Pharmacology Exam 3

What indicates that a client understands how to use sublingual nitroglycerin? "I should put the pill between my tongue and cheek." "I need to avoid taking any sips of water before using the drug." "I can chew the tablet once it starts dissolving." "I should feel a fizzing or burning sensation."

"I should feel a fizzing or burning sensation."

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

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

A nurse is giving discharge instructions to a client receiving nitroglycerin for angina. The nurse recognizes the client needs additional information when the client makes what statement?

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

A 52-year-old client who exerienced 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?

"I will take three nitroglycerin tablets 5 minutes apart, and if I do not have any relief I will seek emergency care immediately."

A client is diagnosed with erectile dysfunction. He asks what effect sildenafil (Viagra) has because he is taking nitroglycerin for chest pain. What is the best explanation for why nitrates are contraindicated with sildenafil?

"The combination can cause a severe decrease in blood pressure."

A client is diagnosed with angina pectoris. What would the nurse include when explaining this condition to the client?

"The heart muscle isn't getting enough oxygen"

A client is using nitroglycerin in translingual spray form. The nurse would inform the client that the drug would begin working within which time frame

1-3 minutes

Oral hypoglycemic

A drug that reduces blood sugar; used in the treatment of Type II diabetes

A 75-year-old client is being treated for type 2 diabetes, hypertension, gout, angina, coronary arter disease, and peptic ulcer disease. The nurse is concerned because the client is taking a traditional antianginal drug in combination with seven other medications. The nurse understands that what could be the consequence?

A greater incidence of adverse drug effects

A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which action should the nurse do first when he reports chest pain.

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

When a client is prescribed nitroglycerin transdermal spray, what instructions should the nurse provide the client concerning how to administer the spray

Administer the spray as soon as chest pain develops

-olol

Beta Blocker

Following the administration of a scheduled dose of 50-mg atenolol PO, the nurse should prioritize what assessment?

Blood pressure

The client is taking a calcium channel blocker. Which assessment findings would the nurse expect? Palpitations Restlessness Vomiting Bradycardia

Bradycardia

A client with a long-standing diagnosis of asthma is prescribed a beta-blocker for treatment of angina. The nurse should consequently prioritize assessment for what health problem?

Bronchospasm

The 47-year-old client is experiencing chest pain and has taken three sublingual nitroglycerin tablets, but the pain remains. What should the client do next?

Call 911

Which would be important to do when administering nitroglycerin transbuccally Have the patient wave the capsule under the nose Place the tablet under the tongue Check the inside of the cheeks for ulcers or breakdown Have the patient chew the tablet before swallowing

Check the inside of the cheeks for ulcers or breakdown

After teaching a group of students about angina, the instructor determines that the teaching was successful when the sudents describe stable angina as:

Chest pain that is relieved by rest

Ms. Quinn is admitted to the surgical intensive care unit after open heart surgery. The physician prescribes IV nitroglycerin, according to a hospital protocol for titration of the drug. Which factor would be most important when determining increases or decreases in the dose?

Current blood pressure

A patient has been prescribed a beta-adrenergic blocker to help control angina. What effect might the patient experience as a result of the drug therapy?

Decreased cardiac output

A client with angina is prescribed atenolol. Following absorption of the drug, the nurse should monitor the client for what desired effect?

Decreased heart rate

The chest pain and pressure a client experiences during an anginal attack is caused by which of the following? Decreased workload on the heart Vasodilation of the arteries around the heart Increased oxygen supply to the heart Decreased oxygen supply to the heart

Decreased oxygen supply to the heart

A client is diagnosed with atherosclerosis. What would the nurse say is the most likely cause of his angina? A reduction in plaque secondary to atherosclerosis Decreased musculature of the myocardium related to plaque Decreased oxygenation to the myocardium Hypertension of the myocardium

Decreased oxygenation to the myocardium

Beta Blocker

Decreases Heart rate and dialates arteries by blocking beta receptors

The nurse is providing education to a client who has been prescribed bisoprolol. During teaching, the nurse explains that the drug achieves a therapeutic effect in what way?

Decreasing heart rate

Beta-adrenergic blocking agents decrease the oxygen demands of the heart by what mechanism

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

Beta-adrenergic blocking agents decrease the oxygen demands of the heart by what mechanism?

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

A nurse is caring for a patient with chronic angina. The patient is receiving ranolazine (Ranexa) 500 mg PO bid. Which sign or symptom would the nurse attribute to being a common adverse effect of this medication? Bradycardia Perspiring skin that is cold to the touch Diarrhea Dizziness

Dizziness

A male client does not respond to traditional treatment for his chronic angina. The health care provider orders ranolazine (Ranexa) and orders a baseline ECG prior to medication administration. Three months later, the health care provider orders a repeat ECG. For what reason is the provider monitoring the client? Dose-dependent ST elevation Dose-dependent QT prolongation Dose-dependent premature ventricular beats Dose-dependent ectopic beats

Dose-dependent QT prolongation

Antihyperlipidemic

Drugs used to lower high levels of cholesterol

A current patient, an overweight, 61-year-old man with a history of diabetes mellitus, is status post-MI 1 month and has returned for his cardiology follow-up. Included with his dietary changes, the cardiologist recommended which nonpharmacological lifestyle changes to reduce microvascular changes?

Glucose control

A client with diabetes is prescribed propranolol. For what should the client be assessed? Hypercholesterolemia Hypermagnesemia Hypoglycemia Hypocalcemia

Hypoglycemia

A health care provider has prescribed sublingual nitroglycerin and the nitroglycerin patch for a client. When the nurse explains the medications to the client, what advantage of the patch might the nurse mention?

It has a longer duration of action than sublingual tablets

After teaching a group of students about drugs used as antianginal agents, the instructor determines that the teaching was successfull when the students identify which as a beta-blocker antianginal agent?

Nadolol

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

Nicardipine

The nurse is performing a history for a black client that is concerned about developing coronary artery disease since it "runs in the family." What risk factor, that is modifiable, does the nurse identify when taking the history?

Obese 40% over total body weight

A patient is using propranolol for treatment of angina. The nurse understands that this drug is administered by which route?

Oral

What drug is used for long-term management of angina pectoris caused by atherosclerosis?

Propranolol (Inderal)

What effect, if any, would extensive facial and oral trauma have on a clint's sublingual nitroglycerin therapy prescribed to manage the angina?

Route changed to transdermal

While teaching a patient about sublingual nitroglycerin, the nurse explains proper use and storage. When the patient asks whether the medication ever expires, the nurse should respon that it:

Should be replaced every six months

What should the nurse tell the client about storage of oral nitroglycerin products? (Select all that apply.)

Store oral nitroglycerin with the container lid tightly sealed. Store oral nitroglycerin in the original container. Store oral nitroglycerin away from light exposure

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

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

A recent episode of chest pain while doing yard work prompted a 70-year-old man to seek care and he has been subsequently diagnosed with chronic stable angina. The nurse should recognize what guiding principle in the treatment of this patient's angina?

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

The nurse is evaluating the effectiveness of flavoxate (Urispas). Which report by the patient indicates the drug has been effective? a. "I slept uninterrupted through the night." b. "I have reddish-orange urine." c. "I have been constipated recently." d. "I use hard candy for my dry mouth."

a. "I slept uninterrupted through the night."

A nurse is describing the reasons why more women than men are affected by cystitis. Which would the nurse identify as a major reason? a. "The urethra exits into an area rich in gram-negative bacteria." b. "A woman's bladder stretches to accommodate more urine." c. "A woman's urine has a tendency to be more alkaline." d. "The urethra doesn't have the protection of the prostate gland."

a. "The urethra exits into an area rich in gram-negative bacteria."

A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman? a. "You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued." b. "You'll likely find that you have scant amounts of blood in your urine for the first few days, but this is not unusual or problematic." c. "You'll probably need to stop taking your hormone replacement therapy when you're taking Detrol." d. "It's good to measure your heart rate before you take your Detrol each day, and withhold it if your heart rate is below 60 beats/minute."

a. "You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued."

What percentage of the total number of nephrons is estimated to be necessary to maintain healthy renal function? a. 25% b. 50% c. 75% d. 100%

a. 25%

This hormone is released by the pituitary when the sodium concentration of blood rises. a. ADH b. aldosterone c. calcitonin d. FSH

a. ADH

When a patient develops renal failure and the production of erythropoietin drops, the patient will develop: a. Anemia b. Leukemia c. Hypertension d. Diabetes

a. Anemia

A patient with benign prostatic hypertrophy is receiving treatment with finasteride (Proscar). What is an appropriate patient instruction? a. Do not let your wife handle the pills. b. You may donate blood every 3 months. c. Your libido may be increased by this drug. d. Enhance the drug with saw palmetto.

a. Do not let your wife handle the pills

A nurse is seeing a client who has been prescribed phenazopyridine in combination with an antibacterial medication to treat a urinary tract infection. What is important for the nurse to tell the client about this treatment? a. Do not take this medication for more than two days b. It is normal for the urine to contain some blood with this medication c. Loss of appetite is likely when taking this medication d. If taken incorrectly, a bacterial superinfection can result

a. Do not take this medication for more than two days

A patient using an oxybutynin patch must change the patch daily. T/F a. False b. True

a. False

The three major classes of drugs used to control blood lipids are statins, bile acid resins (or sequestrants), and fibrates. Which is a fibrate? a. Gemfibrozil b. Colestipol c. Colesevelam d. Cholestyramine

a. Gemfibrozil

The nurse is evaluating the effectiveness of drug therapy in a client with hyperlipidemia. Effective therapy is best demonstrated by which laboratory values? a. HDL 58 LDL 96 Cholesterol 178 b. HDL 78 LDL 115 Cholesterol 189 c. HDL 82 LDL 96 Cholesterol 240 d. HDL 58 LDL 115 Cholesterol 210

a. HDL 58 LDL 96 Cholesterol 178

Which factors would predispose a female child to urinary tract infections? Select all that apply. a. History of congenital bladder conditions b. Wiping back to front after using the toilet c. Taking daily showers instead of a bath d. Evidence of recent sexual abuse e. Wearing cotton underwear

a. History of congenital bladder conditions b. Wiping back to front after using the toilet d. Evidence of recent sexual abuse

A nurse should not administer solifenacin (Vesicare) to a patient with which medical condition? a. Myasthenia gravis b. Parkinson's disease c. Huntington's disease d. Graves' disease

a. Myasthenia gravis

A nurse educating a client on nitrofurantoin should warn the client about which common gastrointestinal adverse reactions? (Select all that apply.) a. Nausea b. Diarrhea c. Ileus d. Toxic megacolon e. Anorexia

a. Nausea b. Diarrhea e. Anorexia

The nurse is caring for an older adult. What is the primary nursing intervention to increase fluid intake in older adults? a. Offer a variety of fluids to the client every hour. b. Ambulate the client every four hours to encourage thirstiness. c. Place a pitcher of water at the client's bedside. d. Increase the client's intake of salty foods.

a. Offer a variety of fluids to the client every hour.

Which is released in response to a decrease in blood flow to the nephron? a. Renin b. Aldosterone c. Calcium d. Angiotensinogen

a. Renin

Which is an appropriate intervention for a side effect of a urinary antispasmodic medication? a. Suck on ice or hard candy to treat dry mouth. b. Reduce fluid intake to avoid nocturia. c. Take milk of magnesia daily to control constipation. d. Use caffeinated drinks to prevent drowsiness.

a. Suck on ice or hard candy to treat dry mouth.

A patient with metabolic syndrome usually has increased plasminogen activator levels. a. True b. False

a. True

The nurse is providing care for a client with an enlarged prostate gland. What assessment finding should the nurse attribute to this problem? a. Urinary hesitancy and frequency b. Hyperkalemia and hyponatremia c. Edema and fluid volume excess d. Hematuria

a. Urinary hesitancy and frequency

Which adverse effects might be experienced by a patient taking an antispasmodic? Select all that apply. a. Vomiting b. Blurred vision c. Bradycardia d. Diarrhea e. Dizziness

a. Vomiting b. Blurred vision e. Dizziness

A bile acid sequestrant is the drug of choice for a client who has which conditions? (select all that apply) a. A high LDL concentration b. A high triglyceride concentration c. Biliary obstruction d. Vitamin K deficiency e. A high HDL concentration f. Intolerance to statins

a. a high LDL concentration f. Intolerance to statins

Coronary artery disease results in a. an imbalance in cardiac muscle oxygen supply and demand. b. delivery of blood to the heart muscle during systole. c. increased pulse pressure. d. a decreased workload on the heart.

a. an imbalance in cardiac muscle oxygen supply and demand

Which of these ions plays an important role in pH homeostasis? a. bicarbonate b. potassium c. chloride d. sodium

a. bicarbonate

When describing the action of antianginal drugs to a patient, which would the nurse include? (select all that apply) a. Decrease the workload on the heart b. Increase the supply of oxygen to the heart c. Change the metabolic pathway in the heart muscle to remove the need for oxygen d. Restore the supply-and-demand balance of oxygen in the heart e. Decrease venous return to the heart f. Alter the coronary artery filling pathway

a. decrease the workload on the heart b. increase the supply of oxygen to the heart d. restore the supply-and-demand balance of oxygen in the heart e. decrease venous return to the heart

A client is prescribed phenazopyridine. In addition to informing the client that the drug can cause a change in urine color, the nurse would tell the client that which may also change color? a. fluid lubricating the eyes b. nail beds c. facial color d. tooth enamel

a. fluid lubricating the eyes

A nurse is caring for a client prescribed nicotinic acid for hyperlipidemia. The nurse would assess the client for which findings as a possibility? a. Flushing of the skin b. Weakness c. Tachycardia d. Dyspnea

a. flushing of the skin

A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of: a. muscle pain. b. dry mouth. c. pruritus (itching) d. increased thirst.

a. muscle pain

An acute myocardial infarction is usually associated with which conditions? (select all that apply) a. Permanent injury to the heart muscle b. Potentially serious arrhythmias c. Pain d. The development of hypertension e. Loss of consciousness f. A feeling of anxiety

a. permanent injury to the heart muscle b. potentially serious arrhythmias c. pain f. a feeling of anxiety

The students are studying the male reproductive system. The instructor tells the students that in the male, the urethra leaves the urinary bladder and passes through the: a. prostate gland. b. vas deferens. c. renal calyx. d. renal cortex.

a. prostate gland

The outer portion of the kidney is called the a. renal cortex b. adrenal medulla c. renal medulla d. adrenal cortex

a. renal cortex

Teaching a client who is prescribed an HMG-CoA reductase inhibitor to treat high cholesterol and high lipid levels should include which information? (select all that apply) a. The importance of exercise b. The need for dietary changes to alter cholesterol levels c. That taking a statin will allow a full, unrestricted diet d. That drug therapy is always needed when these levels are elevated e. The importance of controlling blood pressure and blood glucose levels f. That stopping smoking may also help to lower lipid levels

a. the importance of exercise b. the need for dietary changes to alter cholesterol levels e. the importance of controlling blood pressure and blood glucose levels f. that stopping smoking may also help to lower lipid levels

The renal pelvis drains directly into the a. ureter b. urethra c. bladder d. urinary calyces

a. ureter

Treating angina involves modifying factors that could decrease myocardial oxygen consumption. It could be expected that this might include (select all that apply) a. weight loss. b. use of nitrates. c. use of angiotensin-converting enzyme inhibitors. d. activity modification. e. use of a piperazine acetamide agent. f. use of a calcium channel blocker.

a. weight loss b. use of nitrates d. activity modification e. use of a piperazine acetamide agent f. use of a calcium channel blocker

Calcium channel blockers

agents that inhibit the entry of calcium ions into heart muscle cells, causing a slowing of the heart rate, a lessening of the demand for oxygen and nutrients, and a relaxing of the smooth muscle cells of the blood vessels to cause dilation; used to prevent or treat angina pectoris, some arrhythmias, and hypertension

-statin

antihyperlipidemics

A 39-year-old nulliparous woman has been taking atorvastatin for 2 years and has now decided that she would like to become pregnant. What health education should the nurse provide to this client? a. "There's no evidence that atorvastatin is either safe or unsafe during pregnancy, so it's best to err on the side of caution." b. "It's important that you stop taking atorvastatin before you stop using contraception." c. "Atorvastatin is approved to be taken during pregnancy, but you would have to stop taking it if you chose to breastfeed." d. "Atorvastatin can be taken safely throughout your pregnancy since it does not cross through the placenta."

b. "It's important that you stop taking atorvastatin before you stop using contraception."

A male client who takes dutasteride for benign prostatic hypertrophy calls the clinic. He says he tried to donate blood and was denied because of his medication. The client is very concerned about this and wants to know why this happened. What is the nurse's best response to the client? a. "Have you ever given blood before? This medication may make your veins harder to access for blood donation." b. "This medication can harm a developing fetus so your blood could be harmful if given to a pregnant woman." c. "Your blood is slightly thicker while you are on this medication and the blood donation equipment is unable to handle it." d. "It is dangerous for you to give blood because this medication makes you dizzy."

b. "This medication can harm a developing fetus so your blood could be harmful if given to a pregnant woman."

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. 1/10 b. ¼ c. 1/5 d. ½

b. 1/4

The amount of fluid excreted as urine each day averages approximately less than how many liters? a. 1 L b. 2 L c. 3 L d. 4 L

b. 2 L

The formation of atheromas in blood vessels precedes the signs and symptoms of a. hepatitis. b. CAD. c. diabetes mellitus. d. chronic obstructive pulmonary disease (COPD).

b. CAD

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. Low VLDL levels b. Elevated LDL levels c. Elevated HDL levels d. A high ratio of HDL to LDL

b. Elevated LDL levels

What intervention may help the client increase HDL levels? a. Leg elevation b. Exercise c. Smoking cessation d. TED hose

b. Exercise

Which would a nurse identify as responsible for causing the release of antidiuretic hormone? a. Parasympathetic stimulation b. Falling blood volume c. Decreasing sodium levels d. Increasing potassium levels

b. Falling blood volume

A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment? a. Inspect skin and eyelids for evidence of xanthomas. b. Frequently monitor blood cholesterol. c. Obtain reports of fasting blood sugar levels. d. Take a dietary history of the patient.

b. Frequently monitor blood cholesterol.

Which structure acts as an ultra-fine filter for all the blood that flows through it? a. Renal cortex b. Glomerulus c. Renal medulla d.Bowman's capsule

b. Glomerulus

Renin and erythropoietin are produced in which structure? a. Bowman's capsule b. Juxtaglomerular apparatus c. Glomerulus d. Loop of Henle

b. Juxtaglomerular apparatus

A client has begun taking cholestyramine. Which are noted as the most common adverse effects? a. Fatigue and mental disorientation b. Nausea, flatulence, and constipation c. Hiccups, nasal congestion, and dizziness d. Increased appetite and blood pressure

b. Nausea, flatulence, and constipation

A group of students are reviewing the structure and function of the renal system. The students demonstrate understanding when they identify what as the functional unit? a. Convoluted tubule b. Nephron c. Glomerulus d. Bowman's capsule

b. Nephron

A client is to receive methenamine. The nurse anticipates administering this drug by which route? a. Intravenous b. Oral c. Intramuscular d. Subcutaneous

b. Oral

A health care provider prescribes a urinary antispasmodic as a transdermal patch. The nurse identifies this as drug as: a. Flavoxate b. Oxybutynin c. Tolterodine d. Darifenacin

b. Oxybutynin

When describing the mechanism for blood pressure control by the kidneys, which occurs first when oxygenation to the nephron is decreased? a. Vasoconstriction due to angiotensin II b. Renin release c. Activation of angiotensinogen d. Release of aldosterone

b. Renin release

What is the most serious side effect of lovastatin? a. Liver damage b. Rhabdomyolysis c. Headache d. Muscle aches

b. Rhabdomyolysis

Which nursing diagnosis is highest priority for a patient with history of urinary urgency who is taking oxybutynin (Ditropan)? a. Risk for alteration in bowel elimination b. Risk for impaired urinary elimination c. Risk for altered comfort: dry mouth d. Risk for alteration in body image

b. Risk for impaired urinary elimination

An obese client who has an elevated triglyceride level and reduced high-density lipoprotein cholesterol is seen by the primary health care provider. What do these data suggest in this client? a. The development of Tay-Sachs disease b. The development of metabolic syndrome c. The development of Reye's syndrome d. The development of arthritic syndrome

b. The development of metabolic syndrome

What is the focus of the renal system's renin-angiotensin-aldosterone system? a. The regulation of red blood cell production b. The regulation of blood pressure c. Maintaining serum calcium levels in balance d. Keeping body fluids in balance

b. The regulation of blood pressure

Prinzmetal angina occurs as a result of a. electrolyte imbalance. b. a spasm of a coronary vessel. c. decreased venous return to the heart. d. a ventricular arrhythmia.

b. a spasm of a coronary vessel

Calcium channel blockers are effective in treating angina because they a. prevent any CV exercise, preventing strain on the heart. b. block strong muscle contractions, causing vasodilation. c. alter the electrolyte balance of the heart, preventing arrhythmias. d. increase the heart rate, making it more efficient.

b. block strong muscle contractions, causing vasodilation

Recommended treatments for clients with dyslipidemia are made according to their blood levels of total and low-density lipoproteins (LDL) cholesterol and risk factors for cardiovascular disease. What does the impact of existing cardiovascular disease have on recommendations? a. has no effect on either LDL or HDL levels b. decreases target serum LDL level c. decreases target serum triglyceride level d. increases target serum high-density lipoproteins (HDL) level

b. decreases target serum LDL level

The nurse is describing the need to maintain the acidity of urine based on the understanding that this is necessary to: a. prevent loss of sphincter control. b. destroy any bacteria that may enter. c. maintain fluid balance. d. maintain peristaltic movement.

b. destroy any bacteria that may enter.

A client asks the nurse about herbal products that can help to lower serum cholesterol and triglycerides. Which herbal product would the nurse include in the response? a. Black cohosh b. Garlic c. Ginseng d. Feverfew

b. garlic

Within the kidney, the process of filtration takes place in the: a. ascending tubule b. glomerulus c. calyx d. nephron loop

b. glomerulus

Angina a. causes death of heart muscle cells. b. is pain due to lack of oxygen to myocardial cells. c. cannot occur at rest. d. is not treatable.

b. is pain due to lack of oxygen to myocardial cells

Blood calcium levels are increased by a. aldosterone b. parathyroid hormone c. antidiuretic hormone d. calcitonin

b. parathyroid hormone

HMG-CoA reductase inhibitors work in the a. process of bile secretion. b. process of cholesterol formation in the cell. c. intestinal wall to block fat absorption. d. kidney to block fat excretion.

b. process of cholesterol formation in the cell

A client with a urinary tract infection (UTI) has a new prescription for nitrofurantoin. The nurse would question this order if the client has a history of: a. chronic UTI. b. renal dysfunction. c. hypertension. d. glaucoma.

b. renal dysfunction

The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which? a. pruritis. b. rhabdomyolysis. c. cholecystitis. d. cholelithiasis.

b. rhabdomyolysis.

Which way that the body uses cholesterol stated by a community group indicates that the group has understood teaching about cholesterol? a. The production of water-soluble vitamins b. The formation of steroid hormones c. The mineralization of bones d. The development of dental plaques

b. the formation of steroid hormones

A nurse is conducting a presentation for a local community group about hyperlipidemia. When discussing the factors that individuals can work on to reduce their risk, which information would the nurse include? Select all that apply. a. Age b. Weight c. Family history d. Diet e. Gender

b. weight d. diet

A client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating: a. "I need to take both drugs at the same time of the day." b. "I'll take the digoxin about 15 minutes before the cholestyramine." c. "I will take the digoxin about an hour before the cholestyramine." d. "I'll take the cholestyramine at 8 AM and the digoxin at 9 AM."

c. "I will take the digoxin about an hour before the cholestyramine."

A client is receiving niacin as part of therapy for hyperlipoproteinemia. The nurse would explain that the lipid levels will usually begin to drop in approximately which amount of time? a. 7 to 10 days b. 3 to 5 days c. 5 to 7 days d. 10 to 14 days

c. 5 to 7 days

A nurse is planning care for a client who is taking tolterodine. Which is an appropriate nursing diagnosis that is an indication for using this drug? a. Risk for Deficient Fluid Volume related to the action of the drug b. Risk for Injury related to multiple drug therapies and drug interactions c. Altered Urinary Elimination related to overactive bladder d. Risk for Injury related to hyperkalemia secondary to use of the drug

c. Altered Urinary Elimination related to overactive bladder

A nurse is planning care for a client who is taking tolterodine. Which is an appropriate nursing diagnosis that is an indication for using this drug? a. Risk for Injury related to multiple drug therapies and drug interactions b. Risk for Deficient Fluid Volume related to the action of the drug c. Altered Urinary Elimination related to overactive bladder d. Risk for Injury related to hyperkalemia secondary to use of the drug

c. Altered Urinary Elimination related to overactive bladder

The nurse cautions the client taking methenamine (Urex) for chronic, bacterial urinary tract infections to avoid using antacids that contain sodium bicarbonate. Why? a. Because of the increased risk for bleeding b.To decrease gastric emptying and increase absorption of methenamine c. Because the effectiveness of methenamine is decreased d. To avoid renal damage

c. Because the effectiveness of methenamine is decreased

A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for: a. Liver failure b. Abdominal pain c. Bleeding d. Cataract development

c. Bleeding

A patient with atrial fibrillation is receiving warfarin therapy. The patient is also prescribed ezetimibe. The nurse would instruct the patient to watch for: a. Blurred vision b. Yellowing of the skin c. Blood in urine or stool d. Abdominal pain

c. Blood in urine or stool

Which drug is most effective in reducing serum triglyceride levels? a. Niacin b. HMG-CoA reductase inhibitors c. Fibrates d. Bile acid sequestrants

c. Fibrates

What term is used to describe the process that moves fluid and small particles out of the blood through the glomerulus and into the nephron tubule a. Excretion b. Secretion c. Filtration d. Reabsorption

c. Filtration

Which would lead a nurse to suspect that a client most likely has pyelonephritis? a. Urgency b. Dysuria c. Flank pain d. Urinary frequency

c. Flank Pain

The pharmacology instructor is discussing medications used in the treatment of dyslipidemia. Which drug class would the instructor identify as the most widely used dyslipidemia drugs? a. Fibrates b. Niacin c. HMG-CoA reductase inhibitors d. Bile acid sequestrants

c. HMG-CoA reductase inhibitors

Which lipid level would the nurse interpret as being high? a. Triglyceride level of 160 mg/dL b. Total cholesterol of 200 mg/dL c. LDL cholesterol of 190 mg/dL d. HDL cholesterol of 48 mg/dL

c. LDL cholesterol of 190 mg/dL

Which agent would the nurse identify as inhibiting the release of free fatty acids from adipose tissue? a. Gemfibrozil b. Fenofibrate c. Niacin d. Fenofibric acid

c. Niacin

Which would be most important prior to beginning therapy with a urinary anti-infective agent? a. Assessing the usual urinary pattern b. Inspecting the skin for rashes c. Obtaining a urine culture and sensitivity test d. Assessing client's level of orientation

c. Obtaining a urine culture and sensitivity test

What would a nurse expect to be prescribed for a patient experiencing bladder spasms? a. Alfuzosin b. Phenazopyridine c. Oxybutynin d. Nitrofurantoin

c. Oxybutynin

Which would the nurse expect the healthcare provider to prescribe for a patient who has high lipid levels and cannot take fibrates or HMG-CoA reductase inhibitors? a. Nicotine b. Vitamin C c. PCSK9 inhibitor d. Nitrates

c. PCSK9 inhibitor

The nurse is caring for a client with a nursing diagnosis of "Impaired urinary elimination related to discomfort of urinary tract infection." Which medication will provide comfort to this client? a. Fosfomycin b. Nitrofurantoin c. Phenazopyridine d. Sulfamethoxazole

c. Phenazopyridine

A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters? a. Nephron b. Glomerulus c. Renal pelvis d. Parenchyma

c. Renal pelvis

The nurse is caring for a client being treated for urosepsis. The client's medication regimen includes phenazopyridine. What outcome best indicates therapeutic effects of this medication? a. The client's urine remains free of blood b. The client has two consecutive urine cultures that are negative c. The client reports an absence of urinary burning and pain d. The client's urine output is ≥ 1250 mL/24 hours

c. The client reports an absence of urinary burning and pain

What best describes the structure of the kidneys? a. The cortical nephrons concentrate urine. b. The renal arteries arise from the renal cortex. c. The renal pelvises drain urine into the ureters. d. The glomerulus produces erythropoietin.

c. The renal pelvises drain urine into the ureters.

After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic? a. Fasting blood glucose below 110 mg/dL b. Blood pressure below 130/85 mm Hg c. Triglyceride level above 150 mg/dL d. Waist measurement over 40 inches in women

c. Triglyceride level above 150 mg/dL

Hyperlipidemia is considered to be a. a normal finding in adult males. b. related to stress levels. c. a treatable CAD risk factor. d. a side effect of cigarette smoking.

c. a treatable CAD risk factor

The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin? a. increased appetite and blood pressure. b. fatigue and mental disorientation. c. headache and flatulence. d. hiccups, sinus congestion, and dizziness.

c. headache and flatulence.

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. Hypertension b. Glaucoma c. Heart disease d. Diabetes

c. heart disease

What health problems contraindicate the use of fibrates for the treatment of dyslipidemia? Select all that apply. history of venous thromboembolism a. ischemic heart disease b. diabetes mellitus c. liver disease d. chronic renal failure

c. liver disease d. chronic renal failure

The part of the nephron that drains into the nephron loop is the a. glomerular capsule b. afferent arteriole c. proximal tubule d. collecting duct

c. proximal tubule

Which would the nurse include when teaching a patient about HMG-CoA reductase inhibitors? a. The patient will not have a heart attack. b. The patient will not develop CAD. c. The patient might develop cataracts as a result. d. The patient might stop absorbing fat-soluble vitamins.

c. the patient might develop cataracts as a result

A client who has nitroglycerin to avert an acute anginal attack would need to be taught (select all that apply) a. to take five or six tablets and then seek medical help if no relief occurs. b. to buy the tablets in bulk to decrease the cost. c. to protect tablets from light and humidity. d. to store the tablets in a clearly marked, clear container in open view. e. to use the nitroglycerin before an event or activity that will most likely precipitate an anginal attack. f. to discard them if they do not fizzle when placed under the tongue.

c. to protect tablets from light and humidity e. to use the nitroglycerin before an event or activity that will most likely precipitate an anginal attack f. to discard them if they do not fizzle when placed under the tongue

A client comes to the clinic complaining of dysuria and frequency. The nurse practitioner suspects that the client is experiencing a UTI. Before instituting anti-infective therapy, which laboratory testing would be most important? a. serum sodium level b. white blood cell count c. urine culture and sensitivity d. urine glucose evaluation

c. urine culture and sensitivity

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calcium channel blockers

A client has been taking a urinary tract anti-infective for two days for treatment of a severe urinary tract infection. Today, the client calls the clinic reporting continued burning on urination. What is the nurse's best response? a. "The medication is not working. Stop taking it and drink cranberry juice." b. "All of your urinary symptoms should have stopped immediately after you started taking the medication. Are you sure you are taking it correctly?" c. "You must have a very severe infection. Come back to the clinic and we will give you your medication intravenously." d. "Burning on urination is a common side effect of these drugs. This may continue the entire time that you are on the medication."

d. "Burning on urination is a common side effect of these drugs. This may continue the entire time that you are on the medication."

A 58-year-old man has recently been prescribed atorvastatin (Lipitor) in an effort to reduce his cholesterol levels. The man has acknowledged the potentially harmful effects of hyperlipidemia and is motivated to make changes to resolve this health problem. What advice should the nurse give to this client? a. "Try to get most of your food energy from protein sources rather than carbohydrates." b. "A low-fat diet is a good idea, and the animal sources of fat are always preferable to plant sources." c. "I'll give you the names of some salt substitutes that you can start using to season your food." d. "It's a good idea to keep your intake of saturated fat to a bare minimum."

d. "It's a good idea to keep your intake of saturated fat to a bare minimum."

A daughter is talking with the urologist who is caring for the woman's 78-year-old mother. The mother has multiple sclerosis and has lost control of her bladder. The young woman asks the urologist what made her mother become incontinent. What would be the urologist's best answer? a. "I don't know, but there are lots of medicines we can try to fix it." b. "Your mother's age has a lot to do with it." c. "This happens sometimes, and no one is quite sure why." d. "Once control of the bladder is learned, you must have a functioning nervous system to maintain it."

d. "Once control of the bladder is learned, you must have a functioning nervous system to maintain it."

Which would lead to a release of aldosterone? a. Parasympathetic stimulation b. Low potassium levels c. Natriuretic hormone d. Angiotensin III

d. Angiotensin III

A nurse is caring for a hospitalized client with a urinary tract infection (UTI). The nurse is preparing to administer nitrofurantoin, which is a bacteriostatic antibiotic. Which statement best differentiates bacteriostatic and bactericidal medications? a. Bacteriostatic medications destroy bacteria. b. Bactericidal medications preserve bacteria growth. c. Bactericidal medications improve the destruction of bacteria. d. Bacteriostatic medications slow or retard the multiplication of bacteria.

d. Bacteriostatic medications slow or retard the multiplication of bacteria.

A nurse would question an order for which drug if the patient was also receiving verapamil? a. Oral contraceptives b. Cyclosporine c. Digoxin d. Barbiturate anesthetics

d. Barbiturate anesthetics

Which would be classified as a bile acid sequestrant? a. Ezetimibe b. Gemfibrozil c. Lovastatin d. Cholestyramine

d. Cholestyramine

A client asks the nurse what the atorvastatin (Lipitor) prescribed for the client will do. What is an expected outcome for this client? a. Decrease in serum cholesterol only b. Decrease in campesterol and LDL levels c. Decrease in sitosterol and serum cholesterol d. Decrease in serum cholesterol and LDL levels

d. Decrease in serum cholesterol and LDL levels

A client is seeking treatment for bladder spasms causing dysuria and urgency. Which clinical condition identified in the client's medical history will serve to contraindicate treatment with a urinary tract antispasmodic medication? a. Currently pregnant b. Diabetes c. Chronic hypertension d. Glaucoma

d. Glaucoma

The nurse instructs a client to take the prescribed pravastatin at bedtime based on understanding that: a. Lack of dietary intake during sleep increases absorption. b. Compliance is enhanced with nighttime administration. c. Adverse effects are less likely during the night. d. Greater drug effectiveness is achieved at this time.

d. Greater drug effectiveness is achieved at this time.

What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism? a. His sedentary lifestyle b. His waist size c. His alcohol intake d. His dietary intake of saturated fat

d. His dietary intake of saturated fat

Which drug would the nurse identify as turning a client's urine reddish orange? a. Norfloxacin b. Oxybutynin c. Solifenacin d. Phenazopyridine

d. Phenazopyridine

For which disorder would treatment with an anti-infective be appropriate? a. Overactive bladder b. Benign prostatic hypertrophy c. Urinary spasms d. Pyelonephritis

d. Pyelonephritis

The clinic nurse admitting a 39-year-old female who reports left-sided tenderness, fever, chills, and flank pain. What does the nurse suspect the patient has? a. Cystitis b. Kidney stones c. Neurogenic bladder d. Pyelonephritis

d. Pyelonephritis

A client who takes digoxin for heart failure is also prescribed trospium. The nurse would monitor the client closely for: a. Changes in urine color b. Excess anticholinergic effects c. Increased central nervous system effects d. Signs of digoxin toxicity

d. Signs of digoxin toxicity

What should the nurse suggest to assist a client to improve his cholesterol levels? a. Limit exercise to the weekends b. Weight lifting c. Diet high in polysaturated fats d. Smoking cessation

d. Smoking cessation

Which substance acts to increase blood pressure by inducing vasoconstriction? a. erythropoietin b. ADH c. atrial natriuretic peptide d. angiotensin II

d. angiotensin II

Which would a nurse identify as a carrier for small units of fats? a. Cholesterol b. Bile acids c. Micelles d. Chylomicrons

d. chylomicrons

The glomerulus is a: a. collecting area for urine b. triangular section in the kidney c. type of diagnostic test d. cluster of capillaries that filters blood e. flared portion of the ureter

d. cluster of capillaries that filters blood

Nitrates are commonly used antianginal drugs that act to a. increase the preload on the heart. b. increase the afterload on the heart. c. dilate coronary vessels to increase the delivery of oxygen through those vessels. d. decrease venous return to the heart, decreasing the myocardial workload.

d. decrease venous return to the heart, decreasing the myocardial workload

In addition to being synthesized in the liver and intestine, from where are blood lipids derived? a. exercise b. kidneys c. medications d. diet

d. diet

After teaching a group of students about fats and biotransformation, the instructor determines that the teaching was successful when the students identify what as the storage location of bile acids? a. Stomach b. Liver c. Small intestine d. Gallbladder

d. gallbladder

Which would alert the nurse to suspect that a patient receiving HMG-CoA reductase inhibitors is developing rhabdomyolysis? a. Flatulence and abdominal bloating b. Increased bleeding and bruising c. The development of cataracts and blurred vision d. Muscle pain and weakness

d. muscle pain and weakness

The bile acid sequestrants a. are absorbed into the liver. b. take several weeks to show an effect. c. have no associated adverse effects. d. prevent bile salts from being reabsorbed.

d. prevent bile salts from being reabsorbed

The health care provider has ordered phenazopyridine to a client with a urinary tract infection as a urinary analgesic. The client has also been prescribed an anti-infective. The client may use the phenazopyridine for what duration? a. one day b. Entire course of treatment with anti-infective c. 12 hours d. two days

d. two days

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

no episodes of angina since ointment was initiated.

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oral hypoglycemic