exam 2 practice questions
which tasks should a nurse assist a client with in the ambulatory setting in regards to hypertensive management
-finds local resources in the community for taking bp -teaches client how to properly record weight &bp -schedules regular monitoring of weight & bp
a nursing professor is teaching a class on use of antihistamines in older adults. which of the following statements made by the students indicates an understanding of the lecture
-first gen antihistamines may cause confusion -sedation effects may be misinterpreted as senility or mental depression -diphenhydramine is sometimes used as a sleep aid for older adults
when should a pt take their other medications while on cholestyramine
1hr before or 4-6 hrs after
which serum digoxin level would the nurse interpret as indicating digoxin toxicity?
2.3 ng/mL
a pediatric client is on digoxin. which of the following heart rates would indicate the need to hold the medication?
82 beats/min
what are s/s of digoxin toxicity
GI upset and visual changes
a client with what condition should not take pseudophedrine
HTN
a client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating:
I will take the digoxin about an hour before the cholestyramine
a client is receiving warfarin. which would the nurse monitor to determine the effectiveness of therapy?
INR & PT
what route would you expect to give nitroglycerin after trying sl without results
IV
what is a reversal agent for warfarin (coumadin)
Vitamin K
a client w/ HTN has been started on losartan, an angiotensin II receptor blocker (ARB). After 6 weeks of therapy, the health care provider concludes that losartan alone is not controlling the HTN. What would the health care provider likely add to the regimen to better control the client's HTN?
a diuretic
what lab test do you monitor with heparin therapy
aPTT
a client is prescribed metoprolol extended-release PO for heart failure. What assessment finding would suggest an exacerbation of the client's underlying diagnosis?
adventitious breath sounds
a child is brought to the pediatrician's office with trouble breathing. On exam, the child has wheezing in bilateral lung fields. The nurse suspects the provider will order which medication?
albuterol
what medication is considered a "rescue drug"?
albuterol
which of the following is a second-line agent for treating severe asthma
aminophylline
what class of medications would be used for a dry hacking cough
antiussive
what is a type of obstructive pulmonary disease
asthma
a client with a longstanding diagnosis of angina has been prescribed nitroglycerin & diltiazem. In addition to monitoring the client's heart rate, the nurse should prioritize what assessment?
bp
what does a nurse need to monitor closely with recombinant tissue plasminogen activator
bp
what food will increase the effect of albuterol
caffeine
a pt with diabetes has HTN- which drug is first in line
captopril
the nurse's assessment should prioritize what system when caring for a client who has just been admitted for an OD of pseudoephedrine?
cardiovascular
a client is taking cholestyramine. the nurse will assess for which common adverse effect of the drug?
constipation
which side effect causes pts to stop taking their captopril
cough
the nurse is caring for a client with HTN who is preparing to be discharged from the hospital after suffering a MI. what drug would both treat the client's HTN & reduce myocardial oxygen consumption?
diltiazem
which class of drugs increases the effect of losartan
diuretics
when a client is on lasix & digoxin- what can lead to digoxin toxicity
hypokalemia
a nurse is caring for a 59 year old client who has been prescribed nitroglycerin to control angina. Which adverse effect might the nurse observe in this client?
hypotension
a nurse is giving medication instruction to a client who is taking metoprolol (Lopressor). Which statement by the client would indicate that teaching has been effective?
i should never stop taking this drug abruptly
how does fenofibrate work
increases oxidation of fatty acids in the liver
what does filgrastim (neupogen) do
increases wbc production
a 39 year old woman has been taking atorvastatin for 2 years and has now decided that she would like to become pregnant. What health education should the nurse provide to this client?
it's important that you stop taking atorvastatin before you stop using contraception
a 58 year old man has recently been prescribed atorvastatin (Lipitor) in an effort to reduce his cholesterol levels. The man has acknowledged the potentially harmful effects of hyperlipidemia & is motivated to make changes to resolve this health problem. What advice should the nurse give to this client?
its a good idea to keep your intake of saturated fat to a bare minimum
fexofenadine (Allegra) is prescribed for a client w/ seasonal allergies. What should the nurse teach the client about the side effects of this medication?
less drowsiness occurs with this medication compared to other antihistamines
second generation H1 receptor antagonists have less sedative effects
true
a client asks the nurse about how his prescribed digoxin helps his heart. The nurse would include which response?
-increases force if contraction -decreases heart rate
the elderly client has been taking digoxin for the past several months. To assess the client for toxicity of digoxin, what would the nurse evaluate?
-serum digoxin level -apical pulse rate -reports of yellow halo around lights -electrolyte levels
a 42 year old client is seen by the health care provider for follow-up for diabetic nephropathy. The provider prescribed losartan for the treatment of this condition because the medication has been shown to reduce the rate of end-stage renal disease. Which drug class does this drug belong to?
Angiotensin II receptor blockers
what is a symptom of an arterial thrombosis (clot)
MI
losartan is frequently prescribed for HTN management. For which client would the health care provider write a smaller starting dose of the medication, based on medical history and age?
Nick, age 35, who is suffering from hepatic impairment
the nurse will appraise the success or failure of treatment of filgrastim therapy by regularly monitoring the results of what diagnostic test?
absolute neutrophil count
which drug class is used first for a client who has gained weight and has HTN
diuretics
a 25 year old female client presents at the clinic w/ bronchitis. the health care provider orders guaifenesin. which instruction should the clinic nurse offer when teaching the client about the medication?
drink at least two liters of fluids each day
what medication is used for treatment of anaphylaxis
epinephrine
the pt w/ chronic renal failure requires an agent to increase red blood cell production. which drug does the nurse anticipate administering?
epoetin alfa
a client has a productive cough- what medication would be beneficial
expectorant
what are reasons why atorvastatin (lipitor) may not be prescribed
expensive and requires blood work
a client with angina can take pseudophedrine
false
medications for the common cold cure the disease
false
a nurse is caring for a pt prescribed warfarin. which of the following foods should the nurse inform the pt as having high vit K content?
green leafy vegetables
which food is low in sodium
grilled chicken
when would you not use nitroglycerin
head injury
a 76 year old client is receiving IV heparin 5,000 units qh. An activated thromboplastin time (aPTT) is drawn 1 hour before the 8:00 AM dose; the aPTT is at 3.5 times the control value. what would be the most appropriate action?
hold the dose and call the result to the health care provider
the health care provider prescribes captopril (Capoten) for a client, & the nurse provides the client w/ the appropriate client education. What statement by the client tells the nurse that teaching has been effective?
i will make sure that I rise slowly from a supine position d/t the hypotension effect of the medication
a pt is to receive budesonide. the nurse would anticipate administering this drug by which route?
inhalation
an 86 year old client, admitted with thrombophlebitis, is being sent home on enoxaparin (Lovenox). The client has a good understanding of why enoxaparin is being used if he states that it will:
inhibit the formation of additional clots
the nurse is caring for a client who is receiving epoetin alfa. what adjunct treatment will the nurse expect the health care provider to order for this client?
iron supplement
which drug class is used to treat exercise-induced asthma or nighttime coughing episodes
leukotrine modifiers
which medication is given to pts w/ heart failure not responding to other medications
milrinone lactate
what are the main side effects of atorvastatin
nausea and diarrhea
pseudoephedrine (Sudafed) is prescribed for a client suffering from nasal and sinus congestion. what is the most important assessment the nurse should complete before the client leaves the clinic to purchase the medication?
obtain the pts bp
a client, newly diagnosed w/ HTN is started on captopril, an ACE inhibitor. The client should be informed of the possibility of what adverse effect?
persistent cough
when would a pt be changed from warfarin to heparin therapy
pregnancy
a young female is going to be started on losartan. what test should be ordered?
pregnancy test
an adult client with a diagnosis of asthma has been prescribed montelukast. the nurse should teach the client that this drug will help relieve symptoms by which mechanism?
preventing the bronchoconstriction & inflammation that is caused by leukotrienes
a nurse is caring for a 64 year old female client who is receiving IV heparin & reports bleedings from her gums. The nurse checks the clients lab test results and finds that she has a very high aPTT. The nurse anticipates that which drug may be ordered?
protamine sulfate
which pt should not receive epoetin alfa (Epogen) as ordered at 9 am?
pt who has a bp of 240/120 mmHG
how does the nurse providing medication education describe how the drug atorvastatin achieves its desired therapeutic effect?
reducing the amount of cholesterol synthesized by the liver
what is a reason for a client to be prescribe clopidogrel (plavix)
reduction of MI
what can put a pt at risk for hyperkalemia while on potassium sparing diuretics
renal insufficiency
the nurse is caring for a client receiving digoxin. The nurse would intervene for possible digoxin toxicity when the client exhibits which symptoms?
reported feelings of N/V in an emesis basin
what are priority physical assessments that should be performed after administering albuterol
respiratory and cardiovascular
a client has been diagnosed with asthma & prescribed albuterol 2 inhalations q6h. when providing client education, what should the nurse teach the client?
restlessness and anxiety are possible after administration
which is a priority pt education fact for a pt on inhaled corticosteroids
rinse mouth out with water after every use
what medication should men not take while on nitroglycerin
sildenafil
what diet restriction is necessary with lasix
sodium
what type of chest pain lasts 5 mins and gets better with rest
stable angina
the nurse is caring for a female client in the home. The client is prescribed filgrastim. what would be included in the nurse's education plan?
techniques to reduce exposure to infection
a man who smokes one pack of cigs daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family provider. What effect will the client's smoking status have on the therapeutic use of theophylline?
the client may require higher doses of theophylline than a nonsmoker
what reason would a client be placed on epoetin alfa
treatment of anemia
children being given diphenhydramine can have a paradoxical effect
true
