Pharmacology exam 3 practice

The nurse reviews lab studies of a client receiving digoxin (Lanoxin). Intervention by the nurse is required if the results include a Serum sodium level of 140 mEq/L. Serum digoxin level of 1.2 ng/dL. Serum potassium level of 3.0 mEq/L. Hemoglobin 14.4 g/dL.

Serum potassium level of 3.0 mEq/L. Rationale: Normal serum potassium level is 3.5-5.0 mEq/L. Hypokalemia may predispose the client to digitalis toxicity. The other lab values are WNL.

Lisinopril (Prinivil) is part of the treatment regimen for a client with HF. The nurse monitors the client for which electrolyte imbalance of this drug? Hyponatremia Hyperkalemia Hypokalemia Hypernatremia

Hyperkalemia Rationale: ACE inhibitors block aldosterone secretion, which results in sodium loss and potassium retention. Hyperkalemia may occur, especially when the drug is taken concurrently with potassium-sparing diuretics.

When caring for a client receiving triamterene (Dyrenium), the nurse places priority on which nursing intervention? Monitor electrolytes for hyperkalemia. Monitor electrolytes for hypernatremia. Monitor heart rate closely. Monitor blood pressure closely.

Monitor electrolytes for hyperkalemia. Rationale: triameterene is a potassium-sparing diuretic. The client should be monitored for signs of hyperkalemia.

2 A middle-aged woman is experiencing severe vertigo. The nurse expects this patient will receive which drug, which is considered the most appropriate drug treatment for vertigo/motion sickness?

a meclizine (Antivert)

A patient is undergoing chemotherapy. When giving antiemetics like Ondansetron, the nurse will remember that these drugs are most effective against nausea when given at which time? a. Before meals b. At bedtime c. Before the chemotherapy begins d. Just after the chemotherapy begins

c. Before the chemotherapy begins

A nurse is administering a dopamine infusion at a moderate dose to a client who has severe HF. Which of the following is an expected effect? 1. Lowered heart rate 2. Increased myocardial contractility 3. Decreased conduction through the AV node D. Vasoconstriction of the renal blood vessels

2. Increased myocardial contractility -- thus increasing CO

A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select all that apply. 2. Ranitidine (Zantac) 3. Famotidine (Pepcid) 4. Cimetidine (Tagamet) 5. Esomeprazole (Nexium) 6. Lansoprazole (Prevacid)

2. Ranitidine (Zantac) 3. Famotidine (Pepcid) 4. Cimetidine (Tagamet) Rationale: H2-receptor antagonists suppress secretion of gastric acid, alleviate symptoms of heartburn, and assist in preventing complications of peptic ulcer disease. These medications also suppress gastric acid secretions and are used in active ulcer disease, erosive esophagitis, and pathological hypersecretory conditions. The other medications listed are proton pump inhibitors.

An older client recently has been prescribed metoclopramide. The nurse monitors the client for which most frequent central nervous system side effect of this medication? 1. Tremors 2. Dizziness 3. Confusion 4. diarrhea

3. Confusion, Monitor for EPS and NMS, elderly patients may act crazy on this drug

A nurse in a provider's office is monitoring serum electrolytes for 4 older adult clients who take digoxin(Lanoxin) & furosemide(Lasix). Which of the following electrolyte values puts a client at risk for dig toxicity? 1. Calcium 9.2 mg/dL 2. Calcium 10.3 mg/dL 3. Potassium 2.4 mEq/L 4. Potassium 4.8 mEq/L

3. Potassium 2.4 mEq/L

For a patient receiving a positive inotropic drug, which nursing assessments should be performed? (Select all that apply.) A. Check apical pulse. B. Obtain daily weights. C. Auscultate lung sounds. D. Monitor serum electrolytes. E. Review red blood cell count.

A, B, C, D

which is the most common upper GI problem? " 1. peptic ulcer disease 2. Crohns 3. Gerd 4. ulcerative colitis

Answer 3, Gerd is the only upper GI problem

"The nurse determines that a patient has experienced the beneficial effects of medication therapy with famotidine (Pepcid) when which of the following symptoms is relieved? " A) Nausea B) Belching C) Epigastric pain D) Difficulty swallowing

Answer C, "Famotidine is an H2-receptor antagonist that inhibits parietal cell output of HCl acid and minimizes damage to gastric mucosa related to hyperacidity, thus relieving epigastric pain

5. Which of the following drugs is a histamine blocker and reduces levels of gastric acid?" A. Omeprazole (Prilosec) B. Metoclopramide (Reglan) C. Cimetidine (Tagamet) D. Aluminum Hydroxide gel

Answer C, Cimetidine bind to H2 in the tissue and decreases the production of gastric acid

Caffeinated beverages and smoking are risk factors to assess for in the development of what condition? A. Duodenal ulcers B. Peptic ulcers C. Helicobacter pylori D. Esophageal reflux

Answer: B PUD risk factors include family history, blood group O, smoking tobacco, and beverages containing caffeine

The family member caring for a client with Parkinson's disease at home notifies the nurse that the client is demonstrating extrapyramidal symptoms. The nurse should instruct the caregiver to: a. Give diphenhydramine (Benadryl) 25 mg p.o. b. Transport the client to the Emergency Department. c. Increase dosage of antiparkinsonism drugs. d. Make an appointment with the health care provider for evaluation.

Answer: b. Transport the client to the Emergency Department. Rationale: The symptoms can cause severe muscle spasms and can be life-threatening without intervention. The client should be transported to the Emergency Department. Diphenhydramine must be given parenterally for effective treatment.

The nurse is giving medication to reduce nausea. Which antiemetic drug class is commonly known to cause drying of secretions and drowsiness when given? (can't see can't spit)

Anticholinergics

Which drug class is used to treat both hypertension and antidysrhythmias? A. Sodium channel blockers B. Calcium channel blockers C. Direct-acting vasodilators D. Alpha-adrenergic-blocking

B adverse effects of procanimide/lidocaine is hypotension, bradycardia, asystole

For patients prescribed amiodarone (Cordarone), the nurse should monitor for which potential adverse effects of this drug? (Select all that apply.) A. Diarrhea B. Visual halos C. Blue gray skin discoloration D. Photosensitivity E. Overgrowth of gum tissue

B, C, D eye exams are needed about every 6 months, patients can get a blue tinted nose/eye area discoloration, and they can be sensitive to light

In developing a plan of care for a patient receiving an antihistamine antiemetic drug, which nursing diagnosis would be of highest priority? A. Deficient knowledge regarding medication administration B. Deficient fluid volume related to nausea and vomiting C. Risk for injury related to side effects of medication D. Anxiety related to nausea and vomiting

B. Deficient fluid volume related to nausea and vomiting R: Although all of the options are appropriate nursing diagnoses, fluid volume deficit is the highest priority because it has the highest associated mortality rate. Although a fall or injury could also prove fatal, this diagnosis is a risk; actual nursing diagnoses have priority over potential diagnoses.

The nurse recognizes what as the most adverse effect of digoxin? A) Hypokalemia B) Dysrhythmias C) Hyperglycemia D) Esophageal erosion

B. Dysrhythmias

The nurse provides nutritional counseling for a client receiving levodopa. The client should be encouraged to: a. Lower the intake of simple carbohydrates. b. Increase vitamin B6 intake. c. Take the drug right after a meal d. Decrease intake of dairy products.

C minimizes GI side effects

A patient prescribed digoxin (Lanoxin) 0.25 mg and furosemide (Lasix) 40 mg for the treatment of systolic heart failure states, "I am starting to see yellow halos around lights." Which action will the nurse take? A. Perform a visual acuity test on each eye. B. Document the finding and reassess in 1 hour. C. Assess for other symptoms of digoxin toxicity. D. Prepare to administer digoxin immune fab (Digifab).

C dizziness, palpitations, visual disturbances all indicate dig toxicity and should be assessed first. Serum values would be higher than 2ng/mL and the nurse should then administer digoxin immune Fab (Digibind)

The nurse is caring for a patient prescribed amiodarone (Cordarone). The nurse knows the MOST serious adverse effect of this medication can occur in which body system? A. Nervous B. Immune C. Respiratory D. Gastrointestinal

C long term use can lead to stiff lungs, pulmonary toxicity and increased issues of CHF. Combining amiodarone with a beta blocker, verapamil, or diltiazem can severely decrease the heart rate leading to respiratory distress, ARDS, pulmonary fibrosis, heart failure

When planning to administer metoclopramide (Reglan), the nurse is aware that this drug must be given A. with food to decrease gastrointestinal upset. B. every 6 hours around the clock. C. 30 minutes before meals and at bedtime. D. with a full glass of water first thing in the morning.

C. 30 minutes before meals and at bedtime. R: Metoclopramide should be administered 30 minutes before meals and at bedtime. It can cause drowsiness. Administering the medication before meals allows time for onset to increase gastrointestinal motility before food ingestion, thus decreasing stomach distention and resulting nausea and vomiting.

Which powerful diuretic would be most effective in the treatment of the patient with decreased renal function associated with heart failure? A) Hydrochlorothiazide (HydroDIURIL) B) Spironolactone (Aldactone) C) Furosemide (Lasix) D) Triamterene (Dyrenium)

C. Furosemide (Lasix)

The nurse recognizes that digoxin (Lanoxin) is administered to a patient to improve which cardiac function? A) Increased heart rate B) Decreased heart rate C) Increased cardiac contractility D) Decreased cardiac contractility

C. Increased cardiac contractility

A patient is receiving lidocaine (Xylocaine) by continuous intravenous (IV) infusion. The nurse understands this medication is prescribed for what condition? A. Atrial fibrillation B. Sinus bradycardia C. First-degree heart block D. Ventricular dysrhythmias

D Although lidocaine and procanimide are not first line drugs due to adverse effects

The nurse monitors the patient receiving an ACE inhibitor for which adverse effect? A) Rebound hypertension B) Diminished pulses C) Hyperglycemia D) Hyperkalemia

D. Hyperkalemia Can also cause renal failure so monitor BUN and Creatinine

A patient going on a vacation cruise is prescribed a scopolamine transdermal patch for motion sickness. The nurse teaches the patient to recognize which side effect? Increased heart rate Dry mouth Irritability Urinary frequency

Dry mouth

The nurse would expect to teach a patient about which antiemetic commonly used to prevent motion sickness? A. scopolamine patch (Transderm-Scōp) B. droperidol (Inapsine) C. prochlorperazine (Compazine) D. metoclopramide (Reglan)

A. scopolamine (Transderm-Scōp) R: Scopolamine blocks the binding of acetylcholine with cholinergic receptors in the inner ear, an imbalance of which is a common cause of motion sickness.

A patient receiving an anticholinergic drug to treat nausea and vomiting should be taught to expect which side effect? A. Diarrhea B. Lacrimation C. Dry mouth D. Bradycardia

C. Dry mouth R: Anticholinergic drugs block the parasympathetic nervous system, which causes the body to "rest and digest." Blocking of these effects leads to constipation, urinary retention, and decreased secretions (dry mouth).

The client is prescribed digoxin (Lanoxin) for treatment of HR. Which of the following statements by the client indicates the need for further teaching by the nurse? "I should not get short of breath anymore." "This drug will help my heart muscle pump less." "I may notice my heart rate decrease." "I may feel tired during early treatment."

"This drug will help my heart muscle pump less." Rationale: The ability to increase the strength of contractions is a characteristic of cardiac glycosides. It may result in a decrease in pulse. Initially the client may experience some fatigue. Symptoms of CHF, such as dyspnea, should improve.

Which assessment data support to the the nurse the client's diagnosis of gastric ulcer? A. Presence of blood in the client's stool for the past month? B. Reports of a burning sensation moving like a wave. C. Sharp pain in the upper abdomen after eating a heavy meal. D. Complaints of epigastric pain 30-60 minutes after ingesting food

- Answer: D In a client diagnosed with a gastric ulcer, pain usually occurs 30-60 minutes after eating, but not at night. In contrast, a client with a duodenal ulcer has pain during the night often relieved by eating foods. Other answers: the presence of blood does not specifically indicate diagnose of an ulcer. The client could have hemorrhoids or cancer. A waveline burning sensation is a symptom of GERD. Sharp pain in the upper abdomen after eating a heavy meal is a symptom of gallbladder disease

A client with congestive heart failure, CHF, is prescribed digoxin (Lanoxin) and furosemide (Lasix). Nursing interventions will include:

-Checking apical pulse before administering medication. -Monitor serum electrolytes. Rationale: Digoxin is a cardiac glycoside. which can slow heart rate, and an apical heart rate is checked prior to administration. Lasix is a loop diuretic used in treatment of CHF, which promotes not only water loss, but also loss of electrolytes. A low potassium level increases risk of digoxin toxicity. Fluids are often restricted with CHF.

The nurse is preparing to administer digoxin (Lanoxin) 0.25mg intravenous push to a patient. Which is an expected patient outcome related to the administration of digoxin? A. Low serum potassium B. Reduction in urine output C. Decrease in the heart rate D. Increase in blood pressure

C

A client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? 1. Diarrhea 2. Heartburn 3. Flatulence 4. Constipation

2. Heartburn Omeprazole is a proton pump inhibitor classified as an antiulcer agent. The intended effect of the medication is relief of pain from gastric irritation, often called heartburn by clients. Watch for adverse effects such as C. diff and tarry stools

A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen? 1. "My ulcer will heal because these medications will kill the bacteria." 2. "These medications are only taken when I have pain from my ulcer." 3. "The medications will kill the bacteria and stop the acid production." 4. "These medications will coat the ulcer and decrease the acid production in my stomach."

3. "The medications will kill the bacteria and stop the acid production." Rationale: Triple therapy for Helicobacter pylori infection usually includes two antibacterial medications and a proton pump inhibitor. Clarithromycin and amoxicillin are antibacterials. Esomeprazole is a proton pump inhibitor. These medications will kill the bacteria and decrease acid production.

A client has a PRN prescription for loperamide (Imodium). For which condition should the nurse administer this medication? 1. Constipation 2. Abdominal pain 3. An episode of diarrhea 4. Hematest-positive nasogastric tube drainage

3. An episode of diarrhea Rationale: Loperamide is an antidiarrheal agent. It is used to manage acute and chronic diarrhea in conditions such as inflammatory bowel disease. Loperamide also can be used to reduce the volume of drainage from an ileostomy. It is not used for the conditions in options 1, 2, and 4.

A client has a PRN prescription for ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative client? 1. Paralytic ileus 2. Incisional pain 3. Urinary retention 4. Nausea and vomiting

4. Nausea and vomiting Rationale: Ondansetron is an antiemetic used to treat postoperative nausea and vomiting, as well as nausea and vomiting associated with chemotherapy. The other options are incorrect.

A client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse should schedule the medication for which times? 1. With meals and at bedtime 2. Every 6 hours around the clock 3. One hour after meals and at bedtime 4. One hour before meals and at bedtime

4. One hour before meals and at bedtime Rationale: Sucralfate is a gastric protectant. The medication should be scheduled for administration 1 hour before meals and at bedtime. The medication is timed to allow it to form a protective coating over the ulcer before food intake stimulates gastric acid production and mechanical irritation. The other options are incorrect.

A client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? 1. Intestinal obstruction 2. Peptic ulcer with melena 3. Diverticulitis with perforation 4. Vomiting following cancer chemotherapy

4. Vomiting following cancer chemotherapy Rationale: Metoclopramide is a gastrointestinal stimulant and antiemetic. It tightens sphincter to prevent vomiting and aids in peristalsis to get the food moving through. Typically given 30min before meals or used in the treatment of emesis after surgery, chemotherapy, and radiation.

Before administering a dose of an antidysrhythmic drug to a patient, what is the priority nursing assessment? A. Check apical pulse and blood pressure. B. Measure urine output and specific gravity. C. Obtain temperature and pulse oximetry on room air. D. Evaluate peripheral pulses and level of consciousness.

A

When teaching a patient regarding the administration of digoxin (Lanoxin), the nurse instructs the patient not to take this medication with 2 hours of taking ____? A. Antacids and St. John's wort B. Salt C. IV potassium D. Scrambled eggs

A

The nurse is reviewing the protocol for administration of IV adenosine (Adenocard). What is the MOST important nursing intervention to remember when giving this medication? A. Administer it as a fast IV push. B. Assess for burning sensation at the IV site. C. Monitor the infusion site for hematoma. D. Flush the IV catheter with normal saline.

A The half life is 10sec so flush fast

Before administering the anticholinergic drug scopolamine, the nurse would be careful to assess the patient for a history of which condition? A. Glaucoma B. Hyperthyroidism C. Rheumatoid arthritis D. Gastroenteritis

A. Glaucoma R: Anticholinergic drugs are contraindicated in patients with glaucoma. These drugs can cause pupillary dilation and blurry vision, which can obstruct the flow of aqueous humor and increase intraocular pressure.

A patient is receiving digoxin (Lanoxin) for the treatment of heart failure. The nurse recognizes which therapeutic effect(s) of this treatment? (Select all that apply.) A) Increased cardiac output B) Increased heart rate C) Decreased blood volume D) Decreased cardiac contractility E) Arteriole vasodilation F) Peripheral vasoconstriction

A. Increased cardiac output, C. Decreased blood volume, E. Arteriole vasodilation

In preparing to administer digoxin (Lanoxin) to a patient with heart failure, which finding would cause the nurse to withhold the medication? A) Pulse 52 B) Increased thirst C) Blood pressure 142/86 D) Urine output of 250 mL over the last 8 hours

A. Pulse 52

Gastroesophageal reflux disease (GERD) weakens the lower esophageal sphincter, predisposing older persons to risk for impaired swallowing. In managing the symptoms associated with GERD, the nurse should assign the highest priority to which of the following interventions? 1. Decrease daily intake of vegetables and water, and ambulate frequently 2. Drink coffee diluted with milk at each meal, and remain in an upright position for 30 minutes. 3. Eat small, frequent meals, and remain in an upright position for at least 30 minutes after eating 4. Avoid over-the-counter drugs that have antacids in them

Answer 3, Eating small and frequent meals requires less release of hydrochloric acid. Remaining in an upright position for 30 minutes after meals prevents reflux into the esophagus which is often exacerbated when lying down, expecially after a large meal which makes the patient tired

The nurse explains to the patient with gastroesophageal reflux disease that this disorder: A. results in acid erosion and ulceration of the esophagus caused by frequent vomiting, B. will require surgical wrapping or repair of the pyloric sphincter to control the symptoms, C. is the protrusion of a portion of the stomach into to esophagus through an opening in the diaphragm, D. often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the espophagus

Answer: D. The acidic contents of the stomach touching the inside of the esophagus are responsible for the physical sensation known as "heart-burn" that is a cardinal symptom of GERD

A client has been started on benztropine (Cogentin) for relief of parkinsonian symptoms. Which of the following statements made by the client best indicates that the drug is producing a therapeutic effect? a. "My hands aren't as shaky as they used to be." b. "I feel so calm and relaxed." c. "I can tie my shoes now without difficulty." d. "That annoying lip smacking is much less frequent."

Answer: a. "My hands aren't as shaky as they used to be." Rationale: Cogentin blocks excess cholinergic stimulation and helps to suppress tremors. It does not affect symptoms of tardive dyskinesia, such as lip smacking. It does not affect mood.

A client with Alzheimer's disease has been receiving medication therapy for several months. The nurse should teach the client and caregiver to report signs of overdose, which include: a. Bradycardia and muscle weakness. b. Tachycardia and hypertension. c. Abdominal pain and dry mouth. d. Emotional withdrawal and tachypnea.

Answer: a. Bradycardia and muscle weakness. Rationale: An overdose of drugs to treat Alzheimer's disease could occur if they are taken improperly, or if decreased liver or renal function occurs. Symptoms of overdose include severe nausea/vomiting, sweating, drooling, hypotension, bradycardia, seizures, and increased muscle weakness, including respiratory muscles.

A client receiving an anticholinergic drug for treatment of Parkinson's disease complains of dry mouth. Nursing intervention should include advising the client to: a. Take the drug with food or milk. b. Chew sugarless gum, and suck on sugarless hard candy. c. Use mouthwash before taking the drug. d. Rinse mouth with warm water.

Answer: b. Chew sugarless gum, and suck on sugarless hard candy. Rationale: Frequent drinking of cool liquids, sucking on hard candy or ice chips, and chewing sugarless gum can add moisture to the mucous membranes.

Donepezil (Aricept) is prescribed for a client with Alzheimer's disease. The nurse determines that the medication is having positive effects when what is observed? a. Absence of wandering b. Decreased progression of memory loss c. Increase in "pin rolling" d. Regaining the ability to drive a car

Answer: b. Decreased progression of memory loss Rationale: Aricept is effective in the early stages of Alzheimer's disease. It might slow or decrease progression of symptoms, but it will not reverse behaviors that are lost.

The client asks what can be expected from drug therapy for treatment of parkinsonism. The best response by the nurse would be: a. That a cure can be expected within six months. b. That symptoms can be reduced, and the ability to perform ADLs can be improved. c. That disease progression will be stopped. d. That EPS will be prevented.

Answer: b. That symptoms can be reduced, and the ability to perform ADLs can be improved. Rationale: Pharmacotherapy does not cure the disease, but it does improve the client's ability to perform normal activities, such as eating, bathing, and walking. The symptoms are often reversed if medications are taken long-term.

During the initial treatment with levodopa for clients with Parkinson's disease, nursing interventions should include: a. Monitoring for suicidal ideation. b. Observing for EPS. c. Providing safety to prevent falls. d. Increasing foods high in vitamin B6, such as bananas and liver.

Answer: c. Providing safety to prevent falls. Rationale: Orthostatic hypotension is likely during early treatment. Clients should be protected from falls. Suicidal ideation is monitored when clients are first started on antidepressants. EPS occurs with some antipsychotic medications. Bananas and liver are high in vitamin B6 and will decrease absorption of levodopa.

Levodopa (Laradopa) is prescribed for a client with Parkinson's disease. The nurse's discharge teaching should include: (Select all that apply.) a. Monitor the blood pressure every two hours for the first two weeks. b. Expect the urine color to be orange. c. Report the development of diarrhea. d. Report to the lab for a follow-up of liver and renal function tests. e. Avoid taking the medication with high-protein meals.

Answer: d. Report to the lab for a follow-up of liver and renal function tests.; e. Avoid taking the medication with high-protein meals. Rationale: A decrease in kidney and liver function could slow the metabolism and excretion of the drug, leading to overdose and toxicity. Protein decreases the absorption of levodopa. Blood pressure needs to be closely monitored when the dose is adjusted. It might cause urine and sweat to darken in color. It does not cause diarrhea.

A nurse administers metoclopramide [Reglan] to a patient who is having nausea and vomiting postoperatively. The nurse should expect which therapeutic action if the medication is having the desired result? Blocking of serotonin and dopamine receptors Inactivation of histaminergic (H1) receptors Activation of chloride channels in the intestine Reduced motility in the small intestine

Blocking of serotonin and dopamine receptors R: Metoclopramide works by blocking serotonin and dopamine receptors in the chemoreceptor trigger zone (CTZ) and by increasing motility in the small intestine.

When planning administration of antiemetic medications to a patient, the nurse is aware that combination therapy is preferred because A. the risk of constipation is decreased. B. lower doses of medication are cost-effective. C. different vomiting pathways are blocked. D. increased sedation is achieved by higher doses of medication.

C. different vomiting pathways are blocked. R: Combining antiemetic drugs from various categories allows the blocking of the vomiting center and chemoreceptor trigger zone through different pathways, thus enhancing the antiemetic effect.

The client with a hiatal hernia chronically experiences heartburn following meals. The nurse planc to teach the client to avoid which action because it is contraindicated with hiatal hernia? 1. Lying recumbent following meals 2. Taking in small, frequent, bland meals 3. Raising the head of the bed on 6-inch blocks 4. Taking H2-receptor antagonist medication

Correct answer: 1Laying recumbant following meals or at night will cause reflux and pain. Relief is usually achieved with the intake of small, bland meals, use of H2 receptor antagonists and antacids, and elevation of the thorax after meals and during sleep

The nurse reviews an adult patient's laboratory values and notes a digoxin level of 11 ng/mL and a serum potassium level of 6.2 mEq/L. The nurse would notify the health care provider and anticipate which medication will be prescribed to administer? A. Sodium polystyrene sulfonate (Kayexalate) B. Atropine C. Epinephrine (Adrenalin) D. Digoxin immune Fab

D

The nurse understands adenosine (Adenocard) is used to treat which condition? A. Atrial flutter B. Atrial fibrillation C. Second-degree atrioventricular block D. Paroxysmal supraventricular tachycardia (PSVT)

D

The patient's serum digoxin level is 0.4 ng/mL. How does the nurse interpret this laboratory value result for digoxin? A. Normal therapeutic level B. A toxic serum blood level C. Above the therapeutic level D. Below the therapeutic level

D Therapeutic level is 0.8-2

Which drug works by blocking serotonin in the gastrointestinal tract, vomiting center, and chemoreceptor trigger zone (CTZ)? A. metoclopramide (Reglan) B. meclizine (Antivert) C. droperidol (Inapsine) D. ondansetron (Zofran)

D. ondansetron (Zofran) R: Ondansetron is a serotonin blocker. (assess for serotonin syndrome- fever, diarrhea, agitation)

The nurse recognizes that metoclopramide (Reglan) is useful in treating postoperative nausea and vomiting because it A. decreases motility in the gastrointestinal tract. B. decreases chemoreceptor stimulation. C. improves the body's response to analgesia. D. promotes motility in the small intestine.

D. promotes motility in the small intestine. R: Metoclopramide works by increasing gastrointestinal motility in the small intestine, thus minimizing gastric distention and accompanying stimulation of the vomiting center.

The client's serum digoxin level is 2.2 ng/dL and the heart rate is 120 and irregular. The nurse expects to administer which of the following drugs? Digoxin immune Fab (Digibind) Furosemide (Lasix) 60 mg I.V. Digoxin 0.5 mg bolus I.V. Potassium 40 mEq added to I.V. fluids

Digoxin immune Fab (Digibind) Rationale: Digibind binds and removes digoxin from the body and prevents toxic effects of digoxin overdose. A serum level of 2.2 is elevated, and the client is exhibiting signs of digoxin toxicity. The question does not indicate that the potassium level is low. Giving additional digoxin would exacerbate the toxicity. Giving Lasix may reduce potassium levels and contribute to increased toxicity.

The nurse developing a teaching plan for a client receiving thiazide diuretics should include the following. Teaching the client to take apical pulse. Decreasing potassium-rich foods in the diet. Including citrus fruits, melons, and vegetables in the diet. Teaching the client to check blood pressure t.i.d.

Including citrus fruits, melons, and vegetables in the diet. Rationale: Thiazide diuretics are potassium wasting, and levels should be closely monitored. Encouraging foods rich in potassium could help maintain potassium levels. Taking an apical pulse is indicated before administering cardiac glycosides and beta blockers. It would not be necessary to check blood pressure TID unless the client was experiencing hypotension.

A client is being started on lisinopril (Zestril). Nursing interventions during initial therapy with this medication must include Monitoring blood pressure. Monitoring intake and output. Monitoring EKG. Monitoring serum levels.

Monitoring blood pressure. Rationale: Lisinopril is an ACE inhibitor, which can cause severe hypotension with initial doses. The nurse should monitor the client closely for several hours.

The client is prescribed a beta-blocker as adjunct therapy to treatment of heart failure. The nurse recognizes that beta blockers act by Increasing contractility and cardiac output. Decreasing preload. Slowing the heart and decreasing afterload. Decreasing peripheral resistance

Slowing the heart and decreasing afterload. Rationale: Beta-blockers improve symptoms of HF by slowing heart rate and decreasing blood pressure. The decreased afterload causes decreased workload on the heart.

The nurse is providing patient teaching regarding scopolamine transdermal patches (Transderm-Scōp) to a patient who is planning an ocean cruise. Which instruction is most appropriate? a "Apply the patch the day before traveling." b "Apply the patch at least 1 hour before traveling." c "Apply the patch to the shoulder area." d "Apply the patch to the temple just above the ear."

b "Apply the patch at least 1 hour before traveling."