Pharmacology Exam 2 Prep U
A nurse obtains the serum digoxin level and immediately reports a level greater than which value? a) 2.0 ng/mL. b) 1.0 ng/mL. c) 0.5 ng/mL. d) 0.1 ng/mL.
a) 2.0 ng/mL.
A client with chronic bronchial asthma is prescribed montelukast. What will the nurse instruct the client to avoid taking? a) Aspirin b) Penicillin c) Sertraline d) Nifedipine
a) Aspirin
A nurse is preparing to administer spironolactone to a client. The nurse would question this order if which disorder is noted in the client's history? a) Hyperkalemia b) Liver disease c) Gout d) Diabetes
a) Hyperkalemia
A client is prescribed metoprolol extended-release PO for heart failure. What assessment finding would suggest an exacerbation of the client's underlying diagnosis? a) adventitious breath sounds b) bradycardia c) upward trend in blood pressure d) chest pain on exertion
a) adventitious breath sounds
The nurse has completed a comprehensive assessment of a new client. What assessment findings would support a diagnosis of metabolic syndrome? Select all that apply. a) waist measurement 107 cm (42 in) b) high-density lipoprotein (HDL) 1.29 mmol/L (50 mg/dL) c) blood pressure 148/93 mm Hg d) resting heart rate 77 beats/min e) fasting blood glucose 7.2 mmol/L (121 mg/dL)
a) waist measurement 107 cm (42 in) b) high-density lipoprotein (HDL) 1.29 mmol/L (50 mg/dL) c) blood pressure 148/93 mm Hg e) fasting blood glucose 7.2 mmol/L (121 mg/dL)
A group of students are reviewing the function of the kidneys and demonstrate understanding when they identify that the kidneys receive what portion of the cardiac output? a) ¼ b) 1/10 c) 1/5 d) ½
a) ¼
Which would a nurse expect to assess if a client is experiencing right-sided heart failure? a) Wheezing b) Peripheral edema c) Hemoptysis d) Dyspnea
b) Peripheral edema
The nurse is providing discharge instructions to a 72-year-old client who has been discharged home on a diuretic. What should the nurse include when providing discharge instructions regarding the use of a diuretic at home? a) Measuring intake and output of urine b) To weigh themselves on the same scale, at the same time of day, in the same clothing c) Restrict fluids to 500 mL/day to limit the need to urinate d) Decrease exercise to conserve energy
b) To weigh themselves on the same scale, at the same time of day, in the same clothing
The nurse has completed medication teaching for a client who has been prescribed aliskiren. What meal choice made by the client best demonstrates an understanding of dietary concerns related to the drug? a) 2 egg omelet, hash brown potatoes, toast b) baked white fish, rice, and a green salad c) grilled cheese sandwich, french fries, and a fruit salad d) pork chop, quinoa, and spinach salad
b) baked white fish, rice, and a green salad
How does captopril contribute to a reduction of a client's blood pressure? a) increasing rebel excretion of sodium and water b) blocking the conversion of angiotensin I to angiotensin II c) blocking the blood pressure-raising effects of angiotensin II d) dilating peripheral arteries and relaxing vascular smooth muscle
b) blocking the conversion of angiotensin I to angiotensin II
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? a) heparin b) digoxin c) furosemide d) hydrochlorothiazide
b) digoxin
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: a) constipation. b) falls. c) xerostomia (dry mouth). d) depression.
b) falls.
The nurse is administering lidocaine to a client with ventricular tachycardia. The nurse will need to observe for adverse effects, including a) hyperthermia. b) hypotension. c) hypertension. d) dysphagia.
b) hypotension.
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: a) blocking adrenergic receptors and producing antisympathetic effects. b) inhibiting the movement of calcium ions across the cardiac muscle cell membrane. c) decreasing sodium and potassium conduction. d) weakening diastolic depolarization and the action potential duration.
b) inhibiting the movement of calcium ions across the cardiac muscle cell membrane.
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 a) low serum chloride levels. b) low serum potassium levels. c) low serum sodium levels. d) low serum calcium levels.
b) low serum potassium levels.
The client reports a mild stinging sensation after using a nasal spray decongestant. Which response by the nurse would be most appropriate? a) "You need to stop the medication immediately." b) "The dose is probably too strong and needs to be reduced." c) "This sensation is common and usually disappears with continued use." d) "We better contact your primary health care provider right away."
c) "This sensation is common and usually disappears with continued use."
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? a) "We can use over-the-counter products for our 5-year-old but not for our 18-monthold." B) "We need to read the label carefully to see how often and how much to give." c) "We can use the adult brand, but we just have to decrease the amount." d) "We should use the cup that comes with the drug to measure it out."
c) "We can use the adult brand, but we just have to decrease the amount."
A client's most recent digoxin level is reported to be 2.2 ng/mL. What conclusion should the nurse draw? a) The medication is at a subtherapeutic drug level. b) A therapeutic drug level has been achieved. c) Digoxin toxicity is a possibility. d) A loading dose of digoxin has been given.
c) Digoxin toxicity is a possibility.
A client is using transdermal nitroglycerin. The nurse would instruct the client to apply a new patch at which frequency? a) Each time he has chest pain b) Before activities that may cause chest pain c) Every day d) Every week
c) Every day
What values are used to monitor the effectiveness of warfarin therapy? a) RBC b) aPTT c) PT and INR d) Platelet count
c) PT and INR
A client has had cholestyramine added to his or her treatment plan for dyslipidemia. What effect will cholestyramine have on the pharmacokinetics of the thiazide diuretic that the client is currently prescribed? a) increased first-pass effect b) increased metabolism c) decreased absorption d) faster excretion
c) decreased absorption
A client being treated for hypokalemia has a medication history that includes propranolol, digoxin, and warfarin. When the client reports nausea, abdominal discomfort, and visual changes, the nurse suspects what as the causative factor? a) heart failure b) myocardial infarction c) digitalis toxicity d) acute renal failure
c) digitalis toxicity
A 66-year-old woman has a complex medical history that includes poorly-controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman's medication regimen. The nurse should consequently assess for signs and symptoms of a) atrial fibrillation. b) thrombophlebitis. c) hyperkalemia. d) leukocytosis.
c) hyperkalemia.
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: a) chronic heart failure secondary to a tachyarrhythmia. b) idiosyncratic reaction to cinchona derivatives. c) hypersensitivity to beta blockers. d) hypersensitivity to sulfonylureas.
c) hypersensitivity to beta blockers.
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? a) "Do you tend to exercise before going to bed?" b) "Are you a smoker?" c) "Are you out in the sun much during a typical day?" d) "How much coffee, tea, and soda do you drink daily?"
d) "How much coffee, tea, and soda do you drink daily?" Caffeine can enhance the adverse effects of pseudoephedrine.
Which client is most likely to be diagnosed with secondary hypertension? a) A client whose most recent blood pressure readings were 143/92, 147/94 and 144/94 mm Hg b) A client with type 1 diabetes who has developed nephropathy c) A client whose body mass index is 31 (obese) d) A client who is being treated for pheochromocytoma
d) A client who is being treated for pheochromocytoma
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? a) Propafenone b) Amiodarone c) Disopyramide d) Acebutolol
d) Acebutolol
A nurse is creating a plan of care for a 68-year-old client with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which nursing diagnoses should the nurse prioritize in the planning of this client's care? a) Incontinence, Functional, related to adverse effects of drug therapy b) Risk for Fluid Volume Deficit related to adverse effects of drug therapy c) Confusion, Acute, related to adverse effects of drug therapy d) Acute Pain, Headache, related to adverse effects of drug therapy
d) Acute Pain, Headache, related to adverse effects of drug therapy
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? a) The medication doesn't pass into the breast milk. b) The safety of this class of antiarrhythmic medications has not been established. c) The decision to continue breast-feeding should be based on the stress is creates for the woman d) Breast-feeding must be discontinued and other forms of feeding should be introduced.
d) Breast-feeding must be discontinued and other forms of feeding should be introduced.
What class of antiarrhythmic agents does the nurse administer to slow the outward movement of potassium during phase 3 of the action potential? a) Class Ib b) Class Ic c) Class II d) Class III
d) Class III
A client with asthma has been prescribed an anti-inflammatory medication. How does an anti-inflammatory drug reduce this client's bronchoconstriction? a) Increasing ability to metabolize medication b) Decreases formation of mucus secretions c) Increasing uptake of corticosteroids to medication d) Decreasing airway hyperreactivity to stimuli
d) Decreasing airway hyperreactivity to stimuli
The nurse is assessing a client who reports taking cholestyramine mixed with diet cola twice per day. What is the most appropriate nursing diagnosis for this client? a) Imbalanced nutrition: less than body requirements related to decreased caloric intake b) Constipation related to GI effects c) Risk for infection related to inappropriate medication use d) Deficient knowledge regarding drug therapy
d) Deficient knowledge regarding drug therapy
A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a client who has just been admitted. What is the most likely goal of this intervention? a) To treat sinus bradycardia accompanied by hypotension b) To resolve the client's uncompensated heart failure c) To treat the client's ventricular tachycardia d) To convert the client's atrial fibrillation to normal sinus rhythm
d) To convert the client's atrial fibrillation to normal sinus rhythm
The nurse cautions the client taking nitroglycerin to avoid the use of which vitamin? a) Vitamin A b) Vitamin B c) Vitamin D d) Vitamin E
d) Vitamin E
A client accidentally ingested extra doses of warfarin at home and now presents with an elevated INR and bleeding. Which medication will the nurse prepare as prescribed to administer along with vitamin K? a) idarucizumab b) tranexamic acid c) aminocaproic acid d) prothrombin complex concentrate
d) prothrombin complex concentrate
A client, recovering from a cold and now experiencing a hacking cough, asks if taking an antihistamine would be helpful. What response demonstrates the nurse's understanding of the effective use of antihistamines? Select all that apply. a) "Antihistamines are not recommended because they tend to worsen your cough." b) "Antihistamines are used for allergy-related coughs." c) "Antihistamines are effective but only if you also increase your fluid intake." d) "Antihistamines are not recommended in your situation but an antibiotic may be useful." e) "Antihistamines are recommended for your type of cough, but you must monitor for adverse effects."
a) "Antihistamines are not recommended because they tend to worsen your cough." b) "Antihistamines are used for allergy-related coughs."
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? a) "Did the medication contain pseudoephedrine?" b) "Have you asked the pharmacist about a substitute medication?" c) "How long has it been since you last needed to take a decongestant?" d) "Would you like your health care provider to prescribe something for congestion?"
a) "Did the medication contain pseudoephedrine?"
After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states: a) "I need to make sure I don't eat too many high potassium foods." b) "I should take the medicine around dinnertime for the best effect." c) "I need to take the drug on an empty stomach." d) "I can still use my salt substitute if I want to."
a) "I need to make sure I don't eat too many high potassium foods."
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? a) "I should avoid beverages that contain caffeine." b) "I will need to increase my intake of foods high in potassium." c) "I should limit my fluid intake to 1,000 mL a day." d) "I can expect this drug to have a sedating effect."
a) "I should avoid beverages that contain caffeine."
Which client statement demonstrates an accurate understanding of the action of a prescribed anticoagulant? a) "This medication will keep unnecessary clots from forming in my blood." b) "If a big clot starts to form, this medication will help break it up." c) "Anticoagulants thin the blood so clots can't get as big." d) "If I have another stroke, this medication will bust up the clot before too much damage is done."
a) "This medication will keep unnecessary clots from forming in my blood."
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? a) 6.2 mcg/mL b) 2.5 mcg/mL c) 3.8 mcg/mL d) 4.1 mcg/mL
a) 6.2 mcg/mL Therapeutic serum levels of quinidine is 2-5 mcg/mL
A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client's history, what would the nurse expect the health care provider to order? a) A modified dose of aminophylline b) The standard dose of aminophylline c) A drug other than aminophylline d) Phenytoin intravenously
a) A modified dose of aminophylline
After teaching group of students about antiarrhythmic agents, the instructor determines that the teaching was successful when the students identify which of the following as examples of class III antiarrhythmics? Select all that apply. a) Amiodarone b) Dofetilide c) Sotalol d) Ibutilide e) Flecainide f) Verapamil
a) Amiodarone b) Dofetilide c) Sotalol d) Ibutilide
The nurse explains to a client the action of a hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor. What enzyme does the nurse state this drug inhibits? a) An enzyme that controls the production of cellular cholesterol b) An enzyme used immediately for energy c) An enzyme that combines with proteins to become chylomicrons d) An enzyme used to make bile acids
a) An enzyme that controls the production of cellular cholesterol
After teaching a group of students about antiplatelet agents, the instructor determines that the teaching was successful when the students identify which drug as blocking the production of platelets in the bone marrow? a) Anagrelide b) Cilostazol c) Clopidogrel d) Ticlopidine
a) Anagrelide
The goals of pharmacotherapy for asthma management are to reduce acute asthma episodes and maintain long-term control of persistent asthma. Two major groups of medications are used, one with a directly positive effect on the other's efficacy. Which medication group affects both pathophysiologies? a) Anti-inflammatory drugs b) Proton-pump inhibitors c) Bronchodilators d) H2-blockers
a) Anti-inflammatory drugs
A nurse is caring for a client who has been prescribed propranolol for angina. After administering the drug, which action would the nurse do? a) Ask about relief of symptoms and record responses on the chart. b) Determine signs of infection in the client. c) Monitor for sudden decrease in urine output. d) Monitor for sudden increase in intraocular pressure.
a) Ask about relief of symptoms and record responses on the chart.
The nursing instructor is teaching a session explaining the various drugs used to treat chronic obstructive pulmonary disease (COPD). The instructor determines the session is successful when the students correctly choose which condition(s) as being considered part of the COPD spectrum? Select all that apply. a) Asthma b) Pulmonary embolism c) Pulmonary hypertension d) Chronic bronchitis e) Pneumonia
a) Asthma c) Pulmonary hypertension
Which statement would be true about the mechanism of action of class II antiarrhythmic agents? a) Block the stimulation of the adrenergic receptors b) Cause depression in phase 2 of repolarization c) Block the influx of sodium into the cells d) Stimulate the uptake of potassium in the tissues
a) Block the stimulation of the adrenergic receptors
Alpha/beta blockers block both alpha-adrenergic and beta-adrenergic receptors. Which antiadrenergic drug is an alpha/beta blocker? a) Carvedilol b) Sotalol c) Propranolol d) Phentolamine
a) Carvedilol
A client is receiving fosinopril. Which adverse effect would the nurse caution the client about to help to promote compliance? a) Cough b) Constipation c) GI irritation d) Photosensitivity
a) Cough
A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer? a) Cromolyn b) Montelukast c) Calfactant d) Triamcinolone
a) Cromolyn
A client is prescribed warfarin. The client also takes a diuretic for the treatment of cardiac problems. The nurse will monitor the client for which potential interaction? a) Decreased effectiveness of the anticoagulant b) Increased effectiveness of the diuretic c) Increased absorption of the anticoagulant d) Increased absorption of the diuretic
a) Decreased effectiveness of the anticoagulant
The nurse would caution clients with which disorders to avoid the use of over-the-counter pseudoephedrine? (Select all that apply.) a) Diabetes b) Cardiovascular disorders c) Chronic sinusitis d) Glaucoma e) Diverticulosis
a) Diabetes b) Cardiovascular disorders d) Glaucoma
Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived? a) Diet b) Medications c) Exercise d) Kidneys
a) Diet
As part of a routine physical examination, a 60-year-old client's primary care provider has ordered blood work that includes cholesterol levels. What result would strongly suggest the need for an antihyperlipidemic drug? a) Elevated LDL levels b) Elevated HDL levels c) A high ratio of HDL to LDL d) Low VLDL levels
a) Elevated LDL levels
A resident of a long-term care facility has been prescribed furosemide 40 mg PO daily. When beginning this drug therapy, what are appropriate nursing actions? Select all that apply. a) Ensure the resident has easy access to a toilet or commode. b) Remove foods that are high in potassium from the resident's meal trays. c) Limit the resident's fluid intake to 1 L/d, unless contraindicated. d) Instruct the client to report any loss of hearing. e) Monitor the resident's blood pressure frequently.
a) Ensure the resident has easy access to a toilet or commode. d) Instruct the client to report any loss of hearing. e) Monitor the resident's blood pressure frequently.
A male client's triglycerides are still elevated despite lifestyle changes. What does the nurse expect the health care provider to order for this client? a) Fenofibrate b) Cholestyramine c) Niacin d) Atorvastatin
a) Fenofibrate Fibrates are the most effective drugs for reducing serum triglyceride levels.
What should the nurse tell a client about the normal skin reactions that can occur with the use of nicotinic acid? Select all that apply: a) Flushing is normal. b) Sensations of warmth are normal. c) Tingling is normal. d) Rash is normal. e) Pustule formation is normal.
a) Flushing is normal. b) Sensations of warmth are normal. c) Tingling is normal.
After teaching a group of nursing students about diuretics, the instructor determines that the teaching was successful when the group identifies which as a loop diuretic? a) Furosemide b) Hydrochlorothiazide c) Acetazolamide d) Spironolactone
a) Furosemide
After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)? a) Gemfibrozil b) Colesevelam c) Niacin d) Ezetimibe
a) Gemfibrozil
A 64-year-old client in hypertensive crisis is to receive furosemide 40 mg IV. Furosemide comes in 100 mg/10 mL containers. What is the correct action by the nurse when giving the prescribed medication? a) Give 4 mL over 1 to 2 minutes. b) Give 4 mL over 10 minutes. c) Flush the line with normal saline, give 4 mL at 1 mL/min, flush again when finished. d) Fix 10 mL in an IV piggyback and deliver it over 30 minutes. TAKE ANOTHER QUIZ
a) Give 4 mL over 1 to 2 minutes.
A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition? a) Heart disease b) Diabetes c) Glaucoma d) Hypertension
a) Heart disease
The nurse is teaching a 45-year-old client about ways to lower cholesterol level. What effects of exercise does the nurse describe? a) Increases high-density lipoproteins (HDLs) and decreases low-density lipoproteins (LDL) b) Increases LDL and decreases triglycerides c) Decreases HDL and increases LDL d) Decreases both HDL and LDL
a) Increases high-density lipoproteins (HDLs) and decreases low-density lipoproteins (LDL)
A patient is prescribed esmolol for treatment of supraventricular tachycardia. The nurse would expect to administer this drug by which route? a) Intravenous b) Oral c) Subcutaneous d) Intramuscular
a) Intravenous
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? a) Intravenously b) Intramuscularly c) Subcutaneously d) Orally
a) Intravenously
The nursing instructor is conducting a teaching session with a group of nursing students analyzing the differences between first- and second-generation antihistamines. The instructor determines the class is successful when the students correctly choose which actions as advantages for administering second generation antihistamines? Select all that apply. a) Less sedation b) Fewer anticholinergic effects c) Less nausea d) Can be used during pregnancy e) Can be used during lactation
a) Less sedation b) Fewer anticholinergic effects
The health care provider has prescribed spironolactone for a client. The nurse is prepared to carefully monitor the client's potassium level if the client is also administered which drug? a) Lisinopril b) Metoprolol c) Terazosin d) Diltiazem
a) Lisinopril
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? a) Milrinone b) Captopril c) Digoxin d) Hydrochlorothiazide
a) Milrinone
Autoregulation of blood flow is directly connected to raising or lowering blood pressure via vasoactive substances. Which substances are examples of vasodilators? Select all that apply. a) Nitric oxide b) Prostacyclin c) Serotonin d) Angiotensin II e) Thromboxane A2
a) Nitric oxide b) Prostacyclin
A client is receiving hydrochlorothiazide. The nurse would expect to administer this drug by which route? a) Oral b) Subcutaneous c) Intramuscular d) Intravenous
a) Oral
A client is to receive clopidogrel. The nurse would expect to administer this agent by which route? a) Oral b) Intravenous c) Intramuscular d) Subcutaneous
a) Oral
The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide? a) Potassium losses are greater with spironolactone than with hydrochlorothiazide. b) Potassium losses are greater with hydrochlorothiazide than with spironolactone. c) Spironolactone is more likely to be taken with a potassium supplement. d) The two diuretics act in different parts of the nephron.
a) Potassium losses are greater with spironolactone than with hydrochlorothiazide.
A client with hypertension has been prescribed spironolactone. The client's previous diuretic, furosemide, has been discontinued. The nurse should explain what benefit of this change? a) Potassium losses are lower with spironolactone than with furosemide. b) Unlike furosemide, spironolactone can be taken on an outpatient basis. c) The diuretic effect is greater with spironolactone than with furosemide. d) Sodium losses are greater with spironolactone.
a) Potassium losses are lower with spironolactone than with furosemide.
HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category? a) Pregnancy Category X b) Pregnancy Category A c) Pregnancy Category B d) Pregnancy Category C
a) Pregnancy Category X
A client suffers from motion sickness. Which drug would the nurse anticipate the primary health care provider to prescribe? Select all that apply. a) Promethazine b) Diphenhydramine c) Levocetirizine d) Azelastine e) Pseudoephedrine
a) Promethazine b) Diphenhydramine
The nurse is preparing to administer nadolol. Which assessment(s) should the nurse investigate before administering the medication? Select all that apply. a) Pulse rate on both arms b) Pulse rate on one arm c) Blood pressure in the sitting position d) Blood pressure on both arms e) Blood pressure on one arm
a) Pulse rate on both arms c) Blood pressure in the sitting position d) Blood pressure on both arms
The nurse cautions a client receiving nitrate therapy about avoiding the use of alcohol to prevent which reaction? a) Severe hypotension b) Hypertensive emergency c) Acute anginal attack d) Myocardial infarction
a) Severe hypotension
Several forms of nitroglycerin have been developed to relieve acute angina pectoris, prevent exercise-induced angina, and decrease anginal episodes in frequency and severity. What characteristics of nitrate therapy can contribute to the ineffectiveness of the medication when prescribed via the oral route? Select all that apply. a) Slow onset of action b) Delayed pain relief c) Short duration of action d) Rapid metabolism by the liver e) Large doses reaching systemic circulation
a) Slow onset of action b) Delayed pain relief d) Rapid metabolism by the liver
A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client? a) Spironolactone b) Dyazide c) Hydrochlorothiazide d) Bumetanide
a) Spironolactone
The client has been prescribed amlodipine for hypertension. The client's blood pressure upon a revisit remains elevated. The nurse inquiries about the use of which alternative therapy? a) St. John's Wort b) Lavender c) Prune juice d) Hawthorn
a) St. John's Wort
What should the nurse tell the client about storage of oral nitroglycerin products? (Select all that apply.) a) Store oral nitroglycerin in the original container. b) Store oral nitroglycerin with the container lid tightly sealed. c) Store oral nitroglycerin and other medications in the container. d) Store oral nitroglycerin in a plastic pill box so doses are not missed. e) Store oral nitroglycerin away from light exposure.
a) Store oral nitroglycerin in the original container. b) Store oral nitroglycerin with the container lid tightly sealed. e) Store oral nitroglycerin away from light exposure.
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? a) Take the medication at bedtime. b) Take the medication with a high-fat meal. c) Increase fluid intake for 48 hours before taking the first dose. d) Start with a low dose and increase gradually over 2 to 3 weeks.
a) Take the medication at bedtime.
The nurse is preparing to administer an antitussive to a client. Which assessments will the nurse prioritize in the preadministration assessment? Select all that apply. a) Temperature b) Sputum presence c) Type of cough d) Bowel sounds e) Heart sounds
a) Temperature b) Sputum presence c) Type of cough
What is the expected outcome when the glomerular membrane is damaged? a) The filtration of fluid from the blood into the kidney's nephron tubule is impaired b) The kidney's ability to regulate the concentration of urine is impaired c) The reabsorption of substances from the renal tubule back into the vascular system is altered d) The chemical reaction that results in the formation of sodium bicarbonate is impaired
a) The filtration of fluid from the blood into the kidney's nephron tubule is impaired
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? a) The heart beats in response to impulses that are generated by specialized cells located in the heart not the brain. b) When the brain is unable to trigger the heart to beat, the sinoatrial (SA) node in the heart assumes that role. c) The inability to control the heart is not among the losses associated with "brain death". d) The heart will eventually stop beating as the losses associated with "brain death" become more extensive.
a) The heart beats in response to impulses that are generated by specialized cells located in the heart not the brain.
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? a) The importance of having required laboratory work performed on time b) The need to take the medication at the same time each day regardless of her heart rate c) The correct technique for using a home blood pressure cuff d) Timing household activities to coincide with the administration times of her digoxin
a) The importance of having required laboratory work performed on time
A client with moderately elevated lipid levels requests immediate pharmacotherapy for dyslipidemia. The nurse explains that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered based on what rationale? a) Therapeutic lifestyle changes are the preferred method for lowering blood lipids. b) Continued therapeutic lifestyle changes during drug therapy will guarantee success. c) Therapeutic lifestyle changes work only when used in conjunction with medications. d) The needed lifestyle changes are usually easy for most people to achieve.
a) Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
What is the basis for a nurse's recommendation of a period of intensive diet therapy and lifestyle modification before initiation of drug therapy for a client newly diagnosed with dyslipidemia? a) Therapeutic lifestyle changes are the preferred method for lowering blood lipids. b) Continued therapeutic lifestyle changes during drug therapy will guarantee success. c) Therapeutic lifestyle changes are easier to comply with than medication therapies. d) Nonpharmacologic interventions are cheaper than using medications.
a) Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
The health care provider indicates that a client experiencing renal failure is not a candidate for therapy with potassium-sparing diuretics. How will the nurse respond when the client's family member asks why this is the case? a) They may cause hyperkalemia. b) They are the strongest form of diuretics. c) They promote excretion of potassium. d) They may cause rebound edema.
a) They may cause hyperkalemia.
When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism? a) Vasoconstriction of small blood vessels of the nasal membranes b) Selectively binding to peripheral H1 receptors c) Non-selectively binding to central and peripheral H1 receptors d) Anesthetizing stretch receptors in the respiratory passages
a) Vasoconstriction of small blood vessels of the nasal membranes
The nurse is preparing to administer furosemide to a client. Which factor(s) should the nurse prioritize on the preadministration assessment? Select all that apply. a) Weight b) Blood glucose c) Pulse d) Temperature e) Respiratory rate
a) Weight c) Pulse d) Temperature e) Respiratory rate
The nurse is conducting an ongoing assessment after the administration of an antihypertensive. About which finding(s) should the nurse prioritize notifying the primary health care provider? Select all that apply. a) Weight gain of 0.9 kg (2 lb) or more per day b) Headache c) Edema d) Insomnia e) Sedation
a) Weight gain of 0.9 kg (2 lb) or more per day c) Edema
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) an adrenergic antagonist. b) an adrenergic agonist. c) a cardiotonic. d) a neurotransmitter.
a) an adrenergic antagonist.
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: a) atrial fibrillation. b) hypertensive crisis. c) ischemic heart disease. d) ventricular tachycardia.
a) atrial fibrillation.
What term is used to describe the heart's ability to independently generate an electrical impulse? a) automaticity b) spontaneous stimulation c) perpetuity d) initiation
a) automaticity
A client has had an exacerbation of hemorrhoidal irritation. What drug should the nurse suspect as most likely to contribute to this adverse effect? a) bile acid sequestrants b) hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors c) cholesterol absorption inhibitor d) fibrates
a) bile acid sequestrants
A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system? a) cardiovascular b) neurological c) gastrointestinal d) renal
a) cardiovascular
The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin? a) headache and flatulence. b) increased appetite and blood pressure. c) fatigue and mental disorientation. d) hiccups, sinus congestion, and dizziness.
a) headache and flatulence.
A health care provider is considering ordering hydrochlorothiazide for a client. This drug must be used cautiously, if at all, if the client has a history of: a) hypersensitivity to sulfonamides. b) stable angina. c) hypertension. d) obesity.
a) hypersensitivity to sulfonamides.
A physician has prescribed triamterene to a client with renal disease. The client informs the nurse that they are taking potassium supplements to address some heart problems. The nurse would be alert for which of the following? a) increased risk of hyperkalemia. b) increased risk of bleeding. c) decreased diuretic effectiveness. d) increased risk of arrhythmias.
a) increased risk of hyperkalemia.
When prescribed for angina, how does oral nifedipine achieve a therapeutic effect? a) inhibiting the influx of calcium through slow channels. b) potentiating the effect of B-type natriuretic peptide c) preventing the outflow of intracellular potassium d) binding extracellular sodium ions with chloride ions
a) inhibiting the influx of calcium through slow channels.
A client with a history unstable angina is being prepared for percutaneous transluminal coronary angioplasty (PTCA). The nurse assessing the client should focus on identifying a history of which conditions/situations that are considered contraindications to this procedure? Select all that apply. a) major trauma within the last 6 weeks b) uncontrolled hypertension c) thrombocytopenia d) diabetes mellitus e) heparin use
a) major trauma within the last 6 weeks b) uncontrolled hypertension c) thrombocytopenia
An older adult client, diagnosed with chronic obstructive pulmonary disease (COPD), is being considered for corticosteroid therapy. The nurse should anticipate that these drugs may be administered by what routes? Select all that apply. a) oral b) topical c) inhaled d) parenteral e) sublingual
a) oral d) parenteral
The health care provider has prescribed quinidine. The nurse knows this drug is used for what physiologic effects on the heart? (Select all that apply.) a) reduces automaticity b) speeds conduction c) prolongs the refractory period d) shortens the refractory period e) increases contractility
a) reduces automaticity c) prolongs the refractory period
After teaching a group of students about conditions that can lead to heart failure, the instructor determines that additional teaching is needed when the students identify: a) renal failure. b) valvular disease. c) coronary artery disease. d) hypertension.
a) renal failure.
The nurse is caring for a client who has been taking atorvastatin for several weeks. The nurse should teach the client to expect decreases in what values? Select all that apply. a) serum cholesterol b) low-density lipoprotein (LDL) levels c) sitosterol levels d) campesterol levels e) high-density lipoprotein (HDL) levels
a) serum cholesterol b) low-density lipoprotein (LDL) levels
Sotalol is a Class III antidysrhythmic drug with both beta-adrenergic-blocking and potassium channel-blocking activity. Use of sotalol is contraindicated in patients with a) sinus bradycardia. b) colitis. c) renal impairment. d) cataracts.
a) sinus bradycardia.
A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? a) Dextromethorphan works in the medulla to suppress the cough reflex. b) Dextromethorphan works on the receptors in the throat to prevent a cough. c) Dextromethorphan works by inhibiting allergen response. d) Dextromethorphan works by relaxing the smooth muscles in the bronchioles.
a)Dextromethorphan works in the medulla to suppress the cough reflex.
A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion? a) "That would probably help, but we'd have to do blood work first." b) "Actually, patients with renal failure usually can't take hydrochlorothiazide." c) "That would only work if he could come in twice a day to get it intravenously." d) "Maybe, but hydrochlorothiazide affects the bladder more than the kidneys."
b) "Actually, patients with renal failure usually can't take hydrochlorothiazide."
A nurse is preparing to discharge a client who has been prescribed warfarin. While assessing the client's knowledge of the drug, what statement should the nurse address? a) "I take vitamin C when I feel like I'm getting a cold." b) "I take aspirin to help with the pain of my arthritis." c) "I aim to walk 2 miles a day." d) "I drink a glass of wine with dinner some evenings."
b) "I take aspirin to help with the pain of my arthritis."
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? a) "I will monitor the effectiveness by watching for any symptoms of hypertension." b) "I will call my doctor if I bruise easily or become extremely tired." c) "I'll take the drug in the morning so that I don't have to go to the bathroom often at night." d) "I will increase my intake of foods high in potassium, such as bananas."
b) "I will call my doctor if I bruise easily or become extremely tired."
A 52-year-old client who experienced a myocardial infarction has an order for discharge. Part of the discharge teaching includes prior administration of nitroglycerin for chest pain. Which statement by the client indicates understanding of the teaching provided? a) "I will take two nitroglycerin tablets 15 minutes apart, and if I do not have any relief I will contact my health care provider." b) "I will take three nitroglycerin tablets 5 minutes apart, and if I do not have any relief I will seek emergency care immediately." c) "I will take three tables every 5 minutes until the chest pain subsides." d) "I will take one tablet and lay down for an hour."
b) "I will take three nitroglycerin tablets 5 minutes apart, and if I do not have any relief I will seek emergency care immediately."
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? a) "Maybe you do not need medication with your history." b) "With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease." c) "The effects of high blood pressure are different for different people." d) "We always treat high blood pressure with medicine to prevent further damage to your body."
b) "With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease."
The nurse identifies the therapeutic range for digoxin as: a) 3 to 4 ng/mL. b) 0.8 to 2 ng/mL. c) 0.1 to 0.9 ng/mL. d) 2 to 3 ng/mL.
b) 0.8 to 2 ng/mL.
After the nurse has administered a bolus of lidocaine, the nurse should run a continuous infusion at which rate? a) 0.25-0.75 mg/min b) 1-4 mg/min c) 6-8 mg/min d) 10-20 mg/min
b) 1-4 mg/min
A client is prescribed albuterol, 2 puffs every 6 hours. After teaching the client about the drug and its administration, the nurse determines that the teaching was successful when the client states that they will allow how much time between each puff? a) 1 minute b) 3-5 minutes c) 10-30 seconds d) 2 minutes
b) 3-5 minutes
After receiving a loading dose of milrinone, what is a client most likely to experience? (Select all that apply.) a) Hypertension b) Angina c) Hyperkalemia d) Headache e) Insomnia
b) Angina d) Headache
Which of following should the nurse tell the client in regard to the use of translingual nitroglycerin sprays? Select all that apply: a) Shake the canister before use. b) At the onset of an anginal attack place one to two metered doses under the tongue. c) Prophylactic use of this dosage form is not recommended. d) Do not exceed three metered doses in 15 minutes. e) Translingual nitroglycerin spray can be sprayed onto or under the tongue.
b) At the onset of an anginal attack place one to two metered doses under the tongue. d) Do not exceed three metered doses in 15 minutes. e) Translingual nitroglycerin spray can be sprayed onto or under the tongue.
When describing the action of class II antiarrhythmics, which would the nurse include? a) Membrane stabilization with depression of phase 0 action potential b) Blockage of beta receptors in the heart and kidneys c) Blockage of potassium channels during phase 3 action potential d) Interference with calcium ion movement across the membrane
b) Blockage of beta receptors in the heart and kidneys
The nurse is admitting a client with an obstructive respiratory disorder. For which disorders should the nurse assess this client? Select all that apply. a) Atelectasis b) Cystic fibrosis c) Asthma d) Pneumonia e) Bronchiectasis
b) Cystic fibrosis c) Asthma
The nurse would encourage clients with prehypertension to follow what type of diet? a) High-sodium diet b) DASH diet c) Restricted-calorie diet d) High-protein diet
b) DASH diet
Key behavioral determinants of blood pressure are related to what factor? a) Minimal body mass b) Dietary consumption of calories and salt c) Dietary consumption of sugars and fat d) Comorbidities
b) Dietary consumption of calories and salt
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? a) Black cohosh b) Ginseng c) Saw palmetto d) Valerian
b) Ginseng
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? a) Hypertension and tachycardia b) Headache and dizziness c) Itching and rash d) Nausea and diarrhea
b) Headache and dizziness
The nurse is preparing to administer protamine emergently to a client per instructions from the health care provider. The nurse concludes this is necessary due to an adverse reaction to which drug? a) Clopidogrel b) Heparin c) Alteplase d) Warfarin
b) Heparin
Which would the nurse identify as being involved with asthma? a) Acute infection b) Hyperactive airways c) Alveolar collapse d) Progressive loss of lung compliance
b) Hyperactive airways
A client is receiving a diuretic for the treatment of hypertension. Which assessment finding on the laboratory reports should the nurse prioritize? a) Hyperkalemia b) Hyponatremia c) Hypomagnesemia d) Hypocalcemia
b) Hyponatremia
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? a) "I'll try to make sure that I drink plenty of fluids each day." b) I'll keep taking my medications until I'm not experiencing any more symptoms." c) "I'll make sure I don't take my inhalers more often than they've been prescribed." d) "I'm a heavy coffee drinker, but I know that I now know I need to cut down on this."
b) I'll keep taking my medications until I'm not experiencing any more symptoms."
A primary health care provider has prescribed a loop diuretic for hypertension in a client with diabetes mellitus. Which assessment should the nurse prioritize? a) Sudden pain in the joints b) Increased blood glucose levels c) Occurrence of gout attacks d) Sudden increase in weight
b) Increased blood glucose levels
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? a) 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. b) It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins. c) It binds selectively to the mineralocorticoid receptors. d) It inhibits the movement of calcium ions across cell membranes.
b) It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins.
A group of students are reviewing the various antihypertensive agents. The students demonstrate understanding of the information when they identify what as an example of an angiotensin II receptor blocker? a) Moexipril b) Losartan c) Minoxidil d) Amlodipine
b) Losartan
A nurse should be aware that use of statin drugs is contraindicated in clients with which conditions? (Select all that apply.) a) Kidney disease b) Pregnancy c) Serious hepatic disease d) Carcinoma of the breast e) Lactation
b) Pregnancy c) Serious hepatic disease e) Lactation
A patient is admitted to the cardiology unit of a health care facility for ventricular arrhythmia. In which condition can an anti-arrhythmic drug be safely administered? a) Aortic stenosis b) Premature ventricular contraction c) Third-degree heart block d) Severe congestive heart failure
b) Premature ventricular contraction
The health care provider has prescribed fenofibrate for a client discovered to have very high serum triglyceride levels. The nurse should question this order if the client has a history of which additional disorder? a) Endocrine disorder b) Primary biliary cirrhosis c) Arterial bleeding d) Respiratory depression
b) Primary biliary cirrhosis
Which agent would be classified as a class 1A antiarrhythmic? a) Lidocaine b) Procainamide c) Mexiletine d) Flecainide
b) Procainamide
The nurse is caring for a client who takes an antiarrhythmic agent and is reporting a complete lack of appetite. Which cardiac antiarrhythmic agent would the nurse suspect the client is taking? a) Diltiazem b) Propranolol c) Lidocaine d) Amiodarone
b) Propranolol
A client exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering: a) Vitamin K b) Protamine sulfate c) Urokinase d) Drotrecogin alfa
b) Protamine sulfate
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? a) Xylometazoline b) Pseudoephedrine c) Ephedrine d) Tetrahydrozoline
b) Pseudoephedrine
A client on antiarrhythmic drug therapy reports nausea, vomiting, abdominal pain, diarrhea, and a ringing sensation in the ears. Which drug should the nurse investigate first to determine possible cause? a) Lidocaine b) Quinidine c) Flecainide d) Procainamide
b) Quinidine
A client presents to the urgent care clinic reporting severe dizziness. On assessment, the nurse learns the client was recently prescribed losartan and quit taking it thinking it was responsible for the dizziness. Which assessment should the nurse prioritize? a) Breathing difficulty b) Rebound hypertension c) Orthostatic hypotension d) Anginal attacks
b) Rebound hypertension
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? a) Orientation and cognition b) Respiratory assessment c) Neurological assessment d) Active and passive range of motion
b) Respiratory assessment
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? a) Essential hypertension b) Secondary hypertension c) Rebound hypertension d) Hypertensive emergency
b) Secondary hypertension
The nurse is assessing a client with renal disease and discovers the client's blood pressure has increased since the last visit. The nurse suspects the client has developed which concern? a) Essential hypertension b) Secondary hypertension c) Rebound hypertension d) Hypertensive emergency
b) Secondary hypertension
Which statement correctly distinguishes between the therapeutic effects of sublingual isosorbide and sublingual nitroglycerin? a) Sublingual isosorbide has a faster onset and a shorter duration of action than sublingual nitroglycerin. b) Sublingual isosorbide has a slower onset and a longer duration of action than sublingual nitroglycerin. c) Sublingual isosorbide has a lesser sustained effect than sublingual nitroglycerin. d) Sublingual isosorbide is not as effective as sublingual nitroglycerin.
b) Sublingual isosorbide has a slower onset and a longer duration of action than sublingual nitroglycerin.
A client began taking hydrochlorothiazide 1 week ago and is reporting occasional dizziness when she stands up quickly from sitting or lying. What is the nurse's best action? a) Arrange for the client's potassium levels to be assessed as soon as possible. b) Teach the client about the blood pressure effects of the medication and relevant safety measures. c) Educate the client about the need for bed rest until her body adjusts to the new medication. d) Tell the client to withhold the next scheduled dose until she can be assessed by the provider.
b) Teach the client about the blood pressure effects of the medication and relevant safety measures.
A stable daily dose of warfarin is reached when which parameter is achieved? a) The PTT is within the therapeutic range. b) The PT and INR are within their therapeutic ranges, and the dose does not cause bleeding. c) The INR is between 4 and 5. d) The INR is between 1 and 2, and the dose does not cause bleeding.
b) The PT and INR are within their therapeutic ranges, and the dose does not cause bleeding.
The nurse monitors which client for an increased risk of digoxin toxicity? a) The client with liver dysfunction b) The client with renal dysfunction c) The client with an integumentary dysfunction d) The client with a peripheral vascular dysfunction
b) The client with renal dysfunction
The nurse is preparing to administer sublingual nitroglycerin to a client for the first time. What effect might the client experience right after administration? a) Nervousness or paresthesia b) Throbbing headache or dizziness c) Drowsiness or blurred vision d) Tinnitus or diplopia.
b) Throbbing headache or dizziness
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: a) blocking adrenergic receptors and producing antisympathetic effects. b) inhibiting the movement of calcium ions across the cardiac muscle cell membrane. c) decreasing sodium and potassium conduction. d) weakening diastolic depolarization and the action potential duration.
b) inhibiting the movement of calcium ions across the cardiac muscle cell membrane.
A nurse is teaching a client who is diagnosed with angina how to properly administer transdermal nitroglycerin. The nurse instructs the client to apply the patch for how long? a) 4-6 hours b) 6-8 hours c) 10-12 hours d) 12-14 hours
c) 10-12 hours
The nurse is providing health promotion education to a client regarding proper hydration. How much urine will the nurse indicate an adequately hydrated adult produces each day? a) 0.5 L/d b) 1 L/d c) 2 L/d d) 3 L/d
c) 2 L/d
The nurse is administering furosemide IV to a client. How soon after administration does the nurse expect diuretic effects to peak? a) 5 minutes b) 15 minutes c) 30 minutes d) 60 minutes
c) 30 minutes
The client is learning to self-administer heparin daily. The home care nurse draws blood every 2 to 3 days to monitor the client's platelet levels. What platelet count would the nurse report to the health care provider as a critical laboratory result? a) 150,000 b) 160,000 c) 90,000 d) 400,000
c) 90,000
The nurse is caring for a client who has been prescribed an antiarrhythmic agent. What nursing assessment should the nurse prioritize? a) Mental status b) Breath sounds and respiratory rate c) Apical heart rate and blood pressure d) Activity level and exercise tolerance
c) Apical heart rate and blood pressure
Mr. Zee is being discharged home after treatment for a myocardial infarction. During the hospital stay he was also diagnosed with uncomplicated diabetes mellitus type 2 and hypertension. The health care provider has prescribed several new drugs, one of which is captopril. What instruction is important to include in the teaching plan regarding captopril administration? a) Discontinue drug if persistent dry cough occurs. c) Avoid dairy products. c) Avoid potassium supplements. d) Implement a low-carbohydrate diet as part of your weight loss program.
c) Avoid potassium supplements.
A staff nurse on a renal unit knows that most patients require treatment for hypertensive disease. What would the nurse expect to assess prior to the beginning of antihypertensive treatment? a) A temporary increase in renal function b) A sustained increase in renal dysfunction c) Baseline renal function d) A sustained decrease in renal function
c) Baseline renal function
The nurse is teaching a client with hypertension about losartan which the health care provider has prescribed. The nurse can explain that losartan exerts which action on the body? a) Blocks aldosterone receptors b) Prevents conversion of angiotensin I c) Blocks angiotensin II receptors d) Prevents renin secretion
c) Blocks angiotensin II receptors
Which would be classified as a bile acid sequestrant? a) Lovastatin b) Ezetimibe c) Cholestyramine d) Gemfibrozil
c) Cholestyramine
A client arrives in the emergency room with an attack of acute bronchiectasis. What is the principal pathologic finding in the diagnosis of bronchiectasis? a) Increase in the red blood cell concentration in the blood b) Leakage of fluid into the alveolar interstitial spaces c) Chronic, irreversible dilation of the bronchi and bronchioles d) Obstruction of the pulmonary vasculature by a clot
c) Chronic, irreversible dilation of the bronchi and bronchioles
A client is admitted to the emergency department with a severe headache, nausea, shortness of breath, and blood pressure of 200/120 mm Hg. Which response should the nurse prioritize? a) Take a blood pressure every 30 minutes. b) Alternate the arms for assessing the blood pressure and pulse. c) Continuously monitor the client's status. d) Measure the pulse rate every hour.
c) Continuously monitor the client's status.
Which would the nurse identify as a cardiac glycoside? a) Inamrinone b) Milrinone c) Digoxin d) Captopril
c) Digoxin
The nurse cares for a 10-year-old child who has been diagnosed with hypercholesterolemia. What is the most common cause of hypercholesterolemia in children? a) Gender b) Diet c) Familial connection d) Sedentary lifestyle
c) Familial connection
A client taking atorvastatin presents to the clinic reporting acute muscle pain not associated with exercise or injury. The nurse asks questions to determine if this client has been taking what contraindicated substance? a) Over-the-counter (OTC) medications b) Ginseng c) Grapefruit juice d) Saw palmetto
c) Grapefruit juice
A male client has cirrhosis of the liver that has caused ascites. The nurse knows that what condition may occur if diuretics are used to reduce the ascites? a) Ammonia absorption b) Subtherapeutic drug levels c) Hepatic encephalopathy d) Hepatomegaly
c) Hepatic encephalopathy
The nurse is preparing to teach the client about diet therapy when beginning bile sequestrant medication to lower lipid levels. What important point will the nurse include in the teaching plan? a) Increasing carbohydrate intake b) Reducing protein intake c) Increasing fiber intake d) Reducing fluid intake
c) Increasing fiber intake
A group of students are reviewing information about isosorbide dinitrate. The students demonstrate the need for additional study when they identify that this drug is available in which form? a) Oral b) Sublingual c) Intravenous d) Chewable tablet
c) Intravenous
The nurse has admitted a client with type 1 diabetes mellitus who has been prescribed captopril for treatment of hypertension. The nurse knows this medication is used in clients with diabetes for what reason? a) It reduces fasting blood glucose. b) It will prevent the development of blindness. c) It reduces proteinuria. d) It decreases peripheral tissue ischemia.
c) It reduces proteinuria.
The nurse is teaching a client with arrhythmia about the prescribed verapamil. Which potential adverse reaction should the nurse point out to the client? a) Diarrhea b) Hyperactivity c) Peripheral edema d) Hypertension
c) Peripheral edema
A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy? a) Reduction of the inflammatory response b) Decrease in the production of leukotrienes D4 and E4 c) Relaxation of smooth muscle d) Enhancement of alveolar expansion
c) Relaxation of smooth muscle
The nurse is preparing to administer warfarin to a female client, who also uses oral contraceptives. Which assessment finding(s) should the nurse prioritize? Select all that apply. a) Bruising b) Blood in the stool c) Subtherapeutic INR d) Supratherapeutic INR e) Calf pain and warmth
c) Subtherapeutic INR e) Calf pain and warmth
You are teaching a client how to follow his antidysrhythmic drug regimen. Which of the following should you advise the client to report as a possible adverse effect of his therapy? a) Diarrhea b) Gastric upset c) Syncope d) Dry mouth
c) Syncope
The nurse is teaching a young female about the prescribed anticoagulant. The nurse determines the session is successful when the client correctly indicates they will apply which recommendation? a) Avoid caffeinated drinks. b) Take the drug on an empty stomach. c) Use a reliable contraceptive. d) Take the drug with a glass of milk.
c) Use a reliable contraceptive.
The nurse is caring for a 35-year-old client taking a beta-hydroxy-beta-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor to lower serum lipid levels. When teaching this client about the medication, what priority teaching point will the nurse include in the teaching plan? a) Need for frequent ophthalmic examinations b) Information about a cholesterol-lowering diet c) Use of barrier contraceptives d) Calling her doctor with any respiratory symptoms
c) Use of barrier contraceptives
A client diagnosed with heart disease is prescribed an antiarrhythmic drug. Further teaching is needed when the client makes which statement? a) "I will take my medication at the prescribed time." b) "I need to call my primary care provider before taking any herbal supplements." c) "I can check the drug label about taking the medicine with food." d) "I know I must take my medication every day for my heartbeat to be fixed."
d) "I know I must take my medication every day for my heartbeat to be fixed."
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? a) "There is an error on the prescription." b) "I will contact the provider immediately." c) "People of Asian descent excrete the drugs more rapidly, so the doses prescribed are smaller." d) "People of Asian descent excrete the drugs more slowly, so the doses prescribed are smaller."
d) "People of Asian descent excrete the drugs more slowly, so the doses prescribed are smaller."
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? a) 0.218 mg b) 0.418 mg c) 0.618 mg d) 0.818 mg
d) 0.818 mg
A nurse is administering digoxin intravenously as ordered. The nurse would administer the drug over which time frame? a) 2 minutes b) 3 minutes c) 4 minutes d) 5 minutes
d) 5 minutes
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? a) By directly relaxing vascular smooth muscle b) By blocking aldosterone from binding to mineralocorticoid receptors c) By blocking the movement of calcium ions into arterial smooth muscles d) By inhibiting the transformation of angiotensin I to angiotensin II
d) By inhibiting the transformation of angiotensin I to angiotensin II
What acts as a catalyst to reabsorb sodium ions into the body? a) Aldosterone b) Sodium bicarbonate c) Angiotensin d) Carbonic anhydrase
d) Carbonic anhydrase
A client is prescribed propranolol (Inderal). Which condition in the client's history may affect the treatment regimen? a) Nausea b) Diarrhea c) Dizziness d) Elevated glucose
d) Elevated glucose
The pharmacology instructor is discussing cardiac glycosides with a class of pre-nursing students. According to the instructor, what physiologic effect do cardiac glycosides trigger? a) Decreased cardiac output b) Decreased afterload c) Increased ventricular rate d) Increased force of heart contraction
d) Increased force of heart contraction
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? a) Withhold the scheduled dose of theophylline pending the next day's blood work results. b) Administer the scheduled dose of theophylline with as needed (PRN) dose of a bronchodilator. c) Inform the health care provider that an increase in the client's dose of theophylline may be necessary. d) Inform the health care provider that the client has toxic theophylline levels.
d) Inform the health care provider that the client has toxic theophylline levels.
Which drug is in the class of drugs called human B-type natriuretic peptides? a) Bosentan b) Milrinone c) Digoxin d) Nesiritide
d) Nesiritide
After teaching a group of nursing students about antianginal drugs, the instructor determines that the teaching was successful when the students correctly choose which drugs as a calcium channel blocker? a) Minoxidil b) Hydralazine c) Isosorbide d) Nifedipine
d) Nifedipine
What elicits their pharmacological effect by reducing swelling in the nasal passages by vasoconstriction? (Select all that apply.) a) Loratadine b) Guaifenesin c) Dextromethorphan d) Phenylephrine e) Oxymetazoline
d) Phenylephrine e) Oxymetazoline
A nurse is caring for a 64-year-old female client who is receiving IV heparin and reports bleeding from her gums. The nurse checks the client's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which drug may be ordered? a) Coumadin b) Alteplase c) Ticlopidine d) Protamine sulfate
d) Protamine sulfate
The nurse is preparing to teach a child with asthma and caregivers about the prescribed corticosteroids. Which factor should the nurse point out will require monitoring? a) Blood pressure b) Skin turgor c) Urine output d) Rate of growth
d) Rate of growth
What primary event has occurred when a client experiences an ectopic focus? a) The contractibility of the heart has been diminished greatly. b) The arterial resistance has been increased significantly c) Fluid is no longer being pulled back int the venous system effectively d) The location of the heart's functioning pacemaker is no longer the sinoatrial (SA) node
d) The location of the heart's functioning pacemaker is no longer the sinoatrial (SA) node
A male client presents to the health care provider's office for his annual visit. When questioned about over-the-counter medication use, he states that he uses echinacea to prevent colds. What statement is true about echinacea? a) He is healthier because he uses the echinacea. b) Echinacea is the OTC drug of choice for prevention of viral infections. c) To be effective, echinacea must be taken daily regardless of symptoms. d) There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold.
d) There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold.
A client visits the clinic and is diagnosed with acute sinusitis. To promote sinus drainage, what medication might be ordered? a) Topical nasal steroid decongestants b) First-generation antihistamines c) Second-generation antihistamines d) Topical decongestants
d) Topical decongestants
Which substances are moved from the glomerulus into the tubule due to hydrostatic pressure? a) Lipids b) Proteins c) Blood cells d) Water
d) Water
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? a) low sodium levels b) low hemoglobin levels c) elevated neutrophil levels d) elevated potassium levels
d) elevated potassium levels
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 a) is a 56-year-old man. b) has a history of pneumonia. c) prefers a high-calorie diet. d) has a high coffee intake.
d) has a high coffee intake.
The nurse is caring for a 76-year-old client who is receiving IV heparin 5000 units q4h. At the initiation of therapy, the client's control activated thromboplastin time (aPTT) was found to be 35 seconds. One hour prior to the next scheduled dose, aPTT is determined to be 92 seconds. Based on this result, the nurse will: a) administer an increased dose at the scheduled time. b) administer the scheduled dose. c) administer the scheduled dose and monitor the client closely. d) hold the dose and contact the provider.
d) hold the dose and contact the provider. During heparin therapy, aPTT values are typically maintained between 1.5 to 2.5 times the control value.
A client presents to the ED with wheezing and blood-tinged sputum. The nurse suspects the client is experiencing pulmonary edema. The nurse should suspect the cause of the pulmonary edema is most likely: a) cardiomyopathy. b) right ventricular failure. c) valvular heart disease. d) left ventricular failure.
d) left ventricular failure.
