Cardiovascular I

Before administering hydralazine (Apresoline), it is most important for the nurse to obtain which assessment? a. Peripheral pulses b. Homan's sign c. Blood pressure d. Capillary refill

Answer: c. Blood pressure

Carbonic anhydrase inhibitors are primarily used for what? a) GI stimulant b) Chronic open angle glaucoma c) Overactive bladder d) Edema

B

The most important long-term goal for a client with hypertension would be to: a. Learn how to avoid stress. b. Explore a job change or early retirement. c. Make a commitment to long-term therapy. d. Lose weight.

c

The nurse is planning to administer hydrochlorothiazide to a client. The nurse understands that which is a concern related to the administration of this medication? A. Hypouricemia, hyperkalemia B. Increased risk for osteoporosis C. Hypokalemia, hyperglycemia, sulfa allergy D. Hyperkalemia, hypoglycemia, penicillin allergy

C

Which of the following drugs should not be coadministered with drugs that may cause hyperkalemia? a. Triamterene(dyrenium) b. Furosemide(Lasix) c. Hydrochlorothiazide(HCTZ) d. Ethacrynic acid(Edecrin)

A

Which of the following is a contraindicated for the use of mannitol (osmitrol)? a. Pulmonary edema b. Asthma c. Hypertension d. Diabetes

A

A nurse is providing patient education to a patient recently prescribed nitroglycerin for chest pain. The nurse knows the patient needs additional education when the patient tells the nurse: a) She will keep her tablets next to her while she lays out at the pool b) She will ensure that her husband, who takes erectile dysfunction medication, will not accidently take her nitroglycerine tablets c) She will place buccal tablets between her cheek and gum d) She will remove her patch for 10-12 hours in a 24hr period. A

A

A patient has a new Rx for metropolol and asks his nurse how it works to lower his blood pressure. The nurse knows that metropolol: a) Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial contractility, and conduction. b) Increases norepinephrine secretion and thus decreases blood pressure and heart rate. c) Is a potent arterial and venous vasodilator that reduces peripheral vascular resistance and lowers blood pressure. d) Is an angiotensin-converting enzyme inhibitor that reduces blood pressure by blocking the conversion of angiotensin I to angiotensin II.

A

A patient is diagnosed with primary hypertension. When taking the patient's history, the healthcare provider anticipates the patient will report which of the following? a) "I have not noticed any significant changes in my health." b) "Sometimes I get pain in my lower legs when I take my daily walk." c) "Every once in a while I wake up at night covered in sweat." d) "I'm starting to get out of breath when I go up a flight of stairs."

A

All of these collaborative interventions are ordered by the health care provider for a patient stung by a bee who develops severe respiratory distress and faintness. Which one will the nurse administer first? a) Epinephrine (Adrenalin) b) Normal saline infusion c) Dexamethasone (Decadron) d) Diphenhydramine (Benadryl)

A

Furosemide is administered intravenously to a client with heart failure. How soon after administration should the nurse begin to see evidence of the drug's desired effect? a) 5-10 minutes b) 20-60 minutes c) 2-4 hours d) 6-8 hours

A

Lozartan(cozaar) , and angiotensin II blocking agent, works by blocking the a. Conversion of angiotensin I to angiotensin II. b. Release of renin c. Binding of angiotensin I to angiotensin II d. Symphatetic response to alpha-I receptors.

A

Thiazide diuretic may cause hypersensitivity in patients with a known history of a. Sulfa drugs b. Penicillin allergy c. Nasal polyps d. Asthma

A

What is the most important ongoing assessment while IV nitroprusside is infusing? a) Blood pressure monitoring b) EKG pattern c) Fluid balance d) Urinary output

A

What is the most serious adverse effect of nitroprusside? a) Cyanide toxicity b) Skin rash c) Nausea d) Irritation around IV needle

A

The use of verapamil (Calan) is contraindicated in patients with heart failure due to: a) Tachycardia b) Negative inotropic effects c) Positive dromotrophic effects d) Fluid retention

Answer: B Verapamil is used for treatment of tachycardia-related arrhythmias. Calcium channel blockers, block calcium channels in the heart muscle and cause a negative inotropic effect, not positive. Fluid retention NOT related to heart failure is not a contraindication

A nurse is planning care for a client who is receiving furosemide (Lasix) for peripheral edema. Which of the following should the nurse include in the plan of care? (Select all that apply) A) Assess for tinnitus B) Report urine output of 50 ml/hr C) Monitor serum potassium levels D) Elevate the head of bed slowly before ambulation E) Recommend eating a banana daily

A, C, D, E

Labetolol primarily exerts its effects which adrenergic receptor: a) alpha 1 b) beta 2 c) beta 1 d) alpha 2

Answer: C. Labetolol is a beta blocker. Beta 1 receptors are located in the heart, where Beta 2 receptors are located in the lungs. Alpha 1 receptors stimulate and 2 receptors are not usually a target of pharmaceutical therapy.

Which substance acts as a hormone and a neurotransmitter in the CNS? a) epinephrine b) angiotensin c) acetylcholine d) norepinephine

Answer: D. Norepinephine and epinephrine hormones involved in the direct stimulation or inhibition of adrenergic receptors. NE is neurotransmitter in the CNS.

The nurse is preparing to administer a dose of clonidine (Catapres). Which is the best description of the action of this drug? a. It selectively activates alpha-2 receptors in the central nervous system (CNS) b. It causes peripheral activation of alpha-1 and alpha-2 receptors c. It depletes sympathetic neurons of norepinephrine d. It directly blocks alpha and beta receptors in the periphery

Answer: a. It selectively activates alpha-2 receptors in the central nervous system (CNS)

The nurse is caring for a patient receiving a nitroprusside (Nipride) intravenous infusion. The patient's wife asks why furosemide (Lasix) is being prescribed along with this drug. The nurse's best response is based on which concept? a. Furosemide will help reduce reflex tachycardia b. Many vasodilators cause retention of sodium and water c. Thiocyanate may accumulate in patients receiving nitropursside d. Vasodilators can cause serious orthostatic hypotension

Answer: b. Many vasodilators cause retention of sodium and water

Because of its effect on the heart, verapamil (Calan) should be used with extra caution in patietns with: a. hypertension b. tachycardia c. heart failure d. angina

Answer: c. heart failure Rationale: Calcium channel blockers such as verapamil are used cautiously in patients with heart failure because of the negative inotropic effects on cardiac muscle, which may precipitate or worsen heart failure

Captopril, an ACE-I, has been ordered for a patient. Which condition in the patient's history is a contraindication to this medication? a. hypokalemia b. dysrhythmias c. hypotension d. increased intracranial pressure

Answer: c. hypotension

The nursing is providing education for a patient who has been prescribed losartan (Cozaar), an angiotensin II receptor blocker (ARB). The patient demonstrates understanding of the teaching when she states a. "If I become pregnant, I will continue to take the medication." b. "I will eat more foods that contain potassium to reduce the risk of adverse effects." c. "I will stop taking the medication if I have diarrhea." d. "I will not use salt substitutes."

Answer: d. "I will not use salt substitutes." Rationale: Salt substitutes often contain potassium, which increases the risk of hyperkalemia when taking losartan. Pregnancy and breast-feeding are contraindications for losartan. Patients should not increase their intake of potassium while taking losartan. Diarrhea is a common adverse reaction of losartan

The nurse is caring for a patient receiving hydralazine (Apresoline). The primary care provider prescribes propranolol (Inderal). The nurse knows that a drug such as propranolol often is combined with hydralazine for what purpose? a. To reduce the risk of headache b. To improve hypotensive effects c. To prevent heart failure d. To protect against reflex tachycardia

Answer: d. To protect against reflex tachycardia

After suffering an acute myocardial infarction (MI), a client with a history of type 1 diabetes is prescribed metroprolol (Lopressor) IV. Which nursing interventions are associated with IV metroprolol administration? a. Monitor glucose levels closely. b. Monitor for heart block and bradycardia. c. Monitor blood presure closely d. b and c e. All of the above

Answer: e. All of the above Rationale: Metoprolol can cause alterations in blood glucose levels. Metoprolol has adverse reactions that include heart block, bradycardia, and hypotension

A client has a history of heart failure and has been on furosemide, digoxin, and potassium chloride. The client has nausea, blurred vision, headache and weakness. The nurse notes that the client is confused. The telemetry strip shows first-degree atrioventricular block. The nurse should assess the client for signs of which of the following? a) hyperkalemia b) digoxin toxicity c) fluid deficit d) pulmonary edema

B

A client is prescribed losartan (Cozaar). The nurse teaches the client that an angiotensin II receptor blocker (ARB) acts by doing what? A. Inhibiting angiotensin-converting enzyme B. Blocking angiotensin II from AT1 receptors C. Preventing the release of angiotensin I D. Promoting the release of aldosterone

B

A client is taking hydrochlorothiazide 50 mg/day and digoxin 0.25 mg/day. What type of electrolyte imbalance does the nurse expect to occur? A) Hypocalcemia B) Hypokalemia C) Hyperkalemia D) Hypermagnesemia

B

A patient in septic shock has not responded to fluid resuscitation, as evidenced by a decreasing BP and cardiac output. The nurse anticipates the administration of a) nitroglycerine (Tridil). b) dobutamine (Dobutrex). c) norepinephrine (Levophed). d) sodium nitroprusside (Nipride).

B

A patient presents to the emergency department with a blood pressure of 180/130 mmHg, headache, and confusion. Which additional finding is consistent with a diagnosis of hypertensive emergency? a) Bradycardia b) Retinopathy c) Urinary retention d) Jaundice

B

A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments? A. Oxygen saturation & respiratory rate B. Heart rate & blood pressure C. Level of consciousness & pain level D. Temperature & respiratory rate

B

Nitroprusside (Nitropress) is prescribed for a client admitted with a blood pressure of 220/110. What action by a new nurse would require intervention by the preceptor? a) The nurse cautions the client to call for assistance prior to getting out of bed b) The nurse uses electronic monitor of blood pressure every hour. c) The nurse documents IV rate and status of site every 15 minutes d) The nurse inserts a Foley catheter.

B

Nitroprusside (Nitropress) is the drug of choice in the management of a. Rebound hypotension b. Hypertensive crisis c. Rebound tachycardia d. Bradycardia

B

Patient education for female patients receiving ACE inhibitors or angiotensin II blocking agents must include a. Dietary restriction b. Potential harm to a fetus or an infant child c. Need for supplemental potassium d. Risk for increased menstrual bleeding

B

The client newly prescribed with Losartan (Cozaar) tells the nurse that this medication has made him feel dizzy in the morning. Which of the following would be an appropriate response by the nurse? a) Take this medication during lunchtime to decrease the symptoms b) This is a side effect of the medication, sit down for awhile before standing up in the morning or slowly change positions to prevent lightheaded. c) Stop taking this medication whenever you feel dizzy and prop your feet up with one pillow underneath. d) Do not take the medication on days that you feel lightheaded.

B

The health care provider is planning to discontinue a client's beta blocker. What instruction should the nurse give the client regarding the beta blocker? A. The beta blocker should be abruptly stopped when another cardiac drug is prescribed. B. The beta blocker should NOT be abruptly stopped; the dose should be tapered down. C. The beta blocker dose should be maintained while taking another antianginal drug. D. Half the beta blocker dose should be taken for the next several weeks.

B

The nurse knows that which diuretic is most frequently combined with an antihypertensive drug? A. chlorthalidone B. hydrochlorothiazide C. bendroflumethiazide D. potassium-sparing diuretic

B

The nurse recognizes that calcium channel blockers prescribed for the treatment of angina exert their effect by: a) Increasing preload b) Decreasing afterload c) Positive chronotropic effect d) Positive inotropic effect

B

The patient is taking tolterodine (Detrol). The nurse should teach the patient to report which condition? a) Alkaline urine b) Urinary retention c) Excessive tearing d) Reddish orange urine

B

Tolterodine(Detrol) is used in the management of a. Peripheral edema b. Urinary incontinence c. Hypertension d. Head trauma

B

What is the best information for the nurse to provide to the client who is receiving spironolactone (Aldactone) and furosemide (Lasix) therapy? a) "Moderate doses of two different diuretics are more effective than a large dose of one." b)"This combination promotes diuresis but decreases the risk of hypokalemia." c) "This combination prevents dehydration and hypovolemia." d) "Using two drugs increases the osmolality of plasma and the glomerular filtration rate."

B

What steps must be taken when administering an osmotic diuretic, mannitol? a) Place on ice directly before administering. b) Warm to body temperature and use an in-line filter to draw up the medication. c) Food must be administered with the medication. d) A full glass of water should be consumed at this time.

B

What will the nurse instruct the client to do to prevent the development of tolerance to nitroglycerin? A. Apply the nitroglycerin patch every other day. B. Switch to sublingual nitroglycerin when the client's systolic blood pressure elevates to more than 140 mm Hg. C. Apply the nitroglycerin patch for 14 hours and remove it for 10 hours at night. D. Use the nitroglycerin patch for acute episodes of angina only.

C

Which client would the nurse need to assess first if the client is receiving mannitol (Osmitrol)? A. A 67-year-old client with type 1 diabetes mellitus B. A 21-year-old client with a head injury C. A 47-year-old client with anuria D. A 55-year-old client receiving cisplatin to treat ovarian cancer

C

Which intervention will the nurse perform when monitoring a client receiving triamterene (Dyrenium)? a. Assess urinary output hourly. b. Monitor for side effect of hypoglycemia. c. Assess potassium levels. d. Monitor for Hypernatremia.

C

A 35-year old patient is receiveing diuretic therapy. Which of the following assessments would best reflect the patients fluid volume? a) Blood pressure and pulse b) Serum potassium and sodium levels c) Intake, output, and daily weights d) Measurements of abdominal girth and calf circumference

C

A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons? a) To reduce intraocular pressure b) To prevent acute tubular necrosis c) To promote osmotic diuresis to decrease ICP d) To draw water into the vascular system to increase blood pressure

C

A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons? a) To reduce intraocular pressure b) To prevent acute tubular necrosis c) To promote osmotic diuresis to decrease ICP d) To draw water into the vascular system to increase blood pressure

C

A client with acute pulmonary edema receives furosemide (Lasix). What assessment finding indicates that the intervention is working? A. Potassium level decreased from 4.5 to 3.5 mEq/L. B. Crackles auscultated in the bases. C. Lungs clear. D. Output 30 mL/hr.

C

A nurse in an acute care facility is infusing IV nitroprusside for a client who is in hypertensive crisis. For which of the following adverse reactions should the nurse monitor this client? A. Intestinal ileus B. Neutropenia C. Delirium D. Hyperthermia

C

A nurse is caring for a client who is starting captopril (Capoten) for hypertension. For which of the following adverse effects should the nurse monitor the client? A. Hypokalemia B. Hypernatremia C. Neutropenia D. Anemia

C

A post-MI patient is started on an angiotensin converting enzyme (ACE) inhibitor during his hospital stay. Which of the following is the most common serious side effect that may occur? A) Non-productive cough B) Pedal edema C) Swelling of the tongue and face D) Rhinorrhea

C

Because of its effect on the heart, verapamil (Calan,Covera- HS, Isoptin SR, Verelan) should be used with extra caution or is contraindicated in patients with: a) Hypertension b) Tachycardia c) Heart failure d) Angina

C

Because of the action of captopril (capoen), which of the following electrolytes should be monitored? a. Calcium and chloride b. Chloride and sodium c. Potassium and sodium d. Magnesium and calcium

C

Serious potential adverse effects to eplerenone (Inspra) occur in the _____system. a. Respiratory b. Hematopoietic c. Cardiovascular d. Skeletal

C

The nurse determines that further education is needed for a patient receiving the antihypertensive medication, Verapamil, when the patient states he is trying to eat healthier and adding new foods and drinks to his diet. He stated he will eat which of the following for breakfast: A) Omelet & coffee B) Oatmeal, coffee & a banana C) Omelet, toast & grapefruit juice D) Oatmeal, & prune juice

C

The nurse is aware that which group(s) of antihypertensive drugs are less effective in African-American clients? a) Diuretics b) Calcium channel blockers and vasodilators c) Beta blockers and ACE inhibitors d) Alpha blockers

C

When discussing hypertension with a student, which of the following will the healthcare provider identify as a factor related to hypertension? a) Hypovolemia b) Decreased cardiac output c) Hypervolemia d) Increased afterload

D

Which intervention will the nurse perform when monitoring a client receiving triamterene (Dyrenium)? A) Assess urinary output hourly. B) Monitor for side effect of hypoglycemia. C) Assess potassium levels. D) Monitor for Hypernatremia

D

The nurse is monitoring a client who is taking propanolol (Inderal LA). Which assessment data indicates a potential serious complication associated with this medication? a. The development of complaints of insomnia b. The development of audible expiratory wheezes c. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication d. A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72 beats/minute after two doses of the medication

Correct Answer: b; audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm. Beta blockers may induce this reaction, particularly in clients with chronic obstructive pulmonary disease or asthma. Normal decreases in blood pressure and heart rate are excepted. Insomnia is a frequent mild side effect and should be monitored.

Which of the following effects of calcium channel blockers causes a reduction in blood pressure? a. Increased cardiac output b. Decreased peripheral vascular resistance c. Decreased renal blood flow d. Calcium influx into cardiac muscles

Correct Answer: b; by reducing PVR, the BP is reduced. D is incorrect because this drug blocks calcium from entering cardiac muscles

Which type of diuretic is composed of sugar? a) Thiazide diuretic: Hydrochlorothiazide b) Loop diuretic: Furosemide c) Potassium sparring diuretic: Triamterine d) Osmotic diuretic: Mannitol

D

A patient comes to the ER with a BP of 220/130. The provider orders nitroprusside (Nitropress). After administration, the patient experiences confusion and shortness of breath. The most appropriate nursing intervention is: a. Facilitate a relaxing environment for the patient, as confusion and anxiety are common side effects of this medication b. Administer oxygen to help decrease the patient's respiratory workload c. Notify the provider immediately d. Administer IV fluids

Correct Answer: c; the patient is likely experiencing cyanide toxicity.

A patient with hypertension is started on a new medication for treatment and is reporting a continuous dry cough. Which of the following medications do you suspect is causing the problem? a. Losartan b. Labetalol c. Hydrochlorothiazide d. Lisinopril

Correct Answer: d; an adverse effect of ACE inhibitors is a chronic dry cough

A patient with HTN receives a prescription for Eplerenone. The Nurse can judge that patient education has occurred when the patient states the following? (Select all that apply) a. This medication will take about 8 weeks for it to begin working b. I should avoid eating bananas while using this medication c. I should take this medication with meals d. I will need to have labs done periodically during therapy e. This medication works more effectively if I take it with grapefruit juice

Correct Answers: b, d; a is incorrect because medication takes 4 weeks for effectiveness; b: pt should avoid high-potassium foods and potassium supplements r/t risk of hyperkalemia; c: food does not affect absorption; d: potassium levels should be monitored periodically; e: grapefruit juice and St. John's Wort should be avoided while taking this medication because they affect bioavailability)

A patient with hypertension is to take an angiotensin II receptor blockers (ARB). What information related to the need to stop the medication should the nurse plan to include when teaching the client about this medication? Select all that apply. a. Monitor BP daily b. Avoid the use of NSAIDs c. Stop treatment if a cough develops d. Stop the medication if swelling of the mouth, lips, or face develops e. Have blood drawn for potassium levels 2 weeks after starting the medication

Correct Answers: d, e; important nursing considerations for patients taking ARBs include assessing for signs of CHF, angioedema, and hyperkalemia.

"Epinephrine reversal" could occur if epinephrine is administered in the presence of: A) cocaine B) imipramine C) propranolol D) phentolamine E) dopamine

D

. James, a 73 year old patient with atrial fibrillation, has been prescribed Amiodarone. What assessment for complications has the highest priority: a) monitor daily weights b) daily vision tests c) blood pressure q4 d) assess for changes in respiratory status

D

A patient is prescribed a thiazide diuretic for the treatment of hypertension. When teaching the patient about the medication, which of the following will the healthcare provider include? a) "Take this medication each day with a large glass of water after you evening meal." b) "I'll teach you how to teak your radial pulse before taking the medication." c) "Stop taking this mediation if you notice changes in how much you urinate." d) "Be sure to include a number of foods that are rich in potassium in your diet."

D

A patient was admitted from the emergency department after receiving treatment for dysrhythmias and will be started on amiodarone (Cordarone, Pacerone) because of lack of therapeutic effects from his other antidysrhythmic therapy. When the nurse checks with him in the afternoon, he complains of feeling lightheaded and dizzy. The nurse will first assess: A. Whether there is the possibility of sleep deprivation from the stress of admission to the hospital B. Whether an allergic reaction is occurring with anticholinergic-like symptoms C. Whether the amiodarone level is not yet therapeutic enough to treat the dysrhythmias D. Whether the patient's pulse and blood pressure are within normal limits

D

Nitroprusside is available in which of the following formulations? A) Capsules B) B) Sublingual Tablets C) Topical Ointment D) Intravenous Solution

D

The drug of choice to control premature ventricular contractions, ventricular tachycardia, or ventricular fibrillation is A. quinidine B. procainamide C. bretylium D. lidocaine

D

The nurse is caring for a client with hypertension who is prescribed Clonidine transdermal preparation. What is the correct information to teach this client? A) Change the patch daily at the same time. B) Remove the patch before taking a shower or bath. C) Do not take other antihypertensive medications while on this patch. D) Get up slowly from a sitting to a standing position.

D

The results of an adult patient's blood pressure screening on three occasions are: 120/80 mmHg, 130/76 mmHg, and 118/86 mmHg. How will the healthcare provider interpret this information? a) Normal blood pressure b) Hypertension stage 2 c) Hypertension stage 1 d) Prehypertension

D

The teaching plan for a client being started on long acting nitroglycerin includes the action of this drug. The nurse teaches that this drug relieves chest pain by which action? A. Dilating just the coronary arteries B. Decreasing the blood pressure C. Increasing contractility of the heart D. Dilating arteries and veins

D

A major side effect of angiotensin-converting enzyme (ACE) inhibitors is intractable cough. The nurse recognizes which ethnic group to be at highest risk for this side effect? A. Asians B. Hispanics C. Native Americans D. Whites

Explanation: Answer A. Intractable dry cough is a common side effect of ACE inhibitors. It is thought to be related to the accumulation of kinins. Asians, especially those of Chinese descent have a high risk (15%-50%) for ACE inhibitor-related cough. Persons of African descent are also at high risk of developing cough and angioedema.

The nurse is planning to administer furosemide (Lasix) 40 mg IV directly. The nurse uses which of the following techniques in administering this medication? a. Pushes the medication rapidly b. Gives the medication slowly diluted in 50 mL of NS c. Injects the medication slowly over two to three minutes d. Dilutes the medication with sterile water and inject over five minutes

RATIONALE: C. Most IV medications should be injected slowly. Rapid injection of furosemide can cause hearing loss as a result of ototoxicity. It does not need to be further diluted before injection

Bethanechol chloride (Urecholine) is prescribed for a patient with urinary retention. Which disorder would be a contraindication to this medication? a. Gastric atony b. Urinary strictures c. Neurogenic atony d. Gastroesophageal reflux

RATIONALE: B. Bethanechol can be hazardous to patients with urinary obstruction or weakness of the bladder wall. The medication has the ability to contract the bladder, thereby increase pressure within the urinary tract. Elevation of pressure within the urinary tract can rupture the bladder in patients with these conditions

The nurse is planning to administer hydrochlorothiazide to a patient. The nurse understands that which is a concern related to the administration of this medication? a. Hypouricemia, hyperkalemia b. Increased risk of osteoporosis c. Hypokalemia, hyperglycemia, sulfa allergy d. Hyperkalemia, hypoglycemia, penicillin allergy

RATIONALE: C. Thiazide diuretics such as hydrochlorothiazide are sulfa based medications and a patient with a sulfa allergy is at risk for an allergic reaction. Also, patients are at risk for hypokalemia, hyperglycemia, hypercalcemia, hyperlipidemia, and hyperuricemia

A nurse is planning dietary counseling for the client taking triamterene (Dyrenium). The nurse plans to include which of the following in a list of foods that are acceptable? a. baked potato b. bananas c. oranges d. pears canned in water

RATIONALE: D. Triamterene is a potassium-sparing diuretic, and clients taking this medication should be cautioned against eating foods that are high in potassium, including many vegetables, fruits, and fresh meats. Because potassium is very water-soluble, foods that are prepared in water are often lower in potassium

Your patient has a new order for hydrochlorothiazide, however upon examination of the patient's chart, which finding would indicate you holding the medication and calling the physician? a. The patient has an allergy to sulfa drugs b. The patient has had hypertension for the past 15 years c. The patient has recently begun an exercise program d. The patient is female and African American

a

What is the purpose of antiarrhythmic drugs? A. To change the flow of blood through the heart B. To substitute for implantable cardioverter defibrillators C. To prevent, suppress, or treat a disturbance in cardiac rhythm D. To increase or decrease the contractility of the heart muscle

c

A 72 yo patient has been prescribed sublingual nitroglycerin PRN for chest pain. You recognize that all of the statements by the patient indicate understanding of the drug EXCEPT: A. After 5 minutes, I can chew the pill. B. I won't drink coffee or tea while the pill is in my mouth. C. I will place the pill in the pouch between my cheek and gum. D. I can take one tablet every 5 minutes, up to 3 tablets in 15 minutes.

a

The drug of choice for treating increased intracranial pressure is: a. Mannitol b. Hydrochlorothiazide c. Furosemide d. Tolterodine

a

Which of the following adverse effects may occur with all antihypertensive medications a. Orthostatic hypotension b. Hypokalemia c. Hyperkalemia d. Hypovolemia

a

Which of the following patients should be monitored carefully while receiving lidocaine therapy? A. Henry, with migraine headaches B. Calvin, with hypothyroidism C. Molly, with congestive heart failure D. Leslie, with diabetes

c

. The nurse is caring for a client receiving digoxin (Lanoxin). Which of the following manifestations correlate with a digoxin level of 2.3 ng/dl? Select all that apply. A. Nausea B. Drowsiness C. Photophobia D. Increased appetite E. Increased energy level F. Seeing halos around bright objects

a, b, c, f

Your patient is to begin a regimen of propranolol, a beta blocker, for treatment of cardiac arrhythmia. Before administering the first dose of the drug, the nurse should assess the patient's health status and confirm that the patient does not have: A. Hypertension B. Angina C. Asthma D. All of the above

c

Furosemide has the potential to cause a. Nephrotoxicity b. Otoxocity c. Hepatotoxicity d. Cardiotoxicity

b

Why would it be necessary to use caution when giving metoprolol to a diabetic? a. It raises blood sugar b. It masks the signs of hypoglycemia c. It can likely cause palpitations in diabetics d. It inhibits the activity of insulin

b

Your patient begun treatment with a diuretic a few weeks ago. You would be sure to check which of the following patient's lab values before administering? a. CBC b. Electrolyte levels c. HgbA1c d. Liver Enzymes

b

Your patient has been prescribed eplerenone and you are educating the patient on the drug. Which of the following should be included in the teaching? a. Increase intake of green leafy vegetables b. Avoid salt substitutes that contain potassium c. Avoid dairy products d. Make sure to take it concurrently with spironolactone (Aldactone)

b

ACE inhibitors are associated with which unique adverse effect? a. Hyperkalemia b. Hypotension c. Cough d. Peripheral edema

c

Amiodarone is labeled for use only in the treatment of documented life-threatening recurrent ventricular arrhythmias because of its: A. Prohibitive cost B. Extremely long half-life C. Potentially adverse effects D. Ability to interact with any other medication

c

Mr. Brown takes sublingual nitroglycerine PRN for chest pain. Which drug may produce hypotension if taken in combination with nitro? A. Losartan B. Verapamil C. Sildenafil D. Metoprolol

c

Mr. Smith has been experiencing tolerance to transdermal nitroglycerin. Which of the following suggestions would be appropriate? A. You should change the patch every 24 hours. B. You should only use the patch at the first sign of chest pain. C. You should remove the patch when you go to bed and put on a new patch in the morning. D. You should only use sublingual tablet from now on.

c

A nurse is assessing a bedridden client and notes sacral edema. The nurse determines that the edema is most likely the result of which of the following? A. Diabetes mellitus B. Pulmonary emboli C. Chronic kidney failure D. Right-sided heart failure

d

Monitor for signs of hyperkalemia when administering which drug? a. Furosemide b. Hydrochlorothiazide c. Mannitol d. Triameterine

d

Which of the following drug classes should be administered to a client with heart failure to maximize cardiac performance? A. Beta-adrenergic blockers B. Calcium channel blockers C. Diuretics D. Inotropic agents

d