QUIZ 1

The nurse is providing patient education to a patient who has just been given a new prescription for sublingual nitroglycerine tablets. Which statement by the client would indicate a need for additional teaching?

"I should take the nitro every 2-3 minutes until my pain goes away."

A client with stable angina asks why the physician told her to put her nitro patch on at 0800 and take it off at 2000. What explanation should the client be given?

"Patch free intervals are needed to sustain medication effectiveness."

A client with stable angina is starting treatment with Nifedipine, a calcium channel blocker. The client's spouse asks how Nifedipine alleviates chest pain. How should the nurse respond?

"They reduce the work of the heart by reducing aortic pressure (afterload)."

In which of the following situations should the nurse prepare to administer protamine sulfate?

A patient on a heparin drip with a PTT >120 seconds and active GI bleeding.

A client presents in the clinic with concerns of having taken his dabigatran (Pradaxa) twice this morning. Realizing that this is a new oral anticoagulant, what should the nurse do next? (Select all that apply)

Calm the client by explaining that the medication has a 12 hours half- life. Assess for signs of active bleeding. Seek advice from the physician. Ask the client to share how the overdose happened.

While preparing to administer a scheduled dose of digoxin, the nurse finds a new lab result showing a digoxin level of 0.7 ng/mL. What action should the nurse take?

Check the patient's apical pulse; if it is within normal limits, administer the digoxin.

Potassium chloride 10mEq IV has been ordered for a client whose potassium is 2.9 following diuretics. How will the nurse administer the potassium dose?

Dilute the dose in 50 mL IV rider/piggyback and infuse over 1 hour.

A client has been taking digoxin 0.25mg and furosemide 40 mg daily. Upon routine assessment by the nurse, the client states, "I see yellow halos around lights." The nurse should perform which of the following actions based on this assessment?

Consult the provider, then request a digoxin and potassium level be checked.

If a client is taking carvedilol, a beta blocker, which adverse effect should the nurse monitor for?

Dizziness

A client is brought to the emergency department for accidental warfarin (Coumadin) overdose. The nurse determines that the client has no apparent signs of bleeding. Which action should the nurse take next?

Draw a stat blood level for PT or INR.

A client with angina is preparing to go home with a prescription of Nifedipine, a calcium channel blocker. What should the client be taught?

Elevate your feet when you are sitting to avoid edema side effects.

A client presents to the emergency department with chest pain. On a scale of 1:10 he rates the pain as a 6. His respiratory rate is 22/minute. His blood pressure is 156/92. His heart rate is 110/minute. He is afebrile. What other information should the nurse obtain before administering nitroglycerin?

Has the patient used any alcohol or drugs for erectile dysfunction recently?

A client is being discharged to his home on enoxaparin (Lovenox) injections for treatment of a deep vein thrombosis (DVT). Which of the following statements made by the client indicate a need for further discharge teaching by the nurse?

I will need to go to my doctor's office each day to have my enoxaparin blood level checked."

A client is experiencing edema. Which over-the-counter medication might be reducing the diuretic effects of her Lisinopril?

Ibuprofen

A client has had hypertension for approximately 7 years and now is interested in becoming pregnant. What is the safest antihypertensive for a woman in the early stages of pregnancy?

Methyldopa

A client is starting sildenafil (Viagra) for the treatment of pulmonary hypertension. Which of these medications could cause a serious reaction if they are taken with sildenafil?

Nitroglycerin, an antianginal

In preparing discharge education for a client who has just begun hydrochlorothiazide therapy, a nurse reviews the client's lab results. Which finding should the nurse be concerned about in relation to the discharge prescription?

Potassium level of 3.1 mEq/L

A client, who has been seeing multiple doctors, reports that she is taking Lisinopril and another antihypertensive medication, the name of which she can't recall. What type of antihypertensive is contraindicated when people are taking ACE inhibitors due to the risk of compound effects?

Potassium-sparing diuretics

Atenolol (Tenormin) has been prescribed for a client who is recovering from a recent heart attack. The nurse would consult the provider before giving the medicine in which of these situations? (Select all that apply)

Pulse 52 BP 108/62 Respirations 32 with wheezes Blood glucose of 50 Tension headaches Parkinsonian tremors

A client who has been taking Lisinopril, an ACE inhibitor, for 2 weeks complains of a dry cough. How should the nurse respond to this complaint?

The cough is a common side effect of "prils." "Sartans" may be prescribed instead if it becomes intolerable.