exam 3 app questions

Which of the following conditions is a contraindication to statin use? A) Active liver disease B) Diabetes mellitus C) Hypothyroidism D) Coronary artery disease

Answer: A Rationale: Active liver disease is a contraindication to statin use because these medications are metabolized by the liver and can cause further damage

A patient is prescribed aspirin and clopidogrel after a myocardial infarction. Which of the following is an important nursing consideration? A) Monitor for signs of gastrointestinal bleeding B) Administer both medications on an empty stomach C) Monitor for bradycardia D) Increase dietary potassium

Answer: A Rationale: Both aspirin and clopidogrel increase the risk of bleeding, particularly gastrointestinal bleeding, so patients should be monitored for signs such as black stools or hematemesis​

Which of the following diagnostic findings is commonly associated with pericarditis? A) ST-segment elevation in all ECG leads B) ST-segment depression in the anterior leads C) Pathologic Q waves in the inferior leads D) Prolonged QT interval

Answer: A Rationale: Diffuse ST-segment elevation in almost all leads is characteristic of acute pericarditis and helps distinguish it from myocardial infarction​

Which of the following symptoms is most commonly associated with Dressler syndrome? A) Low-grade fever and chest pain B) Severe headache and blurred vision C) Nausea and vomiting D) Severe hypotension and shock

Answer: A Rationale: Dressler syndrome is characterized by low-grade fever, pleuritic chest pain, pericardial effusion, and possibly malaise​

What medications are typically used in dual antiplatelet therapy (DAPT) for patients with coronary artery disease? A) Aspirin and clopidogrel B) Warfarin and aspirin C) Heparin and clopidogrel D) Aspirin and metoprolol

Answer: A Rationale: Dual antiplatelet therapy (DAPT) typically involves the use of aspirin and a P2Y12 inhibitor, such as clopidogrel, to prevent platelet aggregation and reduce the risk of stent thrombosis​

Which insulin should be given within 15 minutes of a meal to control postprandial glucose levels? A) Insulin lispro (Humalog) B) Insulin glargine (Lantus) C) NPH insulin D) Regular insulin

Answer: A Rationale: Insulin lispro (Humalog) is a rapid-acting insulin that should be administered within 15 minutes of a meal to control postprandial blood glucose【

Which of the following LDL cholesterol levels is considered optimal? A) < 100 mg/dL B) 100-129 mg/dL C) 130-159 mg/dL D) > 160 mg/dL

Answer: A Rationale: LDL levels below 100 mg/dL are considered optimal for reducing the risk of cardiovascular disease

Which of the following findings may indicate a complication of Dressler syndrome? A) Muffled heart sounds and jugular venous distention B) ST-segment depression on ECG C) Decreased white blood cell count D) Hyperactive bowel sounds

Answer: A Rationale: Muffled heart sounds, jugular venous distention, and hypotension are signs of cardiac tamponade, a potential complication of Dressler syndrome​

A nurse is teaching a patient about the peak time of rapid-acting insulin (e.g., insulin aspart). When should the patient expect their blood sugar to drop the most after taking insulin aspart? A) 1 to 2 hours after administration B) 4 to 6 hours after administration C) 30 minutes after administration D) 6 to 8 hours after administration

Answer: A Rationale: Rapid-acting insulins like insulin aspart peak 1 to 2 hours after administration, which is when the patient may experience the most significant drop in blood glucose

What is the most common cause of new cases of blindness in adults with diabetes? A) Retinopathy B) Glaucoma C) Cataracts D) Macular degeneration

Answer: A Rationale: Retinopathy, especially proliferative retinopathy, is the most common cause of new cases of blindness in diabetic patients​

What is the primary mechanism of action of statins (HMG-CoA reductase inhibitors)? A) Increase LDL receptor activity in the liver B) Decrease HDL levels C) Block the absorption of dietary cholesterol D) Increase triglyceride levels

Answer: A Rationale: Statins work by increasing LDL receptor activity in the liver, which enhances the removal of LDL from the blood​

In the treatment of acute coronary syndrome (ACS), the acronym MONA stands for: A) Morphine, Oxygen, Nitroglycerin, Aspirin B) Metoprolol, Oxygen, Nitroglycerin, Atropine C) Morphine, Ondansetron, Nitroglycerin, Atorvastatin D) Magnesium, Oxygen, Norepinephrine, Aspirin

Answer: A Rationale: The acronym MONA stands for Morphine, Oxygen, Nitroglycerin, and Aspirin, which are commonly used in the initial treatment of ACS to relieve pain, improve oxygenation, reduce myocardial workload, and prevent clot formation​

A patient presents with severe chest pain unrelieved by nitroglycerin and is diagnosed with a STEMI. What is the priority treatment? A) Thrombolytic therapy B) Beta-blockers C) Coronary artery bypass grafting D) Administering diuretics

Answer: A Rationale: Thrombolytic therapy is a priority in patients with ST-elevation myocardial infarction (STEMI) to dissolve the clot and restore perfusion

Which of the following insulin regimens mimics the natural pattern of insulin secretion in the body? A) A combination of insulin glargine (Lantus) once daily and insulin lispro (Humalog) before meals B) NPH insulin twice daily with regular insulin as needed C) Regular insulin administered every 4 hours D) Insulin detemir (Levemir) given twice daily

Answer: A Rationale: Using a long-acting insulin like glargine (Lantus) for basal coverage and a rapid-acting insulin like lispro (Humalog) before meals mimics the body's natural insulin secretion pattern

A patient with hypertension is started on losartan (Cozaar). Which statement by the patient indicates understanding of the medication? A) "I will avoid foods high in potassium." B) "I need to monitor my blood sugar closely." C) "This medication may cause a dry cough." D) "I should take this medication on an empty stomach."

Answer: A) "I will avoid foods high in potassium." Rationale: Losartan is an angiotensin II receptor blocker (ARB) that can cause hyperkalemia; patients should avoid excessive potassium intake.

38. A nurse is educating a client on the use of an insulin pen. Which statement indicates a need for further teaching? A) "I will store the pen with the needle attached." B) "I need to prime the pen before each injection." C) "I can carry the pen with me for convenience." D) "I should keep the pen at room temperature when in use."

Answer: A) "I will store the pen with the needle attached." Rationale: The needle should be removed after each use to prevent air bubbles and contamination.

A nurse is preparing to administer medications to several clients. Which client should the nurse assess first? A) A client receiving a first dose of doxazosin B) A client scheduled for a routine dose of atenolol C) A client who takes amlodipine complaining of headache D) A client with a blood pressure of 138/86 mm Hg

Answer: A) A client receiving a first dose of doxazosin Rationale: The first dose of doxazosin, an alpha-blocker, can cause severe hypotension (first-dose effect), requiring close monitoring.

A client is experiencing the Somogyi effect. What intervention should the nurse anticipate? A) Administer a bedtime snack B) Increase the morning dose of insulin. C) Decrease the morning dose of insulin. D) Administer glucagon at bedtime.

Answer: A) Administer a bedtime snack. Rationale: The Somogyi effect occurs due to nocturnal hypoglycemia followed by rebound hyperglycemia. A bedtime snack can help prevent hypoglycemia

A client presents with symptoms of acute coronary syndrome (ACS). Which medication is the priority to administer? A) Aspirin B) Clopidogrel C) Atorvastatin D) Losartan

Answer: A) Aspirin Rationale: Aspirin is administered immediately in ACS to reduce platelet aggregation and limit the size of the thrombus.

33. A client is scheduled for a percutaneous coronary intervention (PCI). Which medication should the nurse anticipate administering before the procedure? A) Aspirin B) Warfarin C) Furosemide D) Lisinopril

Answer: A) Aspirin Rationale: Aspirin is given to reduce platelet aggregation before PCI to prevent thrombus formation during the procedure.

Select all that apply: Which medications are typically used in the treatment of chronic stable angina? A) Aspirin B) Beta-blockers C) Insulin D) Calcium channel blockers E) Long-acting nitrates

Answer: A) Aspirin, B) Beta-blockers, D) Calcium channel blockers, E) Long-acting nitrates Rationale: Aspirin is an antiplatelet, beta-blockers reduce myocardial oxygen demand, calcium channel blockers promote vasodilation, and long-acting nitrates help reduce the frequency of angina episodes.

Select all that apply: A nurse is caring for a patient with chronic stable angina who is prescribed beta-blockers. What are common side effects of beta-blockers? A) Bradycardia B) Hypotension C) Hyperkalemia D) Bronchospasm E) Increased libido

Answer: A) Bradycardia, B) Hypotension, D) Bronchospasm Rationale: Beta-blockers reduce heart rate and blood pressure. They can also cause bronchospasm, especially in patients with asthma.

Select all that apply: A client is prescribed a beta-blocker for hypertension. Which side effects should the nurse teach the client to monitor? A) Bradycardia B) Hypotension C) Hyperkalemia D) Erectile dysfunction E) Bronchospasm

Answer: A) Bradycardia, B) Hypotension, D) Erectile dysfunction, E) Bronchospasm Rationale: Beta-blockers can cause bradycardia, hypotension, erectile dysfunction, and bronchospasm, particularly in patients with asthma.

48. Select all that apply: Which client education points are important for a patient taking antihypertensive medications? A) Do not stop the medication abruptly B) Rise slowly from sitting or lying positions C) Report any persistent cough D) Monitor blood pressure regularly E) Avoid all physical activity

Answer: A) Do not stop the medication abruptly, B) Rise slowly from sitting or lying positions, C) Report any persistent cough, D) Monitor blood pressure regularly Rationale: Stopping antihypertensives abruptly can cause rebound hypertension; orthostatic hypotension may occur, so rising slowly is important. A persistent cough may indicate an ACE inhibitor side effect. Regular BP monitoring is essential. Physical activity should be encouraged as tolerated.

The nurse is educating a client about calcium channel blockers. What is a common side effect of this class of medications? A) Edema B) Hyperglycemia C) Hypertension D) Tachycardia

Answer: A) Edema Rationale: Calcium channel blockers can cause peripheral edema due to vasodilation.

Which of the following is a priority nursing intervention when administering nitroglycerin for a patient experiencing angina? A) Have the patient sit or lie down before taking the medication. B) Monitor the patient's potassium levels. C) Give nitroglycerin with food. D) Check for signs of bleeding.

Answer: A) Have the patient sit or lie down before taking the medication. Rationale: Nitroglycerin causes vasodilation and can lead to hypotension and dizziness, making it important for the patient to sit or lie down.

Select all that apply: Which of the following are side effects of long-acting nitrates used to treat angina? A) Headache B) Orthostatic hypotension C) Hypertension D) Bradycardia E) Flushing

Answer: A) Headache, B) Orthostatic hypotension, E) Flushing Rationale: Long-acting nitrates can cause headaches, orthostatic hypotension, and flushing due to vasodilation.

47. A patient with hypertension is prescribed a beta-blocker. What is the most important assessment before administering the medication? A) Heart rate and blood pressure B) Respiratory rate C) Blood glucose level D) Urine output

Answer: A) Heart rate and blood pressure Rationale: Beta-blockers can decrease heart rate and blood pressure; these should be assessed to prevent bradycardia and hypotension.

A client taking metformin (Glucophage) is scheduled for a CT scan with contrast. What is the appropriate nursing action? A) Hold the metformin 48 hours before the procedure. B) Administer metformin with breakfast the day of the procedure. C) Increase the dose of metformin the day before the procedure. D) Monitor the client's blood glucose every hour during the procedure.

Answer: A) Hold the metformin 48 hours before the procedure. Rationale: Metformin should be held before a procedure using contrast dye due to the risk of lactic acidosis and renal damage.

A client is taking lisinopril for hypertension. What electrolyte imbalance should the nurse monitor for? A) Hyperkalemia B) Hypokalemia C) Hyponatremia D) Hypercalcemia

Answer: A) Hyperkalemia Rationale: ACE inhibitors like lisinopril can cause potassium retention, leading to hyperkalemia.

A client with hypertension is prescribed lisinopril (Prinivil). The nurse knows that the client should be monitored for which potential side effect? A) Hyperkalemia B) Hypokalemia C) Bradycardia D) Hyperglycemia

Answer: A) Hyperkalemia Rationale: Lisinopril is an ACE inhibitor, which can cause potassium retention, leading to hyperkalemia.

44. Select all that apply: Which factors can affect insulin absorption? A) Injection site B) Depth of injection C) Exercise of injected limb D) Dose of insulin E) Time of day

Answer: A) Injection site, B) Depth of injection, C) Exercise of injected limb, D) Dose of insulin Rationale: Insulin absorption can be affected by the site, depth, exercise of the limb, and dose. Time of day does not significantly affect absorption.

40. Select all that apply: Which of the following are considered rapid-acting insulins? A) Insulin lispro (Humalog) B) Insulin glargine (Lantus) C) Insulin aspart (NovoLog) D) Regular insulin E) Insulin glulisine (Apidra) .

Answer: A) Insulin lispro (Humalog), C) Insulin aspart (NovoLog), E) Insulin glulisine (Apidra) Rationale: Lispro, aspart, and glulisine are rapid-acting insulins. Glargine is long-acting, and regular insulin is short-acting

A client taking metformin (Glucophage) reports muscle pain and fatigue. What condition should the nurse assess for? A) Lactic acidosis B) Hyperglycemia C) Hypocalcemia D) Thyroid storm

Answer: A) Lactic acidosis Rationale: Metformin can cause lactic acidosis, especially in clients with kidney problems or those undergoing procedures requiring contrast dye.

Select all that apply: Which of the following are rapid-acting insulins? A) Lispro B) Glargine C) Aspart D) NPH E) Glulisine

Answer: A) Lispro, C) Aspart, E) Glulisine Rationale: Lispro, Aspart, and Glulisine are all rapid-acting insulins. Glargine is long-acting, and NPH is intermediate-acting.

A patient is prescribed simvastatin (Zocor). Which laboratory test should the nurse monitor for potential complications? A) Liver function tests B) Serum glucose C) Potassium levels D) Thyroid function tests

Answer: A) Liver function tests Rationale: Statins, including simvastatin, may cause liver damage, so liver function should be monitored regularly.

Select all that apply: Which medications are used in type 2 diabetes to reduce glucose production by the liver? A) Metformin B) Glipizide C) Pioglitazone D) Sitagliptin E) Canagliflozin

Answer: A) Metformin, D) Sitagliptin Rationale: Metformin reduces hepatic glucose production. Sitagliptin is a DPP-4 inhibitor that also affects glucose production indirectly.

Which diabetes medication works by increasing insulin sensitivity at target tissues? A) Pioglitazone (Actos) B) Glipizide (Glucotrol) C) Acarbose (Precose) D) Canagliflozin (Invokana)

Answer: A) Pioglitazone (Actos) Rationale: Pioglitazone is a thiazolidinedione that increases insulin sensitivity at target tissues.

36. Select all that apply: Which laboratory tests are important to monitor in a client receiving heparin therapy? A) Platelet count B) Prothrombin time (PT )C) Activated partial thromboplastin time (aPTT) D) International normalized ratio (INR) E) Hemoglobin and hematocrit

Answer: A) Platelet count, C) Activated partial thromboplastin time (aPTT), E) Hemoglobin and hematocrit Rationale: Heparin affects aPTT and can cause thrombocytopenia; monitoring hemoglobin and hematocrit is important to detect bleeding. PT and INR are monitored for warfarin therapy. Diabetes Medications and Management (Continued)

Select all that apply: Lifestyle modifications for managing hypertension include: A) Reducing sodium intake B) Increasing physical activity C) Smoking cessation D) Limiting potassium-rich foods E) Drinking red wine daily

Answer: A) Reducing sodium intake, B) Increasing physical activity, C) Smoking cessation Rationale: Lifestyle modifications include reducing sodium, increasing exercise, and quitting smoking. Limiting potassium is not typically advised unless on certain medications. Alcohol intake should be moderated.

A client is taking clonidine for hypertension. What is a common side effect of this medication? A) Sedation B) Diarrhea C) Increased salivation D) Hypertension

Answer: A) Sedation Rationale: Clonidine is a centrally acting alpha-agonist that can cause sedation and dry mouth.

Select all that apply: Which of the following are modifiable risk factors for hypertension? A) Smoking B) Gender C) Physical inactivity D) Family history E) Obesity

Answer: A) Smoking, C) Physical inactivity, E) Obesity Rationale: Modifiable risk factors are those that can be changed, such as smoking, lack of exercise, and obesity. Gender and family history are non-modifiable risk factors.

37. A client with type 2 diabetes is prescribed glipizide (Glucotrol). What is the mechanism of action of this medication? A) Stimulates insulin release from the pancreas B) Decreases insulin resistance C) Delays carbohydrate absorption D) Decreases hepatic glucose production

Answer: A) Stimulates insulin release from the pancreas Rationale: Glipizide is a sulfonylurea that stimulates the pancreas to release more insulin.

Which of the following is a major complication associated with myocardial infarction? A) Bradycardia B) Hypertrophic cardiomyopathy C) Dysrhythmias D) Aortic aneurysm

Answer: C Rationale: Dysrhythmias are the most common complication of myocardial infarction, occurring in 80-90% of patients

43. A client is prescribed exenatide (Byetta) for type 2 diabetes. What is the primary action of this medication? A) Stimulates insulin secretion in response to meals B) Replaces deficient insulin C) Inhibits hepatic glucose production D) Increases insulin sensitivity

Answer: A) Stimulates insulin secretion in response to meals Rationale: Exenatide is an incretin mimetic that enhances glucose-dependent insulin secretion.

Select all that apply: When teaching a client about diuretics, which instructions should the nurse include? A) Take the medication in the morning. B) Limit fluid intake to reduce urination. C) Change positions slowly to prevent dizziness. D) Report any muscle weakness or cramps. E) Avoid foods high in vitamin K.

Answer: A) Take the medication in the morning, C) Change positions slowly to prevent dizziness, D) Report any muscle weakness or cramps Rationale: Diuretics should be taken in the morning to prevent nocturia. Orthostatic hypotension can occur, so changing positions slowly is advised. Muscle weakness or cramps may indicate electrolyte imbalances.

Select all that apply: Which of the following are signs and symptoms of hypoglycemia? A) Tremors B) Confusion C) Polyuria D) Sweating E) Tachycardia

Answer: A) Tremors, B) Confusion, D) Sweating, E) Tachycardia Rationale: Hypoglycemia is characterized by symptoms such as tremors, confusion, sweating, and tachycardia due to the release of adrenaline and a lack of glucose.

A client with hypertension is advised to follow the DASH diet. Which foods should the nurse recommend? A) Whole grains, fruits, vegetables B) Processed meats and cheeses C) Canned soups and sauces D) Sugary cereals and snacks

Answer: A) Whole grains, fruits, vegetables Rationale: The DASH diet emphasizes whole grains, fruits, vegetables, and low-fat dairy to help reduce blood pressure.

Which of the following factors contributes to the development of atherosclerosis in coronary artery disease? (Select all that apply) A) Endothelial injury B) Lipid deposits in arterial walls C) Insulin sensitivity D) Vasodilation of arteries

Answer: A, B Rationale: Atherosclerosis begins with endothelial injury and lipid deposits within the arterial walls, which contribute to plaque formation​

Which of the following are common side effects of statins? (Select all that apply) A) Muscle pain or myopathy B) Liver damage C) Hyperglycemia D) Weight gain

Answer: A, B Rationale: Common side effects of statins include muscle pain (myopathy) and liver enzyme elevations, which can indicate liver damage

A patient is diagnosed with hypertension. Which of the following factors could contribute to their high blood pressure? (Select all that apply) A) High sodium intake B) Physical inactivity C) Chronic stress D) Increased potassium intake

Answer: A, B, C Rationale: High sodium intake, physical inactivity, and chronic stress are modifiable risk factors for hypertension​

Which of the following should be monitored closely during thrombolytic therapy? (Select all that apply) A) Blood pressure B) Mental status C) Clotting studies (e.g., PT/INR) D) Blood glucose

Answer: A, B, C Rationale: Monitoring blood pressure, mental status (for signs of intracranial bleeding), and clotting studies are crucial during thrombolytic therapy

Which of the following complications can occur in patients with both hypertension and diabetes? (Select all that apply) A) Heart failure B) Diabetic retinopathy C) Chronic kidney disease D) Deep vein thrombosis

Answer: A, B, C Rationale: Patients with both hypertension and diabetes are at high risk for heart failure, retinopathy, and chronic kidney disease

Which of the following lipid parameters are affected by statins? (Select all that apply) A) LDL cholesterol B) HDL cholesterol C) Triglycerides D) VLDL cholesterol

Answer: A, B, C Rationale: Statins primarily reduce LDL cholesterol, but they also moderately increase HDL cholesterol and lower triglycerides​

A patient with hypertension is at risk for which of the following target organ diseases? (Select all that apply) A) Stroke B) Retinopathy C) Heart failure D) Hypotension E) Diabetes

Answer: A, B, C Rationale: Target organs affected by hypertension include the brain (stroke), eyes (retinopathy), and heart (heart failure)​

Which target organs are most commonly affected by hypertension? (Select all that apply) A) Brain B) Heart C) Kidneys D) Liver

Answer: A, B, C Rationale: The brain, heart, and kidneys are target organs commonly affected by uncontrolled hypertension, leading to complications such as stroke, heart failure, and chronic kidney disease​

Which of the following lifestyle interventions should a patient with diabetes implement to reduce the risk of microvascular complications? (Select all that apply) A) Maintain healthy blood glucose levels B) Perform daily foot care C) Increase dietary sodium D) Perform regular physical exercise

Answer: A, B, D Rationale: Tight blood glucose control, daily foot care to prevent injury, and regular exercise are essential in reducing the risk of complications​

Which of the following are microvascular complications of diabetes? (Select all that apply) A) Retinopathy B) Coronary artery disease C) Nephropathy D) Peripheral vascular disease E) Neuropathy

Answer: A, C, E Rationale: Retinopathy, nephropathy, and neuropathy are microvascular complications caused by damage to small blood vessels due to chronic hyperglycemia​

Which of the following conditions is an absolute contraindication for thrombolytic therapy? A) Recent major surgery B) History of hemorrhagic stroke C) Hypertension D) Peptic ulcer disease

Answer: B Rationale: A history of hemorrhagic stroke is an absolute contraindication because thrombolytic therapy can increase the risk of catastrophic bleeding

A nurse hears a high-pitched, scratchy sound on auscultation of the heart in a patient with pericarditis. This sound is most likely: A) A ventricular gallop (S3) B) A pericardial friction rub C) Aortic regurgitation murmur D) Mitral valve prolapse

Answer: B Rationale: A pericardial friction rub is a high-pitched, scratchy sound heard best at the left lower sternal border when the patient is leaning forward. It is caused by the rubbing of inflamed pericardial layers​

Which of the following is a common side effect of antihypertensive therapy with ACE inhibitors? A) Hypokalemia B) Persistent cough C) Bradycardia D) Thrombocytopenia

Answer: B Rationale: A persistent cough is a common side effect of ACE inhibitors due to the accumulation of bradykinin

For patients with diabetes and hypertension, which antihypertensive medication class is commonly recommended to prevent nephropathy? A) Beta-blockers B) ACE inhibitors C) Calcium channel blockers D) Diuretics

Answer: B Rationale: ACE inhibitors are recommended for patients with diabetes and hypertension to prevent or slow the progression of nephropathy

What is the most common cause of coronary artery disease (CAD)? A) Genetic predisposition B) Atherosclerosis C) Myocardial infarction D) Valvular disease

Answer: B Rationale: Atherosclerosis is the major cause of CAD, characterized by lipid deposits within the arterial walls

A patient with hypertension has been prescribed a calcium channel blocker. What is the primary action of this medication? A) Increase sodium excretion B) Promote vasodilation C) Increase heart rate D) Block beta-adrenergic receptors

Answer: B Rationale: Calcium channel blockers promote vasodilation by preventing calcium from entering vascular smooth muscle cells, leading to decreased vascular resistance​

Which of the following is the leading cause of death among patients with diabetes? A) Chronic kidney disease B) Cardiovascular disease C) Infection D) Retinopathy

Answer: B Rationale: Cardiovascular disease (CVD) is responsible for 68% of diabetes-related deaths, especially in those over age 65

Which of the following conditions would most likely require the initiation of dual antiplatelet therapy (DAPT)? A) Hypertension B) Post-percutaneous coronary intervention (PCI) with stent placement C) Atrial fibrillation D) Deep vein thrombosis

Answer: B Rationale: DAPT is often prescribed for patients who have undergone percutaneous coronary intervention (PCI) with stent placement to reduce the risk of stent thrombosis

Dressler syndrome is an inflammatory response that involves which of the following? A) The pleura and myocardium B) The pericardium and pleura C) The coronary arteries D) The lungs and bronchi

Answer: B Rationale: Dressler syndrome involves inflammation of both the pericardium and pleura. It is thought to be an autoimmune response following damage to the heart tissue​

What is the main treatment for Dressler syndrome? A) Antibiotics B) Corticosteroids and anti-inflammatory drugs C) Thrombolytic therapy D) Beta-blockers

Answer: B Rationale: Dressler syndrome is treated with corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and relieve symptoms​

Which of the following drugs is commonly used to manage diabetic neuropathy by reducing pain? A) Metformin B) Gabapentin C) Insulin D) ACE inhibitors

Answer: B Rationale: Gabapentin, an antiseizure medication, is commonly used to reduce the pain associated with diabetic neuropathy

Which insulin has an onset of action of 1 to 2 hours, peaks at 6 to 8 hours, and lasts up to 24 hours? A) Insulin glargine (Lantus) B) Insulin detemir (Levemir) C) NPH insulin D) Regular insulin

Answer: B Rationale: Insulin detemir (Levemir) is a long-acting insulin with an onset of 1 to 2 hours, a peak at 6 to 8 hours, and a duration of up to 24 hours

A patient is receiving insulin glargine (Lantus) once a day. Which statement by the nurse best explains the action of this insulin? A) "It peaks in about 4 to 6 hours, so make sure you eat at that time." B) "It has no peak time and provides a consistent level of insulin throughout the day." C) "It should be taken with each meal to control post-meal glucose spikes." D) "It has a short duration and should be taken multiple times per day."

Answer: B Rationale: Insulin glargine (Lantus) has no pronounced peak and provides basal insulin coverage over 24 hours, so it does not cause significant fluctuations in blood glucose levels

What should the nurse advise a patient with type 1 diabetes experiencing nausea and vomiting? A) Stop taking insulin until symptoms improve B) Check blood glucose every 2 to 4 hours C) Increase physical activity D) Drink fluids high in glucose

Answer: B Rationale: It is essential for the patient to monitor blood glucose levels frequently during illness to prevent dangerous fluctuations​

Which of the following is a contraindication for administering morphine in a patient with suspected myocardial infarction? A) Severe chest pain B) Respiratory depression C) Oxygen saturation below 90% D) History of aspirin allergy

Answer: B Rationale: Morphine should not be administered in patients with respiratory depression because it can further depress respiratory function​

A patient with diabetes has a total cholesterol level of 220 mg/dL and LDL of 140 mg/dL. Which intervention is most appropriate? A) No treatment is needed B) Lifestyle modification and statin therapy C) Initiate aspirin therapy D) Increase dietary sodium

Answer: B Rationale: Patients with diabetes and elevated cholesterol levels should receive statin therapy and lifestyle modifications to reduce cardiovascular risk

The priority concept in managing coronary artery disease is: A) Infection B) Perfusion C) Mobility D) Nutrition

Answer: B Rationale: Perfusion is the priority in CAD as it directly affects cardiac output and tissue oxygenation

Which of the following conditions is considered a relative contraindication to thrombolytic therapy? A) Active internal bleeding B) Pregnancy C) Aortic dissection D) Uncontrolled hypertension (BP > 180/110 mm Hg)

Answer: B Rationale: Pregnancy is a relative contraindication to thrombolytic therapy, meaning the benefits must outweigh the risks before administering the therapy

Which of the following insulins is typically used to manage postprandial hyperglycemia? A) Insulin glargine (Lantus) B) Insulin lispro (Humalog) C) NPH insulin D) Insulin detemir (Levemir)

Answer: B Rationale: Rapid-acting insulins like insulin lispro (Humalog) are used to manage postprandial (after-meal) hyperglycemia because of their quick onset and short duration of action

For a patient with recent major surgery (within 3 weeks), thrombolytic therapy is: A) Absolutely contraindicated B) Relatively contraindicated C) The first line of treatment D) Safely administered with aspirin

Answer: B Rationale: Recent major surgery is a relative contraindication, meaning the risks and benefits must be carefully weighed before administering thrombolytic therapy

A patient with pericarditis reports chest pain. Which position is likely to provide the most relief? A) Lying flat on the back B) Sitting up and leaning forward C) Lying on the left side D) Reclining with legs elevated

Answer: B Rationale: Sitting up and leaning forward typically relieves the chest pain associated with pericarditis by reducing the pressure on the pericardium

The patient with stable angina typically experiences which symptom? A) Crushing chest pain unrelieved by nitroglycerin B) Chest pain that resolves with rest or nitroglycerin C) Sharp pain that increases with deep breathing D) Sudden onset of severe chest pain at rest

Answer: B Rationale: Stable angina is characterized by chest pain that occurs with exertion and is relieved by rest or nitroglycerin

Which of the following is the most common symptom of acute pericarditis? A) Crushing chest pain radiating to the left arm B) Sharp, pleuritic chest pain that worsens with deep breathing C) Substernal pressure that improves with rest D) Severe epigastric pain radiating to the back

Answer: B Rationale: The hallmark symptom of acute pericarditis is sharp, pleuritic chest pain that worsens with inspiration, coughing, or lying flat. It often improves when the patient sits up and leans forward​

A patient on NPH insulin asks when they are most at risk for hypoglycemia. What is the best response by the nurse? A) "Within 30 minutes of injection." B) "Between 4 and 12 hours after administration." C) "Immediately after taking the insulin." D) "24 hours after the injection."

Answer: B Rationale: The peak action of NPH insulin occurs 4 to 12 hours after administration, which is when the patient is most at risk for hypoglycemia

Which of the following HDL cholesterol levels is considered protective against heart disease? A) < 40 mg/dL B) 40-59 mg/dL C) ≥ 60 mg/dL D) > 80 mg/dL

Answer: C Rationale: HDL levels of 60 mg/dL or higher are considered protective against heart disease​

What is the primary goal of dual antiplatelet therapy (DAPT) following a percutaneous coronary intervention (PCI)? A) Lower cholesterol levels B) Prevent stent thrombosis C) Control hypertension D) Reduce heart rate

Answer: B Rationale: The primary goal of DAPT after PCI is to prevent stent thrombosis, which can occur if platelets adhere to the newly placed stent​

Which of the following is the primary goal of thrombolytic therapy for a patient with an acute myocardial infarction (MI)? A) Prevent future MIs B) Dissolve the thrombus and restore blood flow C) Reduce cholesterol levels D) Decrease the workload of the heart

Answer: B Rationale: The primary goal of thrombolytic therapy is to dissolve the clot that is causing the myocardial infarction and restore blood flow to the affected area of the heart​

Which of the following is the correct sequence of interventions when using MONA in the treatment of a patient with suspected myocardial infarction? A) Administer oxygen, nitroglycerin, aspirin, and then morphine B) Administer aspirin, nitroglycerin, oxygen, and then morphine C) Administer morphine, oxygen, aspirin, and then nitroglycerin D) Administer oxygen, morphine, aspirin, and then nitroglycerin

Answer: B Rationale: The typical sequence of MONA is to first administer Aspirin (to prevent platelet aggregation), then Nitroglycerin (to relieve ischemic chest pain), Oxygen (if oxygen saturation is low), and Morphine last, for pain unrelieved by nitroglycerin​

A patient with type 1 diabetes is prescribed insulin glargine (Lantus) once daily and insulin lispro (Humalog) at mealtimes. The nurse explains that this regimen is designed to: A) Reduce the number of insulin injections needed each day B) Provide both basal and mealtime insulin coverage C) Provide short-term control of blood glucose D) Eliminate the need for blood glucose monitoring

Answer: B Rationale: This regimen provides basal coverage with long-acting insulin (glargine) and mealtime (prandial) coverage with rapid-acting insulin (lispro), mimicking the body's natural insulin response

A patient who has received thrombolytic therapy is at increased risk for which of the following complications? A) Myocardial infarction B) Bleeding C) Hypertension D) Hypercholesterolemia

Answer: B Rationale: Thrombolytic therapy increases the risk of bleeding, especially intracranial hemorrhag

Which of the following interventions is recommended to reduce the risk of cardiovascular complications in diabetic patients? A) Avoid statins B) Weight loss and increased physical activity C) Limit antihypertensive medications D) Increase sodium intake

Answer: B Rationale: Weight loss and increased physical activity are crucial in reducing cardiovascular risks such as hypertension and dyslipidemia​

Patients with diabetes are at increased risk for infection due to which of the following? A) Increased platelet aggregation B) Defective mobilization of inflammatory cells C) Enhanced immune response D) Increased insulin sensitivity

Answer: B Rationale: Diabetes impairs the mobilization of inflammatory cells and decreases phagocytic activity, leading to a higher risk of infections

A nurse is teaching a client about insulin injection sites. Which site is the best for fast absorption? A) Thigh B) Abdomen C) Buttock D) Upper arm

Answer: B) Abdomen Rationale: Insulin is absorbed fastest from the abdomen.

Which of the following is a correct instruction for administering insulin aspart (NovoLog)? A) Administer 1 hour before meals. B) Administer within 15 minutes of starting a meal. C) Administer after the meal. D) Administer at bedtime.

Answer: B) Administer within 15 minutes of starting a meal. Rationale: Insulin aspart is a rapid-acting insulin that should be given just before or with meals to control postprandial glucose levels.

A client with type 1 diabetes is prescribed insulin glargine (Lantus). When should this insulin be administered? A) Before each meal B) At bedtime C) After meals D) Twice a day before breakfast and dinner

Answer: B) At bedtime Rationale: Insulin glargine is a long-acting insulin usually administered once daily, often at bedtime, to provide basal glucose control.

Which of the following drugs helps to reduce the size of a thrombus by inhibiting platelet aggregation in a patient with unstable angina? A) Niacin B) Clopidogrel (Plavix) C) Losartan D) Ezetimibe

Answer: B) Clopidogrel (Plavix) Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation, reducing the risk of thrombus formation.

A nurse is teaching a client how to mix insulin. Which of the following steps is correct? A) Draw up the long-acting insulin first, then the short-acting insulin. B) Draw up the short-acting insulin first, then the long-acting insulin C) Shake both vials before drawing up the insulin. D) Mix glargine with NPH in the same syringe.

Answer: B) Draw up the short-acting insulin first, then the long-acting insulin. Rationale: When mixing insulin, the short-acting insulin should be drawn up first to avoid contaminating the short-acting insulin vial with the long-acting insulin.

A patient with CAD is prescribed niacin (vitamin B3). What side effect should the nurse expect? A) Hypertension B) Flushing C) Diarrhea D) Hypoglycemia

Answer: B) Flushing Rationale: Niacin commonly causes flushing, which can be uncomfortable for patients but is usually harmless.

41. A client with diabetes is experiencing hypoglycemia with cold sweats and confusion. What is the nurse's immediate action? A) Administer 50% dextrose intravenously B) Give 15 grams of fast-acting carbohydrate orally C) Inject glucagon intramuscularly D) Have the client lie down and rest

Answer: B) Give 15 grams of fast-acting carbohydrate orally Rationale: For conscious clients with hypoglycemia, administer 15 grams of carbohydrate. Intravenous dextrose or glucagon is used if the client is unconscious or unable to swallow.

A client with CAD is prescribed rosuvastatin (Crestor). What is the priority adverse effect the nurse should monitor for? A) Hypoglycemia B) Liver damage C) Hypertension D) Muscle pain

Answer: B) Liver damage Rationale: Rosuvastatin is a statin that can cause liver damage. Liver enzymes should be monitored.

A patient with CAD is being treated with rosuvastatin (Crestor). What lab values should the nurse monitor for potential adverse effects? A) Serum potassium B) Liver function tests C) Blood glucose D) Complete blood count (CBC)

Answer: B) Liver function tests Rationale: Statins can cause liver damage, so liver function tests should be monitored regularly.

A nurse is educating a client about lipid-lowering therapy with atorvastatin (Lipitor). What is the most important adverse effect the nurse should include in the teaching? A) Joint pain B) Muscle pain C) Increased appetite D) Dry skin

Answer: B) Muscle pain Rationale: Statins like atorvastatin can cause myalgia, and in rare cases, rhabdomyolysis. Muscle pain should be reported immediately.

A patient with hypertension reports a persistent dry cough after starting an ACE inhibitor. What is the best action by the nurse? A) Advise the patient to use cough suppressants. B) Notify the healthcare provider for a possible medication change. C) Instruct the patient to increase fluid intake. D) Reassure the patient that this is a normal side effect and will diminish.

Answer: B) Notify the healthcare provider for a possible medication change. Rationale: A persistent dry cough is a common side effect of ACE inhibitors. The provider may consider switching to an ARB.

A client is prescribed amlodipine for hypertension. What important side effect should the nurse monitor? A) Dry cough B) Peripheral edema C) Hypokalemia D) Constipation

Answer: B) Peripheral edema Rationale: Amlodipine is a calcium channel blocker that can cause vasodilation leading to peripheral edema.

A nurse is caring for a patient on a calcium channel blocker for hypertension. What is a common side effect? A) Bradycardia B) Peripheral edema C) Hypokalemia D) Hypertension

Answer: B) Peripheral edema Rationale: Calcium channel blockers can cause peripheral edema due to vasodilation of peripheral vessels.

Which of the following insulins has the fastest onset of action? A) NPH insulin B) Insulin glargine (Lantus) C) Insulin aspart (NovoLog) D) Regular insulin

Answer: C Rationale: Insulin aspart (NovoLog) is a rapid-acting insulin with an onset of action of 10-15 minutes, making it the fastest among the options

39. A patient is using an insulin pump. Which advantage does this method of insulin delivery provide? A) Eliminates the need for blood glucose monitoring B) Provides continuous subcutaneous insulin infusion C) Requires fewer needle sticks than multiple daily injections D) Allows for oral administration of insulin

Answer: B) Provides continuous subcutaneous insulin infusion Rationale: Insulin pumps deliver continuous insulin subcutaneously, mimicking normal pancreatic function.

A client is prescribed hydralazine for hypertension. What is the mechanism of action of this medication? A) Blocks beta receptors to decrease heart rate B) Relaxes arterial smooth muscle causing vasodilation C) Inhibits angiotensin-converting enzyme D) Increases excretion of sodium and water

Answer: B) Relaxes arterial smooth muscle causing vasodilation Rationale: Hydralazine is a direct vasodilator that relaxes arterial smooth muscle, decreasing systemic vascular resistance.

35. Which medication is contraindicated in a client taking nitrates for angina? A) Metformin B) Sildenafil (Viagra) C) Acetaminophen D) Lisinopril

Answer: B) Sildenafil (Viagra) Rationale: Sildenafil can cause severe hypotension when taken with nitrates due to additive vasodilation effects.

42. A nurse is teaching a client about acarbose (Precose). Which instruction should be included? A) Take this medication at bedtime B) Take this medication with the first bite of each meal C) Skip a dose if you do not eat a meal D) This medication may cause weight gain

Answer: B) Take this medication with the first bite of each meal Rationale: Acarbose delays carbohydrate absorption and should be taken with the first bite of a meal.

34. A patient with variant (Prinzmetal's) angina is prescribed a calcium channel blocker. What is the rationale for this medication? A) To reduce heart rate B) To prevent coronary artery spasms C) To decrease blood pressure D) To lower cholesterol levels

Answer: B) To prevent coronary artery spasms Rationale: Calcium channel blockers help prevent coronary artery spasms associated with variant angina.

Which of the following is an absolute contraindication to thrombolytic therapy in a patient with acute ischemic stroke? A) Recent history of peptic ulcer disease B) Ischemic stroke within the last 3 months C) Active gastrointestinal bleeding D) History of controlled hypertension

Answer: C Rationale: Active gastrointestinal bleeding is an absolute contraindication for thrombolytic therapy due to the risk of worsening the bleed​

Why is aspirin administered first in patients experiencing acute coronary syndrome (ACS)? A) To relieve pain B) To reduce myocardial oxygen demand C) To prevent platelet aggregation and clot formation D) To dilate the coronary arteries

Answer: C Rationale: Aspirin is administered first to prevent platelet aggregation, which reduces the risk of further clot formation and limits the size of the myocardial infarction​

Which of the following medications should be given to a patient with unstable angina to prevent platelet aggregation? A) Metoprolol B) Nitroglycerin C) Aspirin D) Furosemide

Answer: C Rationale: Aspirin is commonly used to prevent platelet aggregation and reduce the risk of myocardial infarction in patients with unstable angina

What symptom is most characteristic of chronic stable angina? A) Chest pain lasting more than 30 minutes B) Pain that occurs at rest C) Chest pain that occurs with exertion and is relieved by rest D) Sharp stabbing pain with every breath

Answer: C Rationale: Chronic stable angina typically occurs with exertion and is relieved by rest or nitroglycerin

In a patient with both hypertension and diabetes, what is the primary goal of blood pressure management? A) Maintain a systolic BP below 140 mm Hg B) Prevent orthostatic hypotension C) Control blood pressure to reduce the risk of microvascular complications D) Reduce blood pressure to prevent retinopathy progression

Answer: C Rationale: Controlling blood pressure in diabetic patients reduces the risk of microvascular complications such as nephropathy and retinopathy

How long is dual antiplatelet therapy (DAPT) typically recommended after drug-eluting stent (DES) placement? A) 1 week B) 1 month C) 6 to 12 months D) 5 years

Answer: C Rationale: DAPT is typically recommended for 6 to 12 months after drug-eluting stent placement to prevent thrombotic complications​

What is the leading cause of end-stage renal disease (ESRD) in the United States? A) Chronic hypertension B) Chronic kidney infections C) Diabetic nephropathy D) Glomerulonephritis

Answer: C Rationale: Diabetic nephropathy, caused by chronic hyperglycemia, is the leading cause of end-stage renal disease in the U.S

Which of the following types of insulin is considered basal insulin and used to maintain glucose control throughout the day and night? A) Insulin lispro (Humalog) B) Regular insulin C) Insulin glargine (Lantus) D) NPH insulin

Answer: C Rationale: Insulin glargine (Lantus) is a long-acting insulin used for basal control, providing consistent blood glucose management over 24 hours without a significant peak

The presence of microalbuminuria in a patient with diabetes indicates early: A) Neuropathy B) Retinopathy C) Nephropathy D) Hypertension

Answer: C Rationale: Microalbuminuria is an early indicator of nephropathy, a common microvascular complication of diabetes​

A patient is prescribed NPH insulin. The nurse understands that this type of insulin has a peak time of: A) 30 minutes to 1 hour B) 2 to 4 hours C) 4 to 12 hours D) 24 hours

Answer: C Rationale: NPH insulin is an intermediate-acting insulin that peaks in 4 to 12 hours, making it important for controlling glucose levels between meals and at night

A patient with acute chest pain is receiving nitroglycerin. The nurse should monitor for which of the following side effects? A) Hypertension B) Bradycardia C) Hypotension D) Hyperglycemia

Answer: C Rationale: Nitroglycerin can cause hypotension by vasodilating blood vessels and reducing preload, so blood pressure should be closely monitored​

When is the best time to administer rapid-acting insulin like insulin lispro (Humalog)? A) 1 hour after a meal B) At bedtime C) Immediately before a meal D) 1 hour before a meal

Answer: C Rationale: Rapid-acting insulin, such as insulin lispro, should be given immediately before a meal because of its rapid onset (10-15 minutes) to manage postprandial glucose spikes

Which insulin is commonly used for continuous subcutaneous insulin infusion (CSII) in an insulin pump? A) NPH insulin B) Regular insulin C) Insulin aspart (NovoLog) D) Insulin glargine (Lantus)

Answer: C Rationale: Rapid-acting insulins like insulin aspart (NovoLog) are commonly used in insulin pumps because of their quick onset and ability to control blood sugar spikes after meals

A nurse administers regular insulin at 0800. At what time should the nurse expect this insulin to peak? A) 0830 B) 0900 C) 1000 to 1200 D) 1400

Answer: C Rationale: Regular insulin is a short-acting insulin with a peak time of 2 to 4 hours, so the nurse should expect the peak around 1000 to 1200 for an 0800 dose

Which of the following is a modifiable risk factor for coronary artery disease? A) Gender B) Family history C) Smoking D) Age

Answer: C Rationale: Smoking is a modifiable risk factor for CAD as it increases the likelihood of atherosclerosis and heart disease

Which of the following is classified as stage 1 hypertension? A) 110/70 mm Hg B) 120/80 mm Hg C) 130/88 mm Hg D) 150/95 mm Hg

Answer: C Rationale: Stage 1 hypertension is defined as systolic blood pressure between 130-139 mm Hg or diastolic blood pressure between 80-89 mm Hg

Which class of drugs is typically prescribed to reduce cholesterol levels in patients with coronary artery disease? A) ACE inhibitors B) Beta-blockers C) Statins D) Calcium channel blockers

Answer: C Rationale: Statins are commonly prescribed to lower LDL cholesterol levels, a key factor in the development of atherosclerosis and coronary artery disease

When should statins be administered for maximum effectiveness? A) In the morning B) With food C) In the evening D) Before exercise

Answer: C Rationale: Statins are most effective when taken in the evening because cholesterol synthesis in the liver is highest at night

n patients with hypertension, the RAAS system contributes to elevated blood pressure by: A) Decreasing heart rate B) Promoting vasodilation C) Retaining sodium and water D) Increasing potassium excretion

Answer: C Rationale: The RAAS system leads to sodium and water retention, increasing blood volume and blood pressure

Which of the following is a priority nursing intervention for a patient with acute pericarditis? A) Administer morphine for pain relief B) Position the patient flat for comfort C) Monitor for signs of cardiac tamponade D) Encourage deep breathing and coughing exercises

Answer: C Rationale: The nurse should closely monitor for signs of cardiac tamponade, such as hypotension, jugular venous distension, and muffled heart sounds, which can be life-threatening complications of pericarditis​

Which of the following systems plays a role in the long-term regulation of blood pressure? A) Nervous system B) Vascular endothelium C) Renal system D) Digestive system

Answer: C Rationale: The renal system plays a key role in long-term regulation of blood pressure by controlling sodium excretion and fluid volume

Which of the following is a relative contraindication to thrombolytic therapy? A) History of intracranial hemorrhage B) Malignant intracranial neoplasm C) Use of anticoagulants D) Suspected aortic dissection

Answer: C Rationale: Use of anticoagulants is a relative contraindication because it increases the risk of bleeding, but thrombolytic therapy may still be used depending on the situation​

Which of the following factors directly increases blood pressure by increasing systemic vascular resistance (SVR)? A) Vasodilation of arteries B) Increased heart rate C) Vasoconstriction of arteries D) Decreased cardiac output

Answer: C Rationale: Vasoconstriction increases systemic vascular resistance, leading to an increase in blood pressure

Which lifestyle modification has the greatest impact on reducing systolic blood pressure? A) Reducing sodium intake B) Increasing potassium intake C) Weight loss D) Smoking cessation

Answer: C Rationale: Weight loss has the greatest impact on reducing systolic blood pressure, with a reduction of approximately 1 mm Hg per kilogram of weight loss​

50. A patient is prescribed spironolactone for hypertension. Which statement indicates a need for further teaching? A) "I will avoid foods high in potassium. "B) "I should notify my doctor if I experience muscle weakness." C) "I can use salt substitutes to improve the taste of my food." D) "I need to have my kidney function monitored regularly."

Answer: C) "I can use salt substitutes to improve the taste of my food." Rationale: Spironolactone is a potassium-sparing diuretic; salt substitutes often contain potassium and should be avoided to prevent hyperkalemia.

49. A client with hypertension reports feeling dizzy upon standing. What is the nurse's best response? A) "This is a normal side effect; continue your medication." B) "You should stop taking your medication immediately." C) "Rise slowly when changing positions to prevent dizziness." D) "Increase your sodium intake to improve your blood pressure."

Answer: C) "Rise slowly when changing positions to prevent dizziness."Rationale: Orthostatic hypotension is a common side effect; teaching the client to rise slowly helps prevent dizziness.

Which antihypertensive medication is contraindicated in pregnancy? A) Methyldopa B) Labetalol C) Enalapril D) Nifedipine

Answer: C) Enalapril Rationale: ACE inhibitors like enalapril are contraindicated during pregnancy due to the risk of fetal harm.

45. A nurse is reviewing the lab results of a client with diabetes. Which value indicates good long-term glycemic control? A) Fasting glucose of 120 mg/dL B) Postprandial glucose of 180 mg/dL C) Hemoglobin A1C of 6% D) Random glucose of 200 mg/dL

Answer: C) Hemoglobin A1C of 6% Rationale: An A1C of 6% indicates good long-term control (ADA recommends less than 7% for most adults). Hypertension and Antihypertensive Medications (Continued)

46. A client is starting therapy with a thiazide diuretic. What dietary instruction should the nurse provide? A) Increase intake of leafy green vegetables B) Limit intake of potassium-rich foods C) Increase intake of potassium-rich foods D) Avoid dairy products

Answer: C) Increase intake of potassium-rich foods Rationale: Thiazide diuretics can cause hypokalemia; increasing dietary potassium is advised.

A client is prescribed clopidogrel (Plavix) after a coronary artery stent placement. What should the nurse include in the discharge instructions? A) Avoid grapefruit juice. B) Take the medication with food to reduce GI upset. C) Monitor for signs of bleeding such as bruising or black stools. D) Discontinue the medication if a headache occurs.

Answer: C) Monitor for signs of bleeding such as bruising or black stools. Rationale: Clopidogrel is an antiplatelet medication, and bleeding is a significant risk. The patient should be educated to monitor for signs of bleeding

A client with chest pain is prescribed morphine. What is the primary reason for administering morphine in this situation? A) To reduce anxiety B) To decrease pain C) To decrease myocardial oxygen demand D) To promote sedation

Answer: C) To decrease myocardial oxygen demand Rationale: Morphine reduces pain and anxiety but importantly decreases myocardial oxygen demand by reducing preload and afterload.

A patient with diabetes is prescribed empagliflozin (Jardiance). What is a common side effect of this medication? A) Weight gain B) Hypoglycemia C) Urinary tract infection D) Increased appetite

Answer: C) Urinary tract infection Rationale: SGLT-2 inhibitors like empagliflozin increase glucose excretion in urine, which can lead to an increased risk of urinary tract infections.

Dressler syndrome typically occurs how long after a myocardial infarction (MI)? A) 24 to 48 hours B) 1 to 2 weeks C) 2 to 3 days D) 1 to 2 months

Answer: D Rationale: Dressler syndrome, a form of pericarditis, usually occurs 1 to 2 months after a myocardial infarction or cardiac surgery. It is an autoimmune response to myocardial injury​

Which of the following insulins has no pronounced peak and is used for basal control of blood sugar? A) Insulin detemir (Levemir) B) NPH insulin C) Regular insulin D) Insulin glargine (Lantus)

Answer: D Rationale: Insulin glargine (Lantus) is a long-acting insulin with no pronounced peak, providing consistent basal control over 24 hours

At what triglyceride level is a patient considered to be at increased risk for cardiovascular disease? A) < 100 mg/dL B) 150-199 mg/dL C) 200-499 mg/dL D) ≥ 500 mg/dL

Answer: D Rationale: Triglyceride levels of 500 mg/dL or higher are associated with an increased risk of cardiovascular disease and pancreatitis​

The nurse is educating a client about the use of sublingual nitroglycerin (SL NTG) for chest pain. Which statement by the client indicates the need for further teaching? A) "I can take one tablet every 5 minutes, up to 3 doses." B) "If the pain is not relieved after 3 doses, I will call emergency services." C) "I should store the tablets in a dry place, away from light." D) "I can take more than 3 doses if the pain persists."

Answer: D) "I can take more than 3 doses if the pain persists." Rationale: Sublingual nitroglycerin should not be taken more than 3 times in 15 minutes. If pain persists, emergency medical attention is necessary.

A patient is being treated for resistant hypertension with multiple medications. Which drug class is commonly added for resistant hypertension? A) Diuretics B) Alpha blockers C) Calcium channel blockers D) Aldosterone antagonists

Answer: D) Aldosterone antagonists Rationale: Aldosterone antagonists (like spironolactone) are often added to manage resistant hypertension.

A client is taking hydrochlorothiazide for hypertension. Which laboratory value should be monitored? A) Serum calcium B) Serum sodium C) Blood urea nitrogen D) Potassium levels

Answer: D) Potassium levels Rationale: Thiazide diuretics like hydrochlorothiazide can cause potassium depletion.

Which insulin can be given intravenously in the treatment of diabetic ketoacidosis (DKA)? A) Insulin glargine B) Insulin lispro C) Insulin aspart D) Regular insulin

Answer: D) Regular insulin Rationale: Regular insulin is the only insulin that can be administered intravenously and is the treatment of choice in DKA.