Pharm. Chapter 21, 22, Pharm. Chapter 23, Pharm. Chapter 24

What is the correct medical term used to describe impaired blood flow in the coronary arteries? 1. Myocardial infarction 2. Angina pectoris 3. Cerebrovascular accident 4. Coronary heart disease

4. Coronary heart disease

The nurse caring for a client receiving heparin (Hep-Lock) monitors the patient for what serious complication that occurs in up to 30% of patients taking the drug? 1. Tachycardia 2. Hypotension 3. Angioedema 4. Heparin-induced thrombocytopenia (HIT)

4. Heparin-induced thrombocytopenia (HIT)

9. The nurse is preparing to administer a crystalloid IV to a client. Which IV fluid is a crystalloid? 1. Dextran 2. Fresh frozen plasma 3. Hetastarch (Hespan) 4. Lactated Ringer's

4. Lactated Ringer's

1. If the client is entering hypovolemic shock, the nurse anticipates which item to be a priority? 1. Maintenance of the airway 2. Maintenance of heart rate 3. Maintenance of brain tissue 4. Maintenance of volume

4. Maintenance of volume

A client is receiving heparin (Hep-Lock) therapy, and serious hemorrhage occurs. Which medication should the nurse administer to reverse the effects of heparin (Hep-Lock)? 1. Vitamin K 2. Desirudin (Iprivask) 3. Potassium chloride 4. Protamine sulfate

4. Protamine sulfate

The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed? 1. Atenolol (Tenormin) 2. Nitroglycerin (Nitrostat) 3. Sildenafil (Viagra) 4. Ranolazine (Ranexa)

4. Ranolazine (Ranexa)

A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse? 1. A headache indicates a serious allergic reaction to nitroglycerin. 2. The client will not have a headache if the nitroglycerin is taken with a high-fat meal. 3. Nitroglycerin does not cause a headache. 4. The most common side effect of nitroglycerin is a headache.

4. The most common side effect of nitroglycerin is a headache.

A client has been ordered a thrombolytic medication. Why is it important for the nurse to obtain a comprehensive medication history for this client? 1. Many patients are allergic to this medication. 2. Thrombolytics cannot be given to a patient with a history of asthma. 3. Thrombolytics will stop bleeding. 4. Thrombolytics are contraindicated in patients with active bleeding or with a history of recent trauma.

4. Thrombolytics are contraindicated in patients with active bleeding or with a history of recent trauma.

Following a stroke, a client has been started on clopidogrel (Plavix). Why is this medication being administered? 1. To prevent stroke in high-risk patients, such as those with prosthetic heart valves 2. To decrease blood pressure 3. To increase heart rate 4. To provide antiplatelet activity in patients who cannot tolerate aspirin

4. To provide antiplatelet activity in patients who cannot tolerate aspirin VERY EXPENSIVE

10. A client has not responded to IV fluids to raise blood pressure for acute shock. Which medication does the nurse anticipate will be ordered? 1. Whole blood 2. Additional crystalloids 3. Vasodilators 4. Vasopressors

4. Vasopressors

A client arrives in the Emergency Department with severe chest pain. What is the best explanation by the nurse to differentiate angina from a myocardial infarction? 1. "Angina usually goes away with rest, and is rarely fatal, but a myocardial infarction requires immediate treatment, and can be life threatening." 2. "There is no way to tell the difference between the two. You will be treated for a myocardial infarction." 3. "Both are caused by a clot blocking the coronary arteries. Angina occurs if a small vessel is blocked, and a myocardial infarction occurs if a large vessel is blocked." 4. "Angina does not cause severe chest pain, but a myocardial infarction always causes severe chest pain."

1. "Angina usually goes away with rest and is rarely fatal, but a myocardial infarction requires immediate treatment and can be life-threatening."

A client asks the nurse what the most common side effect of anticoagulant therapy is. What is the best response by the nurse? 1. "Bleeding." 2. "Ataxia." 3. "Headache." 4. "Hypotension."

1. "Bleeding."

The client asks the nurse how most medications for dysrhythmias work. What is the best response by the nurse? 1. "Blocking potassium, sodium, or calcium ion channels is the primary way to prevent or terminate dysrhythmias." 2. "Most medications for dysrhythmias shorten the refractory period." 3. "These medications will lower your blood pressure, which will change the rhythm of your heart." 4. "The mechanism of these drugs is unknown."

1. "Blocking potassium, sodium, or calcium ion channels is the primary way to prevent or terminate dysrhythmias.

A client asks the nurse to explain the difference between stable and unstable angina. What is the best response by the nurse? 1. "Stable angina is predictable in its frequency, intensity, and duration. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest." 2. ""Unstable angina is caused by spasms of the coronary arteries. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest." 3. "Unstable angina is predictable in its frequency, intensity, and duration. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest." 4. "Stable angina is caused by spasms of the coronary arteries. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."

1. "Stable angina is predictable in its frequency, intensity, and duration. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."

A client is taking aspirin (ASA), and asks the nurse how long the anticoagulant effect of a single dose of aspirin can last. Which reply by the nurse is the most appropriate? 1. "The anticoagulant effect of a single dose of aspirin can last for as long as a week." 2. "The anticoagulant effect of a single dose of aspirin can last for as long as a day." 3. "The anticoagulant effect of a single dose of aspirin can last for as long as 12 hours." 4. "The anticoagulant effect of a single dose of aspirin can last for as long as a month."

1. "The anticoagulant effect of a single dose of aspirin can last for as long as a week."

A client has been prescribed an anticoagulant, and asks the nurse to explain why this medication has been prescribed. Which response by the nurse is the most appropriate? 1. "These medications are used to prevent the formation of clots." 2. "These medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time." 3. "These medications are used to dissolve life-threatening clots." 4. "These medications are used to prevent clot formation in arteries."

1. "These medications are used to prevent the formation of clots."

The physician orders a potassium channel blocker for a client. Which medication would the nurse anticipate the physician to order? 1. Amiodarone (Cordarone) 2. Acebutolol (Sectral) 3. Lidocaine (Xylocaine) 4. Mexiletine (Mexitil)

1. Amiodarone (Cordarone)

A client has been prescribed clopidogrel (Plavix). The nurse instructs the client that which types of drugs can increase the risk for bleeding? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Anticoagulants 2. Protein pump inhibitors 3. Thrombolytic agents 4. Antibiotics 5. Aspirin

1. Anticoagulants 2. Protein pump inhibitors 3. Thrombolytic agents 5. Aspirin

A client has been prescribed several medications. Which medication is a beta blocker? 1. Atenolol (Tenormin) 2. Verapamil (Calan) 3. Captopril (Capoten) 4. Clopidogrel (Plavix)

1. Atenolol (Tenormin)

A client has been prescribed a drug to prevent angina pain. What is the first type of medication prescribed to prevent angina? 1. Beta blockers 2. Alpha blockers 3. Calcium channel blockers 4. Organic nitrates

1. Beta blockers

A client has been prescribed propranolol (Inderal) for a dysrhythmia. Which side effects noted in the nursing assessment might be related to propranolol (Inderal)? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Bradycardia 2. Tachycardia 3. Hypertension 4. Hypotension 5. Hyperglycemia

1. Bradycardia 4. Hypotension

The nurse is caring for a client who has been diagnosed with angina. Which drug classes are used to treat angina? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Calcium channel blockers 2. Organic nitrates 3. Alpha blockers 4. Beta blockers 5. Diuretics

1. Calcium channel blockers 2. Organic nitrates 4. Beta blockers

The nurse is describing angina to a family member of a client recently diagnosed with the condition. Which characterization of angina is the most appropriate? 1. Chest pain on physical exertion or emotional stress 2. Slow heart rate and difficulty standing 3. Difficulty breathing and increased temperature 4. Sudden weakness with severe headache

1. Chest pain on physical exertion or emotional stress

8. The nurse is caring for a client who is experiencing shock. Which fluid replacement agents does the nurse anticipate will be used when providing care? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Crystalloids 2. Colloids 3. Water 4. Blood products 5. Oral electrolyte replacement solutions

1. Crystalloids 2. Colloids 4. Blood products

The client with angina is being discharged to home. The nurse is instructing the client on dietary changes. What should be included in this teaching? 1. Decrease salt and fat intake and limit alcohol intake. 2. There are no dietary restrictions for a person diagnosed with angina. 3. Limit smoking and increase protein and sugar intake. 4. Increase fruits, vegetables, and foods high in cholesterol.

1. Decrease salt and fat intake and limit alcohol intake.

A client asks the nurse to describe conditions that require coagulation-modifying medications. Which conditions should the nurse include in the explanation? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Deep vein thrombosis (DVT) 2. Angina 3. Myocardial infarction 4. Headache 5. Hyperglycemia

1. Deep vein thrombosis (DVT) 2. Angina 3. Myocardial infarction

18. At low doses, which inotropic medication selectively increases blood flow to the kidneys? 1. Dopamine (Dopastat) 2. Dobutamine (Dobutrex) 3. Digoxin (Lanoxin) 4. Norepinephrine (Levophed)

1. Dopamine (Dopastat)

The client asks the nurse what common side effects of calcium channel blockers are. What should the nurse include in client teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Headache 2. Constipation 3. Epistaxis 4. Edema of lower extremities 5. Dysuria

1. Headache 4. Edema of lower extremities

Which parts of the body need continuous supply of oxygen and vital nutrients to support life and death? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Heart 2. Liver 3. Kidneys 4. Brain 5. Muscles

1. Heart 4. Brain

A client has ordered a thrombolytic medication for treatment of CVA. Which type of stroke does the nurse know should not be treated with a thrombolytic? 1. Hemorrhagic stroke 2. Thrombotic stroke 3. Both types can be treated with a thrombolytic 4. Neither type can be treated with a thrombolytic

1. Hemorrhagic stroke

15. A client is receiving norepinephrine (Levophed). The nurse knows vital signs must be continually monitored to watch for which effect? 1. Hypertension 2. Bradypnea 3. Oliguria 4. Tachycardia

1. Hypertension

Most medications used to treat dysrhythmias block ion channels. Which ion is not blocked when treating dysrhythmia? 1. Magnesium 2. Sodium 3. Calcium 4. Potassium

1. Magnesium

16. A client presents with anaphylaxis. What treatment options are likely to be administered to this client? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Oxygen 2. Albuterol (Ventolin) 3. Aspirin (ASA) 4. Diphenhydramine (Benadryl) 5. Acetaminophen (Tylenol) 354

1. Oxygen 2. Albuterol (Ventolin) 4. Diphenhydramine (Benadryl)

21. Which of the following IV fluids is not a crystalloid? 1. Plasma protein fraction (Plasmanate) 2. Lactated Ringer's 3. Normal saline (0.9% sodium chloride) 4. Hypertonic saline (3% sodium chloride)

1. Plasma protein fraction (Plasmanate)

19. The nurse is caring for a client who is receiving albumin (Albuminar). The nurse anticipates the need to monitor for an excess of what substance? 1. Protein 2. Sodium 3. Calcium 4. Potassium

1. Protein

A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should be included in client teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Reflex tachycardia 2. Hyperkalemia 3. Dizziness 4. Hyponatremia 5. Hypotension

1. Reflex tachycardia 3. Dizziness 5. Hypotension

3. A client presents with shock in the hospital, and has a history of a recent infection. What does the nurse suspect that this client is experiencing? 1. Septic shock 2. Hypovolemic shock 3. Cardiogenic shock 4. Neurogenic shock

1. Septic shock

The nurse is caring for a client with a dysrhythmia. The nurse anticipates this client may be placed on which classes of medications to treat dysrhythmias? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Sodium channel blockers 2. Potassium channel blockers 3. Magnesium channel blockers 4. Angiotensin channel blockers 5. Antihyperlipidemics

1. Sodium channel blockers 2. Potassium channel blockers

What is the correct medical term for dysrhythmias that originate in the atria? 1. Supraventricular 2. Fibrillation 3. Heart block 4. Tachycardia

1. Supraventricular

2. The nurse is providing care to a client who is experiencing an allergic reaction. What initial, usual responses of the body to an antigen does the nurse anticipate? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Swelling of the larynx 2. Itching with development of hives 3. Release of histamine and mast cells 4. Inflammation production 5. Antibody production

1. Swelling of the larynx 2. Itching with development of hives 3. Release of histamine and mast cells 4. Inflammation production 5. Antibody production

A client has been prescribed diltiazem (Cardizem). According to the nurse instructing the client, occurrence of which side effects should be notified to the physician? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Systolic blood pressure is less than 90 mmHg. 2. Dizziness occurs when standing up quickly. 3. Heart rate is less than 60 beats per minute. 4. Blood glucose increases. 5. Nausea and vomiting occurs.

1. Systolic blood pressure is less than 90 mmHg. 2. Dizziness occurs when standing up quickly. 3. Heart rate is less than 60 beats per minute.

A client taking warfarin (Coumadin) should be instructed to avoid herbal supplements such as green tea, ginkgo, feverfew, garlic, cranberry, chamomile, and ginger. The client asks the nurse why these items should be avoided. The nurse bases her response on what knowledge? 1. These items increase the risk of bleeding. 2. These items cause severe hypotension. 3. These items decrease the effect of the warfarin (Coumadin). 4. These items cause severe headache.

1. These items increase the risk of bleeding.

A client asks the nurse about having a pacemaker placed in the "AV node". Which statement by the nurse best describes a pacemaker placed in the AV node? 1. This pacemaker will generate an electrical signal from the atria to the ventricles. 2. This pacemaker will generate an electrical signal from the sinoatrial node. 3. This pacemaker will generate a mechanical disruption of force to the entire heart. 4. This pacemaker will generate a force of contraction from the ventricles to the atria.

1. This pacemaker will generate an electrical signal from the atria to the ventricles.

Which medication may be prescribed for a client who recently had surgery and has a small amount of oozing and bleeding from the surgery site? 1. Thrombin (Evithrom) 2. Warfarin (Coumadin) 3. Enoxaparin (Lovenox) 4. Aspirin

1. Thrombin (Evithrom)

11. The nurse is administering norepinephrine (Levophed) to a client in shock. What is the most appropriate rationale for administering this medication? 1. To produce vasoconstriction 2. To cause bradycardia and reserve heart function 3. To increase urine output 4. To cause the heart's conduction system to work more effectively

1. To produce vasoconstriction

12. The nurse is preparing to administer dopamine (Dopastat) for a client who is experiencing cardiogenic and hypovolemic shock. Which effects does the nurse anticipate will occur? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Vasoconstriction 2. Increased renal blood flow 3. Hypotension 4. Increased cardiac output 5. Decreased heart rate

1. Vasoconstriction 2. Increased renal blood flow 4. Increased cardiac output

A nurse is discussing the use of a thrombolytic. The client tells the nurse that they thought blood clots are very important to the body. Which is the nurse's best response? 1. "Yes clotting is very important." 2. "A balance of blood fluidity and coagulation is important to functioning of blood." 3. "Let's call the prescriber to explain." 4. "By maintaining a proper diet with a variety of electrolytes can restore blood coagulation."

2. "A balance of blood fluidity and coagulation is important to functioning of blood."

The client asks the nurse why an ACE inhibitor has been prescribed following an MI. What is the best response by the nurse? 1. "This medication will lower your potassium level." 2. "ACE inhibitors have been found to reduce mortality following MI." 3. "ACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following an MI." 4. "This medication will treat your hypotension."

2. "ACE inhibitors have been found to reduce mortality following MI."

The client asks the nurse what the medical term for a slow heart rate is. Which response by the nurse is the most appropriate? 1. "Atrial fibrillation." 2. "Bradycardia." 3. "Premature ventricular contraction." 4. "Tachycardia."

2. "Bradycardia."

The client is being discharged with nitroglycerin (Nitrostat). What should the nurse include in the client education? 1. "Your chest pain should go away with one tablet." 2. "If your chest pain doesn't go away after three tablets, call 911; you might be having a heart attack." 3. "If your chest pain doesn't go away with one tablet, you can repeat the dose as many times as you need to." 4. "Be sure to call 911 before you take any tablets."

2. "If your chest pain doesn't go away after three tablets, call 911; you might be having a heart attack."

A client has been prescribed an antiplatelet drug, and asks the nurse to explain why this medication has been prescribed. Which response by the nurse is the most appropriate? 1. "These medications are used to dissolve life-threatening clots." 2. "These medications are used to prevent clotting action of platelets." 3. "These medications are used to prevent the formation of clots." 4. "These medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time."

2. "These medications are used to prevent clotting action of platelets."

The nurse is preparing to administer adenosine (Adenocard) to a client. What is the half-life for the medication? 1. 10 days 2. 10 seconds 3. 10 hours 4. 10 minutes

2. 10 seconds

The nurse is preparing to administer alteplase (Activase). In order for this medication to be effective in treating a thrombolytic stroke, when must the medication be administered? 1. 6 hours prior to symptoms 2. 3 hours prior to symptoms 3. 24 4. 12

2. 3 hours prior to symptoms

Reteplase (Retavase) has been ordered for a client diagnosed with an MI. The nurse understands that this drug needs to be administered within which time frame following the onset of symptoms? 1. 45 minutes to 18 hours 2. 30 minutes to 12 hours 3. 90 minutes to 36 hours 4. 60 minutes to 24 hours

2. 30 minutes to 12 hours Given during and acute MI to decrease Heart attack and death

What are the primary classes of antiplatelet agents? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Thrombolytics 2. Aspirin (ASA) 3. Adenosine diphosphate (ADP) receptor blockers 4. Glycoprotein IIb/IIIa receptor blockers 5. Antipyretic agents Correct Answer: 2, 3, 4

2. Aspirin (ASA) 3. Adenosine diphosphate (ADP) receptor blockers 4. Glycoprotein IIb/IIIa receptor blockers

6. The nurse is treating a client who has been diagnosed with shock. What is the first step in treating this client? 1. Medications to counteract the sequelae 2. Basic life support 3. Blood and/or blood products 4. Fluid replacement

2. Basic life support [BLS]

Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload? 1. Antiplatelet 2. Beta-adrenergic blockers 3. ACE inhibitors 4. Calcium channel blockers

2. Beta-adrenergic blockers

A client has been prescribed a calcium channel blocker for angina. The nurse knows this medication should be used with caution in combination with which drug classes? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. NSAIDs 2. Cardiac glycosides 3. Beta blockers 4. Diuretics 5. Hypolipidemics

2. Cardiac glycosides 3. Beta blockers

The physician has ordered a nonpharmacologic therapy for a client diagnosed with bradycardia. The nurse anticipates what to be ordered for this client? 1. External defibrillation 2. Catheter ablation 3. Calcium channel blockers 4. Increased exercise

2. Catheter ablation

A client states that the physician is going to prescribe an antiplatelet agent. The nurse knows which medications are antiplatelet agents? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Heparin (Hep-Lock) 2. Dipyridamole (Persantine) 3. Warfarin (Coumadin) 4. Cilostazol (Pletal) 5. Acetaminophen (Tylenol)

2. Dipyridamole (Persantine) 4. Cilostazol (Pletal)

A nurse is reviewing laboratory report of a client and realizes the liver function tests are elevated. The client should be monitored for which potential complication? 1. Abnormal coagulation 2. Electrolyte imbalance 3. Respiratory issues 4. Reduced cardiac output

2. Electrolyte imbalance

14. The nurse is providing care to a client who is experiencing symptoms of life-threatening shock. Which drug does the nurse anticipate to administer to this client? 1. Corticosteroids 2. Epinephrine 3. Antihistamines 4. Calcium channel blockers

2. Epinephrine

13. Which vasoconstrictor is usually associated with the treatment of anaphylaxis? 1. Norepinephrine (Levophed) 2. Epinephrine (Adrenalin) 3. Dopamine (Dopastat) 4. Dobutamine (Dobutrex)

2. Epinephrine (Adrenalin)

The client is receiving digoxin (Lanoxin) for a dysrhythmia. Why does the nurse expect medication levels in the blood to be monitored closely? 1. Digoxin causes ventricular dysrhythmias. 2. Excessive levels can produce serious dysrhythmias. 3. Subtherapeutic levels are fatal. 4. Interactions with other medications are common.

2. Excessive levels can produce serious dysrhythmias

A nurse is reviewing the laboratory data of a hospitalized client. The nurse recognizes that the white blood cell (WBC) count is lower than expected. The nurse anticipates the prescriber to order which medication? 1. Epoetin alfa (Epogen) 2. Filgrastim (Neupogen) 3. Dalteparin (Fragmin) 4. Warfarin (Coumadin)

2. Filgrastim (Neupogen)

The client has just been started on procainamide (Procan SR). The nurse will assess for which common side effects? 1. Drowsiness and lethargy 2. GI upset and diarrhea 3. Anxiety and tremors 4. Confusion and dizziness

2. GI upset and diarrhea

A nurse understands that certain medications can boost the production of red blood cells, white blood cells, or platelets in patient. What is the name of this group of medications? 1. Colony stimulating factors 2. Hematopoietic growth factors 3. Anticoagulants 4. Hemostatics

2. Hematopoietic growth factors

The nurse educates the client on dysrhythmia. According to the nurse, which diseases are associated with dysrhythmias? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Arthritis 2. Hypertension 3. Strokes 4. Myocardial infarction 5. Diabetes

2. Hypertension 3. Strokes 4. Myocardial infarction 5. Diabetes

A client has been prescribed a beta blocker for a dysrhythmia. Which side effects could be related to the beta blocker therapy? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Hypertension 2. Hypotension 3. Tachycardia 4. Bradycardia 5. Hyperkalemia

2. Hypotension 4. Bradycardia

The client has been started on propranolol (Inderal). What finding does the nurse expect? 1. Increased respiratory rate 2. Lowered heart rate 3. Higher oxygen saturation 4. Stabilized blood pressure

2. Lowered heart rate

A client presents in the Emergency Department with a suspected MI. Which medications should be given as soon as possible? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Clopidogrel (Plavix) 2. Morphine 3. Aspirin (ASA) 4. Metoprolol (Lopressor)

2. Morphine 3. Aspirin (ASA) 4. Metoprolol (Lopressor)

The client is receiving warfarin (Coumadin). Which laboratory result will the nurse monitor to evaluate the therapeutic response? 1. WBC 2. PT and INR 3. BNP 4. aPTT

2. PT and INR

A client presents in the Emergency Department with chest pain. The nurse knows that which conditions can cause chest pain? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Arthritis 2. Peptic ulcer disease 3. Myocardial infarction 4. Gastric reflux 5. Pelvic inflammatory disease

2. Peptic ulcer disease 3. Myocardial infarction 4. Gastric reflux

Which disorders can cause an extra beat that often originates from a source other than the SA node? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Ventricular fibrillation 2. Premature ventricular contraction 3. Premature atrial contraction 4. Atrial fibrillation 5. Cardiogenic shock

2. Premature ventricular contraction 3. Premature atrial contraction

The nurse is preparing to administer atenolol (Tenormin) to a client with angina. Which vital sign would cause the nurse to question administering this drug? 1. Respirations 12 breaths per minute 2. Pulse 52 beats per minute 3. Blood pressure 134/72 4. Oxygen saturation 95%

2. Pulse 52 beats per minute

The nurse learns that the client has been started on sotalol (Betapace). What is the most likely rationale for this? 1. Hypertension 2. Serious ventricular dysrhythmia 3. Atrial dysrhythmia 4. Chronic atrial fibrillation

2. Serious ventricular dysrhythmia

The client has just been started on disopyramide (Norpace). The client asks why they are getting so many ECGs. Which is the nurse's best response? 1. The prescriber believes these are necessary. 2. The medication can cause new dysrhythmias to occur. 3. Insurance companies are suggesting this helps with treatment. 4. I will call the prescriber for clarification.

2. The medication can cause new dysrhythmias to occur.

The nurse is caring for a client receiving an ADP receptor blocker. Which medications does the nurse anticipate may be included on the MAR? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. Heparin (Hep-Lock) 2. Ticlopidine (Ticlid) 3. Clopidogrel (Plavix) 4. Warfarin (Coumadin) 5. Ibuprofen (Advil)

2. Ticlopidine (Ticlid) 3. Clopidogrel (Plavix)

A client receiving warfarin (Coumadin) therapy has an INR of 5.6. Which medication would the nurse expect the physician to order to reverse the warfarin (Coumadin)? 1. Potassium chloride 2. Vitamin K 3. Desirudin (Iprivask) 4. Protamine sulfate

2. Vitamin K

The client is receiving heparin (Hep-Lock). The nurse will monitor which laboratory results to evaluate therapeutic response? 1. INR 2. aPTT 3. BNP 4. PT

2. aPTT

A client asks the nurse to explain how a normal heart works. Which statement by the nurse should be included in client teaching? 1. "The electrical impulse causes the ventricles to contract, and then the atria contract." 2. "A normal resting heart rate is 50 beats per minute." 3. "For the heart to function properly, the atria must contract simultaneously, sending their blood into the ventricles." 4. "The heart generates electrical impulses that start in the atrioventricular node."

3. "For the heart to function properly, the atria must contract simultaneously, sending their blood into the ventricles."

A client asks the nurse why an antidysrhythmic drug is not prescribed for prophylaxis. Which statement should the nurse include in the response? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. 1. "You should speak with your physician about receiving a prescription for prophylaxis." 2. "These drugs are only prescribed for prophylaxis if you have a family history of dysrhythmias." 3. "Research studies have found that the use of antidysrhythmic medications for prophylaxis can actually increase patient mortality." 4. "Antidysrhythmics have the ability not only to correct dysrhythmias but also to worsen or even create new dysrhythmias." 5. "These drugs cannot be prescribed for prophylaxis since you have a history of diabetes."

3. "Research studies have found that the use of antidysrhythmic medications for prophylaxis can actually increase patient mortality." 4. "Antidysrhythmics have the ability not only to correct dysrhythmias but also to worsen or even create new dysrhythmias."

A client has been prescribed a thrombolytic, and asks the nurse to explain why this medication has been prescribed. Which reply by the nurse is the most appropriate? 1. "These medications are used to prevent the formation of clots." 2. "These medications inhibit the normal removal of fibrin, thus keeping the clot in place for a longer period of time." 3. "These medications are used to dissolve life-threatening clots." 4. "These medications are used to prevent clotting action of platelets."

3. "These medications are used to dissolve life-threatening clots."

The client has a dysrhythmia, and is started on a calcium channel blocker. What is the rationale for why this client is being treated with this type of medication? 1. Is not a candidate for an ICD 2. Will have fewer side effects 3. Has an atrial dysrhythmia 4. Will respond quicker

3. Has an atrial dysrhythmia

What is the medical term for stopping of blood flow, an essential mechanism protecting the body from both external and internal injury? 1. Thrombolytic 2. Coagulation 3. Hemostasis 4. Fibrinolysis

3. Hemostasis

Which classification of medications is used to prevent and treat excessive bleeding following surgical procedures? 1. Thrombolytics 2. Anticoagulants 3. Hemostatics 4. Antiplatelets

3. Hemostatics

The client with asthma has just been placed on a beta blocker for a dysrhythmia. What symptom should the nurse assess this client for due to the beta blocker? 1. Elevated blood pressure 2. Dizziness and fainting 3. Increased asthma attacks 4. Bradycardia

3. Increased asthma attacks

17. The nurse is treating a client who is experiencing cardiac symptoms of shock. Which medication does the nurse anticipate because of its ability to increase the force of myocardial contraction? 1. Crystalloids 2. Colloids 3. Inotropic drugs 4. Vasopressors

3. Inotropic drugs

5. The nurse is performing an assessment on a client who is experiencing shock. What metabolic findings would the nurse expect? 1. Rapid, shallow respiratory effort 2. Restlessness, anxiety, and confusion 3. Low temperature and thirst 4. Tachycardia and hypotension

3. Low temperature and thirst

20. The nurse is preparing to administer IV fluids to her client. The client has been ordered a colloid fluid. Which fluid order should the nurse question? 1. Plasma protein fraction (Plasmanate) 2. Dextran 40 (Gentran 40) 3. Platelets 4. Albumin (Albuminar)

3. Platelets

The client is caring for a client who is prescribed a thrombolytic drug. Which item in the client's history does not support the use of this medication? 1. Pulmonary embolism 2. Acute MI 3. Postoperative bleeding 4. Cerebrovascular accident (CVA)

3. Postoperative bleeding

4. What is the earliest sign of shock that the nurse would monitor for during a routine assessment? 1. Complaints of nausea 2. Complaints of thirst 3. Restlessness 4. Pale skin

3. Restlessness

A client has a heart rate of 130 beats per minute. How does the nurse plan to document this heart rate in the medical record? 1. Atrial fibrillation 2. Bradycardia 3. Tachycardia 4. Premature ventricular contraction

3. Tachycardia

What is the term for a complex series of steps that begins when the injured cells release a chemical called prothrombin activator, or prothrombinase? 1. Hemostatics 2. Clotting factors 3. The coagulation cascade 4. Hemostasis

3. The coagulation cascade

A client with cardiac rhythm disturbance is hospitalized during the initial stage of antidysrhythmic therapy. What is the best explanation to the client about the need for hospitalization? 1. High dosages of medication will have to be administered. 2. Continual ECG monitoring will be necessary. 3. The safety margin of dosing is very narrow. 4. The client will be able to recover sooner.

3. The safety margin of dosing is very narrow.

Which are the steps in hemostasis? 1. Platelets adhere to injury site 2. Vessel spasms 3. Vessel injury 4. Insoluble fibrin strands form and coagulate

3. Vessel injury 2. Vessel spasms 1. Platelets adhere to injury site 4. Insoluble fibrin strands form and coagulate

A client has been prescribed diltiazem (Cardizem), and asks the nurse what type of drug this is. Which response by the nurse is most appropriate? 1. "A beta blocker." 2. "A sodium channel blocker." 3. "An alpha blocker." 4. "A calcium channel blocker."

4. "A calcium channel blocker."

The nurse recognizes the need for further teaching when the client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease? 1. "I will check my weight gain/loss regularly." 2. "I'll make sure to take my high blood pressure pills." 3. "I am going to a smoking cessation class." 4. "As long as I exercise, stress at my job will not bother me."

4. "As long as I exercise, stress at my job will not bother me."

A client asks the nurse what is, if any, common adverse effect of epoetin alfa (Procrit). What is the best response by the nurse? 1. "Bleeding." 2. "Ataxia." 3. "Headache." 4. "Hypertension."

4. "Hypertension."

The client asks the nurse why the nitrate patch needs to be off for 8 hours per day. What is the best response by the nurse? 1. "There is no reason to take the patch off each day." 2. "The patch can be addictive; leaving it off reduces the addiction." 3. "You should only leave the patch off for 15 minutes." 4. "Leaving the patch off for 8 hours per day helps to delay the development of tolerance."

4. "Leaving the patch off for 8 hours per day helps to delay the development of tolerance."

The nurse caring for a client with a dysrhythmia understands the effects of which antidysrhythmic drug can last 4-8 weeks after the drug is discontinued because it has an extended half-life that can exceed 50 days? 1. Digoxin (Lanoxin) 2. Verapamil (Calan) 3. Propranolol (Inderal) 4. Amiodarone (Cordarone)

4. Amiodarone (Cordarone)

7. The nurse is caring for a client who is experiencing anaphylaxis. The family asks the nurse why the client is having difficulty breathing. The nurse responds based on what knowledge? 1. Reflex tachycardia 2. Compensation for a rapid fall in blood pressure 3. Seizures are likely to occur 4. Bronchoconstriction in response to the allergen

4. Bronchoconstriction in response to the allergen