PVN 106 Pharm EAQ Practice Test: CV Meds

A nurse is monitoring a child for toxicity precipitated by digoxin. For what sign of digoxin toxicity will the nurse assess the child?

Vomiting

A nurse is providing discharge instructions about digoxin. Which response should a nurse include as a reason for a client to withhold the digoxin?

Blurred vision. Visual disturbances, such as blurred or yellow vision, may be evidence of digoxin toxicity.

A client with hypertension has received a prescription for metoprolol (Lopressor). Which information should the nurse include when teaching this client about metoprolol?

Do not abruptly discontinue the medication. Sudden discontinuation of therapy has resulted in worsening angina.

A client receives a prescription for nitroglycerin sublingual as needed for anginal pain. What should the nurse include in the teaching about this medication?

Place the tablet under the tongue or between the cheek and gum.

A client who had a femoropopliteal bypass graft is receiving clopidogrel (Plavix) postoperatively. What should the nurse teach the client related to the medication?

Report multiple bruises on the extremities

A client is taking administering warfarin (Coumadin). The nurse recalls that the antidote for this medication is what?

Vitamin K

The healthcare provider prescribes isosorbide dinitrate 10 mg for a client with chronic angina pectoris. The client asks the nurse why the isosorbide dinitrate is prescribed. How will the nurse respond?

"It improves oxygen supply to heart tissue."

A nurse is to administer 5000 units of heparin to a prenatal client on prolonged bed rest. The label indicates that there are 20,000 units of heparin in each milliliter of solution. How much solution should the nurse give the client? Record your answer using two decimal places and include a leading zero if applicable. ___ mL

0.25

Nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina. The client asks the nurse how long it should take for the chest pain to subside after nitroglycerin is taken. What should the nurse tell the client?

1 to 3 minutes

A client is receiving heparin sodium intravenously at 1500 units/hour. The concentration in the bag is 25,000 units/500 milliliters. The nurse determines that how many milliliters will infuse during the nurse's 8-hour shift? Record your answer using a whole number.

240 mL 25,000units/500 mL = 50 units/mL 1 mL/50 units x 1,500 units/hour 30 mL/hour x 8 hours = 240 mL

A child with pulmonary edema is treated with opioids and furosemide. Which nursing interventions should be performed to promote safe drug administration? Select all that apply.

A local anesthetic should be applied at the injection site to promote atraumatic care. Administering drugs with food reduces gastric discomfort. The client's age, weight, and height should be documented to help ensure correct calculation of the drug dose.

A client asks a nurse why captopril was prescribed. What specific drug classification should the nurse include in the explanation to the client?

Antihypertensive

A primary healthcare provider prescribes atenolol 20 mg by mouth four times a day for a client who has had double coronary artery bypass surgery. What information is most important for the nurse to include in the discharge teaching plan for this client?

Avoid abruptly discontinuing the medication. An abrupt discontinuation of atenolol may cause an acute myocardial infarction.

What should the nurse assess to determine if a client is experiencing the therapeutic effect of valsartan (Diovan)?

Blood Pressure

Four clients with cardiac arrhythmias are prescribed different medications. Which client should be monitored for fatigue?

Client C Verapamil is a calcium channel blocker that can cause fatigue, so client C should be monitored for fatigue. Client A, who has been prescribed tocainide, should be monitored for shortness of breath. Blood pressure should be monitored in client B, who has been prescribed adenosine. Heart rate and blood pressure should be monitored in client D, who has been prescribed dobutamine.

A client who takes high-dose aspirin for arthritis has an acute episode of right ventricular heart failure. The healthcare provider prescribes furosemide and lowers the client's usual dosage of aspirin. The client asks the nurse the reason for the lower dose. On what principle does the nurse base a response?

Competition for renal excretion sites by the drugs causes increased serum levels of aspirin. Because furosemide and aspirin compete for the same renal excretory sites, salicylate toxicity may occur even with lower dosages.

A client with a diagnosis of schizophrenia is discharged from the hospital. At home the client forgets to take the medication, is unable to function, and must be rehospitalized. What medication may be prescribed that can be administered on an outpatient basis every 2 to 3 weeks?

Fluphenazine (hint: -phenazine)

After the nurse provides education about hydrochlorothiazide, the client will agree to notify the healthcare provider regarding the development of which symptom?

Generalized weakness

The healthcare provider prescribes atenolol for a client with angina. What potential side effect will the nurse mention when instructing the client about this medication?

Hypotension

The healthcare provider prescribes nitroglycerin ointment for a client who was admitted for chest pain and a myocardial infarction (MI). Which statement, if made by the client, would indicate understanding of the side effects of nitroglycerin ointment?

I may experience a headache.

A 12-month-old infant is to receive ferrous sulfate for iron-deficiency anemia. How should the nurse administer the medication?

In a syringe directed toward the back of the mouth. Very young children should receive ferrous sulfate elixir through a syringe or medicine dropper placed in the back of the mouth; this limits staining of teeth by the ferrous sulfate. A 12-month-old infant may not be able to suck on a straw. A 12-month-old infant cannot swallow a tablet, and ferrous sulfate should not be crushed. Ferrous sulfate is not available in an injectable form.

A pregnant client is prescribed heparin to prevent the risk of thromboembolism. Which adverse effects should the nurse anticipate with this medication? Select all that apply.

Osteoporosis & Compression fractures of the spine Heparin is an anticoagulant. When heparin is taken concurrently during pregnancy, it may cause osteoporosis. This in turn can cause compression fractures of the spine. The use of aspirin in the near term of pregnancy can suppress contractions in labor. The increased risk of serious bleeding also occurs with use of aspirin during pregnancy. The use of prostaglandin during pregnancy can cause stimulation of uterine contraction and can cause abortion.

A client with a partial occlusion of the left common carotid artery is to be discharged while still receiving warfarin (Coumadin). Which clinical adverse effect should the nurse identify as a reason for the client to seek medical consultation?

Presence of blood in urine

For what client response must the nurse monitor to determine the effectiveness of amiodarone (Cordarone)?

Presence of cardiac dysrhythmias Amiodarone is a class III antidysrhythmic used to treat ventricular and supraventricular tachycardia, and conversion of atrial fibrillation. Results of fasting lipid profile are expected with antilipidemics. Degree of blood pressure control is expected with antihypertensives. Incidence of ischemic chest pain is expected with antianginal agents, such as nitrates.

Which antiepileptic drug can cause photophobia?

Trimethadione Trimethadione, used in the treatment of epilepsy, has toxic side effects, including photophobia. Diazepam has toxic side effects, including drowsiness and ataxia. Lamotrigine has toxic side effects, including rash, drowsiness, and ataxia. Carbamazepine has toxic side effects, including diplopia, tremor, and headache.