Exam 3 PrepUs

- Neurogenic shock

A nurse in the ICU receives report from the nurse in the emergency department about a new patient being admitted with a neck injury he received while diving into a lake. The emergency-department nurse reports that his blood pressure is 85/54, heart rate is 53 beats per minute, and his skin is warm and dry. What does the ICU nurse recognize that that patient is probably experiencing? - Anaphylactic shock - Neurogenic shock - Septic shock - Hypovolemic shock

- 5 minutes

A nurse is administering digoxin intravenously as ordered. The nurse would administer the drug over which time frame? - 5 minutes - 4 minutes - 3 minutes - 2 minutes

- Hypotension

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? - Hypokalemia - Renal insufficiency - Hypotension - Sedation

- Regular aerobic exercise - Smoking cessation - Decreased alcohol consumption - Diet with more fruits and vegetables

A nurse is caring for a client who has been diagnosed with primary hypertension. What nursing interventions should be included in the teaching plan? Select all that apply. - Focus on finding a different job - Regular aerobic exercise - Smoking cessation - Decreased alcohol consumption - Diet with more fruits and vegetables

- "Take this medication on an empty stomach."

A nurse is caring for a client who has been prescribed captopril. Which instruction is important to include when teaching the client about the medication? - "Take this medication on an empty stomach." - "This medication will decrease your heart rate." - "You can take this medication at different times each day." - "The dosage will need to be evaluated each week."

- Potassium levels

A nurse is caring for a client who is taking digoxin and a loop diuretic. Which would be most important for the nurse to monitor? - Sodium levels - Liver enzymes - Potassium levels - Electrocardiogram results

- Pseudoephedrine

A patient is advised to take a decongestant drug to relieve nasal congestion associated with hay fever. The patient is not comfortable with a nasal spray or drops and prefers an oral tablet. Which oral decongestant drugs can be administered to the patient? - Pseudoephedrine - Ephedrine - Xylometazoline - Tetrahydrozoline

- The patient will be given digoxin immune fab.

A triage nurse in the emergency department suspects that a 78-year-old patient is experiencing severe digoxin toxicity with significant cardiac arrhythmia. If the nurse is correct, which action is likely to be taken? - The patient will be monitored to see if symptoms resolve without action. - The patient will be given sodium chloride. - The patient's digoxin dosage will be reduced. - The patient will be given digoxin immune fab.

- Administer DigiFab as prescribed.

A triage nurse is assessing a 78-year-old client in the emergency department. The nurse determines that the client is experiencing severe digoxin toxicity. What is the nurse's priority action? - Administer acetylcysteine IV STAT. - Administer DigiFab as prescribed. - Identify the client's troponin levels. - Auscultate the client's apical heart rate for a minimum of 90 seconds.

- Antidote for acetaminophen poisoning

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug? - Conversion of cardiac arrhythmias - Treatment of bronchospasm - Antidote for acetaminophen poisoning - Treatment of peptic ulcer disease

- Every 10 years

Administration of the tetanus toxoid in adults involves two initial injections given four weeks apart, a booster injection given six months to a year later, and periodic injections thereafter. What is the recommended interval for the periodic injections for a 66 year old client ? - Annually - Every 10 years - Every 2 years - Every 5 years

- sympathetic

Adrenergic drugs mimic the effects of stimulating what part of the nervous system? - parasympathetic - sympathetic - autonomic - central

- Propranolol - Acebutolol

After reviewing antiarrhythmic drugs, a group of nursing students demonstrate understanding of the drugs when they identify which as a class II antiarrhythmic? Select all that apply. - Propranolol - Ibutilide - Verapamil - Acebutolol - Amiodarone

- Albuterol

After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)? - Arformoterol - Albuterol - Salmeterol - Formoterol

- "We can use the adult brand, but we just have to decrease the amount."

After teaching a group of parents about the use of over-the-counter cough and cold products with their children, which statement indicates the need for additional teaching? - "We can use the adult brand, but we just have to decrease the amount." - "We can use over-the-counter products for our 5-year-old but not for our 18-monthold." - "We need to read the label carefully to see how often and how much to give." - "We should use the cup that comes with the drug to measure it out."

- Chest pain that is relieved by rest

After teaching a group of students about angina, the instructor determines that the teaching was successful when the students describe stable angina as: - Chest pain that is relieved by rest - Chest pain that occurs at rest - Chest pain that occurs due to vasospasm - Chest pain that occurs with coronary artery disease

- cardiac arrhythmia

An 80-year-old client has been brought to the emergency department in shock. The client is receiving dopamine. The nurse should prioritize the assessment for what potentially serious adverse effect? - blood dyscrasias - hepatic toxicity - cardiac arrhythmia - renal insufficiency

- Increased cardiac output

An instructor is describing positive inotropic activity. Which would the instructor include as a result of this activity? - Increased cardiac output - Decreased heart rate - Increased preload - Increased conduction velocity

- Cells lack an adequate blood supply and are deprived of oxygen and nutrients

An understanding of the pathophysiologic rationale behind shock is something every nurse needs to have. Which of the following statements best describes the pathophysiology for shock? - Blood is shunted from vital organs to peripheral areas of the body - Cells lack an adequate blood supply and are deprived of oxygen and nutrients - Circulating blood volume is decreased - Hemorrhage occurs as a result of trauma

- Treatment chronic stable angina pectoris. - Prevent angina attacks. - Relieve the pain of acute anginal attacks.

Anti-anginal drugs are used in the treatment of cardiac disease for what purposes? (Select all that apply.) - Relieve the pain of acute anginal attacks. - Decrease serum triglyceride. - Prevent angina attacks. - Increase high-density lipoproteins (HDL). - Treatment chronic stable angina pectoris.

- Decreasing the heart rate, allowing for longer filling time and increased blood to the heart

Beta-adrenergic blocking agents decrease the oxygen demands of the heart by what mechanism? - Increasing conduction to the atrioventricular node, thereby increasing cardiac output - Increasing cardiac output, thereby increasing the oxygen supplied to the heart - Increasing blood pressure, which increases the amount of blood returned to the heart - Decreasing the heart rate, allowing for longer filling time and increased blood to the heart

- Peripheral edema

Clients who are taking nifedipine should be monitored for which of the following adverse effects? - Hyperkalemia - Asthma - Peripheral edema - Tetany

- Asthma attack - Anaphylaxis - Myocardial infarction

Clinical indications for the use of adrenergic drugs stem mainly from their effects on the heart, blood vessels, and bronchi. They are often used as emergency drugs. For which of the following conditions would these drugs be used? Choose all that apply. - Fractured hip - Asthma attack - Anaphylaxis - Myocardial infarction - Chronic cirrhosis

- Respiratory depression

Combining first-generation antihistamines with sedating agents can result in what adverse effect? - Respiratory depression - Hypertensive crisis - Liver failure - Myocardial infarction

- Cardiac arrhythmias - Hyperthyroidism - Hypersensitivity to sulfites

Contraindications to adrenergic drugs include what conditions? (Select all that apply.) - Cardiac arrhythmias - Hyperthyroidism - Hypersensitivity to sulfites - Hypersensitivity to penicillins - Hypotension

- Soothing irritated pharyngeal mucosa

Cough syrups serve as vehicles for antitussive drugs and also may exert antitussive effects of their own by doing what? - Soothing irritated pharyngeal mucosa - Precipitating an anticholinergic reaction - Reducing the bacterial load in the respiratory tract - Thinning pharyngeal mucus

- Secondary hypertension

During a routine check up of a 45-year-old patient with renal disease, the nurse observes an increase in the patient's blood pressure. Which is the most likely consequence of renal impairment? - Essential hypertension - Rebound hypertension - Hypertensive emergency - Secondary hypertension

- Albuterol

During the summer, a female client experiences increased periods of acute symptoms of her asthma. The health care provider increases the dose frequency of which of her medications? - Albuterol - Salmeterol - Epinephrine - Omalizumab

- bronchioles.

Epinephrine causes relaxation of: - bronchioles. - sphincter muscles. - superficial blood vessels. - smooth muscles in the intestinal wall.

- bronchiole

Epinephrine typically demonstrates the potential to promote relaxation of muscles in what structure? - bronchiole - superficial blood vessel - intestinal wall - gastrointestinal sphincter

- "You'll have to get another shot in around 2 months."

For the first time, a 10 year-old female has received an IM injection of Gardasil. What follow-up education should the nurse provide? - "Make sure to tell your parents if you have any stomach pain." - "This will keep you healthy until you're old enough for college." - "You'll have to get another shot in around 2 months." - "You might have a fever for the next couple of days, but that's expected."

- Multiple premature ventricular contractions (PVCs)

For what condition would the nurse expect to administer lidocaine intravenously? - Decrease in arterial oxygen saturation (SaO2) - Precipitous increase in blood pressure - Multiple premature ventricular contractions (PVCs) - Increase in intracranial pressure (ICP)

- Endothelial cells

Heart failure is a condition in which the heart cannot pump enough blood to supply adequate oxygen and nutrients to the body. At the cellular level, heart failure stems from dysfunction of what cells? - Endothelial cells - Erythrocytes - Epicardial cells - Pericardial cells

- 30 minutes

If a nurse is administering immune globulin to a client in the health care provider's office, the nurse would monitor the client for hypersensitivity reactions for how long after administering the drug? - 30 minutes - 5 minutes - 15 minutes - 60 minutes

- Tachycardia

In a state of shock, compensatory mechanisms occur in the body. What is a compensatory mechanism to increase cardiac output during hypovolemic states? - Third spacing of fluid - Vasodilation - Tachycardia - Gastric hypermotility

- Insufficient perfusion

In the field, emergency personnel are quick to treat the signs and symptoms of shock because it can quickly lead to organ failure and death. What causes the generalized metabolic acidosis associated with organ failure? - Insufficient perfusion - Cardiomyopathy - GI bleed - Insufficient glucose metabolism

- Specialized cells within the node itself

It is determined that a client's cardiac rhythm is being originated in the sinoatrial (SA) node. What mechanism is responsible for the triggering of this node? - Specialized cells within the node itself - Impulses from the brain - Interpretation of pressure sensors in the aorta - Chemical neurotransmissions from the adrenal cortex.

- Dietary consumption of calories and salt

Key behavioral determinants of blood pressure are related to what factor? - Minimal body mass - Dietary consumption of calories and salt - Dietary consumption of sugars and fat - Comorbidities

- Intravenously

Lidocaine (Xylocaine) is available in a variety of dosage forms. How should a nurse administer lidocaine to a client with a ventricular arrhythmia? - Intravenously - Intramuscularly - Orally - Topically

- lowering blood pressure

Losartan focuses on what aspect of the cardiac process to address the pathophysiology of heart failure? - lowering blood pressure - reducing preload - increasing stroke volume - increasing heart rate

- Nick, age 35, who is suffering from hepatic impairment

Losartan is frequently prescribed for hypertension management. For which client would the health care provider write a smaller starting dose of the medication, based on medical history and age? - Judy, age 36, who is pregnant - Luke, age 28, who is suffering from hypertension - Nick, age 35, who is suffering from hepatic impairment - Cole, age 88, who is suffering from hypertension

- Intravenously

Milrinone is a miscellaneous inotropic drug used in the short-term management of heart failure. What is the only way this drug is approved to be administered? - Intramuscularly - Orally - Subcutaneously - Intravenously

- Albuterol causes relaxation of the bronchial smooth muscles.

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication? - Albuterol causes stimulation of the bronchial tissue. - Albuterol causes relaxation of the bronchial smooth muscles. - Albuterol blocks the stimulation of the beta-2 receptors. - Albuterol decreases vital capacity.

- Changes in temperature or color of skin

Mr. Seeman, 65 years old, is admitted to the hospital for cardiogenic shock. He is placed on dopamine to improve his blood pressure. He also has a history of peripheral vascular disease, hyperlipidemia, and diabetes mellitus type 2. What adverse effect(s) would require health care provider notification? - Vomiting and nausea - Increased urinary output - Changes in temperature or color of skin - Disproportionate rise in diastolic blood pressure

- Increasing heart rate

Primary medications used in the management of shock are adrenergic drugs. How do medications with beta-adrenergic activity raise blood pressure? Select all that apply. - Increasing cardiac stroke volume - Increasing heart rate - Decreasing myocardial contractility - Increasing myocardial activity

- Cimetidine

Quinidine is prescribed to a patient with cardiac arrhythmia. When documenting the patient's drug history, the nurse inquires about the concomitant use of any other drug. Which drug when given concomitantly may cause an increase in serum Quinidine levels? - Nifedipine - Cimetidine - Hydantoins - Barbiturates

- They do not cross the blood-brain barrier.

Second-generation H1 antagonists cause less CNS depression because they are selective for peripheral H1 receptors and because of which other property? - They are metabolized by the liver. - They are excreted by the renal system. - They cross the blood-brain barrier. - They do not cross the blood-brain barrier.

- Heart and respiratory rates are elevated

Sepsis is an evolving process, with neither clearly definable clinical signs and symptoms nor predictable progression. As the ICU nurse caring for a patient with sepsis, you know that tissue perfusion declines and the patient begins to show signs of organ dysfunction. What signs of end-organ damage would you expect to become evident? - Urinary output increases - Skin becomes warm and dry - Adventitious lung sounds occur in lung bases - Heart and respiratory rates are elevated

- decreased oxygen supply to the heart.

The chest pain and pressure a client experiences during an anginal attack is caused by which of the following? - decreased oxygen supply to the heart. - increased oxygen supply to the heart. - vasodilation of the arteries around the heart. - decreased workload on the heart.

- Albuterol first, wait five minutes and then follow with flunisolide

The client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order? - Flunisolide followed immediately by albuterol - Albuterol followed immediately by flunisolide - Flunisolide first, wait five minutes and then follow with albuterol - Albuterol first, wait five minutes and then follow with flunisolide

- 3 months

The client has been on a systemic corticosteroid for the last 3 weeks. How long should the client wait before receiving a live virus vaccine? - 6 months - 3 months - 6 weeks - 1 year

- Hyperkalemia

The client has been started on an ACE inhibitor for hypertension. The client also takes spironolactone (Aldactone) daily. The nurse would evaluate the client for which of the following? - Hypocalcemia - Hypercalcemia - Hyperkalemia - Hypokalemia

- They are used to break down the thickness of secretions.

The instructor is teaching about the use of mucolytics. The nursing student demonstrates an understanding of the action of the mucolytic drugs when stating which? - They are used to depress the cough center in the medulla. - They are used to relieve a nonproductive cough. - They are used to break down the thickness of secretions. - They are used to relieve a productive cough.

- Septic

The nurse anticipates that the immunosuppressed patient is at greatest risk for which type of shock? - Cardiogenic - Anaphylactic - Neurogenic - Septic

- "I need to shake the inhaler well before taking the medication."

The nurse has finished teaching a 15-year-old client how to use an inhaler to treat asthma. What statement by the client suggests an understanding of the teaching? - "I need to shake the inhaler well before taking the medication." - "I should take a deep breath, hold it while I administer the medication, and then exhale." - "I need to wait at least 30 minutes after the first inhalation before taking a second." - "I need to take three short, quick breaths to inhale the medication."

- With water

The nurse is caring for a client who is taking a sustained-release (SR) oral nitrate. How should the nurse instruct this client to take the medication? - 1 hour after eating - With water - With milk or milk products - Sublingually until absorbed

200

The nurse is caring for a pediatric client who has been diagnosed with paroxysmal atrial tachycardia. The order reads digoxin 10 mcg/kg orally. The child weighs 44 lbs (20 kg). How many micrograms should the nurse administer? Record the answer as a whole number.

- SABA

The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication? - Leukotriene modifier - Antiasthma - LABA - SABA

- deep breathing and coughing exercises

The nurse is planning care for a client who is experiencing excessive respiratory tract secretions. What intervention should the nurse include? - administration of pseudoephedrine - supplemental oxygen - administration of guaifenesin - deep breathing and coughing exercises

- Confirming drug dosage calculations

The nurse is preparing digoxin for an infant. What is the nurse's priority intervention? - Checking the infant's blood pressure - Educating the infant's parents about therapeutic effects - Performing hand hygiene - Confirming drug dosage calculations

- "What's your understanding of why you're getting this vaccination?"

The nurse is preparing to administer a dose of the human papillomavirus vaccine to a middle school student. What assessment question should the nurse prioritize when interacting with the student? - "Have you gotten all of your required childhood vaccinations so far?" - "Do you know when you'll need to get a booster shot of this vaccine?" - "What's your understanding of why you're getting this vaccination?" - "Has anyone explained some of the main side effects of this vaccine?"

- Persistent cough

The nurse is providing drug teaching for a client who is prescribed captopril. What drug-specific adverse effect will the nurse include in the drug teaching? - Hepatic dysfunction - Hypersensitivity reaction - Sedation - Persistent cough

- inflammatory processes

The nurse is providing education to a client who has been diagnosed with a sinus infection. What would the nurse identify as a major cause of this disorder? - facial pain - autoimmune processes - impaired blood supply - inflammatory processes

- Every 5 minutes

The nurse is teaching a client with angina who is prescribed sublingual tablets. The nurse would instruct the client to use a tablet at which frequency when experiencing an acute attack? - Every 5 minutes - Every 2 minutes - Every 10 minutes - Every 15 minutes

- Haemophilus influenzae type B conjugate

The nurse is teaching a course to students about immunologic agents. In order for the students to understand active immunity, the nurse explains that there are agents that provide active immunity. Which is an active immunity agent? - Botulism immune globulin (BIG-IV) - Antithymocyte globulin€ - Crotalidae polyvalent immune Fab - Haemophilus influenzae type B conjugate

- Ginseng

The nurse is teaching a female patient about newly prescribed digoxin. The patient tells the nurse that she occasionally uses herbal therapies. The nurse should caution the patient against using therapies that involve which herbs? - Black cohosh - Ginseng - Valerian - Saw palmetto

- Notify the health care provider

The nurse is to administer digoxin to a client with heart failure. The nurse auscultates an apical pulse rate of 52. What action should the nurse take? - Assess the blood pressure - Administer medication - Administer half of the dose - Notify the health care provider

- IV - Transmucosal - Transdermal

The nurse knows that nitroglycerin can be administered in what ways? (Select all that apply.) - IV - Transmucosal - Transdermal - Intrathecally

- Transdermal - Transmucosal - IV

The nurse knows that nitroglycerin can be administered in what ways? (Select all that apply.) - Intrathecally - Transdermal - Transmucosal - IV

- blood pressure

The nurse notes that a client's current medications include both diltiazem for a dysrhythmia and atazanavir. The nurse should recognize the need to closely monitor which client assessment datum? - peripheral pulses - oxygen saturation levels - blood pressure - level of consciousness

- Amiodarone

The nurse recognizes which medications may be the cause of a digoxin level of 2.7 nanograms/mL? - Amiodarone - Antacids - Methotrexate - Cholestyramine

- It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins.

The patient has been placed on a nitroprusside drip for the treatment of a hypertensive crisis. Which mechanism of action does the nurse know is true for nitroprusside? - It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins. - It blocks the action of angiotensin II from all the different pathways where it is formed, not just the single substrate altered by ACE inhibitors. - It inhibits the movement of calcium ions across cell membranes. - It binds selectively to the mineralocorticoid receptors.

- Hepatitis B

The perinatal nurse recognizes that what vaccine can be safely given to a neonate? - Hepatitis B - Varicella - Measles, mumps and rubella (MMR) - Hepatitis A

- III

There are four primary classes of antidysrhythmic drugs. What class consists primarily of potassium channel blockers? - I - II - III - IV

- Vaccine

To prevent meningococcal infections, the nurse would administer: - Toxoid - Antivenin - Immune globulin - Vaccine

- The client holds his or her breath for several seconds after compressing the canister.

What action by the client would indicate that the client understands how to use an inhaler? - The client exhales as soon as he or she compresses the inhaler. - The client uses a spacer to administer a powdered medication. - The client inhales as soon as the inhaler enters his or her mouth. - The client holds his or her breath for several seconds after compressing the canister.

- Type I hypersensitivity reaction to Inhaled allergens

What causes the inflammation of nasal mucosa that is seen in allergic rhinitis? - Type I hypersensitivity reaction to Inhaled allergens - Type III hypersensitivity reaction to inhaled allergens - Type IV hypersensitivity reaction to inhaled allergens - Type II hypersensitivity reaction to inhaled allergens

- Adequate fluid intake - Humidification of the environment - Sucking on hard candy or throat lozenges

What home remedies are effective for mouth dryness and cough? (Select all that apply.) - Administration of over-the-counter antihistamine - Adequate fluid intake - Humidification of the environment - Sucking on hard candy or throat lozenges - Swishing the mouth with astringent mouthwash.

- A one-time administration of pneumococcal vaccine at 65 years of age - A tetanus-diphtheria (Td) booster every 10 years - An annual influenza vaccine

What immunizations are recommended for older adults? (Select all that apply.) - Rotavirus vaccine - An MMR every 7 to 10 years - A one-time administration of pneumococcal vaccine at 65 years of age - A tetanus-diphtheria (Td) booster every 10 years - An annual influenza vaccine

- Rebound congestion

What is an adverse reaction commonly experienced by people taking nasal decongestants? - Headache - Rash - Diarrhea - Rebound congestion

- exercise - allergens - pollutants - cigarette smoke

What is considered a possible trigger for an asthma attack? Select all that apply. - exercise - allergens - pollutants - warm weather - cigarette smoke

- Second-generation

What type of antihistamine is typically preferred for older adults? - First-generation - Second-generation - Antihistamines are contraindicated in older adults. - Neither type is preferred over the other.

- Live vaccines

What type of vaccine is contraindicated in clients who have active malignant disease? - Killed vaccines - Toxoids - Attenuated vaccines - Live vaccines

- Sedation

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased? - Hypersensitivity - Gastrointestinal upset - Sedation - Dry mouth

- β1 receptors

Which of the following adrenergic receptors is responsible for increased heart rate and increased force of myocardial contraction? - β1 receptors - α1 receptors - α2 receptors - β2 receptors

- Alcohol - Phosphodiesterase inhibitors

Which of the following if administered with nitrates can cause severe hypotension and possible cardiovascular collapse? Select all that apply: - Alcohol - Beta 2 agonists - HMG-CoA reductase inhibitors - Angiotensin-converting enzyme inhibitors - Phosphodiesterase inhibitors

- A 47-year-old female with hypertension

Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine? - A 47-year-old female with hypertension - A 62-year-old male with gout - A 17-year-old female with symptoms of an upper respiratory infection - A 52-year-old male with adult-onset diabetes

- Increased force of contraction

Which would be considered a therapeutic effect of digoxin? - Increased heart rate - Increased force of contraction - Decreased cardiac output - Decreased renal perfusion

- Oxymetazoline

Which would the nurse expect to administer as a nasal spray? - Hydrocodone - Oxymetazoline - Dextromethorphan - Benzonatate

- Epinephrine

Which would the nurse expect to be prescribed to a client experiencing acute bronchospasm? - Norepinephrine - Epinephrine - Dopamine - Metaraminol

- Digoxin

Which would the nurse identify as a cardiac glycoside? - Milrinone - Captopril - Digoxin - Inamrinone

- Hyperactive airways

Which would the nurse identify as being involved with asthma? - Acute infection - Hyperactive airways - Alveolar collapse - Progressive loss of lung compliance

- Restrict sodium, reduce fat and calories

You are teaching an obese client with compensated heart failure how to manage his condition with both prescribed drug therapy and nonpharmacologic measures. What modifications would you suggest that your client make to his diet? - Restrict sodium, eliminate fat, reduce calories - Restrict sodium, reduce fat and calories - Maintain sodium, reduce fat, maintain calories - Eliminate sodium, reduce fat, maintain calories

- Coffee

The nurse is caring for a client who is receiving IV theophylline for treatment of severe bronchospasm. The nurse will ensure that which item on the client's food tray will be held while the client is receiving theophylline? - Eggs - Milk - Green leafy vegetables - Coffee

- Increased myocardial contraction

The nursing instructor explains to students that positive inotropic action affects the heart in which way? - Decreased ventricular pressures - Increased myocardial contraction - Decreased venous return - Increased heart rate

- People who receive hemodialysis

For what group of adults is pre-exposure immunization against hepatitis B recommended? - People who receive hemodialysis - People over the age of 70 - People with chronic illnesses - People in their 20s

- Diltiazem

What drug is a safe and effective calcium channel blocker only if the nurse administers it as a sustained-release or extended-release preparation to treat hypertension? - Aliskiren - Diltiazem - Atenolol - Metoprolol

- "Smoking a pack of cigarettes a day for 30 years makes it hard to get air in."

Which statement, made by a client diagnosed with chronic obstructive pulmonary disease (COPD), demonstrates an understanding of the cause of this respiratory disorder? - "It's a genetic disorder that I've had since I was born." - "I have a bacterial lung infection that doesn't respond to antibiotics." - "My allergies trigger a chronic response in my lungs." - "Smoking a pack of cigarettes a day for 30 years makes it hard to get air in."

- "It will start working in about a half hour."

You are teaching a patient about his new prescription for oral propranolol. If the patient asks you how long it will take for the medication to relieve pain, what will you say in response? - "It will start working in about a minute." - "It will start working in about a half hour." - "It will start working in about ten minutes." - "It will start working in about fifteen minutes."

- Recent changes include greater use of nonpharmacologic management of arrhythmias.

Your patient, 4 days status post-radiofrequency cardiac ablation, is heading home, discharge instructions in hand. She questions the lack of medication prescribed to prevent repeating episodes of her arrhythmias. How do you explain to her the recent changes in dysrhythmic therapy? - Recent changes include greater use of nonpharmacologic management of arrhythmias. - Pharmacologic management of her arrhythmia won't help. - Medications are always given to control arrhythmias. - Additional medications are given as tachyarrhythmias increase in frequency and severity.

- forget about the morning dose and take the evening dose.

A 20-year-old woman calls the clinic at 5 PM and reports to the nurse that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The nurse will instruct her to - take the morning dose now and the evening dose at the regular time. - skip the evening dose and start back in the morning. - forget about the morning dose and take the evening dose. - double her evening dose.

- "Drink at least two liters of fluids each day."

A 25-year-old female client presents at the clinic with bronchitis. The health care provider orders guaifenesin. Which instruction should the clinic nurse offer when teaching the client about the medication? - "Take an NSAID to relieve the joint aches that result from taking this medication." - "Drink at least two liters of fluids each day." - "Use a second method of contraception until you've completed the drug therapy." - "Restrict your fluid intake to one liter each day."

- a persistent, dry cough may occur; however, it is not serious.

A 26-year-old white male client has been prescribed captopril for hypertension. A nurse has been assigned to the client to provide education regarding the use of this drug. The nurse will advise the client that: - a persistent, dry cough may occur; however, it is not serious. - the first dose of the medication should be taken at breakfast. - if sore throat, fever, and swollen hands or feet occur, do not be alarmed. These manifestations will subside. - he should use a salt substitute containing potassium to avoid hypokalemia.

- Increase fluids to 2 L/d.

A 29-year-old client has sinusitis and has been prescribed a topical nasal decongestant. What instructions should the nurse provide? - Take the medication with meals. - Increase fluids to 2 L/d. - Temporarily avoid high-sodium foods. - Use two forms of birth control until treatment is complete.

- Sinoatrial node

A 32-year-old client has been admitted to the hospital for cardiac arrhythmias. When providing client education, the nurse should include that the heart has a specialized electrical system, with which structure acting as the pacemaker of the heart? - Atrioventricular node - Bundle of His - Sinoatrial node - Right atrium

- Discontinue the drug

A 35-year-old female client controls the symptoms of her cardiovascular disease with ACE inhibitors. She discovers that she is pregnant and contacts her primary care provider regarding her medication regimen. What would the nurse expect the provider to do? - Discontinue the drug - Increase the dosage of the drug - Decrease the dosage of the drug - Maintain the current dosage of the drug

- 62.5 mcg

A 4-year-old is admitted to the emergency department in shock after a motor vehicle accident. The client weighs 12.5 kg. What would be the minimum effective dose of adrenalin if the pediatric dose is 0.005 to 0.01 mg/kg IV? - 87.5 mcg - 62.5 mcg - 80 mcg - 75 mcg

- Smoking decreases the size of the tubes leading to the lungs

A 42-year-old male client has a history of smoking for 20 years. The client states he is feeling fine and asks why stopping smoking is necessary. What information might the nurse share with the client about smoking? - The chest becomes more elastic with increased time of smoking - Carbon dioxide levels may decrease in the lungs - Smoking decreases the size of the tubes leading to the lungs - Smoking causes the respiratory system to increase oxygen delivery to the lungs

- stop taking the medication and come to the clinic as ordered by the health care provider.

A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to: - stop taking the medication and come to the clinic as ordered by the health care provider. - decrease the dosage by one half. - continue taking the drug because the sensations will resolve with time. - lie down after each dose.

- By inhibiting the transformation of angiotensin I to angiotensin II

A 46-year-old client with a high body-mass index and a sedentary lifestyle has been diagnosed with hypertension after serial blood pressure readings. The clinician has opted to begin the client on captopril (Capoten). The nurse should recognize that the therapeutic effect of this drug is achieved in what way? - By directly relaxing vascular smooth muscle - By blocking aldosterone from binding to mineralocorticoid receptors - By blocking the movement of calcium ions into arterial smooth muscles - By inhibiting the transformation of angiotensin I to angiotensin II

- Implement interventions to lower blood pressure.

A 48-year-old client with a blood pressure of 198/112 mm Hg reports severe headache and drowsiness. The nurse notes that the client is disoriented and has begun to vomit. What is the primary nursing goal for this client experiencing a hypertensive emergency? - Assess the level of head pain. - Administer antiemetic medication. - Monitor the client's level of consciousness. - Implement interventions to lower blood pressure.

- Hypotension

A 49-year-old client is admitted with uncontrolled chest pain. The client is currently taking nitroglycerin. The health care provider adds nifedipine to the client's regimen. The nurse should observe the client for what adverse effects? - Hypokalemia - Renal insufficiency - Hypotension - Hypoglycemia

- 0.818 mg

A 6-year-old child weighing 60 pounds has been prescribed Lanoxin 30 mcg/kg PO daily. How many mg will the child be given? - 0.818 mg - 0.218 mg - 0.418 mg - 0.618 mg

- Take the tablet with food.

A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition? - Drink ample water before taking the tablet. - Take an antacid before the tablet. - Take the tablet with food. - Take the tablet one hour before food.

- Administer a tablet under the tongue and repeat the action in 5 and 10 minutes if the pain has not subsided.

A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which action should the nurse do first when he reports chest pain? - Call the health care provider. - Ask the client to lie back and try to relax. - Have the client swallow a tablet every 5 minutes for 15 minutes. - Administer a tablet under the tongue and repeat the action in 5 and 10 minutes if the pain has not subsided.

- Use of nicotine

A 70-year-old client is being treated for chronic obstructive pulmonary disease (COPD) with theophylline. What will be a priority assessment by the nurse? - Weight - Activity level - Use of nicotine - Intake of fatty foods

- inhibiting the movement of calcium ions across the cardiac muscle cell membrane.

A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by: - decreasing sodium and potassium conduction. - weakening diastolic depolarization and the action potential duration. - inhibiting the movement of calcium ions across the cardiac muscle cell membrane. - blocking adrenergic receptors and producing antisympathetic effects.

- Drowsiness

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients? - Nasal burning - Nonproductive cough - Dry mouth - Drowsiness

- The man's chest sounds are clear and his ankle edema is lessened.

A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? - The man's glomerular filtration rate and creatinine levels are within reference ranges. - The man's heart rate is between 60 and 70 beats per minute with a regular rhythm. - The man's potassium and sodium levels remain with reference ranges. - The man's chest sounds are clear and his ankle edema is lessened.

- result in death.

A 92-year-old male client is being sent home on disopyramide for a ventricular arrhythmia. The client asks why he must continue to take this drug. The nurse's best response would be that a ventricular arrhythmia may: - result in the atria beating independently. - result in death. - lead to the formation of clots in the legs. - cause edema in the extremities.

- Breast-feeding must be discontinued and other forms of feeding should be introduced.

A breast-feeding woman is prescribed a Class 3 antiarrhythmic. What information should the nurse provide to the client regarding the safety of the breast-feeding while taking this medication? - The decision to continue breast-feeding should be based on the stress is creates for the woman - The safety of this class of antiarrhythmic medications has not been established. - The medication doesn't pass into the breast milk. - Breast-feeding must be discontinued and other forms of feeding should be introduced.

- Reye syndrome

A child who is recovering from a chickenpox infection is given aspirin for the fever. Which condition develops following the simultaneous administration of salicylates and the varicella vaccine? - Lymphoma - Angioneurotic edema - Acute renal failure - Reye syndrome

- Toxicity can occur even on low-dose therapy due to various factors including advanced age

A client admitted with digitalis toxicity has been taking the same dose for more than 20 years. The family asks the nurse how someone can develop a toxic level while taking the usual dose. How would the nurse respond? - The client probably has severe renal impairment. - Toxicity can occur even on low-dose therapy due to various factors including advanced age - The client must have been taking the wrong dose. - Toxicity is usually due to incorrect prescription strength.

- Antitussives suppress coughing while expectorants loosen bronchial secretions.

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon? - Antitussives suppress coughing while expectorants loosen bronchial secretions. - Antitussives kill cold viruses while expectorants liquefy bronchial secretions. - Both drug types loosen bronchial secretions for ease of removal. - Antitussives liquefy bronchial secretions while expectorants assist in the expectoration of those secretions.

- Decongestants

A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow? - Antitussives - Expectorants - Mucolytics - Decongestants

- Lifelong

A client develops primary hypertension and asks the nurse, "How long will I need to receive therapy?" The nurse responds based on the understanding that therapy would be required for how long? - 5 years - One year - Until blood pressure is 120/80 mmHg - Lifelong

- Taper down the propranolol dose over a period of 2 weeks.

A client diagnosed with a dysrhythmia has not responded appreciably to treatment with oral propranolol. When the medication is discontinued, what instruction should the nurse provide the client to maximize safety? - Taper down the propranolol dose over a period of 2 weeks. - Be prepared to substitute an intramuscular propranolol for several months. - Gradually replace the propranolol with newly prescribed metoprolol. - Monitor cardiac status at regularly after taking the final dose of propranolol.

- The medication should be taken on an empty stomach.

A client diagnosed with asthma has been prescribed a leukotriene receptor antagonist. What information should the nurse include when discussion medication instructions with this client? - The effectiveness of the medication is enhanced when taken with food - The medication should be taken 30 minutes before a meal - The medication is most effective when taken at breakfast - The medication should be taken on an empty stomach.

- "I know I must take my medication every day for my heartbeat to be fixed."

A client diagnosed with heart disease is prescribed an antiarrhythmic drug. Further teaching is needed when the client makes which statement? - "I know I must take my medication every day for my heartbeat to be fixed." - "I need to call my primary care provider before taking any herbal supplements." - "I can check the drug label about taking the medicine with food." - "I will take my medication at the prescribed time."

- "Follow the instructions on the label so that you don't end up making the congestion worse."

A client diagnosed with the common cold asks the nurse about taking an over-the-counter (OTC) cold medications. What statement should the nurse include in client teaching? - "You should really consider prescription medications rather than OTC medications." - "Follow the instructions on the label so that you don't end up making the congestion worse." - "While OTC medications may be cheaper, they generally result in more side effects." - "No OTC medication, especially sprays or nose drops, should be taken for more than 3-4 days."

- Antihistamines are not recommended for treating a cold.

A client exhibiting signs and symptoms of the common cold asks the nurse if taking an antihistamine would be helpful. What is the nurse's best response? - Antihistamines are not recommended for treating a cold. - Antihistamines can be helpful when they're combined with an antibiotic. - Yes, but it's important to monitor for adverse effects. - Yes, but be sure to use a brand that mentions 'cold remedy' on the packaging.

- Respiratory assessment

A client has a complex cardiac history that includes recurrent ventricular fibrillation. After the failure of more conservative treatments, the care team has introduced oral amiodarone. What assessments should be prioritized by the nurse who is providing care for this client? - Respiratory assessment - Active and passive range of motion - Orientation and cognition - Neurological assessment

- Loratadine

A client has an important presentation to make in 4 hours, and he needs relief from the congestion of seasonal rhinitis. The client calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. What medication is most likely to meet this client's needs? - Loratadine - Diphenhydramine - Hydroxyzine - Dexchlorpheniramine

- The heart beats in response to impulses that are generated by specialized cells located in the heart not the brain.

A client has been declared "brain dead". The family asks the nurse to explain why their loved one's heart continues to beat in spite of the damage to the brain. The nurse should provide what explanation to the family? - The heart beats in response to impulses that are generated by specialized cells located in the heart not the brain. - The heart will eventually stop beating as the losses associated with "brain death" become more extensive. - When the brain is unable to trigger the heart to beat, the sinoatrial (SA) node in the heart assumes that role. - The inability to control the heart is not among the losses associated with "brain death".

- Inhaled corticosteroids should not be used on an emergency basis.

A client has been diagnosed with asthma and prescribed inhaled steroids. What should the nurse teach the client about this treatment? - Inhaled corticosteroids should not be used on an emergency basis. - Effective levels are usually reached within 72 hours of starting treatment. - Systemic adverse effects should be expected and can be serious. - The drug will stimulate the sympathetic nervous system.

- sit in a fully upright position when administering the medication.

A client has been diagnosed with chronic obstructive pulmonary disease. The client has been prescribed bronchodilators by nebulizer for home use. The nurse should teach the client to: - gargle with an alcohol-based mouthwash after each dose. - sit in a fully upright position when administering the medication. - take the exact number of puffs that have been prescribed. - keep an extra oxygen tank on hand for propelling the medication.

- Immediately

A client has been prescribed IV amiodarone for emergency treatment of a serious ventricular arrhythmia. The nurse monitors the client's ECG anticipating a noted change how long after the medication is delivered? - Immediately - 10 minutes - 90 minutes - 2-3 days

- Decrease the heart rate

A client has been prescribed a beta blocker. The nurse knows that beta blockers can have which effect on the heart? - Prevent normal sinus rhythm - Increase the heart rate - Constrict the heart - Decrease the heart rate

- gastroesophageal reflux disease

A client has been prescribed medication therapy for the treatment of newly diagnosed asthma. During teaching, the nurse should alert the client to potential exacerbation of what concurrent medical condition? - gastroesophageal reflux disease - urinary retention - dermatitis - cataracts

- elevated potassium levels

A client has been prescribed ramipril 5 mg PO daily with the scheduled dose due at 08:00. After reviewing the client's most recent blood work, the nurse should consider withholding the dose because of what laboratory finding? - low sodium levels - low hemoglobin levels - elevated neutrophil levels - elevated potassium levels

- Avoid drinking alcohol while taking antihistamines

A client has begun taking an antihistamine for the treatment of seasonal allergies. What dietary guidelines should the nurse provide to the client? - Avoid grapefruit juice until at least 48 hours after treatment is complete - Increase intake of foods that are high in vitamin C - Avoid drinking alcohol while taking antihistamines - Eat several small meals instead of three larger meals in case of GI upset

- Nasal decongestant - Herbal supplement - OTC appetite suppressant

A client has come to the clinic for the past 7 months with elevated blood pressure. The client has now been prescribed three different antihypertensives as well as a diuretic. The nurse knows that what other factors may be contributing to the client's consistent hypertension? (Select all that apply.) - Meditation - Walking program - Nasal decongestant - Herbal supplement - OTC appetite suppressant

- cardiovascular

A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system? - gastrointestinal - neurological - renal - cardiovascular

- The client is currently prescribed prednisone.

A client has presented to the clinic and is requesting the seasonal influenza vaccine. What aspect of the client's health history may contraindicate the safe and effective use of this vaccine? - The client does not know their blood type and it is not recorded in available health records. - The client is 76 years-old. - The client takes a loop diuretic for the treatment of hypertension. - The client is currently prescribed prednisone.

- Administering tetanus immune globulin as prescribed

A client has presented to the emergency department with a puncture wound suffered a few hours ago while demolishing an old house. The nurse's assessment reveals that the client is not in acute distress. The client's immunization status is unknown. What intervention should the nurse prioritize? - Educating the client about the importance of immunizations - Administering cytomegalovirus immune globulin as prescribed - Assessing the client for signs and symptoms of localized or systemic infection - Administering tetanus immune globulin as prescribed

- an adrenergic antagonist.

A client has recently been prescribed a drug that treats hypertension by blocking the sympathetic receptors in the sympathetic nervous system. This action is characteristic of which? - a neurotransmitter. - an adrenergic antagonist. - an adrenergic agonist. - a cardiotonic.

- The client is being treated for severe hypertension.

A client informs the nurse about taking pseudoephedrine for the relief of nasal congestion due to the common cold. In which situation should the nurse suggest that the client not use this medication since it is a contraindication for this health care concern? - The client is being treated for severe hypertension. - The client has hypothyroidism. - The client has had a cold for 3 days. - The client has a history of cataracts.

- blood pressure

A client is admitted to the emergency department with signs and symptoms of cardiogenic shock. Isoproterenol is administered intravenously. What assessment should the nurse prioritize when monitoring for therapeutic effects? - deep tendon reflexes - blood pressure - level of consciousness - signs and symptoms of hemorrhage

- Respiratory expiration

A client is being evaluated for a possible diagnosis of emphysema. What client characteristic should the nurse monitor to provide evidence of the disorder? - Respiratory expiration - Respiratory inspiration - Presence of a fever - Evidence of underlying trauma

- Beta-2-specific adrenergic agonist

A client is being treated for asthma. What would the nurse expect to administer? - Alpha- and beta-adrenergic agonist - Alpha-specific adrenergic agonist - Beta-1-specific adrenergic agonist - Beta-2-specific adrenergic agonist

- "How much coffee, tea, and soda do you drink daily?"

A client is currently taking pseudoephedrine to help manage the nasal congestion resulting from seasonal allergies. When the client reports being extremely restless and having difficulty getting to sleep at night, what assessment question will the nurse ask to best provide interventions to minimize those effects? - "Are you a smoker?" - "How much coffee, tea, and soda do you drink daily?" - "Are you out in the sun much during a typical day?" - "Do you tend to exercise before going to bed?"

- Increase fluid intake

A client is encouraged to take guaifenesin to loosen the secretions due to a viral respiratory infection. What should the nurse suggest to the client to make the medication work more effectively? - Increase fluid intake - Dilute the liquid medication with water prior to administration - Take the medication with food - Take the medication with other over-the-counter medications to enhance the effect

- Beta-2 selective adrenergic agonist

A client is experiencing an acute asthmatic attack. Which agent would be most effective? - Beta-2 selective adrenergic agonist - Inhaled steroid - Leukotriene receptor antagonist - Mast cell stabilizer

- "Determine if the drug is going to make you drowsy before you drive."

A client is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which statement will the nurse include when providing education concerning this drug? - "This drug has to be taken every 4 to 6 hours." - "Determine if the drug is going to make you drowsy before you drive." - "Be sure to take this medication on a full stomach." - "You should take the medication twice a day."

- Asthma

A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition? - Emphysema - Asthma - Pneumonia - Chronic bronchitis

- Potassium

A client is prescribed aliskiren. The nurse would monitor the laboratory test results of which electrolyte closely? - Potassium - Sodium - Magnesium - Chloride

- Selectively binds with angiotensin II receptors in the vascular smooth muscle

A client is receiving candesartan. The nurse understands that this drug acts in which manner? - Increases the excretion of sodium and water from the kidney - Prevents angiotensin converting enzyme from converting angiotensin I to angiotensin II - Inhibits the movement of calcium ions across the heart and arterial muscle cell membranes - Selectively binds with angiotensin II receptors in the vascular smooth muscle

- Cough

A client is receiving fosinopril. Which adverse effect would the nurse caution the client about to help to promote compliance? - Cough - Constipation - GI irritation - Photosensitivity

- 1- 3 minutes

A client is using nitroglycerin in translingual spray form. The nurse would inform the client that the drug would begin working within which time frame? - Immediately - 4-5 minutes - 15-45 seconds - 1- 3 minutes

- Guaifenesin

A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client? - Dextromethorphan - Codeine - Guaifenesin - Aspirin

- Hypovolemic

A client presents to the ED status post-motor vehicle accident with hypotension, tachycardia, diaphoresis, pallor, and oliguria. Reports from the accident site indicate significant blood loss from the vehicle's only occupant. What type of shock does the nurse suspect is the client demonstrating? - Anaphylactic - Hypovolemic - Distributive - Cardiogenic

- Loop

A client presents to the emergency department with signs and symptoms of acute congestive heart failure. Assessment findings and tests confirm the diagnosis. Which type of diuretic would be the drug of choice to treat the client? - Potassium sparing - Calcium wasting - Loop - Thiazide

- Bronchodilation

A client receives a beta-specific agonist. What would lead the nurse to determine that the drug is effective? - Tremor - Bronchodilation - Decreased heart rate - Slowed cardiac conductivity

- artificially acquired active immunity

A client receives an immunization. The nurse interprets this as providing the client with which type of immunity? - active immunity - naturally acquired active immunity - passive immunity - artificially acquired active immunity

- Bleeding

A client receiving warfarin is prescribed disopyramide. The nurse would monitor for signs and symptoms of what as most important? - Bleeding - Disopyramide toxicity - Renal dysfunction - Arrhythmia

- rebound congestion

A client reports experiencing severe nasal congestion since starting to use an over-the-counter (OTC) nasal decongestant spray a week ago. This symptomology most supports what possible medical condition? - bronchitis - a drug allergy - sinusitis - rebound congestion

- "Did the medication contain pseudoephedrine?"

A client reports having difficulty finding the over-the-counter (OTC) decongestant that the client used in the past. What assessment question should the nurse ask to help address the client's concern? - "Have you asked the pharmacist about a substitute medication?" - "How long has it been since you last needed to take a decongestant?" - "Would you like your health care provider to prescribe something for congestion?" - "Did the medication contain pseudoephedrine?"

- Hypotension

A client taking amlodipine (Norvasc) is having chest pain and is ordered sublingual nitroglycerin. The nurse evaluates the client for: - Hypotension - Hypertension - Hyperkalemia - Hypokalemia

- "Have you developed a cough since the taking the medication?"

A client was prescribed captopril three weeks ago. Which question should the nurse ask at a follow-up appointment to best assess for possible development of a common adverse effect? - "Are you experiencing any difficulty urinating?" - "Have you developed a cough since the taking the medication?" - "How have you been sleeping since starting the captopril?" - "Has constipation been a problem since starting the medication?"

- Cromolyn

A client who has chronic bronchial asthma has had a mast cell stabilizer prescribed. What drug would the provider prescribe? - Ipratropium - Isoetharine - Cromolyn - Aminophylline

- ACE inhibitors are contraindicated during pregnancy because they are teratogenic.

A client who is taking an ACE inhibitor informs the nurse that she is considering having a child. What information should the nurse provide to the client related to this new information? - Since ACE inhibitors cross the placenta, dosage during pregnancy should be reduced. - ACE inhibitors are contraindicated during pregnancy because they are teratogenic. - ACE inhibitors will exacerbate the fluid overload that commonly accompanies pregnancy. - ACE inhibitor therapy can continue during pregnancy.

- 30 to 60 minutes before the ferry trip

A client whose daily commute includes travel on a ferry boat has been prescribed diphenhydramine. During client teaching, the nurse should instruct the client to take the medication at what time? - as soon as the ferry leaves the dock - 30 to 60 minutes before the ferry trip - the night before each trip - when the client boards the ferry

- Take the medication at bedtime.

A client with a long history of hypertension has just been prescribed an alpha1-adrenergic receptor blocker. To reduce this client's risk of orthostatic hypotension and falls, the nurse should encourage the client to implement what intervention? - Take the medication at bedtime. - Take the medication with a high-fat meal. - Increase fluid intake for 48 hours before taking the first dose. - Start with a low dose and increase gradually over 2 to 3 weeks.

- Blood pressure

A client with a longstanding diagnosis of angina has been prescribed nitroglycerin and diltiazem. In addition to monitoring the client's heart rate, the nurse should prioritize what assessment? - Blood pressure - Level of consciousness - Daily weights and abdominal girth - Respiratory status

- a persistent cough.

A client with a respiratory tract infection is prescribed expectorants. A nurse should administer expectorants cautiously in clients with: - oral ulcers. - psychoses. - a persistent cough. - sinus bradycardia.

- digoxin

A client with a ventricular dysrhythmia is prescribed amiodarone. Before giving the client a dose, then nurse will review the medication administration record for any indication of what other prescribed drug that interacts with amiodarone? - heparin - digoxin - furosemide - hydrochlorothiazide

- Assess the client's blood pressure.

A client with angina has been prescribed nifedipine 15 mg PO t.i.d. The client has received the first two doses of the medication and reports dizziness. What is the nurse's best action? - Reassure the client that this is an expected adverse effect. - Report this finding to the client's care provider. - Assess the client's blood pressure. - Withhold the next scheduled dose and implement falls precautions.

- Decreasing airway hyperreactivity to stimuli

A client with asthma has been prescribed an anti-inflammatory medication. How does an anti-inflammatory drug reduce this client's bronchoconstriction? - Increasing ability to metabolize medication - Increasing uptake of corticosteroids to medication - Decreases formation of mucus secretions - Decreasing airway hyperreactivity to stimuli

- Aspirin

A client with chronic bronchial asthma is prescribed montelukast. What will the nurse instruct the client to avoid taking? - Aspirin - Nifedipine - Sertraline - Penicillin

- 130/80 mm Hg

A client with diabetes also has hypertension. The nurse would expect that the blood pressure goal for the client would be which of the following? - 130/80 mm Hg - 140/90 mm Hg - 150/100 mm Hg - 100/70 mm Hg

- "Many clients require two or more drugs for high blood pressure."

A client with primary hypertension asks the nurse why the prescriber added another medication to assist with lowering the blood pressure. What is the nurse's best response? - "The prescriber has not read the current guidelines and needs an update." - "Your diet and exercise are not effective and adding another drug is ideal." - "Many clients require two or more drugs for high blood pressure." - "You should talk to the prescriber for clarification about the medications. "

- Hypovolemic

A client with significant burns develops shock and requires adrenergic drug therapy. The nurse interprets this as which type of shock? - Neurogenic - Septic - Cardiogenic-obstructive - Hypovolemic

- "This is a common adverse effect of nitroglycerin; try taking acetaminophen to treat your headache."

A client's angina pectoris is being successfully treated on an outclient basis with sublingual nitroglycerin. What teaching point should the nurse convey to the client when reporting concern about the headache that follows the use of the medication? - "This is a common adverse effect of nitroglycerin; try taking acetaminophen to treat your headache." - "If you can take your nitroglycerin on a full stomach, it might reduce the frequency and severity of your headaches." - "I'll contact your health care provider. This may mean that nitroglycerin is not the right drug for you." - "The headache is actually a result of your angina, not the nitroglycerin."

- pulmonary edema

A client, diagnosed with left-sided heart failure, should be taught to recognize the signs and symptoms of the onset of what classic manifestation of this condition? - palpitations - venous ulcers - chest pain - pulmonary edema

- Persistent cough

A client, newly diagnosed with hypertension is started on captopril, an ACE inhibitor. The client should be informed of the possibility of what adverse effect? - Sedation - Persistent cough - Sweating - Hypokalemia

- "It inhibits the influx of calcium ions across cardiac and smooth muscle, dilating the coronary arteries."

A client, prescribed amlodipine, asks how this drug works. What is the nurse's best response? - "Blocks conversion of angiotensin I to angiotensin II." - "Increases client's perception of pain and decreases the heart rate." - "Decreases the cardiac output by diuresis of sodium and water." - "It inhibits the influx of calcium ions across cardiac and smooth muscle, dilating the coronary arteries."

- Thiazide

A combination of drugs needs to be incorporated into the drug regimen for a hypertensive client. What type of diuretic would the nurse expect to administer? - Thiazide - Loop - Potassium-sparing - Osmotic

- Monitor cardiac rhythm continuously.

A critical care nurse is caring for a client after open-heart surgery. What nursing intervention would the nurse initiate to help detect life-threatening arrhythmias and manage and minimize any that occur? - Monitor blood pressure continuously. - Palpate the client's pulse and observe the client's response. - Provide supplemental oxygen. - Monitor cardiac rhythm continuously.

- Glucose control

A current client, an overweight 61-year-old with a history of diabetes mellitus, is status post-MI 1 month and has returned for a cardiology follow-up. Along with dietary changes, the nurse will discuss which nonpharmacologic lifestyle modification to reduce microvascular changes? - Increased cholesterol consumption - Glucose control - Maintaining weight - Increased nicotine use

- Misuse could result in overdose.

A female client calls the pediatrician's office for a suggestion regarding the best over-the-counter cough and cold medicine for her 6-month-old child. The pediatrician advises against the medication for what reason? - Misuse could result in overdose. - The medication is not effective for croup. - The medication is contraindicated for viral infections. - The medication is contraindicated for the child's symptoms.

- Dry mouth

A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect? - Incontinence - Slurred speech - Dry mouth - Diarrhea

- Adrenal insufficiency

A female client is prescribed systemic corticosteroids for her asthma. The nurse knows that the client is at risk for what problem? - Pituitary insufficiency - Pancreatic insufficiency - Adrenal insufficiency - Renal insufficiency

- "Different types of drugs have different actions and produce different responses."

A female client's drugs include a furosemide, digoxin, and hydralazine. She is unable to afford all of her medications, so she takes them intermittently to make them last longer. In addition to making a referral to social service, what should the home care nurse tell this client? - "Over-the-counter drugs may be viable substitutes for the more expensive medications." - "Different types of drugs have different actions and produce different responses." - "Your plan is acceptable if the health care provider is aware and laboratory studies are done more frequently." - "Changes in doses may be better than alternating medications."

- Rabies vaccine

A forest ranger arrives at a community clinic for prophylactic vaccination. Which vaccine would be most important to be administered to the ranger? - Rotavirus vaccine - Measles, mumps, and rubella (MMR) vaccine - Rabies vaccine - Varicella vaccine

- Carvedilol

A group of nursing students are reviewing information about adrenergic blockers. The students demonstrate understanding when they identify which as an example of an alpha/beta-adrenergic blocking drug? - Carvedilol - Metoprolol - Prazosin - Reserpine

- Guaifenesin

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example? - Acetylcysteine - Benzonatate - Guaifenesin - Dextromethorphan

- Guaifenesin

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example? - Guaifenesin - Acetylcysteine - Benzonatate - Dextromethorphan

- provide the person with active immunity.

A group of students are reviewing class material about immunizations and vaccines. The students demonstrate understanding of the topic when they state that immunizations and vaccines: - promote the development of antigens for the disease. - commonly result in moderate to severe reactions in children. - result in signs and symptoms of the acute disease. - provide the person with active immunity.

- Loratadine

A group of students are reviewing information about antihistamines. The students demonstrate understanding of the information when they identify which agent as a second generation antihistamine? - Promethazine - Meclizine - Loratadine - Brompheniramine

- Milrinone

A group of students are reviewing the drugs used to treat heart failure. The students demonstrate understanding of the information when they identify which agent as a phosphodiesterase inhibitor? - Milrinone - Captopril - Digoxin - Hydrochlorothiazide

- It has a longer duration of action than sublingual tablets.

A health care provider has prescribed sublingual nitroglycerin and the nitroglycerin patch for a client. When the nurse explains the medications to the client, what advantage of the patch might the nurse mention? - It only has to be administered once a week. - It is more effective than sublingual tablets in treating acute angina. - It has a longer duration of action than sublingual tablets. - It acts more quickly than sublingual tablets.

- assess the skin integrity of potential intramuscular injection sites.

A landscaper has sought care because of a puncture wound to her foot and the provider has prescribed 250 units of the tetanus immune globulin. In preparation for administration, the nurse should: - educate the client about the availability of the tetanus vaccine. - establish reliable intravenous access. - assess the skin integrity of potential intramuscular injection sites. - assess the client for signs of tetany.

- They relax the gastresophageal sphincter.

A male client is concerned because ever since he began his antiasthma medication, his GERD symptoms are worse. The nurse explains that his symptoms are worse because his asthma medications have what effect? - They cause acid indigestion. - They tighten the gastresophageal sphincter. - They relax the gastresophageal sphincter. - They stimulate peristalsis.

- Retention of secretions

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports? - Rhinorrhea - Retention of secretions - Rhinitis - Chronic nasal swelling

- Digoxin's long half-life makes therapeutic serum levels difficult to obtain without loading.

A male client is diagnosed with heart failure. The health care provider orders a loading dose of digoxin. Loading doses are necessary for what reason? - Digoxin's long half-life makes therapeutic serum levels difficult to obtain without loading. - Digoxin's short half-life increases the risk for toxicity. - Oral digoxin is ineffective for the treatment of heart failure. - The client is at risk for dysthymia with titrated doses.

- Notify the health care provider.

A male client is having angina. As the nurse prepares to administer sublingual nitroglycerin, it is noted that the client's blood pressure is 82/54. What is the best action of the nurse? - Administer the medication. - Notify the health care provider. - Withhold medication until blood pressure increases. - Ask the client how he feels.

- Diphenhydramine

A male client presents to the emergency department with symptoms of a gastrointestinal bleed. The health care provider orders a blood transfusion. The client has a history of anaphylaxis. The provider orders the administration of what drug before the blood transfusion? - Desloratadine - Cetirizine - Diphenhydramine - Azelastine

- "People of Asian descent excrete the drugs more slowly, so the doses prescribed are smaller."

A male client who is an Asian executive visiting the United States presents to the emergency department with a severe headache and an elevated blood pressure. He is admitted to the hospital for treatment and regulation of his medication regimen. The client is concerned because the dosage prescribed for his antihypertensive medication is lower than what he researched on the Internet. What is an accurate response for the nurse to make? - "I will contact the provider immediately." - "There is an error on the prescription." - "People of Asian descent excrete the drugs more rapidly, so the doses prescribed are smaller." - "People of Asian descent excrete the drugs more slowly, so the doses prescribed are smaller."

- Every 10 years

A male patient, age 78, presents in the emergency department after stepping on a nail. The patient tells the nurse that he had his last tetanus shot 12 years ago and asks the nurse about the recommended interval for the administration of tetanus toxoid to adults. What would be the nurse's most correct response? - Yearly - Every 10 years - Every 2 years - Every 5 years

- 0.5 mL

A mother brings her 18-month-old into the clinic for a well-baby check-up. A nurse will administer measles, mumps, and rubella vaccine (MMR) to the 18-month-old. What dosage will the nurse administer? - 0.005 mL - 0.05 mL - 0.5 mL - 5 mL

- 0.2

A neonate who weighs 7 lbs, 8 oz kg is prescribed the hepatitis B immune globulin at a dose of 0.06 mL/kg IM. To one decimal place, what dose should the nurse administer?

- Angle-closure glaucoma - Pregnancy

A nurse is assessing patients who are to be initiated with antihistamine therapy. For which of the following conditions is this therapy contraindicated? Select all that apply. - Nausea and vomiting - Anaphylactic shock - Allergic conjunctivitis - Angle-closure glaucoma - Pregnancy

- Continually assess the client for physiological changes and notify the primary care provider with changes.

A nurse is caring for a 25-year-old client who has been prescribed an adrenergic drug for shock. Which action should the nurse implement? - Prepare the family by telling them how sick their loved one is and that he may die. - Observe the client closely for seizures, hypothermia, and dementia; if seen, stop the infusion immediately. - Continually assess the client for physiological changes and notify the primary care provider with changes. - Leave the room so that the client can sleep and not risk sleep deprivation psychosis.

- Damage to the heart - Damage to the kidneys - Damage to the eyes

A nurse is caring for a client experiencing a hypertensive emergency. If blood pressure is not lowered immediately, what can occur? (Select all that apply.) - Damage to the heart - Damage to the kidneys - Damage to the gall bladder - Damage to the pancreas - Damage to the eyes

- Purulent cough

A nurse is caring for a client with chronic bronchiectasis. The nurse should assess the patient for which clinical manifestation? - Purulent cough - Angina - Pigeon chest - Pulmonary hypertension

- Diphenhydramine

A nurse is describing the action of a prescribed antihistamine to a client. The nurse is describing which medication, by explaining that the drug elicits its antihistamine effects by non-selectively binding to central and peripheral H1 receptors? - Loratadine - Cetirizine - Fexofenadine - Diphenhydramine

- By blocking the angiotensin II receptors

A nurse is educating a patient with hypertension who is prescribed losartan on the mechanism of action of the drug. Which mode of action helps losartan to bring about its antihypertensive effect? - By blocking the aldosterone receptors - By preventing the conversion of angiotensin I - By blocking the angiotensin II receptors - By preventing renin secretion

- "I will take a pill every 15 minutes until the pain subsides."

A nurse is giving discharge instructions to a client receiving nitroglycerin for angina. The nurse recognizes the client needs additional information when the client makes what statement? - "I will keep my medication in the original container." - "Before I take my medication, I will lie down." - "I will take a pill every 15 minutes until the pain subsides." - "I may get a headache after I take this medication."

- 6.2 mcg/mL

A nurse is monitoring the drug level of a client receiving quinidine. Which serum drug level would the nurse immediately report to the primary health care provider? - 3.8 mcg/mL - 6.2 mcg/mL - 4.1 mcg/mL - 2.5 mcg/mL

- Review the procedure for intramuscular injection

A nurse is participating in an influenza vaccination clinic on a college campus. What action will best prepare the nurse for this role? - Ask participants to identify their blood type, if known - Review appropriate landmarking for subcutaneous injection - Review the procedure for intramuscular injection - Prepare to educate each client about serum sickness

- Importance of reading the label for ingredients and dosage - Avoidance of use in children under age 2 - Need to follow the directions for how often to give the drug

A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. Which would be most appropriate to include? (Select all that apply.) - Using household measuring devices for dosage measurements - Importance of reading the label for ingredients and dosage - Using adult formulation with smaller doses - Avoidance of use in children under age 2 - Need to follow the directions for how often to give the drug

- vital signs

A nurse is preparing to administer an adrenergic agent for shock. Which nursing assessment should be completed quickly and accurately? - physical assessment - vital signs - pain evaluation - urinary output

- Vital signs

A nurse is preparing to administer an adrenergic agent for shock. Which nursing assessment should be completed with priority? - Vital signs - Urinary output - Pain evaluation - Physical assessment

- Peripheral vascular resistance

A nurse is presenting a class for patients newly diagnosed with hypertension. What factor would the nurse tell the class has the greatest effect on diastolic blood pressure? - Renal function - Pulse pressure - Peripheral vascular resistance - Force of myocardial contraction

- Coffee

A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following? - Alcohol - Vitamin C - Salt - Coffee

- has a high coffee intake.

A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient - prefers a high-calorie diet. - is a 56-year-old man. - has a history of pneumonia. - has a high coffee intake.

- "There is serious narrowing of a coronary artery that is causing a reduction in oxygen to the heart."

A nurse is providing education to a client who has been experiencing unstable angina. What is the nurse's best explanation of this condition? - "There is serious narrowing of a coronary artery that is causing a reduction in oxygen to the heart." - "The pain is caused by a spasm of a blood vessel, not just from the vessel narrowing." - "A coronary vessel has become completely plugged and is unable to deliver blood to your heart." - "Your body's response to a lack of oxygen in the heart muscle is pain."

- "I'll keep taking my medications until I'm not experiencing any more symptoms."

A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse? - "I'll make sure I don't take my inhalers more often than they've been prescribed." - "I'll keep taking my medications until I'm not experiencing any more symptoms." - "I'm a heavy coffee drinker, but I know that I now know I need to cut down on this." - "I'll try to make sure that I drink plenty of fluids each day."

- Immune globulin

A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive? - Immune globulin - Antivenin crotalidae - BCG vaccine - Zoster vaccine

- "I should avoid driving after taking this medication."

A nurse is teaching a 55-year-old client about fexofenadine prescribed to treat allergic symptoms. Which client statement suggests an understanding of this teaching? - "Taking this medication shouldn't stop me from having my after-dinner drink." - "It's safe to take this medication with the nighttime sinus medication that I've been using." - "I should avoid driving after taking this medication." - "This medication has no serious side effects."

- Extremely cold temperatures

A nurse is teaching a client diagnosed with asthma about the disease. Which should the nurse instruct the client to avoid because it may cause bronchoconstriction? - Fatigue - Extremely cold temperatures - Direct sunlight - Food high in sodium

- They provide the person with active immunity.

A nurse is teaching a group of clients about immunizations . What benefit of immunization should the nurse describe? - Promote the development of antigens for the disease. - They provide the person with active immunity. - They are generally considered to be risk free - They are best reserved for clients under age 65

- 2.0 ng/mL.

A nurse obtains the serum digoxin level and immediately reports a level greater than which value? - 0.1 ng/mL. - 1.0 ng/mL. - 2.0 ng/mL. - 0.5 ng/mL.

- Losartan - Olmesartan

A nursing instructor determines that a class discussion on antihypertensive drugs was successful when the students identify which medication as lowering blood pressure by blocking the binding of angiotensin II at receptor sites in the vascular smooth muscle and adrenal glands? Select all that apply. - Losartan - Olmesartan - Ramipril - Quinapril - Atenolol

- Hold the immunization until the child is free of allergic or cold-like symptoms.

A parent brings the 18-month-old client into the clinic for a diphtheria, tetanus, and pertussis vaccine. The child has a runny nose, has a fever of 102.4°F (39.1°C), and is coughing. What is the nurse's appropriate action? - Give an antipyretic and administer vaccine when temperature is within normal range. - Administer the vaccine but monitor the child afterward for an extended time period. - Administer a reduced dose of the vaccine today and the remainder when child is healthy. - Hold the immunization until the child is free of allergic or cold-like symptoms.

- Nicardipine

A patient arrives at the community health care center reporting chest pain and is diagnosed with angina pectoris. Which drug is administered for treating angina? - Nicardipine - Isospin - Papaverine - Cilostazol

- Orthopnea

A patient has been admitted to a health care center with reports of dyspnea. Which signs should the nurse monitor for when assessing the patient for left ventricular dysfunction? - Nocturia - Pitting edema - Weight gain - Orthopnea

- For one week

A patient has been advised to use a transdermal patch of clonidine for hypertension. For which of the following time periods should the nurse ensure that the patch is intact? - For one week - For two weeks - For three weeks - For four weeks

- Intravenous

A patient is prescribed esmolol for treatment of supraventricular tachycardia. The nurse would expect to administer this drug by which route? - Intramuscular - Oral - Intravenous - Subcutaneous

- Excessive hypotension

A patient is receiving an ACE inhibitor. The nurse ensures that the patient's hydration status is maintained to prevent: - Cardiac arrhythmias - ACE inhibitor toxicity - Renal failure - Excessive hypotension

- Quinidine

A patient on anti-arrhythmic drug therapy reports nausea, vomiting, abdominal pain, diarrhea, and a ringing sensation in the ears. Which drug should the nurse consider as the cause for these adverse effects? - Lidocaine - Quinidine - Flecainide - Procainamide

- 10 to 20 minutes

A patient receives lidocaine IV. The nurse would expect the drug to exert its effects for how long? - 10 to 20 minutes - 30 to 40 minutes - 60 to 90 minutes - 90 to 120 minutes

- Delays in appropriate treatment can have serious, even fatal, consequences

A patient tells you that a friend of theirs has recommended the use of caffeine to treat the patient's asthma. What would be the most important reason a nurse should counsel this patient not to delay prescribed treatment for the use of natural health products? - Caffeine can aggravate the drugs used to treat asthma - Most natural products are less toxic or more potent than traditional asthma medications - Natural products decrease the adverse effects associated with adrenergic bronchodilators - Delays in appropriate treatment can have serious, even fatal, consequences

- Rebound hypertension

A patient who is prescribed losartan for hypertension has stopped taking the drug immediately after experiencing adverse effects. Which of the following may result when antihypertensives are abruptly discontinued? - Breathing difficulty - Rebound hypertension - Orthostatic hypotension - Anginal attacks

- blood pressure.

A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regularly assessing the patient's heart rate, the nurse should prioritize assessment of the patient's - blood pressure. - intake and output. - cognition. - exercise tolerance.

- Take the drug regularly without skipping a dose.

A patient with congestive heart failure has been digitalized. The patient requires long-term digoxin therapy. Which instructions should the nurse provide the patient on discharge? - Take the drug regularly without skipping a dose. - Report to the center if the pulse is less than 70 bpm. - Take the drug with high fiber meals. - Take antacids promptly to avoid gastric problems.

- Loratadine

A patient with vasomotor rhinitis has been prescribed an antihistamine. The patient is eager to know whether the prescribed antihistamine may cause excessive sedation. Which of the following antihistamines has very little sedative effect? - Clemastine - Loratadine - Brompheniramine - Chlorpheniramine

- "It is also called delayed hypersensitivity." - "It is a cell-mediated response in which sensitized T lymphocytes react with an antigen to cause inflammation." - "The test for TB is this type of reaction."

A professor of pharmacology has just completed her lecture regarding hypersensitivity (allergic) responses. Her lecture focused on Type IV reactions. Which of the following statements made by her students will show that the students understood the material? Choose all that apply. - "This reaction occurs immediately after exposure to the antigen." - "It is also called delayed hypersensitivity." - "It is a cell-mediated response in which sensitized T lymphocytes react with an antigen to cause inflammation." - "The test for TB is this type of reaction."

- The client's angina may necessitate the use of a calcium channel blocker.

A recent episode of chest pain while doing yard work prompted a 70-year-old man to seek care and he has been subsequently diagnosed with chronic stable angina. The nurse should recognize what guiding principle in the treatment of this client's angina? - The client will likely have a trial of antiplatelet drugs before being prescribed nitrates. - The client would benefit from a weekly intravenous dose of a beta blocker. - The client's angina may necessitate the use of a calcium channel blocker. - The client indicates a need for daily low-molecular weight heparin therapy

- increased heart rate

An adrenergic drug would be prescribed to produce what physiological effect? - decreased respiratory rate - increased heart rate - decreased blood pH - urine concentration

- Potassium ions return to the intracellular space.

After a cardiac muscle contracts, what chemical reaction is needed to prepare the muscle cells for the next contraction? - Calcium ions return to the extracellular space. - Sodium ions return to the intracellular space. - Potassium ions return to the intracellular space. - Potassium ions return to the extracellular space.

- "Nitroglycerin decreases the amount of oxygen needed by the heart to function."

After receiving relief from anginal pain, the client says to the nurse, "That nitroglycerin works great. How does it do that?" What is the nurse's best response? - "Nitroglycerin decreases the amount of oxygen needed by the heart to function." - "Nitroglycerin makes the coronary arteries open much wider." - "Nitroglycerin promotes growth of new, smaller arteries to supply oxygen to the heart." - "Nitroglycerin decreases preload and afterload."

- 1-4 mg/min

After the nurse has administered a bolus of lidocaine, the nurse should run a continuous infusion at which rate? - 0.25-0.75 mg/min - 6-8 mg/min - 1-4 mg/min - 10-20 mg/min

- It decreases contractility of the left ventricle. - It decreases heart rate.

Amiodarone is a potassium channel blocker that prolongs conduction in all cardiac tissues. What is another effect of amiodarone? (Select all that apply.) - It is vasoconstrictive. - It diminishes bradyarrhythmias. - It increases contractility of the left ventricle. - It decreases contractility of the left ventricle. - It decreases heart rate.

- Septic

An adolescent client presents at the primary health care provider's office with hypothermia, hypotension, and malaise. The client's parent indicates that the client had a skin injury and subsequent fever about a week ago, which subsided after a few days. What type of shock does the nurse suspect is involved? - Septic - Anaphylactic - Cardiogenic - Hypovolemic

- "You'll need another dose of the vaccine in six to 12 months from now."

An adult client is scheduled to receive the inactivated hepatitis A vaccine. The nurse should provide what education to the client? - "It's best if you avoid drinking any alcohol for the next week." - "You'll need another dose of the vaccine in six to 12 months from now." - "If possible, you should get annual booster of the vaccine to make sure you're protected." - "It will take up to 48 hours before your immune system protects you against hepatitis."

- "The honey's effectiveness is very likely to wear off after 2-3 days."

An adult client presents with a cough likely related to seasonal allergies. When a prescription for an antitussive medication is suggested, the client responds, "I took a tablespoon of honey before bed last night and it seemed to help. Why can't I just keep taking that a couple of times a day?" Which response should the nurse provide to best assure effective drug therapy for this client? - "Since the honey helps, it would be wise to continue taking it but no more than 3 tablespoons a day." - "That would be all right but don't use raw honey." - "The honey's effectiveness is very likely to wear off after 2-3 days." - "It would be best to alternate between honey and doses of the antitussive medication."

- Explain that vaccines often cause a mild immune response and have the client self-monitor

An adult client received the annual influenza vaccine yesterday afternoon and has now presented back to the clinic reporting malaise. The client's oral temperature is 37.4°C (99.3°F). What is the nurse's best action? - Administer epinephrine as prescribed - Explain to the client that the malaise is likely caused by a mild case of influenza - Ask the client to remain at the clinic to be monitored for signs of anaphylaxis - Explain that vaccines often cause a mild immune response and have the client self-monitor

- Automaticity

An instructor is describing the unique characteristic of cells of the conducting system, explaining that these cells can generate action potentials without outside stimulation. The instructor is describing: - Conductivity - Contractility - Automaticity - Capacitancy

- Epinephrine

An instructor is preparing a teaching plan for a group of students about adrenergic agonists. Which would the nurse include as an alpha- and beta-adrenergic agonist? - Epinephrine - Albuterol - Phenylephrine - Terbutaline

- Each year a new vaccine is developed based on the strains most prevalent.

An older adult client asks the nurse to explain the recommended schedule for influenza vaccination. Which statement should the nurse include in the response? - The vaccine is good for 5 years, so annual re-vaccination is longer required. - Each year a new vaccine is developed based on the strains most prevalent. - Starting at age 75, everyone needs vaccine boosters every 2 years. - The vaccine is given every 6 months to prevent the flu.

- Have the resident rinse his or her mouth after each dose of the drug.

An older adult client has been prescribed an inhaled corticosteroid for the treatment of chronic obstructive pulmonary disease. When administering the drug, what action should the nurse perform to reduce the client's risk for developing oral candidiasis? - Administer prophylactic antifungal medications. - Encourage the resident not to deeply inhale the medication. - Have the client gargle with normal saline prior to administering the drug. - Have the resident rinse his or her mouth after each dose of the drug.

- Protect from injury.

An older adult client is administered dimenhydrinate. Which is the priority nursing intervention for this client? - Encourage fluids with this client. - Have the client void after administration. - Maintain IV access. - Protect from injury.

- Confusion - Dry throat - Sedation

An older adult client is prescribed an antihistamine for the relief of allergic rhinitis. Which findings would the nurse likely assess in this client? Select all that apply. - Confusion - Dry throat - Hypertension - Bradycardia - Sedation

- Symptomatic decompensated heart failure

An older adult client reports fatigue. Upon evaluation, the nurse notes decreased breath sounds, jugular vein distension, and 2+ pedal edema. The nurse suspects which complication? - Unstable angina - Symptomatic decompensated heart failure - Pulmonary edema - Acute inferior wall MI

- falls.

An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for: - constipation. - falls. - xerostomia (dry mouth). - depression.

- Helping the patient identify environmental allergens

Antihistamines are used frequently in the home care setting for the treatment of allergies. Which of the following is most likely to be a responsibility of the nurse caring for a patient who is taking antihistamines for this indication? - Ensuring that the patient uses a second-generation antihistamine - Removing environmental allergens - Administering the antihistamine - Helping the patient identify environmental allergens

- Inhaled nasal steroids are more effective than oral medications in treating the global symptoms associated with allergies.

Mr. Zee is prescribed an inhaled nasal steroid to relieve his symptoms associated with seasonal allergies. What is true about inhaled nasal steroids? - Inhaled nasal steroids do not have any adverse effects. - Inhaled nasal steroids produce a significant systemic effect. - Inhaled nasal steroids are more effective than oral medications in treating the global symptoms associated with allergies. - Inhaled nasal steroids are used only to treat seasonal allergies.

- The importance of having required laboratory work performed on time

Mrs. Houston is a 78-year-old woman who resides in an assisted living facility. Her provider prescribed digoxin at her last visit to the clinic and she has approached the nurse about this new drug. What teaching point should the nurse emphasize to Mrs. Houston? - The need to take the medication at the same time each day regardless of her heart rate - The importance of having required laboratory work performed on time - Timing household activities to coincide with the administration times of her digoxin - The correct technique for using a home blood pressure cuff

- Elevated magnesium levels

Ms. Case is admitted to the cardiac care unit because she developed premature ventricular contractions. Which factor is not a cause of these ectopic beats? - Elevated magnesium levels - Myocardial infarction - Hypokalemia - Oxygen saturation level of 80%

- Current blood pressure

Ms. Quinn is admitted to the surgical intensive care unit after open heart surgery. The health care provider prescribes IV nitroglycerin, according to a hospital protocol for titration of the drug. Which factor would be most important when determining increases or decreases in the dose? - Current respiratory rate - Susceptibility of the client to renal insufficiency - Current blood pressure - Susceptibility of the client to intracranial pressure

- hypersensitivity to beta blockers.

Propranolol is ordered for a client who has a cardiac arrhythmia. It will be important for the nurse to determine if the person has a history of: - hypersensitivity to beta blockers. - chronic heart failure secondary to a tachyarrhythmia. - idiosyncratic reaction to cinchona derivatives. - hypersensitivity to sulfonylureas.

- Obtain the client's blood pressure.

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? - Ask about nausea and vomiting. - Ask about history of hay fever. - Obtain the client's blood pressure. - Observe for swelling in nasal passages.

- "It is a neurotransmitter that keeps the nerve message going from the brain to the organ."

The client has been prescribed norepinephrine. While the nurse is teaching the client about this medication, the client asks the nurse what is it for. What is the nurse's best response? - "It is a medication used to treat severe bacterial infections." - "It is a substance that sends impulses from the heart to the lungs in order to facilitate breathing." - "It is a neurotransmitter that keeps the nerve message going from the brain to the organ." - "It is a neurotransmitter that keeps the kidneys producing insulin during stress."

- no episodes of angina since ointment was initiated.

The client has been started on nitroglycerin ointment for angina. The nurse identifies that the nitroglycerin ointment has been effective if the client reports: - minimal episodes of angina. - that he gets a headache each time the ointment is applied. - no episodes of angina since ointment was initiated. - dizziness after each application.

- Blood pressure daily

The client receiving propranolol (Inderal) at home for management of a ventricular arrhythmia should monitor which parameter? - Daily exercise - Fluid intake - Pulse once a week - Blood pressure daily

- Low

The client's digoxin level is 0.125. How does the nurse interpret this level? - Normal - Elevated - Toxic - Low

- The client's creatinine clearance is steadily declining.

The clinic nurse assesses a client taking benazepril to control hypertension. What change in the client's health status may - require a change in drug therapy? - The client is treated for hepatitis A. - The client is diagnosed with gastroesophageal reflux disease. - The client is diagnosed with depression and begins taking a selective serotonin reuptake inhibitor (SSRI). - The client's creatinine clearance is steadily declining.

- SA node

The critical care nurse is caring for a client with bradycardia after cardiovascular surgery. The nurse knows that the heart rate is determined by myocardial cells with the fastest depolarizing rate. Under normal circumstances, where are these cells located? - AV node - SA node - Bundle of HIS - Purkinje cells

- Hypertensive crisis

The emergency department nurse is asked to prepare a nitroprusside infusion for a client being brought to the hospital in an ambulance. What is this client's most likely diagnosis? - Hypertensive crisis - Myocardial infarction accompanied by hypertension - Hemorrhagic stroke - Hypertension associated with diabetic ketoacidosis

- Identify hypotension.

The nurse is caring for a client experiencing an acute angina attack. Sublingual nitroglycerin has been administered. The nurse assesses the client's vital signs for which reason? - Confirm report of headache. - Identify hypotension. - Reassure client that they are okay. - Evaluate for recurrent pain.

- "With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease."

The female client states that her father has had high blood pressure all of his life and he is healthy. She does not understand why the care provider has prescribed medication for her blood pressure. What is the nurse's best response? - "Maybe you do not need medication with your history." - "With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease." - "The effects of high blood pressure are different for different people." - "We always treat high blood pressure with medicine to prevent further damage to your body."

- A headache occurs.

The health care provider determines the maximum tolerable dose of isosorbide dinitrate (Isordil) by increasing the dose until what happens? - A headache occurs. - Hypertension is managed. - Postural hypotension occurs. - Anginal symptoms dissipate,

- Nausea and vomiting

The health care provider has ordered promethazine (Phenergan) for a client who is having a severe allergic reaction. The nurse is aware that this medication is also used to treat what condition? - Hypotension - Joint pain - Central nervous system depression - Nausea and vomiting

- Diphenhydramine

The health care provider has prescribed medication to prevent posttransfusion reaction in a client with a history of the disorder. Which medication would the nurse anticipate being administered? - Furosemide - Epinephrine - Diphenhydramine - Ibuprofen

- digoxin toxicity

The health care provider orders quinidine for a client who is receiving a common treatment for atrial fibrillation. The nurse would monitor this client for: - increased quinidine effect. - digoxin toxicity. - bleeding. - renal dysfunction.

- Improve blood supply to the myocardium

The health care provider prescribes calcium channel blockers for a client who is diagnosed with angina pectoris. What is the action of calcium channel blockers? - Induce coronary artery vasospasm - Increase blood pressure to increase oxygenation to the myocardium - Improve blood supply to the myocardium - Prevent anginal episodes

- a client who takes immunosuppressants post-renal transplant

The infection control nurse is assessing the immunization status of many of the hospital's current clients. For what client would vaccination most likely be contraindicated? - a client who receives dialysis three times weekly for chronic renal failure - a client with alcoholic liver disease - a client who takes immunosuppressants post-renal transplant - a client who is 82 years old and who has type 1 diabetes

- 1 to 4 mg/min

The nurse administers a bolus of lidocaine to a client with a life-threatening ventricular arrythmia and follows it with a continuous infusion at what rate? - 0.25 to 0.75 mg/min - 1 to 4 mg/min - 6 to 8 mg/min - 10 to 20 mg/min

- Hypokalemia

The nurse assesses the client for which of the following adverse reactions related to the use of digoxin? - Angina - Hypokalemia - Hypermagnesemia - Tachycardia

- at least 3 months

The nurse has just administered the measles, mumps, and rubella vaccine to a female client. The nurse instructs the woman to avoid becoming pregnant for how long? - at least 7 days - at least 3 months - at least 14 days - at least 1 month

- Blood pressure

The nurse is administering milrinone to a client with heart failure. The nurse should prioritize what assessment when monitoring the client for common adverse effects? - Capillary blood glucose - Blood pressure - Orientation to person, place, and time - Respiratory rate

- Increased heart rate

The nurse is assessing a client who received epinephrine, an adrenergic drug, for the treatment of cardiac arrest. The nurse would expect to observe what effect of the drug? - Decreased respiratory rate - Increased heart rate - Urinary retention - Decreased kidney perfusion

- Immune globulins

The nurse is caring for a 16-year-old client who just received a kidney transplant. Which of the following passive immunity agents would the nurse include in the family teaching session regarding prevention of organ rejection? - The attenuated, live varicella virus vaccine - Immune globulins - Antivenins - The killed varicella virus vaccine

- "The drug is only effective if administered before exposure to human papillomavirus (HPV)."

The nurse is caring for a 30-year-old woman who came to her gynecologist today to receive a Gardasil injection, stating that she believes that she may have genital warts. What should the nurse teach this client? - "Gardasil is only given to women between the ages of 9 and 26 years of age." - "The drug cannot be administered until further Food and Drug Administration (FDA) testing has been completed." - "The drug is only effective if administered before exposure to human papillomavirus (HPV)." - "The drug cannot be administered to a woman who is sexually active."

- Tachycardia

The nurse is caring for a 38-year-old client who is beginning treatment with albuterol. Which should the nurse identify as a potential adverse effect of the drug? - Diarrhea - Tachycardia - Polydipsia - Hypotension

- Avoid crowded areas as much as possible. - Keep the child away from any known allergens. - Keep the child away from areas that are filled with cigarette smoke.

The nurse is caring for a child who has been newly diagnosed with asthma. What environmental modifications should the nurse encourage the parents to make to help their child avoid future attacks? Select all that apply. - Avoid crowded areas as much as possible. - Encourage the child to maximize physical activity. - Keep the child away from any known allergens. - Keep the child away from areas that are filled with cigarette smoke. - Make sure the child begins herbal therapy as soon as possible.

- Bronchospasm - Bizarre Dreams - Atrioventricular (AV) block

The nurse is caring for a client receiving propranolol. What problems reported by the client should the nurse suspect are being caused by the drug? Select all that apply. - Bronchospasm - Bizarre Dreams - Seizures - Rash - Atrioventricular (AV) block

- Apical heart rate and blood pressure

The nurse is caring for a client who has been prescribed an antiarrhythmic agent. What nursing assessment should the nurse prioritize? - Breath sounds and respiratory rate - Mental status - Apical heart rate and blood pressure - Activity level and exercise tolerance

- It blocks the effects of histamine.

The nurse is caring for a client with allergic rhinitis who takes clemastine daily. What should the nurse teach the client about the action of the medication? - It blocks the effects of histamine. - It changes the viscosity of mucus. - It promotes the development of mast cells. - It increases the tone of smooth muscle in the bronchi.

- Headache and dizziness

The nurse is caring for a client with angina who is taking a calcium-channel blocker. What adverse effects would the nurse caution this client about? - Hypertension and tachycardia - Headache and dizziness - Itching and rash - Nausea and diarrhea

- Administer the medication as prescribed and monitor the client.

The nurse is caring for a client with heart failure who has been prescribed ivabradine 5 mg PO b.i.d. Before administering the drug, the nurse's assessment reveals temperature 97.2°F (36.2°), blood pressure 106/63 mm Hg, apical heart rate 68 beats/min with regular rhythm and respiratory rate of 21 breaths/min. What is the nurse's best action? - Contact the healthcare provider to report the assessment findings and seek clarification. - Withhold the medication and reassess the client in 90 minutes. - Withhold the medication and reassess the client in 30 minutes. - Administer the medication as prescribed and monitor the client.

- Diltiazem

The nurse is caring for a client with hypertension who is preparing to be discharged from the hospital after suffering a myocardial infarction. What drug would both treat the client's hypertension and reduce myocardial oxygen consumption? - Captopril - Losartan - Diltiazem - Nitroprusside

- Use the medication for as short a time as possible.

The nurse is giving discharge instructions to a client with an upper respiratory infection who has been advised to take an over-the-counter (OTC) topical nasal decongestant. What should the nurse teach the client in order to prevent rhinitis medicamentosa? - Avoid using antihistamines at the same time as the decongestant. - Increase fluid intake for the duration of treatment. - Use the medication for as short a time as possible. - Avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) concurrently.

- Promoting exercise - Reducing dietary sodium - Preventing obesity

The nurse is leading an educational discussion on childhood hypertension at a local school board meeting. A particular focus of the discussion is the promotion of nonpharmacologic treatment measures. Which of the following is appropriate for managing hypertension in children? Select all that apply. - Promoting exercise - Reducing dietary sodium - Preventing obesity - Taking a daily multivitamin

- Clear breath sounds

The nurse is monitoring a premature infant diagnosed with respiratory distress syndrome (RDS). Which assessment finding will serve to demonstrate that the instillation of surfactant as a treatment has been effective? - Return of cough reflex - Body temperature within normal range - Clear breath sounds - Infant is interested in surroundings

- obese 40% over total body weight

The nurse is performing a history for a black client that is concerned about developing coronary artery disease since it "runs in the family." What risk factor, that is modifiable, does the nurse identify when taking the history? - client ethnicity - age of 62 - father had a myocardial infarction at 48 - obese 40% over total body weight

- "When I feel a cold coming on, I know to take an antihistamine."

The nurse is providing education to a client regarding the use of an over-the-counter (OTC) antihistamine. Which client statement demonstrates a need for additional teaching? - "I take the medication to manage my itchy, watery eyes." - "When I know I'm going to spend time outdoors, I take an antihistamine." - "I always need an antihistamine when I visit family members who own pets." - "When I feel a cold coming on, I know to take an antihistamine."

- "Make sure to take your pulse for a minute before taking your digoxin."

The nurse is providing education to a client who has been prescribed digoxin for symptomatic heart failure. What teaching point would the nurse convey to this client? - "If the swelling in your feet gets worse, you can take up twice your normal dose for 1 day." - "Make sure to take your pulse for a minute before taking your digoxin." - "Plan to take your digoxin on an empty stomach to make sure it's fully absorbed." - "Try to limit the number of high-potassium foods in your diet."

- Go to the emergency department

The nurse is providing education to a client who has been prescribed sublingual nitroglycerin tablets. What action should the nurse instruct the client to take if the medication is not effective in relieving chest pain? - Go to the emergency department - Call the health care provider - Lie down after taking an aspirin - Take more tablets until pain subsides, to a maximum of six tablets

- "I should avoid beverages that contain caffeine."

The nurse is providing education to a client who has been prescribed theophylline. The nurse interprets what client statement as a sign of successful teaching? - "I can expect this drug to have a sedating effect." - "I should limit my fluid intake to 1,000 mL a day." - "I should avoid beverages that contain caffeine." - "I will need to increase my intake of foods high in potassium."

- epinephrine

The nurse is providing education to the parent of a child who has been recently diagnosed as allergic to bee venom. What medication would the nurse recommend that the parent have available? - aspirin - epinephrine - norepinephrine - dopamine

- inflammation.

The nurse is providing education to the parents of a child who has been newly diagnosed with asthma. During teaching, the nurse should explain that asthma attacks occur when mast cells release substances that cause what reaction? - smooth muscle dilation. - Decreased fluid leakage. - decreased capillary permeability. - inflammation.

- "I will take this medication with apple juice."

The nurse is providing instructions to a client who will be taking second-generation antihistamines at home. Which statement by the client indicates a need for further instruction? - "I will check the prescription bottle and follow the directions carefully." - "If I miss a dose of medication, I will wait until the next scheduled time to take the medication." - "I will take this medication with apple juice." - "I will be careful to take the medication exactly as it comes."

- sympathetic

The nurse is providing medication education to a client prescribed an adrenergic blocker. Which nervous system is the specific focus of this classification of medications? - peripheral - parasympathetic - central - sympathetic

- The medication does not cross the blood-brain barrier

The nurse is providing medication education to the client who has been prescribed fexofenadine. What information will the nurse provide if the client expresses concern about medication induced drowsiness? - The medication does not cross the blood-brain barrier - The medication reaches peak serum concentration in 2-2.5 hours - The medication is taken once daily at bedtime. - The medication competes with histamine for binding to histamine receptor sites

- Inform the health care provider that the client has toxic theophylline levels.

The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take? - Inform the health care provider that the client has toxic theophylline levels. - Withhold the scheduled dose of theophylline pending the next day's blood work results. - Inform the health care provider that an increase in the client's dose of theophylline may be necessary. - Administer the scheduled dose of theophylline with as needed (PRN) dose of a bronchodilator.

- Atrial flutter

The nurse is reviewing a patient's electrocardiogram and notes that the P waves are saw-toothed in shape and there are three P waves for every QRS complex. The nurse would interpret this as suggesting: - Atrial fibrillation - Paroxysmal atrial tachycardia - Sinus bradycardia - Atrial flutter

- atrial fibrillation.

The nurse is reviewing the medication regimen of a newly admitted client. The client currently takes dofetilide 250 mcg PO b.i.d. This client's health history likely includes: - atrial fibrillation. - hypertensive crisis. - ischemic heart disease. - ventricular tachycardia.

- coffee

The nurse is serving a breakfast tray to the client receiving an alpha- and beta-adrenergic agonist medication. The nurse notifies dietary of a food preparation error with the client's diet when finding what on the tray? - aged cheese - milk - bacon - coffee

- "This medication might cause drowsiness, so I will avoid driving while I use it."

The nurse is teaching a 61-year-old client about the narcotic antitussive syrup that the health care provider has prescribed. Which client statement suggests understanding of what the nurse has taught? - "I should take this medicine followed by a glass of water." - "If this medicine works, I shouldn't cough at all." - "This medication might cause drowsiness, so I will avoid driving while I use it." - "If my cough doesn't improve right away, I'll increase my dose."

- "If you didn't have allergies as a child, you won't develop allergies later in life."

The nurse is teaching a client about the potential for allergic drug reaction. What statement made by a client suggests a need for further teaching? - "All drugs have the potential to cause an allergic reaction." - "The additives that are in drugs can also cause allergic reactions." - "Virtually any drug may induce an immunologic response in a susceptible person." - "If you didn't have allergies as a child, you won't develop allergies later in life."

- Read drug labels before taking OTC medications.

The nurse is teaching a group of clients with allergic rhinitis about the use of their medications. What would be the most essential information to give these clients about preventing possible drug interactions? - Use only one pharmacy so the pharmacist can check drug interactions. - Over-the-counter (OTC) medications are safe to use. - Ask the pharmacy technician for assistance in selecting an OTC medication. - Read drug labels before taking OTC medications.

- Vital signs, skin color and temperature

The nurse is the client's first line of defense in treating shock. When assessing a client for early signs of shock, what would the nurse assess first? - B/P, urine output and mentation - Vital signs, skin color and temperature - Mental status, skin color, dyspnea - Temperature, level of consciousness, and airway obstruction

- "What are some of the safety risks that most concern you?"

The nurse is working with the parents of an infant and has initiated a dialogue about immunizations. The infant's parent states, "We're not comfortable with immunizations because of the safety issue." What is the nurse's best response? - "What are some of the safety risks that most concern you?" - "Immunizations have been proven to be safe and effective and are in your child's best interests." - "Did you read about the risks of immunizations on the internet?" - "The benefits of immunizations far outweigh any of the potential risks."

- The client with renal dysfunction

The nurse monitors which client for an increased risk of digoxin toxicity? - The client with a peripheral vascular dysfunction - The client with liver dysfunction - The client with an integumentary dysfunction - The client with renal dysfunction

- toxoids

The nurse must administer which to a client prior to exposure to the disease-causing organism in order for the client to be protected against the disease? - antivenins - antibodies - immune globulins - toxoids

- IV

The nurse prepares to administer a phosphodiesterase inhibitor by what route? - Oral - IV - Subcutaneous - Intramuscular

- "I will apply the patch for 24 hours and then remove it, and place another transdermal patch."

The nurse provides client teaching for a client diagnosed with angina about the prescribed nitroglycerin transdermal patch. Which client statement establishes the need for further teaching? - "I will apply the patch for 24 hours and then remove it, and place another transdermal patch." - "I will remove the patch and fold it on itself to prevent my dog or grandchildren from touching it." - "I will clean the previous site where I remove an old patch with soap and water and dry it thoroughly." - "I will rotate placement of the transdermal patch on my chest, abdomen, and thighs."

- "I will call my doctor if I bruise easily or become extremely tired."

The nurse provides drug teaching to the client prescribed captopril. What statement made by the client does the nurse interpret to mean teaching has been effective? - "I'll take the drug in the morning so that I don't have to go to the bathroom often at night." - "I will call my doctor if I bruise easily or become extremely tired." - "I will increase my intake of foods high in potassium, such as bananas." - "I will monitor the effectiveness by watching for any symptoms of hypertension."

- penicillins

The nurse regularly assesses clients for risk of anaphylactic reaction to prescribed medications. The nurse is aware that such reactions most commonly occur with what type of medication? - opioid analgesics - penicillins - vaccines - local anesthestics

- 2 months

The nurse should be prepared to administer an infant's first dose of polio vaccine at what age? - 12 months - 2 months - As a newborn, provided the neonate is healthy - 4 to 6 years, or before starting school

- Sildenafil

The nurse would avoid administering nitrates to clients using which medication? - Sildenafil - Lisinopril - Simvastatin - Albuterol

- Cardiovascular disorders - Diabetes - Glaucoma

The nurse would caution clients with which disorders to avoid the use of over-the-counter pseudoephedrine? (Select all that apply.) - Cardiovascular disorders - Diabetes - Diverticulosis - Chronic sinusitis - Glaucoma

- MAO inhibitor

The nurse would contact the health care provider before administering an adrenergic drug to a client who is also taking which drug? - Diuretic - MAO inhibitor - Antibiotic - Analgesic

- Hypokalemia

The nursing instructor is discussing digoxin-induced arrhythmias. What risk factor would the instructor identify as increasing risk of arrhythmia in a client taking digoxin? - Diabetes mellitus - Obesity - Hypokalemia - Hypertension

- a decongestant, an analgesic, and an antihistamine.

The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine - an analgesic, an antitussive, and an antiviral. - an antihistamine, a stimulant, and a decongestant. - a decongestant, an analgesic, and an antihistamine. - a stimulant, a decongestant, and an antitussive.

- They come into direct contact with nasal mucosa.

The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness? - They treat multiple symptoms in a cost-effective manner. - They are absorbed systemically. - They come into direct contact with nasal mucosa. - Their effects last for 48 to 72 hours.

- type I hypersensitivity reaction.

The nursing instructor is explaining the four types of allergic reaction to the nursing students. The instructor explains that allergic rhinitis is a - type II hypersensitivity reaction. - type I hypersensitivity reaction. - type IV hypersensitivity reaction. - type III hypersensitivity reaction.

- High Fowler's

The nursing instructor is teaching their lab students the best position for the administration of nasal sprays. What position would the instructor teach the students? - Supine - Semi-Fowler's - High Fowler's - Side-lying

- low serum potassium levels.

The nursing students are learning about digoxin therapy in their pharmacology class. The students will learn that there is a higher risk of digoxin toxicity in clients with - low serum sodium levels. - low serum potassium levels. - low serum chloride levels. - low serum calcium levels.

- Excessive salivation

The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects? - Excessive salivation - Blurred vision - Drowsiness - Dry mouth

- lidocaine

The primary health care provider prescribes a class I sodium channel blocker to be given intravenously. Which drug would the nurse most likely administer? - lidocaine - disopyramide - mexiletine - flecainide

- Increased secretions - Cough - Mucosal congestion

The pulmonologist sees many patients daily who suffer from a variety of respiratory disorders. What are some of the common signs and symptoms many of these patients present? (Select all that apply.) - Increased secretions - Cough - Increased temperature - Mucosal congestion

- increased heart rate

The stimulation of beta1 adrenergic receptors in the heart by epinephrine would cause what result? - increased heart rate - vasoconstriction of the coronary arteries - decreased heart muscle contractions - decreased oxygen demand by the myocardium

- inflammation - bronchoconstriction

The substances released from mast cells are responsible for what physiological response? Select all that apply. - myalgia - inflammation - bronchoconstriction - smooth muscle dilation - decreased capillary permeability

- Inhibit smooth muscle constriction in blood vessels and the respiratory and GI tracts - Decrease capillary permeability - Decrease salivation and tear formation

The term antihistamine generally indicates classic or traditional drugs. These drugs prevent or reduce most of the physiologic effects that histamine normally induces at H1 receptor sites. Which of the following are direct results of H1 antagonists? Choose all that apply. - Increase mucous production - Decrease capillary permeability - Decrease salivation and tear formation - Increase bronchial constriction - Inhibit smooth muscle constriction in blood vessels and the respiratory and GI tracts

- They do not impair thinking.

What is one of the benefits related to second generation antihistamine administration in older adults? - They do not affect oxygenation. - They reduce the number of falls in clients diagnosed with osteoporosis. - They do not impair thinking. - They increase the ability of clients with dementia to perform ADLs.

- Centers for Disease Control and Prevention

What is the best source of information for current recommendations regarding immunizations and immunization schedules? - Department of Public Health - Department of Epidemiology - Local health care provider's office - Centers for Disease Control and Prevention

- Assess the client's heart rate and hold administration if it is less than 60.

What is the most accurate method for preventing adverse effects associated with the use of digoxin? - Teach clients to take their digoxin in divided doses with each meal. - Teach clients the signs and symptoms of heart failure. - Assess the client's heart rate and hold administration if it is less than 60. - Monitor therapeutic effects based on echocardiogram results.

- Peak-flow monitor

What is the most effective method used to monitor clients with asthma that they can use at home? - Incentive spirometer - Peak-flow monitor - Trough-flow monitor - Manometer

- "When was your last menstrual period (LMP)?"

What is the nurse's priority assessment question before giving a female client her prescription for an angiotensin II-receptor blocker (ARB)? - "Do you eat something when you take your medications?" - "How much physical exercise do you get?" - "When was your last menstrual period (LMP)?" - "Have you always weighed 130 pounds as an adult?"

- maintenance of normal sinus rhythm (NSR)

What is the primary goal of antidysrhythmic drug therapy for a client who has been successfully cardioverted? - increase in blood pressure - suppression of original dysrhythmia - maintenance of normal sinus rhythm (NSR) - proof of increased cardiac contractility

- diphenhydramine

What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction? - diphenhydramine - epinephrine - clemastine - cetirizine

- The location of the heart's functioning pacemaker is no longer the sinoatrial (SA) node

What primary event has occurred when a client experiences an ectopic focus? - The arterial resistance has been increased significantly - The location of the heart's functioning pacemaker is no longer the sinoatrial (SA) node - Fluid is no longer being pulled back int the venous system effectively - The contractibility of the heart has been diminished greatly.

- annual influenza vaccination

What recommendation concerning vaccinations should the nurse provide a 50-year-old adult? - one-time human immunodeficiency virus (HIV) vaccination - annual measles, mumps, rubella (MMR) - annual influenza vaccination - one-time human papillomavirus (HPV)

- The Sinoatrial node, the atrioventricular node, bundle of His, right and left bundle branches, and the Purkinje fibers.

What sequence describes the flow of electrical impulses in the heart? - The Sinoatrial node, the atrioventricular node, bundle of His, right and left bundle branches, and the Purkinje fibers. - The atrioventricular node, sinoatrial (SA) node, bundle of His, right and left bundle branches, and Purkinje fibers. - The bundle of His, atrioventricular node, sinoatrial (SA) node, right and left bundle branches, and Purkinje fibers. - The Sinoatrial node, the Purkinje fibers, bundle of His, right and left bundle branches, and the atrioventricular node.

- The tendencies to overmedicate and use antibiotics inappropriately with the common cold are widespread and pose significant risk for complications and drug resistance.

What statement best describes how the common cold is effected by and managed using medication therapy? - Herbal remedies containing zinc have not demonstrated any ability to reduce the symptoms generally associated with a cold. - Because of the way cold viruses are spread, antibiotics are the most important protective and curative measure. - The tendencies to overmedicate and use antibiotics inappropriately with the common cold are widespread and pose significant risk for complications and drug resistance. - Colds may be difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired.

- The client will require increased doses of vaccines.

What type of modification may be necessary for a client with diabetes mellitus who requires immunizations? - The client will require reduced doses of vaccines. - Immunizations are contraindicated for this client. - The client will require less frequent administration of vaccines. - The client will require increased doses of vaccines.

- "You should come to the clinic to be evaluated. A cough that lasts that long might indicate a medical problem."

What would be the nurse's best response if a client calls the clinic and reports that he has had a persistent cough for 2 weeks and asks the nurse for a recommendation for a cough medicine? - "Drink a lot of fluids and take aspirin, which should reduce the irritation in your throat." - "Look for dextromethorphan as an ingredient in any OTC cough preparation." - "The doctor could order an antihistamine, which might dry up your secretions and stop the cough." - "You should come to the clinic to be evaluated. A cough that lasts that long might indicate a medical problem."

- Tetanus

What would the nurse identify as a vaccine that is a toxoid? - Haemophilus influenza B - Pneumococcal polyvalent - Tetanus - Hepatitis A

- Understand the underlying mechanisms of shock, recognize the subtle and more obvious signs, and then provide rapid assessment and response

When caring for a client in shock, one of the major nursing goals is to reduce the risk that the client will develop complications. What does this require the nurse to do? - Keep the health care provider updated with the most accurate information; in shock the nurse is often powerless to help. - Monitor for significant changes and evaluate client outcomes on a scheduled basis focusing on blood pressure and skin temperature - Understand the underlying mechanisms of shock, recognize the subtle and more obvious signs, and then provide rapid assessment and response - Provide an accurate diagnosis, plan of care, and appropriate interventions to allow the client the best chance for survival

- Nitrates relax the smooth muscle layer of blood vessels. - Nitrates increase the lumen of the artery or arteriole. - Nitrates increase the amount of blood flowing through the vessel.

When describing nitrates, which explanation of mechanisms would the nurse expect to include? Select all that apply. - Nitrates relax the smooth muscle layer of blood vessels. - Nitrates increase the lumen of the artery or arteriole. - Nitrates increase the amount of blood flowing through the vessel. - Nitrates slow the conduction velocity of the cardiac impulse. - Nitrates depress myocardial contractility.

- Heart

When describing the action of beta blockers to a client, the nurse would emphasize that the majority of drug actions involve stimulation of the receptors in which organ? - Liver - Kidney - Heart - Brain

- Vasoconstriction of small blood vessels of the nasal membranes

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism? - Anesthetizing stretch receptors in the respiratory passages - Non-selectively binding to central and peripheral H1 receptors - Selectively binding to peripheral H1 receptors - Vasoconstriction of small blood vessels of the nasal membranes

- calcium channel blockers.

When describing the drugs classified as class IV antiarrhythmics, the nurse would identify these as: - cardiac glycosides. - vasodilators. - beta blockers. - calcium channel blockers.

- Advising the client to avoid alcohol consumption - Using sugarless candies or lozenges to combat dry mouth

When developing the teaching plan for a client receiving an antihistamine, which would the nurse include? (Select all that apply.) - Using sugarless candies or lozenges to combat dry mouth - Encouraging the client to engage in usual activities such as driving - Stopping the drug after 3 days if no relief is obtained - Advising the client to avoid alcohol consumption

- Acebutolol

When educating a group of nursing students on the mechanism of the action of various anti-arrhythmic drugs, the nurse identifies which drugs as inhibiting the beta-adrenergic receptors of the heart and the kidney? - Acebutolol - Amiodarone - Propafenone - Disopyramide

- "When I am short of breath, I will increase the use of my fluticasone."

When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements? - "When I am short of breath, I will increase the use of my fluticasone." - "I will wash my sheets weekly." - "When I can do some, but not all of my usual activities, I am in the yellow zone." - "I need to inhale my medication and hold my breath for 10 seconds."

- Clear the nasal passages.

When instructing a client in how to use a topical nasal spray, what would the nurse emphasize to do first? - Clear the nasal passages. - Spray the medication with the bottle upright. - Lie down to tilt the head back. - Close the opposite nares.

- inhibiting the influx of calcium through slow channels.

When prescribed for angina, how does oral nifedipine achieve a therapeutic effect? - inhibiting the influx of calcium through slow channels. - potentiating the effect of B-type natriuretic peptide - preventing the outflow of intracellular potassium - binding extracellular sodium ions with chloride ions

- One patch lasts an entire day.

When providing client education about nitroglycerin to the client, what should the nurse include in the teaching plan about a nitroglycerin patch? - One patch lasts an entire day. - It is faster-acting than tablets. - It only has to be changed every 3 days. - It is more effective than tablets in treating angina.

- Depolarization

When sodium gates open along the cardiac cell membrane and sodium rushes into the cell it results in the membrane no longer having a positive or negative side but being electrically the same on both sides. The nurse recognizes this period of the cardiac cycle as what? - Depolarization - Repolarization - Polarity - Action potential

- myocardial hypertrophy

When the cardiac workload is increased from secondary hypertension, the client is at risk for developing what associated condition? - arterial lumen dilation - myocardial hypertrophy - increased venous tone - hepatic damage

- Global Initiative for Asthma (GINA)

Where should the nurse initially direct a client who is interested in learning more about the management of asthma? - Global Initiative for Asthma (GINA) - Journal of Allergy and Clinical Immunology - Centers for Disease Control Education Center - National Association of Educational Pulmonologists

- Hypotension

Which adverse effect might occur in a client receiving milrinone? - Confusion - Hyperkalemia - Hypoglycemia - Hypotension

- Codeine

Which agent acts directly on the medullary cough center? - Benzonatate - Codeine - Ephedrine - Tetrahydrozoline

- A client who has chronic allergic rhinitis

Which client is most likely to benefit from the administration of a nasal steroid? - A client with an acute sinus infection - A client who has chronic allergic rhinitis - A client who is recovering from a tonsillectomy - A client who has a deviated nasal septum

- Nesiritide

Which drug is in the class of drugs called human B-type natriuretic peptides? - Digoxin - Nesiritide - Bosentan - Milrinone

- Increased heart rate

Which is an effect of epinephrine? - Peripheral vasodilation - Bronchoconstriction - Decreased blood pressure - Increased heart rate

- Oxymetazoline (Afrin)

Which is classified as a decongestant? - Oxymetazoline (Afrin) - Levocetirizine (Xyzal) - Dextromethorphan (Delsym) - Azelastine (Astelin)

- ineffective airway clearance

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine? - ineffective breathing pattern - impaired tissue perfusion - ineffective airway clearance - risk for infection

- "When was your last menstrual period?"

Which question would be most important for a nurse to ask a female client who is starting on an angiotensin II receptor blocker for hypertension? - "Do you eat something when you take your medications?" - "When was your last menstrual period?" - "Have you always weighed 150 pounds?" - "How much physical exercise do you get?"

- Is a delayed hypersensitivity reaction.

Which statement accurately describes an aspect of serum sickness? - It can develop in 1 to 2 days. - Symptoms include sensitivity to light resulting in optic pain. - Is a delayed hypersensitivity reaction. - Sensitization to the antigen will diminish the reaction.

- Sublingual isosorbide has a slower onset and a longer duration of action than sublingual nitroglycerin.

Which statement correctly distinguishes between the therapeutic effects of sublingual isosorbide and sublingual nitroglycerin? - Sublingual isosorbide has a faster onset and a shorter duration of action than sublingual nitroglycerin. - Sublingual isosorbide has a slower onset and a longer duration of action than sublingual nitroglycerin. - Sublingual isosorbide has a lesser sustained effect than sublingual nitroglycerin. - Sublingual isosorbide is not as effective as sublingual nitroglycerin.

- Block the stimulation of the adrenergic receptors

Which statement would be true about the mechanism of action of class II antiarrhythmic agents? - Cause depression in phase 2 of repolarization - Block the stimulation of the adrenergic receptors - Block the influx of sodium into the cells - Stimulate the uptake of potassium in the tissues

- A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age

Which statements best indicates the client understands recommended vaccines following the 65th birthday? - A tetanus-diphtheria booster every 2 years, annual influenza vaccine, and a yearly administration of pneumococcal vaccine - An influenza vaccine booster every 10 years, annual tetanus-diphtheria vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age - A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age - A tetanus-diphtheria booster every 2 years

- Peripheral edema

Which would a nurse expect to assess if a client is experiencing right-sided heart failure? - Peripheral edema - Wheezing - Hemoptysis - Dyspnea

- acetylcysteine

While providing a medication history, the client reports taking a nebulized drug to liquefy respiratory secretions but cannot recall the name. The nurse suspects the client is taking which medication? - prednisone - guaifenesin - acetylcysteine - pseudoephedrine

- Anaphylactic

While sitting outside, a client at a long-term care reports feeling a stinging sensation on the arm. Shortly thereafter, the client begins to cough, has trouble breathing, and is flushed. What type of shock does the nurse suspect is involved? - Hypovolemic - Septic - Anaphylactic - Cardiogenic

- should be replaced every six months.

While teaching a patient about sublingual nitroglycerin, the nurse explains proper use and storage. When the patient asks whether the medication ever expires, the nurse should respond that it: - has an indefinite shelf life. - should be replaced monthly. - should be replaced every six months. - should be replaced annually.

- They act locally to decrease release of inflammatory mediators

Why are inhaled steroids used to treat asthma and COPD? - They act locally to decrease release of inflammatory mediators - They act locally to increase histamine release - They act locally to decrease histamine release - They act locally to improve mobilization of edema

- Cool, clammy skin

You are admitting a patient with a diagnosis of a gastrointestinal bleed who is in the compensatory stage of shock. You know that an early sign that accompanies initial shock is what? - Decreased heart rate - Increased urine output - Cool, clammy skin - Hyperactive bowel sounds

- fluid circulating in the blood vessels decreases

You are assessing your patient. When prioritizing the patient's care, you recognize that your patient is at risk for hypovolemic shock when - cardiac output is increased. - fluid circulating in the blood vessels decreases - blood pressure increases. - pulse is fast and bounding

- Grilled chicken, green salad, and iced tea

You are caring for a 53-year-old client being treated for hypertension. The nurse is teaching the client about nonpharmacologic methods of managing hypertension. While discussing dietary management, which might be an example of an appropriate meal? - Hot dogs, baked beans, and iced tea - Cheeseburger, potato chips, and cola - Grilled chicken, green salad, and iced tea - Chicken sandwich, pretzels, and a diet cola

- Distributive

You are caring for a client who is in neurogenic shock. You know that this is a subcategory of what kind of shock? - Obstructive - Hypovolemic - Carcinogenic - Distributive

- Check blood pressure and pulse.

You are caring for a patient in hypovolemic shock. What is a priority nursing action for this client? - Check blood pressure and pulse. - Assess lung and bowel sounds. - Check peripheral pulses and skin temperature. - Monitor intake and weight.

- Frequent vitals, monitoring the central line site, and providing accurate drug titration

You are caring for a patient in the ICU whose condition is deteriorating. You receive orders for dopamine, which is an intravenous vasoactive drug. What would be your priority assessment and interventions specific to the administration of vasoactive medications? - Frequent vitals, monitoring the central line site, and providing accurate drug titration - Reviewing medications, performing a focused cardiovascular assessment, and providing patient education - Reviewing the laboratory findings, monitoring urine output, and assessing for peripheral edema - Routine vitals, monitoring the peripheral IV site, and providing early discharge instructions

- Systolic blood pressure of 80 mm Hg

You are caring for an 88-year-old client who was admitted to the ICU. The patient is suspected of being in cardiogenic shock. Which of the following observations could indicate that the patient is in shock? - Temperature of 38.2°C - Systolic blood pressure of 80 mm Hg - Heart rate of 85 bpm - Urine output of 45 mL/hr

- tachycardia.

Your 69-year-old patient is started on IV dopamine for management of hypotension following open-heart surgery. As you care for the patient, you monitor him for adverse effects of the drug, including - fever. - tachycardia. - bradycardia. - cyanosis.