Furosemide 3 Propranolol 4 Spironolactone

1 Digoxin

For which common side effect would a nurse monitor a client prescribed alprazolam? 1 Drowsiness 2 Bradycardia 3 Agranulocytosis 4 Tardive dyskinesia

1 Drowsiness

The nurse explains to a client scheduled to begin chemotherapy 2 weeks after surgery for colon cancer that it is important to delay instituting the drug therapy because the chemotherapy can have which negative effect? 1 Interferes with cell growth and delays wound healing 2 Causes vomiting, which endangers the integrity of the incisional area 3 Decreases red blood cell production, and the resultant anemia adds to postoperative fatigue 4 Increases edema in areas distal to the incision by blocking lymph channels with destroyed lymphocytes

1 Interferes with cell growth and delays wound healing

Which intervention should the nurse implement when the laboratory calls to report that a hospitalized client's lithium level is 1.9 mEq/L (1.9 mmol/L) after 10 days of lithium therapy? 1 Notify the primary health care provider of the findings because the level is dangerously high. 2 Monitor the client closely because the level of lithium in the blood is slightly high. 3 Continue the administration of the medication as prescribed because the level is within the therapeutic range. 4 Report the finding to the primary health care provider so the dosage can be increased because the level is below the therapeutic range.

1 Notify the primary health care provider of the findings because the level is dangerously high.

Which drug is available in an injectable form? 1 Oxytocin 2 Misoprostol 3 Dinoprostone 4 Methylergonovine

1 Oxytocin

A preterm infant is started on digoxin and furosemide for persistent patent ductus arteriosus. Which clinical finding provides the best indication of the effectiveness of the furosemide? 1 Pedal edema is reduced. 2 Digoxin toxicity is avoided. 3 Fontanels appear depressed. 4 Urine output exceeds fluid intake.

1 Pedal edema is reduced.

A client who takes four 325-mg tablets of buffered aspirin four times a day for severe arthritis complains of dizziness and ringing in the ears. Which complication does the nurse conclude that the client probably is experiencing? 1 Salicylate toxicity 2 Anaphylactic reaction 3 Withdrawal symptoms 4 Acetaminophen overdose

1 Salicylate toxicity

Which cautionary advice will the nurse give a client prescribed olanzapine to treat bipolar disorder, manic episode? 1 Sit up slowly. 2 Report double vision. 3 Expect decreased salivation. 4 Take the medication on an empty stomach.

1 Sit up slowly.

Which responsibility does the nurse have when administering prescribed opioid analgesics? Select all that apply. One, some, or all responses may be correct. 1 Count the client's respirations. 2 Document the intensity of the client's pain. 3 Withhold the medication if the client reports pruritus. 4 Verify the number of doses in the locked cabinet before administering the prescribed dose. 5 Discard the medication in the client's toilet before leaving the room if the medication is refused.

1 Count the client's respirations. 2 Document the intensity of the client's pain. 4 Verify the number of doses in the locked cabinet before administering the prescribed dose.

A client receiving the medication buspirone hydrochloride is admitted to the hospital with the diagnosis of possible hepatitis. The nurse identifies that the client's sclerae look yellow. Which action should be the nurse take initially? 1 Withhold the medication. 2 Give the buspirone hydrochloride with milk. 3 Reduce the dosage of the medication. 4 Ensure that the medication can be given parenterally.

1 Withhold the medication.

Which drug is an example of a leukotriene inhibitor? 1 Zileuton 2 Loratadine 3 Epinephrine 4 Fexofenadine

1 Zileuton

Which instruction will the nurse include when teaching a client with bipolar disorder, depressive episode about lithium carbonate? Select all that apply. One, some, or all responses may be correct. 1 "Take this medication with food." 2 "Adjust the dosage if your mood improves." 3 "Have a snack with milk before going to bed." 4 "It may take several weeks for beneficial results to occur." 5 "You do not have to restrict your intake of dietary sodium."

1 "Take this medication with food." 4 "It may take several weeks for beneficial results to occur." 5 "You do not have to restrict your intake of dietary sodium."

Which statement confirms to the nurse that a client diagnosed with bipolar disorder understands medication teaching about lithium carbonate? 1 "I know that I should stop the medication if I think I'm getting sick." 2 "I know that I may need to take the medication for the rest of my life." 3 "I know that this drug causes no serious side effects when it's taken correctly." 4 "I know that I'll have to increase the dosage at the beginning of a manic episode."

2 "I know that I may need to take the medication for the rest of my life."

Which statement by the client would indicate that teaching about steroid therapy is effective? 1 "I will take this medicine at bedtime with a snack." 2 "I will take this medicine in the early morning with food." 3 "I will take this medicine 1 hour before or 2 hours after eating." 4 "I will take this medicine by dividing it into equal parts for each meal."

2 "I will take this medicine in the early morning with food."

A client with severe preeclampsia is receiving an intravenous (IV) infusion of magnesium sulfate. Which explanation will the nurse give to the client on how magnesium sulfate treats her condition? 1 "It improves the quality of uterine contractions." 2 "It decreases the chance that you will have a seizure." 3 "It provides you with pain relief." 4 "It decreases uterine contractions."

2 "It decreases the chance that you will have a seizure."

A nurse prepares to administer vitamin K to a newborn. What rationale explains why newborns are deficient in this vitamin? 1 Alterations in blood coagulation interfere with vitamin K production. 2 A newborn's liver does not produce it immediately after birth. 3 Increased bilirubin levels interfere with vitamin K synthesis during the neonatal period. 4 A newborn's intestinal tract does not synthesize it for several days after birth.

2 A newborn's liver does not produce it immediately after birth.

A client in labor reports to the nurse that she is having severe discomfort, and the nurse administers the prescribed butorphanol. Which phase of labor is the safest time to administer this medication? Incorrect1 Latent phase 2 Active phase 3 Transition phase 4 Pushing phase

2 Active phase

A client who is addicted to opioids undergoes emergency surgery. Postoperatively, the health care provider decreases the previously prescribed methadone dosage. For which clinical manifestation will the nurse monitor the client? 1 Constipation and lack of interest in surroundings 2 Agitation and attempts to escape from the hospital 3 Skin dryness and scratching under the incision dressing 4 Lethargy and refusal to participate in therapeutic exercises

2 Agitation and attempts to escape from the hospital

The health care provider prescribes a regular diet, gait training, elastic stockings, and benztropine mesylate for a client. Which would be the priority nursing action for a client that experiences orthostatic hypotension, a side effect of benztropine mesylate? 1 Postpone gait training. 2 Apply elastic stockings. 3 Withhold the next dose. 4 Increase the fluid intake.

2 Apply elastic stockings.

Which rationale explains why a nurse would avoid using the gluteus maximus muscle for administration of intramuscular medications in a client with gluteal edema? 1 Deposition of an injected drug causes pain. 2 Blood supply is insufficient for adequate absorption. 3 Fluid leaks from the site for a long time after the injection. 4 Tissue fluid dilutes the drug before it enters the circulation.

2 Blood supply is insufficient for adequate absorption.

The nurse expects that metoprolol, when administered with digoxin, may produce which outcome? 1 Headaches 2 Bradycardia 3 Increased blood pressure 4 Stimulation of nodal conduction

2 Bradycardia

Which side effect would the nurse monitor for in the client who is prescribed metoprolol? 1 Hirsutism 2 Bradycardia 3 Restlessness 4 Hypertension

2 Bradycardia

A client with Hodgkin disease is diagnosed at stage IV. Which therapy option does the nurse expect to be implemented? 1 Radiation therapy 2 Combination of several chemotherapy agents 3 Radiation with chemotherapy 4 Surgical removal of the affected nodes

2 Combination of several chemotherapy agents

A young child has a peripheral intravenous (IV) line in place, and a central venous catheter was inserted but has not been checked for placement. Which action would the nurse take first when an antibiotic is prescribed to be administered immediately? 1 Administering the antibiotic through the central venous catheter 2 Connecting the IV antibiotic to the peripheral line 3 Ordering an x-ray confirmation report on central line placement 4 Documenting a verbal prescription on the chart stating the central line can be used

2 Connecting the IV antibiotic to the peripheral line

Which would the nurse expect the health care provider to prescribe for a client admitted to the hospital with a diagnosis of acute salmonellosis? 1 Cathartics 2 Electrolytes 3 Antidiarrheals 4 Antispasmodics

2 Electrolytes

How would the nurse respond when the client admitted for dehydration, screams, "I can't breathe!" 1 hour after fluids are started at 125 mL/hour? 1 Discontinue the IV and notify the health care provider. 2 Elevate the head of the client's bed, and obtain vital signs. 3 Assess the client for allergies, and change the IV to an intermittent lock. 4 Contact the health care provider to request a prescription for a sedative.

2 Elevate the head of the client's bed, and obtain vital signs.

An infant who has undergone cardiac surgery for a congenital defect is to be discharged. Which would the nurse emphasize to the parents regarding administration of the prescribed antibiotic? 1 Give the antibiotic between feedings. 2 Ensure that the antibiotic is administered as prescribed. 3 Shake the bottle thoroughly before giving the antibiotic. 4 Keep the antibiotic in the refrigerator after the bottle has been opened.

2 Ensure that the antibiotic is administered as prescribed.

Which sign of hypokalemia would the nurse monitor for in a client who is taking furosemide? 1 Chvostek sign 2 Flabby muscles 3 Anxious behavior 4 Abdominal cramping

2 Flabby muscles

A client with a mental illness reports weakness and fatigue. During assessment, the primary health care provider notes hoarseness, esophagitis, dental erosion, and palate lacerations. Which medication will the nurse expect to be prescribed to treat these symptoms? 1 Clozapine 2 Fluoxetine 3 Olanzapine 4 Risperidone

2 Fluoxetine

An adolescent with type 1 diabetes is admitted to the hospital with a blood glucose level of 700 mg/dL. A continuous insulin infusion is started. Which complication should the nurse make a priority of detecting while the adolescent is receiving the infusion? 1 Hypovolemia 2 Hypokalemia 3 Hypernatremia 4 Hypercalcemia

2 Hypokalemia

When teaching the parents of an 8-year-old child who is taking a high dose of prednisone for asthma, which critical information about prednisone would be included? 1 It protects against infection. 2 It should be stopped gradually. 3 An early growth spurt may occur. 4 A moon-shaped face will develop

2 It should be stopped gradually.

Which effect is the nurse trying to prevent when teaching a client to avoid regular use of bicarbonate of soda? 1 Gastric distention 2 Metabolic alkalosis 3 Chronic constipation 4 Cardiac dysrhythmias

2 Metabolic alkalosis

Which rationale explains why a nurse would closely observe a client taking phenytoin for a seizure disorder during the initial days of treatment with warfarin? 1 Warfarin affects the metabolism of phenytoin. 2 Phenytoin decreases warfarin's anticoagulant effect. 3 Warfarin's action is greater in clients with seizure disorders. 4 Seizures increase the metabolic degradation rate of warfarin.

2 Phenytoin decreases warfarin's anticoagulant effect.

Which nursing care would be included for a client who is receiving doxorubicin for acute myelogenous leukemia? 1 Serving hot liquids with each meal 2 Providing frequent oral hygiene and increasing oral fluids 3 Emphasizing that the disease will be cured with this treatment 4 Administering medications intramuscularly and encouraging activity

2 Providing frequent oral hygiene and increasing oral fluids

Which is a serious complication of receiving intravenous (IV) therapy? 1 Bleeding at the infusion site 2 Shortness of breath with crackles 3 Feeling of warmth throughout the body 4 Infiltration at the catheter insertion site

2 Shortness of breath with crackles

Which immunomodulator is used topically to treat a client with atopic dermatitis? 1 Mupirocin 2 Tacrolimus 3 Clindamycin 4 Erythromycin

2 Tacrolimus

Which action identified by the client indicates to the nurse that the client needs further instruction about atenolol? 1 Move slowly when changing positions. 2 Take the medication before going to bed. 3 Expect to feel drowsy when taking this drug. 4 Count the pulse before taking the medication

2 Take the medication before going to bed.

A 4-year-old diagnosed with sickle cell anemia is at a high risk for acquiring pneumococcal diseases even after receiving one or two doses of the pneumococcal conjugate vaccine (PCV). Based on the immunization protocol, how many doses of PCV would the child receive? 1 Four more doses of PCV 2 Three more doses of PCV 3 Two more doses of PCV 4 One more dose of PCV

2 Three more doses of PCV

Which type of antibiotic would a nurse expect to be prescribed to a client with burns who develops a local wound infection? 1 Oral 2 Topical 3 Intravenous 4 Intramuscular

2 Topical

Which assessment data most effectively measure the client's intravenous fluid replacement therapy for full-thickness burns? 1 Weights every day 2 Urinary output every hour 3 Blood pressure every 15 minutes 4 Extent of peripheral edema every 4 hours

2 Urinary output every hour

A laboring client is receiving an oxytocin infusion to induce labor. The nurse is aware that which complication can occur with this infusion? 1 Intense pain 2 Uterine tetany 3 Hypoglycemia 4 Umbilical cord prolapse

2 Uterine tetany

Which medication would the nurse expect the health care provider to prescribe if a client exhibits clinical indicators of warfarin overdose? 1 Heparin 2 Vitamin K 3 Iron dextran 4 Protamine sulfate

2 Vitamin K

The nurse determines that prompt intervention is needed for which client response to isoniazid? 1 Orange feces 2 Yellow sclera 3 Temperature of 96.8°F 4 Weight gain of 5 pounds

2 Yellow sclera

Which suggestion from the nurse would be beneficial for a client with tuberculosis? Select all that apply. One, some, or all responses may be correct. Incorrect1 "Take your daily medication dose during daytime." 2 "Avoid exposure to any inhalation irritants." 3 "Eat foods that are rich in fat." 4 "Cover the mouth and nose with a tissue when coughing or sneezing." 5 "Avoid giving sputum specimens for 2 to 4 weeks once drug therapy is initiated."

2 "Avoid exposure to any inhalation irritants."

How long does heparin take to take effect?

20 minutes and it's good quick.

Which assessment finding alerts the nurse to stop administering haloperidol to a client? 1 Grimacing 2 Shuffling gait 3 Yellow sclerae 4 Photosensitivity

3 Yellow sclerae

Which medication is likely to be responsible for development of extrapyramidal symptoms? Select all that apply. One, some, or all responses may be correct. Incorrect1 Clozapine 2 Olanzapine 3 Perphenazine 4 Fluphenazine 5 Trifluoperazine

3 Perphenazine 4 Fluphenazine 5 Trifluoperazine

A client at 31 weeks' gestation presents with preterm labor. Which class of drug will be prescribed by the health care provider? 1 An oxytocic 2 An analgesic 3 A corticosteroid 4 A tocolytic

4 A tocolytic

Which statement by a client about the side effects of haloperidol will the nurse recognize as indication that the client understands the medication teaching? 1 "I'll call my primary health care provider right away if I have any diarrhea or vomiting." 2 "I won't eat anything containing tyramine while I'm taking this drug." 3 "I'll avoid direct sunlight and make sure to use sunscreen when I go outside." 4 "I'll be sure to drink enough fluids because the drug may make me urinate more than usual."

3 "I'll avoid direct sunlight and make sure to use sunscreen when I go outside."

Which statement by a client prescribed paroxetine indicates to the nurse that more medication education is needed? 1 "I'll be a little drowsy in the mornings." 2 "I'm expecting to feel somewhat better, but I may need other therapy." 3 "I've been on the medication for 8 days now, and I don't feel any better." 4 "I know that I'll probably have to take this medication for several months."

3 "I've been on the medication for 8 days now, and I don't feel any better."

A client is taking benztropine in conjunction with an antipsychotic. The client tells a nurse, "Sometimes I forget to take the benztropine." Which statement will the nurse make to teach the client what to do in this situation? 1 "Take two pills at the next regularly scheduled dose." 2 "Notify the health care provider about the missed dose immediately." 3 "Take a dose as soon as possible, up to 2 hours before the next dose." 4 "Skip the dose, and then take the next regularly scheduled dose 2 hours early."

3 "Take a dose as soon as possible, up to 2 hours before the next dose."

Which response would a nurse give when caring for a client with tuberculosis who asks how long chemotherapy will be continued? 1 1 to 2 weeks 2 4 to 5 months 3 6 to 12 months 4 3 years or longer

3 6 to 12 months

Which sign would the nurse expect to decrease in a client with ascites who is receiving serum albumin intravenously? 1 Confusion 2 Urinary output 3 Abdominal girth 4 Serum ammonia level

3 Abdominal girth

For which effect will a nurse assess a client concurrently prescribed galantamine for mild Alzheimer disease and paroxetine for depression? Incorrect1 Allergic 2 Dystonic 3 Additive 4 Extrapyramidal

3 Additive

Which pharmacologic intervention does the nurse anticipate to be beneficial for a client with hypertension who has labor pains before the 35th week of gestation? 1 Prepare the client for an abortion. 2 Administer terbutaline. 3 Administer magnesium sulfate. 4 Administer sedatives and maintain hydration.

3 Administer magnesium sulfate

Which would be done to best prevent stimulation of the pancreas in a client with a history of alcohol abuse and current pancreatitis? 1 Maintain the gastric pH at a level less than 3.5. 2 Encourage the return of activities of daily living. 3 Administer the histamine H2-receptor antagonist as prescribed. 4 Ensure that the nasogastric tube remains in the fundus of the stomach.

3 Administer the histamine H2-receptor antagonist as prescribed.

The health care provider prescribes a stat injection of haloperidol for a schizophrenic client who begins fighting and biting other clients. Which approach will the nurse use to implement this prescription? 1 Quickly, with an attitude of concern 2 Before the client realizes what is happening 3 After the client agrees to receive the injection 4 Quietly, without any explanation of the reason for it

3 After the client agrees to receive the injection

A client has an anaphylactic reaction after receiving intravenous penicillin. Which statement would the nurse conclude as the cause of this reaction? 1 An acquired atopic sensitization occurred. 2 There was passive immunity to the penicillin allergen. 3 Antibodies to penicillin developed after a previous exposure. 4 Potent antibodies were produced when the infusion was instituted.

3 Antibodies to penicillin developed after a previous exposure.

Which therapy goal would the nurse consider when administering allopurinol to a client with gout? 1 Increase bone density. 2 Decrease synovial swelling. 3 Decrease uric acid production. 4 Prevent crystallization of uric acid.

3 Decrease uric acid production.

A pregnant client has labor pains. However, the nurse finds that the client's cervix is not dilated. Which drug would the nurse anticipate being prescribed to promote labor? Incorrect1 Oxytocin 2 Nifedipine 3 Dinoprostone 4 Methylergonovine

3 Dinoprostone

Which would the nurse do first when a woman who is receiving an oxytocin infusion to augment labor is moaning loudly and the nurse notes contractions are becoming more intense and prolonged with little rest between them? 1 Notify the primary health care provider. 2 Continue the fetal monitoring. 3 Discontinue the oxytocin infusion. 4 Place the client in the knee-chest position.

3 Discontinue the oxytocin infusion.

A nurse is caring for a client who has a nasogastric (NG) tube set to low intermittent suction. Which complication is prevented by an intravenous infusion of 5% dextrose with 0.45% sodium chloride and 20 mEq of potassium? 1 Constipation 2 Dehydration 3 Electrolyte imbalance 4 Nausea and vomiting

3 Electrolyte imbalance

Which drug would the nurse expect to be prescribed instead of ibuprofen for a client scheduled for surgery taking ibuprofen for discomfort associated with osteoarthritis? 1 Naproxen 2 Aspirin 3 Ketorolac 4 Acetaminophen

4 Acetaminophen

A 12-year-old child with cystic fibrosis is to receive four pancrelipase capsules five times a day. Which goal is accomplished by taking the medication with meals and snacks? 1 Enhance oxygenation. 2 Limit excretion of fats. 3 Facilitate nutrient utilization. 4 Prevent iron-deficiency anemia.

3 Facilitate nutrient utilization.

Which action would the nurse take when administering tetracycline to a client? 1 Administer the medication with meals or a snack. 2 Provide orange or other citrus fruit juice with the medication. 3 Give the medication 1 hour before milk products are ingested. 4 Offer antacids 30 minutes after administration if gastrointestinal side effects occur.

3 Give the medication 1 hour before milk products are ingested.

A client underwent treatment for a medical condition during pregnancy. The newborn has renal failure attributed to the medication taken. Which medical condition did the client probably receive treatment for? 1 Cancer 2 Epilepsy 3 Hypertension 4 Microbial infection

3 Hypertension

The nurse would monitor the client taking pentamidine isethionate intravenously (IV) for which adverse effect? 1 Hypertension 2 Hypokalemia 3 Hypoglycemia 4 Hypercalcemia

3 Hypoglycemia

While on a hike, a rusty nail pierces the sole of an adolescent's foot, and the adolescent is brought to the emergency department. Tetanus immune globulin is prescribed because the adolescent does not know when the last tetanus immunization was received. Which explanation is given by the nurse as she administers the prescribed dose of tetanus immune globulin? 1 Lifelong passive immunity 2 Long-lasting active protection 3 Immediate passive short-term immunity 4 Stimulation for the production of antibodies

3 Immediate passive short-term immunity

Which medication would the primary health care provider prescribe for a 29-week-pregnant woman having uterine contractions? 1 Oxytocin 2 Dinoprostone 3 Indomethacin 4 Methylergonovine

3 Indomethacin

A nurse assesses a client whose fetal heart rate tracing is reassuring. Contractions, which are of mild intensity, are lasting 30 seconds and are 3 to 5 minutes apart. An oxytocin infusion is prescribed. Which intervention would the nurse take at this time? 1 Checking cervical dilation every hour 2 Keeping the labor environment dark and quiet 3 Infusing oxytocin by piggybacking into the primary line 4 Positioning the client on the left side throughout the infusion

3 Infusing oxytocin by piggybacking into the primary line

Which frequently prescribed antidiarrheal drug would the nurse expect the health care provider to prescribe for a client with severe diarrhea? 1 Bisacodyl 2 Psyllium 3 Loperamide 4 Docusate sodium

3 Loperamide

Which oxytocic drug would be administered to a client who wants to terminate her pregnancy in the first trimester because of malformations in her fetus? 1 Oxytocin 2 Misoprostol 3 Mifepristone 4 Dinoprostone

3 Mifepristone

A pregnant woman at 29 weeks is found to have an increased volume of amniotic fluid and an increase in blood pressure. Which initial nursing action is appropriate? 1 Document the findings. 2 Reassess the client after 2 hours. 3 Notify the primary health care provider. 4 Methylergonovine is administered immediately.

3 Notify the primary health care provider.

Which is the most important sign or symptom for the nurse to be alert for when a child with cancer is prescribed cyclophosphamide, an alkylating agent? 1 Irritability 2 Unpredictable nausea 3 Pain with urination 4 Hyperplasia of the gums

3 Pain with urination

Which is the most important parameter for the nurse to assess while monitoring a client for magnesium sulfate toxicity? 1 Pulse rate 2 Daily weight 3 Patellar reflex 4 Blood pressure

3 Patellar reflex

Which rationale would the nurse give for the need to take penicillin G and probenecid for syphilis? 1 Each drug attacks the organism during different stages of cell multiplication. 2 The penicillin treats the syphilis, whereas the probenecid relieves the severe urethritis. 3 Probenecid delays excretion of penicillin, maintaining blood levels for longer periods. 4 Probenecid decreases the potential for an allergic reaction to the penicillin, which treats the syphilis.

3 Probenecid delays excretion of penicillin, maintaining blood levels for longer periods.

A client who had a femoral-popliteal bypass graft is receiving clopidogrel postoperatively. Which teaching would the nurse provide related to the medication? 1 Eliminate oranges from the diet 2 Eat more roughage if constipation occurs 3 Report multiple bruises on the extremities 4 Take the medication on an empty stomach

3 Report multiple bruises on the extremities

Which action would the nurse take for a client receiving a continuous heparin infusion who is prescribed vancomycin intravenous every 12 hours? 1 Stop the heparin, flush the line, and administer the vancomycin. 2 Use a piggyback setup to administer the vancomycin into the heparin. 3 Start another intravenous (IV) line for the vancomycin and continue the heparin as prescribed. 4 Hold the vancomycin and tell the health care provider that the drug is incompatible with heparin.

3 Start another intravenous (IV) line for the vancomycin and continue the heparin as prescribed.

Which type of drug would the nurse anticipate will be prescribed for a client in the emergency department with mild hypovolemic shock? 1 Loop diuretic 2 Cardiac glycoside 3 Sympathomimetic 4 Alpha-adrenergic blocker

3 Sympathomimetic

Which intervention is important during the course of electroconvulsive therapy (ECT) treatments? 1 Provision of tyramine-free meals 2 Avoidance of exposure to the sun 3 Maintenance of a steady sodium intake 4 Elimination of benzodiazepines given for nighttime sedation

4 Elimination of benzodiazepines given for nighttime sedation

What is the nurse's best response when a client at 31 weeks' gestation who is admitted in preterm labor asks the nurse whether there is any medication that can stop the contractions? 1 "An oxytocic." 2 "An analgesic." 3 "A corticosteroid." 4 "A beta-adrenergic."

4 "A beta-adrenergic."

Which statement indicates the client needs further teaching regarding taking warfarin and food selection? 1 "Eggs provide a good source of iron, which is needed to prevent anemia." 2 "Yellow vegetables are high in vitamin A and should be included in the diet." 3 "Milk and other high-calcium dairy products are necessary to counteract bone density loss." 4 "Dark green leafy vegetables are high in vitamin K and should be eaten to prevent clotting."

4 "Dark green leafy vegetables are high in vitamin K and should be eaten to prevent clotting."

Which statement made by the client with rheumatoid arthritis indicates effective understanding about the side effects of taking ibuprofen 800 mg by mouth three times a day? Correct1 "I need to have my blood work checked every month." 2 "I need to balance exercise with rest." 3 "I need to change positions slowly." 4 "I need to take the medication between meals."

4 "I need to take the medication between meals."

How will the nurse respond to the client who takes furosemide and digoxin and reports that everything looks yellow? 1 "This is related to your heart problems, not to the medication." 2 "It is a medication that is necessary, and that side effect is only temporary." 3 "Take this dose, and when I see your health care provider I will ask about it." 4 "I will hold the medication until I consult with your health care provider."

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

Which statement indicates to the nurse that the client understands the teaching about ampicillin that has been prescribed 250 mg by mouth every 6 hours at discharge? 1 "I should drink a glass of milk with each pill." 2 "I should drink at least six glasses of water every day." 3 "The medicine should be taken with meals and at bedtime." 4 "The medicine should be taken 1 hour before or 2 hours after meals."

4 "The medicine should be taken 1 hour before or 2 hours after meals."

Because of its role in wound healing, which vitamin would the nurse expect the health care provider to prescribe for a client with a large surgical incision? 1 Vitamin A 2 Cyanocobalamin 3 Phytonadione 4 Ascorbic acid

4 Ascorbic acid

During administration of an antibiotic, the client becomes restless and flushed, and begins to wheeze. Which action would the nurse do after stopping the antibiotic infusion? 1 Checking the client's temperature 2 Taking the client's blood pressure 3 Obtaining the client's pulse oximetry 4 Assessing the client's respiratory status

4 Assessing the client's respiratory status

Which treatment has the highest priority when providing discharge teaching to a client with tuberculosis? 1 Getting sufficient rest 2 Getting plenty of fresh air 3 Changing the current lifestyle 4 Consistently taking prescribed medication

4 Consistently taking prescribed medication

Which condition would the nurse identify as a reason for a client to reconsider taking over-the-counter glucosamine? 1 Osteoarthritis 2 Heart disease 3 Hyperthyroidism 4 Diabetes mellitus

4 Diabetes mellitus

Which part of the body would the nurse determine is being affected in a client who reports "I feel dizzy and I can't hear as well as usual" after receiving streptomycin for 2 weeks for tuberculosis? 1 Pyramidal tracts 2 Cerebellar tissue 3 Peripheral motor end plates 4 Eighth cranial nerve's vestibular branch

4 Eighth cranial nerve's vestibular branch

Which intervention is appropriate for a client scheduled for a 6-week electroconvulsive therapy (ECT) treatment program? 1 Provision of tyramine-free meals 2 Avoidance of exposure to the sun 3 Maintenance of a steady sodium intake 4 Elimination of benzodiazepines for nighttime sedation

4 Elimination of benzodiazepines for nighttime sedation

Which would the nurse teach the mother of a child receiving liquid iron preparations? 1 Monitor the stools for diarrhea. 2 Administer the iron at least an hour before meals. 3 Avoid giving the child orange juice with the iron preparation. 4 Have the child drink the diluted iron preparation through a straw.

4 Have the child drink the diluted iron preparation through a straw.

A preeclamptic client is receiving intravenous (IV) magnesium sulfate. Which reason would the nurse give when the client asks why her reflexes are being assessed? 1 Reveals her level of consciousness 2 Demonstrates the mobility of the extremities 3 Assesses her response to painful stimuli 4 Identifies the potential for respiratory depression

4 Identifies the potential for respiratory depression

Which side effect would the nurse monitor in a client receiving dexamethasone to treat an acute exacerbation of asthma? 1 Hyperkalemia 2 Liver dysfunction 3 Orthostatic hypotension 4 Increased blood glucose

4 Increased blood glucose

A lactating woman has hypertension and now presents with a migraine. Which drug combination probably will be prescribed for the breastfeeding mother? 1 Tenormin, sertraline 2 Atenolol, aspirin, acetaminophen, caffeine 3 Tenormin, sumatriptan 4 Labetalol, ibuprofen

4 Labetalol, ibuprofen

Which part of the renal system will the nurse recall is acted upon by furosemide prescribed for a client with hypervolemia? 1 Distal tubule 2 Collecting duct 3 Glomerulus of the nephron 4 Loop of Henle

4 Loop of Henle

A health care provider prescribes daily docusate sodium for a client. Which action does docusate sodium have in the gastrointestinal (GI) tract? 1 Lubricates the feces 2 Creates an osmotic effect 3 Stimulates motor activity 4 Lowers the surface tension of feces

4 Lowers the surface tension of feces

Which teaching will the nurse provide to a client prescribed a monoamine oxidase inhibitor (MAOI)? Incorrect1 It is necessary to avoid the sun. 2 Drowsiness is an expected side effect of this medication. 3 The therapeutic and toxic levels of the drug are very close. 4 Many prescribed and over-the-counter drugs cannot be taken with this medication.

4 Many prescribed and over-the-counter drugs cannot be taken with this medication.

Which complication would the nurse anticipate in a female client on estrogen therapy who has a history of smoking? Incorrect1 Osteoporosis 2 Hypermenorrhea 3 Endometrial cancer 4 Pulmonary embolism

4 Pulmonary embolism

Which blood type and Coombs test result must a pregnant woman have to receive Rho(D) immune globulin after giving birth? 1 Rh positive and Coombs positive 2 Rh negative and Coombs positive 3 Rh positive and Coombs negative 4 Rh negative and Coombs negative

4 Rh negative and Coombs negative

Which component of the complete blood count does the nurse assess as the most important for a client with small-cell lung cancer receiving chemotherapy? 1 Platelets 2 Hematocrit 3 Red blood cells (RBCs) 4 White blood cells (WBCs)

4 White blood cells (WBCs)

A nurse is caring for a client with preeclampsia who is receiving intravenous magnesium sulfate. For which assessment would the nurse need to call the health care provider? 1 Respiratory rate of 18 breaths per minute 2 Patellar reflex response of +2 3 Blood pressure of 112/76 mm Hg 4 Urine output of less than 100 mL in 4 hours

4 Urine output of less than 100 mL in 4 hours

What does aldosterone do?

A mineralocorticoid, its secretion causes sodium retention and potassium excretion.

A patient is prescribed Metoprolol. Which statement by the patient requires the nurse to re-educate the patient on how to take the medication properly? A. "After I stop taking this medication I will let my physician know." B. "I take this medication with my breakfast every morning." C. "I will change positions slowly while I'm taking this medication." D. "While I'm taking this medication I will monitor my heart rate."

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

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 use an inhaler at home for asthma." B. "My heart feels like it is racing, and I feel very weak." C. "I had caffeine this morning with breakfast." D. "I smoke 2 packs of cigarettes per day."

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

Which patient below would MOST benefit from an ACE Inhibitor? A. A 50-year-old female with systolic dysfunction heart failure. B. A 48-year-old male with severe renal failure. C. A 35-year-old female with chronic hepatitis. D. A 54-year-old male with hypovolemic shock.

A. A 50-year-old female with systolic dysfunction heart failure.

A patient is prescribed an ACE Inhibitor after experiencing a myocardial infarction. What effects on the body will this medication achieve? Select all that apply: A. Decreases SVR (systemic vascular resistance) and blood pressure B. Constriction of the vessels C. Kidneys will excrete water and sodium D. Kidneys will retain potassium. E. Increases SVR (systemic vascular resistance) and blood pressure

A. Decreases SVR (systemic vascular resistance) and blood pressure C. Kidneys will excrete water and sodium D. Kidneys will retain potassium.

Angiotensin-converting enzyme (ACE) performs what roles in the body? Select all that apply: A. Inactivates bradykinin by breaking it down B. Dilates vessels C. Causes the kidneys to keep sodium and water D. Converts Angiotensin I to Angiotensin II

A. Inactivates bradykinin by breaking it down; D. Converts Angiotensin I to Angiotensin II

A patient is prescribed Verapamil for treatment of a supraventricular arrhythmia. As the nurse you know that this calcium channel blocker will help control the heart rate and rhythm by causing which of the following changes in the heart? Select all that apply: A. Negative inotropic effect B. Positive inotropic effect C. Negative chronotropic effect D. Positive chronotropic effect E. Negative dromotropic effect F. Positive dromotropic effect

A. Negative inotropic effect C. Negative chronotropic effect E. Negative dromotropic effect

Which statements below CORRECTLY describe how ACE Inhibitors work? Select all that apply: A. This group of medications inhibits the renin-angiotensin-aldosterone system (RAAS). B. ACE Inhibitors prevent the conversion of Angiotensin I to Angiotensin II. C. ACE Inhibitors prevent Angiotensinogen from converting to Angiotensin I. D. ACE Inhibitors have a positive chronotropic and negative inotropic effect on the heart.

A. This group of medications inhibits the renin-angiotensin-aldosterone system (RAAS). B. ACE Inhibitors prevent the conversion of Angiotensin I to Angiotensin II.

A patient is prescribed a calcium channel blocker and Digoxin. Which findings would require the nurse to hold further doses of these medications and to immediately notify the physician? Select all that apply: A. The patient reports seeing yellow-greenish halos and is vomiting. B. The patient reports flushing and has enlargement of the gums. C. The patient's heart rate is regular and 80 beats per minute. D. The patient's Digoxin level is 3 ng/mL.

A.The patient reports seeing yellow-greenish halos and is vomiting. D.The patient's Digoxin level is 3 ng/mL.

What are the responsibilities of the nurse when administering ACE Inhibitors?

Assess Blood pressure: watch for hypotension < 90 systolic Monitor K+ levels(3.5-5) Ekg: tall, peaked, t waves Bun(5-20) and creatinine(0.6-1.2) Angioedema: swelling face, mouth, extremities, and no breath.

Contraindications for prescribing antacid magnesium compounds?

Abdominal pain Nausea and vomiting Diarrhea Severe renal dysfunction Fecal impaction Rectal bleeding Colostomy or ileostomy

Initial treatment of salicylate?

Activated charcoal.

Thrombolytics should be avoid giving to which patients?

Active bleeding (recent trauma, aneurysms, AV malformation, peptic ulcers) Uncontrolled HTN 180/110 Recent surgery within 2 weeks.

Antidote for aspirin toxicity?

Active charcoal

Major assessment for anti-platelet medication?

Assess for bleeding.

Nurse administers Rivaroxaban. What considerations should the nurse know about this medication?

Avoid aspirin NSAIDS Vitamin E garlic ginseng ginkgo

Common antacid medications?

Aluminum hydroxide Magnesium hydroxide Calcium carbonate

Dihydropyridine medication examples?

Amlodipine Felodipine Nifedipine

Tricyclic antidepressants (TCAs)

An antidepressant that works by increasing levels of two neurotransmitters (these are chemicals that relay messages in the brain), norepinephrine and serotonin.

A patient is diagnosed with GERD and Pectic Ulcer. The nurse expects which medication classification to be prescribed to the patient?

Antacid

Which category of beta blockers block beta 1 and beta 2 receptors? A. Selective beta blockers B. Nonselective beta blockers

B. Nonselective beta blockers

You're providing discharge instructions to a patient that will be taking an ACE Inhibitor at home. Which statements by the patient demonstrate they understood your discharge instructions? Select all that apply: A. "If I feel unwell, it is okay that I miss a dose." B. "I will avoid using salt substitutes that contain potassium." C. "I will make sure I incorporate a high amount of potatoes, bananas, oranges, and tomatoes into my diet while taking this medication". D. "I will regularly check my blood pressure and pulse rate while taking this medication and report any significant changes to my doctor."

B. "I will avoid using salt substitutes that contain potassium." D. "I will regularly check my blood pressure and pulse rate while taking this medication and report any significant changes to my doctor."

You're providing discharge instructions to a patient who will be taking a calcium channel blocker at home. Which statement by the patient demonstrates they did NOT understand the teaching instructions and needs re-education? A. "I will follow a low-fat and high-fiber diet." B. "I will limit my consumption of soft drinks and try to incorporate more healthy options, like grapefruit juice." C. "This medication can enlarge my gums so I will maintain good oral hygiene." D. "I will monitor my blood pressure regularly because this medication can cause low blood pressure."

B. "I will limit my consumption of soft drinks and try to incorporate more healthy options, like grapefruit juice."

Select all the beta blocker medications listed below that affect ONLY beta 1 receptors: A. Timolol B. Atenolol C. Metoprolol D. Esmolol

B. Atenolol C. Metoprolol D. Esmolol

A 65-year-old male patient is prescribed an ACE inhibitor for the treatment of hypertension. Which medication below is an ACE inhibitor?* A. Metoprolol B. Benazepril C. Losartan D. Amlodipine

B. Benazepril

Which type of calcium channel blockers below are considered non-dihydropyridines and can provide anti-arrhythmic effects? Select all that apply: A. Nifedipine B. Diltiazem C. Amlodipine D. Verapamil

B. Diltiazem D. Verapamil

A patient is prescribed Diltiazem for the treatment of a cardiac disorder. Which findings below would require the nurse to hold the ordered dose of Diltiazem and notify the physician for further orders? Select all that apply: A. Blood pressure 198/102 B. EKG shows 3rd Degree Atrioventricular Block C. EKG shows Atrial Fibrillation with Rapid Ventricular Response D. Heart Rate 46 beats per minute

B. EKG shows 3rd Degree Atrioventricular Block D. Heart Rate 46 beats per minute

Which calcium channel blockers below are known as the dihydropyridines and are known to be more vascular selective? Select all that apply: A. Verapamil B. Felodipine C. Nifedipine D. Diltiazem E. Amlodipine

B. Felodipine C.Nifedipine E.Amlodipine

What signs and symptoms below would demonstrate a patient is experiencing an overdose of a beta blocker medication? Select all that apply: A. Blood pressure 200/110 B. Heart rate 35 beats per minute C. EKG shows atrial fibrillation with rapid ventricular rate (RVR) D. Patient is maniac and agitated E. Dyspnea F. Patient is severely drowsy G. EKG shows 3rd degree AV block

B. Heart rate 35 beats per minute E. Dyspnea F. Patient is severely drowsy G. EKG shows 3rd degree AV block

Your patient is taking Verapamil. When helping the patient make a lunch selection, the nurse should encourage the patient to choose items that are? A. Low in calcium B. High in fiber C. Low in potassium D. High in sodium

B. High in fiber

Beta 2 receptors can be found in the? Select all that apply: A. Heart B. Lungs C. GI system D. Kidneys E. Vascular smooth muscle F. Skeletal muscle

B. Lungs C. GI system E. Vascular smooth muscle F. Skeletal muscle

A patient states they are experiencing an annoying, persistent dry cough that started once they begin taking an ACE Inhibitor. The patient is not experiencing any other signs and symptoms. As the nurse, your response is? A. Tell the patient to immediately stop taking the medication and seek medical treatment. B. Reassure the patient this is a harmless side effect of this medication and to not abruptly stop taking the medication. C. Recommend the patient start taking the medication at night to decrease the coughing. D. Reassure the patient that the cough will disappear within 6 months of taking the medication.

B. Reassure the patient this is a harmless side effect of this medication and to not abruptly stop taking the medication.

A patient is taking an ACE Inhibitor and Spironolactone. It is priority the nurse teaches the patient? A. To avoid consuming alcoholic beverages B. To limit foods high in potassium C. To limit salt intake D. To take the medications with food

B. To limit foods high in potassium

Your patient is prescribed a calcium channel blocker. As the nurse you know that these medication works to block calcium channels in what areas of the body? Select all that apply: A. Vagal nerve cells B. Vascular smooth muscle C. Cardiac nodal tissue D. Peripheral nervous cells E. Cardiac myocytes

B. Vascular smooth muscle C. Cardiac nodal tissue E. Cardiac myocytes

The patient is taking antacid medication for a pectic ulcer. Which side effects would the nurse expect the patient to experience?

Belching Constipation Flatulence Diarrhea Gastric distention

What does nonselective Beta Blockers target?

Beta 1 and Beta 2 Receptors.

What does selective Beta Blockers target?

Beta 1 receptors, cardoselective.

What are Beta Blockers Nursing Considerations?

Bradycardia Heart block Sudden stop of administering medication to prevent rebound of HTN and angina Don't administer with asthma or COPD patients Blood glucose monitoring Orthostatic hypotension Circulation impairment

What is the major side effect to monitor for Rivaroxaban?

Brain bleeding.

A patient with diabetes and hypertension is being discharged home. The patient will be taking Sotalol and insulin per sliding scale. Which statement by the patient demonstrates they did NOT understand your discharge instructions about the side effects of Sotalol? A. "This medication can affect my blood glucose levels." B. "I will monitor my heart rate and blood pressure everyday while taking this medication." C. "While taking this medication I will monitor for a fast heart rate because this is an early indication that my blood glucose level is low." D. "I will report to my physician if I develop shortness of breath, weight gain, or swelling in my feet."

C. "While taking this medication I will monitor for a fast heart rate because this is an early indication that my blood glucose level is low."

Your patient is taking an ACE Inhibitor to manage blood pressure. Which finding below requires immediate nursing action? A. Urinary output is 190 mL within the past 4 hours. B. Patient has a persistent, dry cough. C. EKG shows tall, peaked t-waves. D. Patient has a negative Chvostek's sign.

C. EKG shows tall, peaked t-waves.

Beta 1 receptors can be found in the? Select all that apply: A. GI tract B. Uterus C. Heart D. Lungs E. Kidneys F. Vascular smooth muscle

C. Heart E. Kidneys

Some patients who take ACE Inhibitors may develop angioedema. What signs and symptoms will you teach the patient to recognize that can present with this adverse reaction? Select all that apply: A. Hyperkalemia B. Persistent, dry cough C. Swelling in the face D. Thin and shiny skin in the lower extremities E. Difficulty breathing

C. Swelling in the face E. Difficulty breathing

At 1000 your patient is scheduled to take a dose of Atenolol. What finding below would require you to hold the scheduled dose and notify the physician? A. The patient's heart rate is 120 beats per minute. B. The patient's blood pressure is 102/76. C. The patient has swelling in lower extremities, dyspnea, and crackles in lung fields.

C. The patient has swelling in lower extremities, dyspnea, and crackles in lung fields.

A patient is prescribed a beta 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 _______ ________ _________ response. A. angiotensin II and angiotensin I; sympathetic nervous system B. dopamine and norepinephrine; parasympathetic nervous system C. norepinephrine and epinephrine; sympathetic nervous system D. dopamine and acetylcholine; parasympathetic nervous system

C. norepinephrine and epinephrine; sympathetic nervous system

Fill in the blanks: Angiotensin II causes ___________ of the vessels and triggers the release of ____________. A. vasodilation; anti-diuretic hormone (ADH) B. vasodilation; aldosterone C. vasoconstriction; aldosterone D. vasoconstriction; anti-diuretic hormone (ADH)

C. vasoconstriction; aldosterone

Patient is prescribed Clopidogrel. What patient teaching would the nurse except to explain?

Clopidogrel is an antiplatelet. It will stop the formation of fibrin to stop clots from forming.

Patient is administered Heparin within 24 hours and the nurse notice that the patients platelets labs drops by half. What intervention should the nurse implement with this information?

Hold heparin and notify HCP.

Contraindications for prescribing antacid calcium compounds?

Hypercalcemia Hypercalciuria Severe renal disease Renal calculi Dehydration GI bleeding or obstruction

Contraindications for prescribing antacid sodium compounds?

Hypertension Heart failure

What is Beta Blockers used for?

Hypertension Stable angina Dysrhythmias Heart failure Glaucoma Migraines Tremors Anxiety

What labs to check for warfarin?

INR

Therapeutic range for warfarin?

INR 2-3

Major side effect of ACE Inhibitors?

dry cough

The HCP orders the nurse to administer anticoagulants to the patient that just came out of surgery. The nurse knows that heparin can only be administered by?

IV or Injection.

Contraindications for prescribing antacid aluminum compounds?

Decreased serum phosphate levels causing hypophosphatemia which manifests in anorexia.

Digoxin toxicity

GI effects (anorexia, n/v, abdominal pain) CNS effects (fatigue, weakness, diplopia, blurred vision, yellow-green or white halos around objects)

When do you hold Calcium Channel Blockers?

Heart below 60 Blood Pressure below 100 systolic

What ACE Inhibitors are used for?

Heart failure Hypertension Post myocardial infection

The nurse is administering warfarin to the patient. The nurse expects what other medication to be given with warfarin to prevent clots?

Heparin

When will the nurse hold antiplatelet medication?

Hgb < 7 Platelets < 150,000

How do statins work?

Inhibits first step in cholesterol synthesis

Monoamine oxidase inhibitors (MAOIs) function?

It inhibits the action of monoamine oxidase, a brain enzyme. Monoamine oxidase helps break down neurotransmitters, such as serotonin. If less serotonin is broken down, there will be more circulating serotonin. In theory, this leads to more stabilized moods and less anxiety.

Why is Mirtazapine preferred?

Less sexual/reproductive side effects.

After a few minutes after the nurse administers warfarin to a patient after a myocardial infarction, the patient complains of redness, pain, and irritation in the injection site. What interventions should the nurse implement?

Let the patient know these are normal findings and offer an ice bag to reduce discomfort.

How long is warfarin usually administer?

Life long

Phenelzine (Nardil)

MAOI antidepressant

Tranylcypromine (Parnate)

MAOI. Increases norepinephrine, dopamine, and serotonin by blocking MAO-A. Avoid foods containing tryamine. Antihypertensives have additive hypotensive effect. Contraindicated with SSRIs, tricyclics, heart failure, CVA, renal insufficiency. Side effects: CNS stimulation, orthostatic hypotension, hypertensive crisis with intake of tryamine, SSRIs, and tricylics.

What does ACE inhibitor do?

Manage blood pressure by inhibiting the conversion of angiotensin to angiotensin || causing vasodilation in the blood vessels.

Calcium Channel Blockers nursing considerations?

Monitor blood pressure and pulse, and change the client's position slowly. Hypotension is a common adverse effect.* Use calcium-channel blockers cautiously with clients who have heart failure. *first dose syncope*

What's a major side effect of statins?

Muscle pain and weakness

Non-dihydropyridines

Myocardium selective

A patient is prescribed penicillin and the patient says that they like to drink everyday after work to relax. What patient teaching should the nurse implement?

No alcohol should be consumed during penicillin treatment because the medication is hard on the liver.

What's the most important intervention while patient is taking thrombolytics(tPA)?

No injection at all.

A patient is prescribed a non opioid and asked what's the difference between opioids and non opioids. How should the nurse respond?

Non opioids are not sedating and opioids are.

Patient is prescribed penicillin and is also taking birth control. What patient teaching should implemented?

Oral contraceptives are ineffective and should use additional contraception.

What is the therapeutic PTT lab range to administer heparin?

PTT 46-70

Which patients you can't use Beta Blockers?

Patients with asthma or COPD

Side effects of ACE Inhibitors?

Persistent, dry cough Dizziness Orthostatic hypotension Hypotension Increase potassium levels Angioedema.

Enoxaparin (Lovenox) are focused in which labs?

Platelets

What labs do you check before administering Aspirin or clopidogrel ?

Platelets.

HCP is administering anti-coagulants to a new admit. The nurse knows this medications are administer for what?

Prevention of new clots and preventing growth of existing clots.

Where are beta 2 receptors located?

Primary in the lungs but also the G.I. System, vascular smooth muscles, skeletal muscles, and ciliary body of the eye.

Patient education for ACE Inhibitors?

Record blood pressure regularly Avoid sodium Avoid potassium Talkto HCP before stopping of these of ace inhibitors If a dose is missed, take it when remembered, and if remembered the next day, skip the dose missed and take the next dose.

HCP prescribes antacid to a patient. The nurse this classification of drug affects the body in what way?

Reduces the acidity of the stomach contents.

What is fluoxetine?

SSRI antidepressant

The most common antidepressants prescribed.

Selective serotonin reuptake inhibitors (SSRIs)

Before a patient is discharge for prescribed antacids for a peptic ulcer diagnosis. The nurse teaches the patient how to administer the medication. Which are the nursing considerations ?

Should be taken on a regular schedule Should raise gastric ph > 5 Chew tablets well and follow with water or milk If in liquid form shake we'll before taking If administered via NGT, flush with water following medication.

What does ACE Inhibitors excrete?

Sodium and potassium.

What herb can't be taken with antidepressants?

St John's worth

A nurse is reviewing PTT labs for a patient tin heparin. Labs show PTT 85. What interventions should the nurse do?

Stop the heparin Notify HCP prepare antidote: protamine sulfate. Reassess labs in an hour.

A new nurse is trying to insert a new IV line to a patient after they received anti-platelet medication. What does the nursing observing this do?

Tell the new nurse to hold the IV because it can cause serious bleeding.

What does tryptophan do?

The body uses tryptophan to help make melatonin and serotonin. Melatonin helps regulate the sleep-wake cycle, and serotonin is thought to help regulate appetite, sleep, mood, and pain.

Patient is prescribed penicillin and states that they will take the medication with lunch because they don't like the taste. What nursing teaching should the nurse implement?

The medication should be taken on an empty stomach with a full glass of water.

A patient is prescribed cephalosporins to treat c.diff. What does the nurse do with this information?

The nurse will question the order and contact the health care provider for clarification.

How do Beta Blockers work?

They BLOCK the BETA cells (receptor sites for catecholamines- the epi and norepi) decreasing the contractility--decreasing CO and workload on the heart.

Noradrenergic and specific serotonergic antidepressants

They are thought to act by noradrenergic autoreceptor and heteroreceptor antagonism combined with specific serotonergic antagonism. This results in increases in both noradrenergic and specific serotonergic transmission.

What do statins do?

They reduce cholesterol so they lower the risk of heart and circulatory diseases.

Major sign is aspirin toxicity?

Tinnitus Hyperventilation

Antibiotic toxicity symptoms.

Tinnitus Vertigo High levels of creatinine > 1.3 High levels of BUN > 20 Urine output of 30 ml or less

Tryptophan

Tryptophan is an amino acid needed for normal growth in infants and for the production and maintenance of the body's proteins, muscles, enzymes, and neurotransmitters. It is an essential amino acid. This means your body cannot produce it, so you must get it from your diet.

Where is warfarin administered?

Two inches from the umbilicus.

Acetaminophen is which medication?

Tylenol

Dihydropyridines

Vascular selective (hypertension and Angie)

Non-dihydropyridines medication examples?

Verapamil Diltiazem

Which calcium channel blockers should not be given with digoxin?

Verapamil and diltiazem increase the toxicity of digoxin

Bradykinin

a powerful vasodilator that increases capillary permeability and constricts smooth muscle

Which category of antidepressants can't be administered while taking SSNI, SNRI, and Tricyclics in the last 14 days?

an MAO inhibitor.

Venlafaxine (Effexor)

an antidepressant belonging to a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Venlafaxine affects chemicals in the brain that may be unbalanced in people with depression. Is a prescription medicine used to treat major depressive disorder, anxiety, and panic disorder.

Life threatening side effect of ACE Inhibitors?

angioedema

What does ACE stand for?

angiotensin-converting enzyme

Pristiq (desvenlafaxine)

belongs to a class of antidepressants called serotonin-norepinephrine reuptake inhibitors (SNRIs)

How does SSRI work?

block the reuptake, or absorption, of serotonin in the brain. This makes it easier for the brain cells to receive and send messages, resulting in better and more stable moods.

Monoamine oxidase inhibitors (MAOIs)

class of antidepressant drugs sometimes used for treating depression

Cymbalta is approved to treat?

major depressive disorder (MDD) generalized anxiety disorder (GAD) pain caused by diabetic neuropathy (nerve damage) fibromyalgia chronic musculoskeletal pain (pain in the bones, muscles, ligaments, nerves, and tendons)

What can happen when a diabetic takes Beta Blockers?

may hide signs of low blood sugar in people with diabetes.