Pharmacology Midterm Review
1. Which antihypertensive medication can be administered by transdermal patch? amlodipine candesartan enalapril clonidine
clonidine
1. A 50-year-old male patient has been admitted to the emergency department in cardiogenic shock. His wife, after hearing the nurse mention that the patient is receiving dobutamine, wants to know how the medication will help him. How would the nurse best answer her question? "He's in shock because his heart rate is too low. The drug will help by increasing his heart rate significantly." "He's in shock because his blood vessels have dilated so severely. The drug will help by reversing that dilation." "He's in shock because his heart can't pump effectively. This drug will help by causing his heart to pump more strongly." "He's in shock because his heart can't pump effectively. This drug will help by increasing his heart rate significantly."
"He's in shock because his heart can't pump effectively. This drug will help by causing his heart to pump more strongly."
1. Which statement by the client would lead the nurse to believe that the client has understood the teaching about angina? "I will not exercise because it precipitates angina." "As long as I take the medicine, I can maintain my lifestyle." "There is no correlation between my hypertension and angina." "Heavy meals and cigarette smoking can precipitate an angina attack."
"Heavy meals and cigarette smoking can precipitate an angina attack."
1. A client diagnosed with heart disease is prescribed an antiarrhythmic drug. Further teaching is needed when the client makes which statement? "I will take my medication at the prescribed time." "I need to call my primary care provider before taking any herbal supplements." "I can check the drug label about taking the medicine with food." "I know I must take my medication every day for my heartbeat to be fixed."
"I know I must take my medication every day for my heartbeat to be fixed."
1. A nurse is giving medication instruction to a client who is taking metoprolol (Lopressor). Which statement by the client would indicate that teaching has been effective? "I may have a very dry mouth while taking this drug." "I should never stop taking this drug abruptly." "I can stop walking a mile a day." "Since I am taking this drug, I no longer need to worry about my diet."
"I should never stop taking this drug abruptly."
1. 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 apply the patch for 24 hours and then remove it, and place another transdermal patch." "I will remove the patch and fold it on itself to prevent my dog or grandchildren from touching it." "I will clean the previous site where I remove an old patch with soap and water and dry it thoroughly."
"I will apply the patch for 24 hours and then remove it, and place another transdermal patch."
1. The nurse provides drug teaching to the client prescribed captopril. What statement made by the client does the nurse interpret to mean teaching has been effective? "I will monitor the effectiveness by watching for any symptoms of hypertension." "I will call my doctor if I bruise easily or become extremely tired." "I'll take the drug in the morning so that I don't have to go to the bathroom often at night." "I will increase my intake of foods high in potassium, such as bananas."
"I will call my doctor if I bruise easily or become extremely tired."
1. An adult client recently diagnosed with hypertension has begun combination therapy. Which client statement would suggest a need for further health education? "I'm going to make up a schedule for checking my blood pressure on a regular basis." "I'll only need to take these drugs on days when my blood pressure is particularly high." "My wife and I are thinking of ways that we can cut down the amount of salt in our diet." "I've made plans with my best friend to start going for walks in the morning four times a week."
"I'll only need to take these drugs on days when my blood pressure is particularly high."
1. A client does not want to take medication to treat existing hypertension if it can be avoided. The client asks the nurse whether any other options are available. What lifestyle changes should the nurse recommend? Select all that apply. "Increase the amount of exercise that you do." "Eliminate all salt from your diet." "Lose some weight, if possible." "Try meditation, if it's something you're interested in." "Reduce your overall intake of fluids."
"Increase the amount of exercise that you do." "Lose some weight, if possible." "Try meditation, if it's something you're interested in."
1. The client has been prescribed norepinephrine. While the nurse is teaching the client about this medication, the client asks the nurse what is it for. What is the nurse's best response? "It is a medication used to treat severe bacterial infections." "It is a neurotransmitter that keeps the nerve message going from the brain to the organ." "It is a neurotransmitter that keeps the kidneys producing insulin during stress." "It is a substance that sends impulses from the heart to the lungs in order to facilitate breathing."
"It is a neurotransmitter that keeps the nerve message going from the brain to the organ."
1. The nurse is caring for a client with angina who has been prescribed nitroglycerin. What health teaching about the client's lifestyle should the nurse provide? "It's important not to take nitroglycerin unless you're actually experiencing chest pain." "It's best to eliminate or reduce your intake of alcoholic beverages." "Avoid drinking grapefruit juice because it will interfere with how your body processes nitroglycerin." "Make sure that you're able to get at least 6 hours of sleep each night, if possible."
"It's best to eliminate or reduce your intake of alcoholic beverages."
1. Digoxin has been prescribed for an outpatient client with symptomatic heart failure. What is the priority teaching point to convey to this client? "Try to limit the number of high-potassium foods in your diet." "Make sure to take your pulse for a minute before taking your digoxin." "Plan to take your digoxin on an empty stomach to make sure it's fully absorbed." "If the swelling in your feet gets worse, you can take up twice your normal dose for 1 day."
"Make sure to take your pulse for a minute before taking your digoxin."
1. When teaching the client to safely administer nitroglycerin ointment, the nurse should convey which instruction? "The backs of your hands and the tops of your feet are ideal sites for applying the ointment." "Make sure you squeeze the ointment on to a paper measuring scale before applying it." "Massage the ointment into your skin for 10 to 15 seconds after applying it." "Don't apply the ointment unless you're experiencing chest pain at the time."
"Make sure you squeeze the ointment on to a paper measuring scale before applying it."
1. A client, diagnosed with erectile dysfunction, is taking nitroglycerin for chest pain. What is the best explanation for why nitrate-like sildenafil would be contraindicated? "Nitroglycerin and sildenafil cause a severe decrease in blood pressure." "Nitroglycerin and sildenafil can lead to prostate cancer." "Nitroglycerin decreases the effect of sildenafil for erectile dysfunction." "Nitroglycerin and sildenafil will diminish the effectiveness of chest pain relief."
"Nitroglycerin and sildenafil cause a severe decrease in blood pressure."
1. A client was given a new prescription for a transdermal nitroglycerin patch. What client education should the nurse provide regarding this medication? "If your patch loses its adhesion during the day, replace it with a new one." "Remove your old patch and put on a new one each morning." "Apply one additional patch if you experience a sudden onset of chest pain." "Put your patch on a part of your skin that doesn't have too much hair on it."
"Put your patch on a part of your skin that doesn't have too much hair on it."
1. A patient is admitted to the intensive care unit after surgery from a gunshot wound. His family is very concerned about him and asks why the dobutamine (Dobutrex) is being administered. What is your best response? "We are giving this drug to increase his blood pressure and heart rate." "The medication will improve his condition and stabilize him." "The medication will increase the force of the heart contraction and increase blood pressure." "The medication will increase his heart rate and decrease his blood pressure."
"The medication will increase the force of the heart contraction and increase blood pressure."
1. A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient's subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication? "By reducing the amount of fluid that your body contains, digoxin will make it easier for your heart to pump." "This will lessen the workload of your heart by reducing your blood pressure." "Most patients see their heart failure resolve in 2 to 4 months after they begin taking digoxin." "This drug won't cure your disease, but it will help you be able to exercise more and be more comfortable."
"This drug won't cure your disease, but it will help you be able to exercise more and be more comfortable."
The female client states that her father has had high blood pressure all of his life and he is healthy. She does not understand why the care provider has prescribed medication for her blood pressure. What is the nurse's best response? "Maybe you do not need medication with your history." "With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease." "The effects of high blood pressure are different for different people." "We always treat high blood pressure with medicine to prevent further damage to your body."
"With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease."
1. A client prescribed nitroglycerin reports to the nurse that he is having headaches. How should the nurse best respond? "You may experience headaches as an adverse reaction to nitroglycerin." "Do not take any more nitroglycerin. It is increasing your blood pressure." "If you lie down when taking nitroglycerin you will not experience a headache." "Nitroglycerin is dropping your blood pressure and that is causing the headache."
"You may experience headaches as an adverse reaction to nitroglycerin."
1. A client is hospitalized for heart failure and is being treated with a beta blocker. What client teaching should the nurse include about side effects? Select all that apply. "You may feel light-headed and dizzy when you stand up, so ask for assistance prior to getting out of bed." "Beta blockers can make your blood glucose drop, so make sure you eat regularly." "You may feel flushed and have very warm extremities, so keep the temperature in the room low." "Your heart rate will decrease so, your blood pressure could become low, too. Notify the nurse if you feel like you are lightheaded."
"You may feel light-headed and dizzy when you stand up, so ask for assistance prior to getting out of bed." "Your heart rate will decrease so, your blood pressure could become low, too. Notify the nurse if you feel like you are lightheaded."
1. A patient is receiving milrinone IV. The nurse would administer the bolus over which time frame? 10 minutes 2 minutes 5 minutes 15 minutes
10 minutes
1. After administering an IV dose of digoxin, the nurse would expect to see effects within what period of time? 30 to 120 minutes 5 to 30 minutes 1 hour 2 hours
5 to 30 minutes
1. A male client has called the clinic because he is taking digoxin and is concerned about his pulse rate. The nurse should tell the client to hold the medication if he reports a pulse rate of: 52 beats/minute. 84 beats/minute. 78 beats/minute. 66 beats/minute.
52 beats/minute.
1. The usual goal of vasopressor drug therapy is to maintain tissue perfusion and a mean arterial pressure of at least what level? 40 to 60 mm Hg 60 to 40 mm Hg 60 to 89 mm Hg 80 to 100 mm Hg
80 to 100 mm Hg
1. Which of the following steps are involved in the proper administration of a Catapes-TTS patch? Select all that apply: A new patch is applied daily. If the patch loosens, a new patch should be applied. The use of the adhesive overlay is not necessary. A different body area should be selected for each application. The patch should be applied to a hairless area.
A different body area should be selected for each application. The patch should be applied to a hairless area.
You are leading an educational discussion on childhood hypertension at a local school board meeting. A particular focus of the discussion is the promotion of non-pharmacologic treatment measures. Which of the following methods is appropriate for managing hypertension in children? Promotion of exercise Prevention of obesity Reduction of dietary sodium All the above
All of the above
1. What statement should underlie the nurse's response when asked if ACE inhibitor therapy can be continued during pregnancy? Since ACE inhibitors cross the placenta, dosage during pregnancy should be reduced. ACE inhibitors are contraindicated during pregnancy because they are teratogenic. ACE inhibitors will exacerbate the fluid overload that commonly accompanies pregnancy. There is no research to support discontinuation of ACE inhibitor therapy during pregnancy.
ACE inhibitors are contraindicated during pregnancy because they are teratogenic.
1. In heart failure, by what mechanism does the body compensate for decreased circulating blood volume? Activation of the renin-angiotensin-aldosterone system Increasing preload Decreasing afterload Increasing stroke volume
Activation of the renin-angiotensin-aldosterone system
1. In a discussion of heart failure, the nursing instructor is explaining preload and afterload. Which of the following statements regarding preload and afterload is accurate? Afterload is related to the ejection of blood from the ventricle, and preload is related to the filling of the ventricle. Preload is related to the ejection of blood from the ventricle, and afterload is related to the filling of the ventricle. Preload is related to the filling of the left ventricle, and afterload is related to the filling of the right ventricle. Preload is related to the filling of the right ventricle, and afterload is related to the filling of the left ventricle.
Afterload is related to the ejection of blood from the ventricle, and preload is related to the filling of the ventricle.
1. A group of students are reviewing the various antihypertensive agents available. The students demonstrate understanding of the information when they identify which agent as an example of a renin inhibitor? Mecamylamine Aliskiren Candesartan Captopril
Aliskiren
1. The nurse recognizes which medications may be the cause of a digoxin level of 2.7 nanograms/mL? Cholestyramine Antacids Methotrexate Amiodarone
Amiodarone
1. The nurse knows that which of the following clients is likely to have hypovolemic shock? Select all that apply. An infant with severe diarrhea and vomiting A man with a burn on his finger A woman bleeding profusely after giving birth A teenage girl who has been taking 80 mg/day of unprescribed Lasix for five days An elderly man in congestive heart failure
An infant with severe diarrhea and vomiting A woman bleeding profusely after giving birth A teenage girl who has been taking 80 mg/day of unprescribed Lasix for five days
1. A 42-year-old client is seen by the health care provider for follow-up for diabetic nephropathy. The provider prescribed losartan for the treatment of this condition because the medication has been shown to reduce the rate of end-stage renal disease. Which drug class does this drug belong to? Antihyperlipidemic drugs Calcium channel blockers Selective aldosterone blockers Angiotensin II receptor blockers
Angiotensin II receptor blockers
1. Effective treatment of septic shock, if caused by bacterial infection, includes draining an abscess (if present) and administration of appropriate medications. Which of the following would be considered an appropriate medication? Antimicrobials Atropine Norepinephrine Adrenaline
Antimicrobials
1. The nurse is teaching a male client who is receiving quinidine about foods to avoid. The client demonstrates the need for additional teaching when he identifies the need to avoid: Citrus juices Antacids Milk Apple juice
Apple juice
1. A patient is being treated for hypovolemic shock. Which of the following assessments is most important in the patient with hypovolemic shock? Monitor intake and weight Assess lung and bowel sounds Assess temperature and peripheral pulses Assess blood pressure and pulse
Assess blood pressure and pulse
1. Clinical indications for the use of adrenergic drugs stem mainly from their effects on the heart, blood vessels, and bronchi. They are often used as emergency drugs. For which of the following conditions would these drugs be used? Choose all that apply. Myocardial infarction Asthma attack Anaphylaxis Chronic cirrhosis Fractured hip
Asthma attack Anaphylaxis
1. When caring for a patient who has been digitalized for his heart failure, the nurse observes that the patient is experiencing bradycardia. Which drug should be administered to patients who develop bradycardia? Atropine Cholestyramine Inamrinone Milrinone
Atropine
1. A female client is prescribed a cardiac glycoside for the treatment of atrial fibrillation. She tells the nurse that she is concerned about her weight and wants to try this new weight loss program she read about on the Internet. What should a nurse advise her about using cardiac glycosides? Follow a protein-rich diet. Avoid most over-the-counter drugs. Avoid heavy exercise for 5 hours after taking the drug. Include balanced levels of fats and carbohydrates in her diet.
Avoid most over-the-counter drugs.
1. 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? Discontinue the drug if persistent dry cough occurs. Avoid dairy products. Avoid potassium supplements. Implement a low-carbohydrate diet as part of your weight loss program.
Avoid potassium supplements.
1. 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 temporary increase in renal function A sustained increase in renal dysfunction Baseline renal function A sustained decrease in renal function
Baseline renal function
1. The client receiving propranolol (Inderal) at home for management of a ventricular dysrhythmia should monitor which parameter? Fluid intake Blood pressure daily Daily exercise Pulse once a week
Blood pressure daily
1. An asthmatic client on a beta blocker should be observed for which adverse reaction? Bronchospasm Hypoglycemia Pleural effusion Pneumonia
Bronchospasm
1. 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? Have someone take him to the emergency department. Take another nitroglycerin and call 911. Call 911. Notify his healthcare provider.
Call 911.
1. The nurse is caring for a client with hypertension who is preparing to be discharged from the hospital after suffering a myocardial infarction. What drug would both treat the client's hypertension and reduce myocardial oxygen consumption? Captopril Losartan Diltiazem Nitroprusside
Captopril
1. Contraindications to adrenergic drugs include what conditions? (Select all that apply.) Cardiac dysrhythmias Hyperthyroidism Hypersensitivity to sulfites Hypersensitivity to penicillin Hypotension
Cardiac dysrhythmias Hyperthyroidism Hypersensitivity to sulfites
1. Which event occurs in a client diagnosed with hypertension? The kidneys excrete more fluid in response to increased blood pressure. Fluid loss increases blood volume in the client with hypertension. Decreased blood volume increases blood pressure. Cardiac output increases and in turn causes an increase in blood pressure.
Cardiac output increases and in turn causes an increase in blood pressure.
1. A group of nursing students are reviewing information about adrenergic blockers. The students demonstrate understanding when they identify which as an example of an alpha/beta-adrenergic blocking drug? Metoprolol Prazosin Reserpine Carvedilol
Carvedilol
1. Alpha/beta blockers block both alpha-adrenergic and beta-adrenergic receptors. Which antiadrenergic drug is an alpha/beta blocker? Carvedilol Sotalol Propranolol Phentolamine
Carvedilol
1. When educating a group of nursing students on the mechanism of action of angiotensin converting enzyme inhibitor (ACEI) drugs, the nurse identifies what as the action brought about by aldosterone? Inhibits renin secretion. Causes sodium and water retention. Causes excess potassium retention. Promotes angiotensin I conversion.
Causes sodium and water retention.
1. The nurse is preparing discharge teaching for a client prescribed chronic antiarrhythmic medication therapy. Which signs/symptoms should be reported to the health care provider immediately? (Select all that apply.) Chest pain Dyspnea Nausea Heart palpations Diarrhea
Chest pain Dyspnea Heart palpations
1. Quinidine is prescribed to a patient with cardiac arrhythmia. When documenting the patient's drug history, the nurse inquires about the concomitant use of any other drug. Which drug when given concomitantly may cause an increase in serum Quinidine levels? Cimetidine Barbiturates Hydantoins Nifedipine
Cimetidine
1. You are admitting a patient with a diagnosis of a gastrointestinal bleed who is in the compensatory stage of shock. You know that an early sign that accompanies initial shock is what? Increased urine output Decreased heart rate Hyperactive bowel sounds Cool, clammy skin
Cool, clammy skin
1. The nurse would encourage clients with prehypertension to follow what type of diet? High-sodium diet DASH diet Restricted-calorie diet High-protein diet
DASH diet
1. The client has been started on an ACE inhibitor for hypertension. The client also takes spironolactone (Aldactone) daily. The nurse would evaluate the client for which of the following? Hyperkalemia Hypokalemia Hypercalcemia Hypocalcemia
Hyperkalemia
1. A nurse is caring for a client experiencing a hypertensive emergency. If blood pressure is not lowered immediately, what can occur? (Select all that apply.) Damage to the heart Damage to the kidneys Damage to the gall bladder Damage to the pancreas Damage to the eyes
Damage to the heart Damage to the kidneys Damage to the eyes
1. The nurse suggests which dietary habits for the client with heart failure? (Select all that apply.) Only salt food once with every meal. Decrease calories to lose weight if needed. Avoid unsaturated fats and include saturated fats in every meal. Try to include vegetables, protein, and carbohydrates in each meal. Use canned soups to decrease the work of cooking.
Decrease calories to lose weight if needed. Try to include vegetables, protein, and carbohydrates in each meal.
1. The nurse teaches the client that antacids when taken with digoxin may have which interactions? Nausea and vomiting Increased digoxin levels Decreased digoxin levels Anorexia
Decreased digoxin levels
1. Beta-adrenergic blocking agents decrease the oxygen demands of the heart by what mechanism? Increasing conduction to the atrioventricular node, thereby increasing cardiac output Increasing cardiac output, thereby increasing the oxygen supplied to the heart Increasing blood pressure, which increases the amount of blood returned to the heart Decreasing the heart rate, allowing for longer filling time and increased blood to the heart
Decreasing the heart rate, allowing for longer filling time and increased blood to the heart
1. What is given to treat a massive digoxin overdose? Digoxin immune Fab (Digibind) Milrinone (Primacor) Activated charcoal Syrup of ipecac
Digoxin immune Fab (Digibind)
1. Which is true about digoxin? Digoxin decreases the mortality associated with heart failure. Digoxin is used to treat paroxysmal atrial fibrillation. Digoxin improves the quality of life for patients with heart failure in the absence of atrial fibrillation. The therapeutic range for digoxin is 0.5 to 2 ng/mL.
Digoxin improves the quality of life for patients with heart failure in the absence of atrial fibrillation.
1. The client is started on a transdermal nitroglycerin patch system. The nurse teaches the client that the system relieves pain by which action? Dilates the coronary arteries Decreases the size of the artery Increases the workload of the heart
Dilates the coronary arteries
1. The client presents to the health care provider with a new onset of bradycardia. The nurse recognizes that which antihypertensive can cause bradycardia? Labetalol Clonidine Enalapril Diltiazem
Diltiazem
1. The nurse is visiting the home of a client who is prescribed antidysrhythmic medication. The nurse will teach the client to report which possible adverse effect? Increased energy Improved functional status Dizziness Improved mentation
Dizziness
1. When describing the possible adverse effects associated with nitroglycerin, what would the nurse include? Dizziness Hypertension Chills Constipation
Dizziness
1. Which would the nurse identify as a naturally occurring catecholamine? Dobutamine Dopamine Ephedrine Metaraminol
Dopamine
1. The teaching plan for a client taking amiodarone should include which instruction? Take this medication with grapefruit juice for optimal absorption. Use a reliable form of birth control while taking this medication. Urinary retention is common and no need for concern. Drowsiness is common but will not interfere with any of your usual activities.
Drowsiness is common but will not interfere with any of your usual activities.
1. An 80-year-old patient in the emergency department is receiving dopamine for treatment of shock. Which of the following adverse effects could the patient experience? Blood dyscrasia Dysrhythmia Hepatic toxicity Respiratory depression
Dysrhythmia
1. Mr. Green is prescribed amiodarone for the treatment of ventricular tachycardia. The nurse teaches him about the importance of follow-up care and routine testing that will need to be done secondary to the side effects of this medication. What testing will the patient require on a routine basis to monitor for side effects of the medication? Pulmonary function testing to assess lung function Amiodarone blood level determinations to assess for toxicity Echocardiography to evaluate ejection fraction Electrocardiography to assess cardiac rhythm
Electrocardiography to assess cardiac rhythm
1. A client is prescribed propranolol (Inderal). Which condition in the client's history may affect the treatment regimen? Nausea Diarrhea Dizziness Elevated glucose
Elevated glucose
1. Non-pharmacological management of acute heart failure includes all of the following EXCEPT: Restrict dietary sodium intake to reduce edema and other symptoms and allow a decrease in diuretic dosage. For clients who are obese, weight loss is desirable to decrease systemic vascular resistance and myocardial oxygen demand. Encourage physical activity in patients with symptomatic HF. Administer oxygen, if needed, to relieve dyspnea, improve oxygen delivery, reduce the work of breathing, and decrease constriction of pulmonary blood vessels (which is a compensatory measure in patients with hypoxemia). Prepare patient and family for heart transplant, if indicated.
Encourage physical activity in patients with symptomatic HF.
1. A client with a history of allergies is prescribed an auto-injector for self-administration in case of an allergic reaction. The nurse understands that this device contains which drug? Dobutamine Dopamine Isoproterenol Epinephrine
Epinephrine
1. A client should be instructed to take sublingual NTG how often if he experiences chest pain? Every 1 minute times 3 Every 2 minutes times 5 Every 5 minutes times 3 Every 10 minutes times 5
Every 5 minutes times 3
1. A male client's friend tells him to stop taking his metoprolol because he read that it causes cancer. The nurse encourages the client to consult his prescriber because abrupt withdrawal from the drug may cause what effect? Postural hypotension and falls Bradycardia Exacerbation of his angina Atrial dysrhythmias
Exacerbation of his angina
1. A client prescribed ramipril earlier in the week states, "Now I have a nagging, dry cough." How should the nurse best follow up the client's statement? Inform the client that the drug should be immediately discontinued. Inform the client that this is an adverse effect of the medication that may lead to pneumonitis. Explain why it will be necessary to obtain a sputum sample. Explain that drugs like ramipril often cause a cough.
Explain that drugs like ramipril often cause a cough.
1. A patient has been advised to use a transdermal patch of clonidine for hypertension. For which of the following time periods should the nurse ensure that the patch is intact? For one week For two weeks For three weeks For four weeks
For one week
1. The nurse is teaching a female patient about newly prescribed digoxin. The patient tells the nurse that she occasionally uses herbal therapies. The nurse should caution the patient against using therapies that involve which herbs? Black cohosh Ginseng Saw palmetto Valerian
Ginseng
When providing dietary instruction on a low-sodium diet, which dietary choice is most appropriate for a client with hypertension? Hot dog, baked beans, and Cole slaw Grilled hamburger, French fries, and cola drink Grilled chicken, green salad, and apple Ham sandwich, potato chips, and cookie
Grilled chicken, green salad, and apple
1. The client is diagnosed with primary hypertension. The nurse is educating a client about dietary changes that help decrease blood pressure. Which menu selection indicates the need for further client education? Salad with a grilled chicken; unsweetened tea Baked fish, broccoli, and oranges Ham sandwich with mustard, carrots and cheesy dip Turkey sandwich on whole wheat with lettuce and tomato; sweetened tea
Ham sandwich with mustard, carrots and cheesy dip
1. When describing the action of beta blockers to a client, the nurse would emphasize that the majority of drug action involve stimulation of the receptors in which organ? Heart Kidney Brain Liver
Heart
1. A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.) Respiratory rate Oxygen saturation Temperature Heart rate Blood pressure
Heart rate Blood pressure
1. A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessment findings? Oxygen saturation and respiratory rate Heart rate and blood pressure Level of consciousness and pain level Temperature and respiratory rate
Heart rate and blood pressure
A community health nurse is facilitating a health promotion session to a group of seniors. Which topic related to hypertension is most important to include in the information? Hypertension will increase the risk of cancer. An increase is sodium is recommended with hypertension. Exercise will increase the risk of hypertension. Hypertension will increase the risk of heart disease.
Hypertension will increase the risk of heart disease.
1. A client who has been prescribed digoxin (Lanoxin) is also taking furosemide (Lasix) 20 mg daily. Which electrolyte imbalances will precipitate the client to develop digoxin toxicity? Hyperkalemia Hypokalemia Hypermagnesemia Hyponatremia
Hypokalemia
1. Digoxin (Lanoxin) must be used cautiously in clients with which of the following electrolyte imbalances? Select all that apply: Hypokalemia Hypermagnesemia Hypocalcemia Hyperkalemia Hypomagnesemia
Hypokalemia Hypomagnesemia
1. A nurse is caring for a 59-year-old client who has been prescribed nitroglycerin to control angina. Which adverse effect might the nurse observe in this client? Hypokalemia Renal insufficiency Hypotension Sedation
Hypotension
1. Which adverse effect might occur in a client receiving milrinone? Hypoglycemia Confusion Hypotension Hyperkalemia
Hypotension
1. The nurse is serving a breakfast tray to the client receiving an alpha- and beta-adrenergic agonist medication. The nurse notifies dietary of a food preparation error with the client's diet when finding what on the tray? aged cheese bacon coffee milk
coffee
1. The nurse is assessing a client and suspects that the client is experiencing a dysrhythmia. What client assessments would support this condition? (Select all that apply.) Polyuria Hypotension Mental confusion Shortness of breath Leg pain
Hypotension Mental confusion Shortness of breath
1. Your 25-year-old patient presents to the ED status post-MVA with hypotension, tachycardia, diaphoresis, pallor, and oliguria. Reports from the accident site indicate significant blood loss from the vehicle's only occupant. What type of shock is your patient demonstrating? Hypovolemic Anaphylactic Cardiogenic Distributive
Hypovolemic
1. A nurse may be asked to administer adrenergic drugs to clients with which conditions? (Select all that apply.) Hypovolemic shock Respiratory distress Severe hypertension Allergic reactions Cardiac arrest
Hypovolemic shock Respiratory distress Allergic reactions
1. What does the use of cardiotonics lead to? (Select all that apply.) Improved myocardial contractility Increased myocardial efficiency Increase in blood pressure Increase in peripheral edema Improved perfusion to all body tissues
Improved myocardial contractility Increased myocardial efficiency Increase in blood pressure Improved perfusion to all body tissues
1. An instructor is describing positive inotropic activity. Which would the instructor include as a result of this activity? Increased cardiac output Decreased heart rate Increased preload Increased conduction velocity
Increased cardiac output
1. The client is given epinephrine for an exacerbation of asthma. What response to the medication would the nurse expect? Increased heart rate and respiratory rate Increased ease of breathing and increased heart rate Bronchodilation and decreased heart rate Decreased inflammation and increased heart rate
Increased ease of breathing and increased heart rate
1. Which would be considered a therapeutic effect of digoxin? Decreased cardiac output Increased heart rate Increased force of contraction Decreased renal perfusion
Increased force of contraction
1. 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? Decreased cardiac output Decreased afterload Increased ventricular rate Increased force of heart contraction
Increased force of heart contraction
1. Which is expected after the administration of an adrenergic medication such as epinephrine? (Select all that apply.) Increased heart rate Vasoconstriction Decreased heart rate Vasodilation Hypotension
Increased heart rate Vasoconstriction
1. A 35-year-old female has been recently diagnosed with hyperthyroidism. Her health care provider has prescribed propranolol (Inderal) for what effect? To decrease heart rate To promote bronchodilation To prevent respiratory depression To decrease systolic blood pressure
To decrease heart rate
1. You are caring for a patient in the compensation stage of shock. You know that in this stage of shock epinephrine and norepinephrine are released into the circulation. What positive effect does this have on your patient? Increases myocardial contractility Decreases blood return to the heart Decreases carbon dioxide exchange Contracts bronchioles
Increases myocardial contractility
1. A patient suffers from bradycardia. Which of the following medications is a synthetic catecholamine for the treatment of bradycardia? Isoproterenol (Isuprel) Pseudoephedrine (Sudafed) Ephedrine Epinephrine
Isoproterenol (Isuprel)
1. A child who is allergic to bee stings is stung by a bee at school. The school nurse administers a EpiPen (epinephrine). Why is epinephrine the drug of choice for this patient? It has a long half-life. It has an effect on the adrenal gland. It has an antihistamine effect. It is inexpensive and affordable.
It has an antihistamine effect.
1. What is the priority nursing assessment for a client who is about to begin digoxin therapy? Blood glucose levels Neurological function Kidney function Liver function
Kidney function
1. A client develops primary hypertension and asks the nurse, "How long will I need to receive therapy?" The nurse responds based on the understanding that therapy would be required for how long? Lifelong Until blood pressure is 120/80 mmHg One year 5 years
Lifelong
1. 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? Moexipril Losartan Minoxidil Amlodipine
Losartan
1. What should a client with newly diagnosed hypertension be counseled to do? Select all that apply. Lose weight Stop smoking Reduce stress Decrease exercise Increase sodium intake
Lose weight Stop smoking Reduce stress
1. The client's digoxin level is 0.125. How does the nurse interpret this level? Normal Elevated Toxic Low
Low
1. Why do clients with impaired renal function require cautious use of epinephrine? Metabolites may accumulate and increase the risk of adverse effects. Epinephrine increases the pH of urine and constitutes a risk for urosepsis. Epinephrine can cause lysis of Bowman's capsules, further reducing renal function. Epinephrine is fully resorbed in the proximate tubules and can accumulate to toxic levels.
Metabolites may accumulate and increase the risk of adverse effects.
1. A group of students are reviewing the drugs used to treat heart failure. The students demonstrate understanding of the information when they identify which agent as a phosphodiesterase inhibitor? Milrinone Captopril Digoxin Hydrochlorothiazide
Milrinone
1. A clinic nurse is following a 62-year-old woman who is taking quinidine for a cardiac arrhythmia. What nursing action will address the most common adverse effects of quinidine therapy? Monitor the client for facial erythema Monitor the client's level of consciousness Monitor normal serum calcium levels Monitor the client for signs and symptoms of GI upset
Monitor the client for signs and symptoms of GI upset
1. A client has come to the clinic for the past 7 months with elevated blood pressure. The client has now been prescribed three different antihypertensives as well as a diuretic. The nurse knows that what other factors may be contributing to the client's consistent hypertension? (Select all that apply.) Meditation Walking program Nasal decongestant Herbal supplement OTC appetite suppressants
Nasal decongestant Herbal supplement OTC appetite suppressants
1. Which drug is in the class of drugs called human B-type natriuretic peptides? Bosentan Milrinone Digoxin Nesiritide
Nesiritide
1. The nursing instructor is discussing shock with the senior nursing students. The instructor tells the students that shock is a life-threatening condition. What else should the instructor tell the students about shock? Occurs when arterial blood flow and oxygen delivery to tissues and cells are inadequate Causes respiratory distress syndrome Begins when peripheral blood flow is inadequate Is a component of any trauma
Occurs when arterial blood flow and oxygen delivery to tissues and cells are inadequate
1. A client has been diagnosed with angina and prescribed nitroglycerin. What aspect of the client's health history should prompt the nurse to monitor the client particularly closely after administration of the drug? Orthostatic hypotension Depression and use of a selective serotonin reuptake inhibitor Reynaud syndrome Gastroesophageal reflux disease (GERD)
Orthostatic hypotension
1. A patient is receiving an infusion of norepinephrine for treatment of acute hypotension. The nurse caring for the patient discovers that extravasation has occurred. What drug should be administered? Phenylephrine Propranolol Epinephrine Phentolamine
Phentolamine
1. The pharmacology instructor is discussing effects on the heart of different medication. What is the term the instructor would use to describe the effect of a medication that increases the force of the contractions of the heart? Positive chronotropic Positive inotropic Negative inotropic Negative dromotropic
Positive inotropic
1. A client is prescribed aliskiren. The nurse would monitor the laboratory test results of which electrolyte closely? Potassium Sodium Magnesium Chloride
Potassium
1. The nurse reviews the laboratory results of a client taking digoxin. What finding creates a risk for digoxin toxicity? Chloride 98 mmol/L (98 mEq/L) Potassium 3.3 mmpl/L (3.3 mEq/L) Sodium 144 mmol/L (144 mEq/L) Hemoglobin 133 g/L (13.3 g/dL)
Potassium 3.3 mmpl/L (3.3 mEq/L)
1. A nurse is caring for a client who is taking digoxin and a loop diuretic. Which would be most important for the nurse to monitor? Electrocardiogram results Potassium levels Sodium levels Liver enzymes
Potassium levels
1. A nurse must recognize which class of medication a drug is part of in order to help in planning ongoing assessment and patient education. Which is an example of a drug in the class of beta-adrenergic blockers? (Select all that apply.) Carvedilol (Coreg) Propranolol (Inderal) Metoprolol (Lopressor) Atenolol (Tenormin) Labetalol (Trandate)
Propranolol (Inderal) Metoprolol (Lopressor) Atenolol (Tenormin)
1. What assessment should the nurse make before administering beta-adrenergic blocking agents? Pulse and blood pressure Weight and caloric intake Serum albumin level Serum sodium level
Pulse and blood pressure
1. A patient, admitted to a health care facility with cardiac arrhythmia, is prescribed propranolol. Which factor should the nurse closely monitor as a part of the ongoing assessment during the therapy? Pulse rate Tendon reflexes Hydration Visual acuity
Pulse rate
1. A patient who is prescribed losartan for hypertension has stopped taking the drug immediately after experiencing adverse effects. Which of the following may result when antihypertensives are abruptly discontinued? Breathing difficulty Rebound hypertension Orthostatic hypotension Anginal attack
Rebound hypertension
1. Which of the following is an effect of systemic administration of phenylephrine? Reflex bradycardia Hypotension Excessive sedation Rebound nasal congestion
Reflex bradycardia
1. A nurse is caring for a client who has been diagnosed with primary hypertension. What nursing interventions should be included in the teaching plan? Select all that apply. Regular aerobic exercise Diet with more fruits and vegetables Decreased alcohol consumption Smoking cessation Focus on finding a different job
Regular aerobic exercise Diet with more fruits and vegetables Decreased alcohol consumption Smoking cessation
1. Which condition would least likely contribute to the development of heart failure? Coronary artery disease Renal failure Valvular disease Hypertension
Renal failure
1. A student asks the instructor what the goal of drug therapy is in hypotension and shock. What would the instructor respond? Restore life to the patient. Replace fluids the patient has lost. Restore and maintain adequate tissue perfusion. Resuscitate the client.
Restore and maintain adequate tissue perfusion.
1. You are teaching an obese client with compensated heart failure how to manage his condition with both prescribed drug therapy and nonpharmacologic measures. What modifications would you suggest that your client make to his diet? Restrict sodium, eliminate fat, reduce calories Maintain sodium, reduce fat, maintain calories Eliminate sodium, reduce fat, maintain calories Restrict sodium, reduce fat and calories
Restrict sodium, reduce fat and calories
1. Which would the nurse explain is the pacemaker of the heart? SA node AV node Bundle of His Purkinje fibers
SA node
1. Which type of shock is caused by an infection? Cardiogenic Septic Hypovolemic Anaphylactic
Septic
1. When caring for a patient at risk for shock, what assessment finding would the nurse consider a potential sign of shock? Elevated systolic blood pressure Elevated mean arterial pressure Shallow, rapid respirations Bradycardia
Shallow, rapid respirations
1. You are assessing a 6-year-old girl in the emergency department (ED) who was brought in by her mother because she was stung by a bee and is allergic to bee venom. The child is now having trouble breathing; she is vasodilated, hypotensive and has broken out in hives. What do you suspect is wrong with this child? She is having an allergic reaction and going into cardiogenic shock She is having an allergic reaction and going into anaphylactic shock She is having an allergic reaction and going into neurogenic shock
She is having an allergic reaction and going into anaphylactic shock.
1. The nurse would avoid administering nitrates to clients using which medication? Sildenafil Lisinopril Simvastatin Albuterol
Sildenafil
1. Before the administration of any anti-arrhythmic, what should the nurse's pre-assessment of the client's general condition include? (Select all that apply.) Skin color Blood glucose Input and output Orientation Level of consciousness
Skin color Orientation Level of consciousness
1. A client with a blood pressure of 165/95 mm Hg would be classified in which stage of hypertension? Stage 2 Stage 1 Prehypertension Normotensive
Stage 2
1. What should the nurse tell the client about storage of oral nitroglycerin products? (Select all that apply.) Store oral nitroglycerin in the original container. Store oral nitroglycerin with the container lid tightly sealed. Store oral nitroglycerin and other medications in the container. Store oral nitroglycerin in a plastic pill box so doses are not missed. Store oral nitroglycerin away from light exposure.
Store oral nitroglycerin in the original container. Store oral nitroglycerin with the container lid tightly sealed. Store oral nitroglycerin away from light exposure.
1. 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? Diarrhea Gastric upset Syncope Dry mouth
Syncope
1. A patient with cognitive heart failure has been digitalized. The patient requires long-term digoxin therapy. Which instructions should the nurse provide the patient on discharge? Take the drug with high fiber meals. Report to the center if the pulse is less than 70 bpm. Take antacids promptly to avoid gastric problems. Take the drug regularly without skipping a dose.
Take the drug regularly without skipping a dose.
1. A client with a long history of hypertension has just been prescribed an alpha1-adrenergic receptor blocker. To reduce this client's risk of orthostatic hypotension and falls, the nurse should encourage the client to implement what intervention? Take the medication at bedtime. Take the medication with a high-fat meal. Increase fluid intake for 48 hours before taking the first dose. Start with a low dose and increase gradually over 2 to 3 weeks.
Take the medication at bedtime.
1. The nurse is teaching a 63-year-old client about sustained-release oral nitrates which has been prescribed for treatment of angina. Which instructions would the nurse offer to the client when teaching how to properly self-administer the medication? Take the medication on an empty stomach. Take the medication immediately following a meal. Crush the medication and mix it with food. Crush the medication and dissolve it in water.
Take the medication on an empty stomach.
1. Adrenergic drugs increase the potential risk for what adverse effect? intestinal wall muscle spasm cardiac dysrhythmias hypoglycemia stupor
cardiac dysrhythmias
1. What is a goal of spironolactone therapy for a client being treated for heart failure (HF)? The client will experience a decrease in edema. The client will not require inotropes or beta-blockers. The client will resume prediagnosis levels of stamina. The client will exhibit increased serum potassium levels.
The client will experience a decrease in edema.
1. The nurse monitors which client for an increased risk of digoxin toxicity? The client with liver dysfunction The client with renal dysfunction The client with an integumentary dysfunction The client with a peripheral vascular dysfunction
The client with renal dysfunction
1. The nurse is caring for a client who has digoxin toxicity. As the nurse assesses the changes in the client's daily activities, what finding could indicate the cause of the toxic level? The client has been sleeping more lately. The client took nitroglycerin for chest pain twice yesterday. The client's daughter brought her a bag of licorice that the client has been enjoying The client's intake of sodium increased lately because the client has been eating seafood.
The client's daughter brought her a bag of licorice that the client has been enjoying
1. The nurse is caring for a client with heart failure who has been prescribed ivabradine. What assessment finding would best indicate therapeutic effect? The client's respiratory rate is 19 breaths per minute and rales are absent. The client's potassium level rises from 3.7 mmol/L (3.7 mEq/L) to 4.1 mmol.L (4.1 mEq/L). The client's blood pressure changes from 144/93 to 138/90 mmHg The client's heart rate changes from 97 to 79 beats per minute.
The client's heart rate changes from 97 to 79 beats per minute.
1. A client has been declared "brain dead". The family asks the nurse to explain why their loved one's heart continues to beat in spite of the damage to the brain. The nurse should provide what explanation to the family? The heart beats in response to impulses that are generated by specialized cells located in the heart not the brain. When the brain is unable to trigger the heart to beat, the sinoatrial (SA) node in the heart assumes that role. The inability to control the heart is not among the losses associated with "brain death". The heart will eventually stop beating as the losses associated with "brain death" become more extensive.
The heart beats in response to impulses that are generated by specialized cells located in the heart not the brain.
1. A client has been administered nesiritide to manage symptoms of acute heart failure. What is the primary action of this drug? exhibits mild inotropic action and decreased platelet aggregation compensates for cardiac deterioration by reducing preload and afterload corrects hyperthyroidism by inhibiting synthesis of the thyroid hormone increases the concentration of acetylcholine to potentiate the action of ACE
compensates for cardiac deterioration by reducing preload and afterload
1. A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? The man's glomerular filtration rate and creatinine levels are within reference ranges. The man's heart rate is between 60 and 70 beats per minute with a regular rhythm. The man's potassium and sodium levels remain with reference ranges. The man's chest sounds are clear and his ankle edema is lessened.
The man's chest sounds are clear and his ankle edema is lessened.
1. The nurse is preparing to administer sublingual nitroglycerin to a client for the first time. What effect might the client experience right after administration? Nervousness or paresthesia Throbbing headache or dizziness Drowsiness or blurred vision Tinnitus or diplopia.
Throbbing headache or dizziness
1. Which medication is a synthetic catecholamine prescribed for the treatment of bradycardia? isoproterenol pseudoephedrine ephedrine epinephrine
isoproterenol
1. A male client has been admitted with digitalis toxicity. He has been taking the same dose for more than 20 years. His family is asking how common this problem is and how he developed a toxic level while taking the usual dose. The nurse's best explanation would be: Toxicity can occur even on low-dose therapy due to various factors including advanced age Toxicity is usually due to incorrect prescription strength. The client must have been taking the wrong dose. The client probably has severe renal impairment.
Toxicity can occur even on low-dose therapy due to various factors including advanced age
1. A patient is being discharged after being treated with nitroglycerin for an acute anginal attack. Which of the following instructions should the nurse provide the patient regarding the administration of nitroglycerin ointment? Apply a thick layer of the ointment. Rub the ointment onto the skin. Use an applicator for applying the ointment. Apply on the same site during every application.
Use an applicator for applying the ointment.
1. The nurse evaluates an improvement in the client's heart failure (HF) status on the basis of what assessment finding? Using fewer pillows to sleep Increased skin turgor Heart rate regular Improved mental status
Using fewer pillows to sleep
1. After reviewing the various antihypertensive agents, a group of students demonstrate the need for additional teaching when they identify which agent as a calcium channel blocker? Valsartan Nicardipine Diltiazem Verapamil
Valsartan
1. The nurse is caring for a client who is taking a sustained-release (SR) oral nitrate. How should the nurse instruct this client to take the medication? With water Sublingually until absorbed With milk or milk products 1 hour after eating
With water
1. A client experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The client's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve which of the client's symptoms? pain and swelling around the sting site. discoloration in her hand. acute anxiety. acute bronchospasm.
acute bronchospasm.
1. Which risk factors increase a client's risk for the development of hypertension? Select all that apply: advancing age family history Caucasian race cigarette smoking chronic alcohol consumption
advancing age family history cigarette smoking chronic alcohol consumption
1. What is the first drug of choice for treatment of a client with a history of a myocardial infarction (MI) 2 years ago? beta-blockers calcium channel blockers (CCBs) cardiac glycosides angiotensin II receptor blockers (ARBs)
beta-blockers
1. What assessment should the nurse perform daily when a client is prescribed furosemide? body weights arterial blood gases magnesium level pupillary response
body weights
1. Epinephrine causes relaxation of: bronchioles smooth muscles in the intestinal wall. superficial blood vessels. sphincter muscles.
bronchioles
1. Epinephrine causes relaxation of: bronchioles. smooth muscles in the intestinal wall. superficial blood vessels. sphincter muscles.
bronchioles.
1. The chest pain and pressure a client experiences during an anginal attack is caused by which of the following? decreased oxygen supply to the heart. increased oxygen supply to the heart. vasodilation of the arteries around the heart. decreased workload on the heart.
decreased oxygen supply to the heart.
1. 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? heart failure myocardial infarction digitalis toxicity acute renal failure
digitalis toxicity
1. The client with a complex health history has been taking medication affecting both alpha- and beta-receptor sites in the past. What medications would the nurse include in this category? Select all that apply. dobutamine epinephrine dopamine clonidine albuterol
dobutamine epinephrine dopamine
1. The nurse should inform the client of the possibility of developing what common adverse effect of captopril therapy? rhinitis dry cough photosensitivity rash to the trunk and extremities
dry cough
1. Arrhythmia may be triggered by which of the following? Select all that apply: emotional stress Heart disease Electrolyte imbalance Diabetes Hypoxia
emotional stress Heart disease Electrolyte imbalance Hypoxia
1. Anaphylaxis kits for clients allergic to bee stings would contain which medication? dopamine aspirin epinephrine norepinephrine
epinephrine
1. An older adult client who resides in a care facility has been prescribed antihypertensives for the first time following many years of generally good health. When administering the first dose of the prescribed antihypertensive medication to an older adult, the nurse should recognize the related risk to which possible side effect? falls Infection acute confusion impaired oxygenation
falls
1. You are assessing your patient. When prioritizing the patient's care, you recognize that your patient is at risk for hypovolemic shock when fluid circulating in the blood vessels decreases cardiac output is increased. blood pressure increases. pulse is fast and bounding
fluid circulating in the blood vessels decreases
1. The nursing students are learning about digoxin therapy in their pharmacology class. The students will learn that there is a higher risk of digoxin toxicity in clients with low serum chloride levels. low serum potassium levels. low serum sodium levels. low serum calcium levels.
low serum potassium levels.
1. Which assessment would be considered a priority for a client receiving amiodarone? urine outputs heart rate checks lung sounds muscle rigidity
heart rate checks
1. A client prescribed a potassium-sparing diuretic is at a risk for developing which electrolyte imbalance? hypernatremia hyponatremia hypokalemia hyperkalemia
hyperkalemia
1. 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 atrial fibrillation. thrombophlebitis. hyperkalemia. leukocytosis.
hyperkalemia.
1. The nurse is administering lidocaine to a client with ventricular tachycardia. The nurse will need to observe for adverse effects, including hyperthermia. hypotension. hypertension. dysphagia.
hypotension.
1. An adrenergic drug would be prescribed to produce what physiological effect? decreased respiratory rate increased heart rate urine concentration decreased blood pH
increased heart rate
1. An adrenergic drug would be prescribed to produce what physiological effect? increased heart rate urine concentration decrease respiratory rate decreased blood pH
increased heart rate
1. A nurse has poured a hospital client's scheduled dose of hydrochlorothiazide (HCTZ). The nurse should know that this drug reduces preload by which means? exerting a direct relaxant effect on the vascular smooth muscle increasing renal excretion of sodium and water increasing the contractility of myocardial fibers stimulating the SA node to fire more frequently
increasing renal excretion of sodium and water
1. 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: blocking adrenergic receptors and producing antisympathetic effects. inhibiting the movement of calcium ions across the cardiac muscle cell membrane. decreasing sodium and potassium conduction. weakening diastolic depolarization and the action potential duration.
inhibiting the movement of calcium ions across the cardiac muscle cell membrane.
1. The nurse is performing a history for a black client that is concerned about developing coronary artery disease since it "runs in the family." What risk factor, that is modifiable, does the nurse identify when taking the history? client ethnicity age of 62 Father had a myocardial infarction at 48 obese 40% over total body weight
obese 40% over total body weight
1. A need for additional education on the administration of epinephrine is needed when a new nursing graduate indicates that epinephrine can be effectively administered by what route? oral topical intravenous subcutaneous
oral
1. What second-line vasopressor is likely to be prescribed when norepinephrine proves ineffective at treating hypotension? Select all that apply. phenylephrine vasopressin epinephrine phentolamine Dopamine
phenylephrine vasopressin epinephrine
1. Epinephrine promotes oxygenation of the heart and brain by what means? promoting the binding of oxygen to hemoglobin redirecting blood flow away from the peripheral circulation promoting vasodilation both in the myocardium and in the brain simultaneously slowing the heart rate and increasing the force of contraction
promoting vasodilation both in the myocardium and in the brain
1. A client, diagnosed with left-sided heart failure, should be taught to recognize the signs and symptoms of the onset of what classic manifestation of this condition? pulmonary edema venous ulcers chest pain palpitations
pulmonary edema
1. 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: renal failure. valvular disease. coronary artery disease. hypertension.
renal failure
1. A 92-year-old male client is being sent home on disopyramide (Norpace) for a ventricular arrhythmia. The client asks why he must continue to take this drug. The nurse's best response would be that a ventricular arrhythmia may: lead to the formation of clots in the legs. result in the atria beating independently. result in death. cause edema in the extremities.
result in death.
1. While teaching a patient about sublingual nitroglycerin, the nurse explains proper use and storage. When the patient asks whether the medication ever expires, the nurse should respond that it: has an indefinite shelf life. should be replaced monthly. should be replaced every six months. should be replaced annually.
should be replaced every six months.
1. Adrenergic drugs mimic the effects of stimulating what part of the nervous system? parasympathetic sympathetic autonomic central
sympathetic
1. The nurse is providing medication education to a client prescribed an adrenergic blocker. Which nervous system is the specific focus of this classification of medications? central peripheral sympathetic parasympathetic
sympathetic
1. How is hypertension defined with regard to blood pressure readings? systolic pressure above 140 mm Hg or diastolic pressure above 90 mm Hg systolic pressure above 160 mm Hg or diastolic pressure above 110 mm Hg systolic pressure above 130 mm Hg or diastolic pressure above 88 mm Hg systolic pressure above 150 mm Hg or diastolic pressure above 100 mm Hg
systolic pressure above 140 mm Hg or diastolic pressure above 90 mm Hg
1. Your 69-year-old patient is started on IV dopamine for management of hypotension following open-heart surgery. As you care for the patient, you monitor him for adverse effects of the drug, including fever. tachycardia. bradycardia. cyanosis.
tachycardia.
1. The goal of therapy for a client taking antihypertensive medication is to maintain: compliance. the blood pressure within normal limits. a fluid volume balance. homeostasis.
the blood pressure within normal limits.
1. An adult client with a long-standing dysrhythmia has been taking oral propranolol for the last several months, resulting in acceptable symptom control. What is a priority teaching point for the nurse to communicate to this client? the need to measure the radial pulse for 1 minute prior to each dose of propranolol the importance of not stopping the medication abruptly the need to avoid taking over-the-counter antacids the need to limit intake of high-potassium foods
the importance of not stopping the medication abruptly
1. A client is admitted to the emergency department with severe heart failure. Milrinone is administered IV. For what adverse effect should the client be assessed? hypertension bradycardia thrombocytopenia lethargy
thrombocytopenia
1. A client, newly diagnosed with heart failure, questions why the therapy with digoxin will begin with four doses of digoxin rather than the usual one dose, in a 24-hour period. What is the rationale for the nurse's response? to more accurately gauge the effect of digoxin on the client's cardiac function to rapidly bring the client's serum digoxin levels up to therapeutic levels to confirm that the client does not have a hypersensitivity to digoxin to mitigate the potential for adverse effects
to rapidly bring the client's serum digoxin levels up to therapeutic levels
1. What sign/symptom would help confirm the possible diagnosis of hypovolemic shock in a client experiencing a significant loss of blood? Select all that apply. weak pulse clammy skin nausea chest pain fever
weak pulse clammy skin
1. The nurse is teaching a client about hypertension. Non-pharmacologic methods to decrease blood pressure would include which? weight loss and decreased salt intake. decreased water intake and decreased potassium intake. increased exercise activity and fat intake. stress reduction techniques and high fat intake.
weight loss and decreased salt intake
